The answer is: not necessarily!
The causes of hypertension fall into two categories:
The first is essential hypertension, which is also the most common hypertension, accounting for more than 95% of patients with hypertension. The cause can not be found, which is caused by many factors such as genetic environment, and the mechanism is not fully clarified.
The second is secondary hypertension, and the basic cause can be found. Hypertension is caused by these basic causes, such as chronic renal insufficiency, renal artery stenosis, pheochromocytoma, aldosteronism, Cushing syndrome, obstructive sleep apnea hypopnea syndrome and so on.
The fundamental treatment of patients with secondary hypertension lies in finding out the root cause and treating according to the cause. After the treatment of the cause, the blood pressure of some patients with secondary hypertension will return to normal without taking antihypertensive drugs. If the underlying cause cannot be cured, antihypertensive drugs should be used according to the situation.
Patients with essential hypertension, blood pressure can not be cured at present. Treatment should be based on the comprehensive evaluation of patients' blood pressure grading level, target organ damage, whether they are complicated with diabetes, cardiovascular and cerebrovascular diseases or risk stratification.
Which hypertensive patients need to take antihypertensive drugs? ① Patients with grade 2 or above hypertension;
② Patients with hypertension complicated with diabetes, or patients with heart, brain and kidney target organ damage or complications;
(3) Where blood pressure continues to rise, blood pressure has not been effectively controlled after lifestyle improvement.
④ From the perspective of cardiovascular risk stratification, high-risk and extremely high-risk patients must receive antihypertensive drugs.
Which hypertensive patients can avoid taking antihypertensive drugs? The newly diagnosed young patients with primary hypertension can take diet control and lifestyle adjustment instead of taking antihypertensive drugs.
If the blood pressure can reach the standard and last for 3 months through the adjustment of lifestyle and eating habits, it can be closely monitored without using antihypertensive drugs; If you still can't meet the standard after three months of lifestyle and eating habits adjustment, you still need to take antihypertensive drugs.
Lifestyle interventions for hypertensive patients include (applicable to all hypertensive patients): ① Weight loss: control the body mass index as much as possible at 24kg/m2；; ; Losing weight is beneficial to improve insulin resistance, diabetes, dyslipidemia and left ventricular hypertrophy;
2 Reduce sodium intake: About 80% of sodium in the diet comes from edible salt and various pickled products, so the edible salt should be reduced, and the salt content per person per day should not exceed 6g;
③ Potassium salt supplement: eat fresh vegetables and fruits every day;
(4) Reduce fat intake: reduce edible oil intake and eat less or no fat and animal offal;
5 quit smoking and limit alcohol;
6 increase exercise: exercise.
Therefore, patients with hypertension do not have to take antihypertensive drugs. Patients with secondary hypertension do not need to take antihypertensive drugs after their blood pressure returns to normal. Newly diagnosed young patients with primary hypertension do not need to take antihypertensive drugs if their blood pressure reaches the standard through lifestyle intervention. Other hypertensive patients need to take antihypertensive drugs to intervene.
In addition, healthy lifestyle intervention is necessary for all patients with hypertension!
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Before considering whether it is necessary to take medicine to treat hypertension, hypertension should be diagnosed first. Generally, the blood pressure is repeatedly measured in the outpatient department within 2 weeks, and the blood pressure is high (greater than 140/90mmhg). If white coat hypertension is excluded, a diagnosis can be made.
Then we need to find out the cause of hypertension: primary or secondary. Secondary hypertension caused by diseases should be actively controlled. For essential hypertension, it is necessary to take medicine to control blood pressure in most cases.
In the early stage of essential hypertension, when the blood pressure rises slightly, such as essential hypertension, the systolic blood pressure is in the range of 140~ 160mmhg, and the diastolic blood pressure is in the range of 90~ 100mmhg. If there is no risk of other cardiovascular diseases, after comprehensive evaluation, blood pressure can be controlled through life intervention first.
Lifestyle interventions for hypertension include:
Many friends are also confused about whether hypertension can be stopped. Let's talk about it today Do I have to stop taking antihypertensive drugs? It also depends:
1. The blood pressure of human body fluctuates, day and night, and also fluctuates with the cold and warm seasons. Under normal circumstances, it is difficult to control high blood pressure in winter, and blood pressure will drop in summer, which may lead to excessive hypotension;
2. Know your blood pressure fluctuation, and you can do 24-hour blood pressure monitoring or self-test your blood pressure frequently;
3. It is best to control the medication 2~3 hours before the daily blood pressure peak.
4. If you feel dizzy and weak after taking antihypertensive drugs and your blood pressure is low, you should consult your doctor to adjust the drug dosage or consider stopping taking drugs;
5. If you find that your blood pressure is still high after stopping taking the medicine, you should still take the medicine. The original drug can be reduced or replaced with other suitable antihypertensive drugs.
6. Last but not least, you can't stop taking medicine just by feeling. It is not reliable to stop taking medicine without feeling. Try not to stop taking medicine yourself. After consulting the doctor, you decided to do it.
First of all, it is necessary to know whether it is really high blood pressure. Clinically, some patients always think that they are hypertensive, but the actually measured blood pressure is within the normal range, which will increase mental stress and affect the quality of life. So what, even high blood pressure? Hypertension refers to the diagnosis of hypertension by randomly measuring systolic blood pressure 140mmHg and/or diastolic blood pressure of 90mmHg for three or more times on different days without taking antihypertensive drugs.
Secondly, after the diagnosis of hypertension, we should distinguish between secondary hypertension and primary hypertension. If it is secondary hypertension, it is necessary to treat the causes and diseases that cause hypertension, which can effectively regulate blood pressure. If it is essential hypertension, it may be the result of the interaction of many factors. At present, there is no cure for essential hypertension, and long-term oral antihypertensive drugs are needed. Although lifestyle intervention helps to lower blood pressure, and for some mild hypertension, blood pressure can be maintained at a normal high value or even a normal blood pressure level, most hypertensive patients need to take antihypertensive drugs in addition to lifestyle intervention.
Hypertension itself is not terrible, but the heart and vascular diseases it causes are the killers of our health and even life, which can be manifested as many diseases. For example: 1, heart disease will lead to left ventricular hypertrophy and thickening. When oxygen consumption increases, it will easily lead to myocardial ischemia and coronary heart disease. , eventually developed into heart failure; 2. Cerebrovascular diseases, including cerebral hemorrhage, cerebral infarction and cerebral thrombosis; 3. Hypertensive patients are at high risk of aortic dissection. More than 95% patients with aortic dissection are complicated with hypertension. Aortic dissection is sudden and difficult to diagnose. If it is not diagnosed in time, the mortality rate is as high as 50% within 48 hours.
Therefore, patients with hypertension should take antihypertensive drugs and have strict life intervention. In addition, due to the great difference in patients with hypertension, we should go to the hospital in time to formulate individualized treatment plans, control blood pressure at an ideal level, prevent diseases caused by hypertension from being rejected, improve the quality of life and prolong life.
A: Guo, Master of Medicine.
Dr. Wang Cardiovascular tells you that there are several possibilities, either taking medicine is useless or not taking medicine.
First, taking medicine is useless. How to take medicine for hypertension? Clinically, about 5% of hypertension belongs to secondary hypertension, which can be divided into several categories. For example, hypertension caused by pheochromocytoma will suddenly increase inexplicably, but it will suddenly decrease without taking medicine. Hypertension caused by this reason, even taking medicine is useless and requires surgery. Hypertension caused by renal artery stenosis, only taking medicine can not solve renal artery stenosis, and the effect is not good!
Second, there is no need to take medicine for the time being, such as newly discovered hypertension, no other complications, and blood pressure is lower than 160/ 100mmHg. Therefore, we suggest not taking antihypertensive drugs for the time being, and first control it by changing living habits, such as low-salt low-fat low-sugar diet, exercise to lose weight, and quitting smoking and drinking. Through these methods, if the blood pressure can reach the standard, but even if you work hard, the effect is still not good, so you need to consider taking antihypertensive drugs.
Hypertension really can't take medicine! Dr. Wang Cardiovascular reminds everyone that there is nothing so easy in the world. It takes more effort not to take medicine for hypertension.
Which do you choose between stopping taking medicine and trying to change yourself?
This question should be looked at this way. What is the harm of hypertension? What is the purpose of taking antihypertensive drugs?
The so-called hypertension is mainly based on the clinical blood pressure measurement results. Systolic blood pressure 140 mmHg and/or diastolic blood pressure 90 mmHg were found at the first visit, and they could be diagnosed twice within 4 weeks, and all the three measurements on the same day reached the above diagnostic threshold.
So why should high blood pressure be treated? Evidence-based medicine shows that if the hypertension value is not controlled, it will cause damage to target organs such as heart, brain and kidney, and eventually it is prone to complications such as coronary heart disease, heart failure, stroke, renal insufficiency and uremia. Research data show that the average life expectancy of patients with hypertension is only 54.7 years, 20 years less than that of normal people. Every year, 3 million people die from cardiovascular and cerebrovascular accidents caused by hypertension, 90% of which die from hypertensive complications such as cerebral hemorrhage, myocardial infarction, cerebral infarction, uremia and renal failure.
So what is the effect of taking antihypertensive drugs? Through antihypertensive drugs, blood pressure can be artificially controlled, and the blood pressure can be controlled at an appropriate level without affecting organ perfusion, thus slowing down the damage to target organs and avoiding complications.
Some people may say that I have high blood pressure and don't take medicine. Why didn't I see anything? How do you say this? First of all, hypertension will greatly increase the probability of cardiovascular and cerebrovascular accidents, but it does not mean that every hypertensive patient will have accidents at any time. For example, patients with high risk of grade 3 hypertension have a probability of cardiovascular events exceeding 30% in the next decade. You've only met a few people who are fine for the time being, but how many patients have you met with cerebral hemorrhage and myocardial infarction in the hospital because of high blood pressure?
Recently, Circulation magazine published the latest results of the national cardiovascular center hypertension sampling survey. In China, the prevalence of hypertension in adults aged 0/8 years old/kloc is 23.2%, with 245 million patients, and the prevalence of normal hypertension is 4 1.3%, with 435 million patients. The awareness rate, treatment rate and control rate of hypertension in China are 46.9%, 40.7% and 15.3%, respectively, which have been greatly improved. More and more people are beginning to pay attention to the control of hypertension.
Only a very small number of patients with 1 grade primary hypertension do not need to take antihypertensive drugs after actively changing their lifestyle in the early stage of secondary hypertension or eliminating the cause of hypertension in time. As for other patients with hypertension, they should take antihypertensive drugs.
Do you have to find a doctor to prescribe antihypertensive drugs for hypertension?
Speaking of hypertension, I believe many people are familiar with it. First, because it is one of the notorious "three highs"; Secondly, because the "three highs" are not only exclusive to the elderly, more and more young people are now recruited. However, both the elderly and young people have a serious lack of understanding of hypertension: the elderly have poor compliance with blood pressure reduction, and the young people feel that they are young, so it is good to resist the first antibody.
Listen to the doctor-the picture comes from the internet.
First of all, it should be emphasized that hypertension is not the same as hypertension and hypertension. Elevated blood pressure is short-lived. When people are in a state of tension, exercise or stress (for example, you are particularly afraid of multi-legged worms, and a centipede suddenly appears next to your pillow when you sleep), your heart will speed up, your breathing will be short, your blood pressure will soar sharply, and your blood pressure will return to normal as your mood calms down. However, hypertension is a disease with clear diagnostic criteria. Generally, it is 24-hour blood pressure monitoring, and an average value is taken. Hypertension can be diagnosed if the 24-hour average blood pressure is higher than 135/85mmHg, or if the daytime average blood pressure is higher than 140/90mmHg, or if the nighttime average blood pressure is higher than 125/75mmHg. Hypertension refers to primary hypertension, accounting for more than 90% of hypertension. Hypertension caused by certain diseases (such as obesity and diabetes) is called secondary hypertension, not hypertension.
Hypertension is called "the silent killer". Although it is not easy to be detected because there are no obvious symptoms in the early stage, both primary hypertension and secondary hypertension will cause damage to important organs such as heart, brain and kidney. Long-term hypertension can lead to stroke, heart failure, myocardial infarction, chronic kidney disease and even sudden death.
Hypertension "Free Package"-Image from the Internet
Therefore, once hypertension is diagnosed, the primary goal is to lower blood pressure! Lower blood pressure! Lower blood pressure! Antihypertensive drugs should be taken regularly under the guidance of a doctor, and treated according to the specific situation to realize individualized medication. In addition, hypertension is a chronic disease. We should change bad habits (such as drinking, smoking, high-sodium diet, etc. ), adhere to moderate exercise, control weight while choosing reasonably, persist for a long time, take antihypertensive drugs regularly, and keep blood pressure stable.
The picture comes from the internet.
Antihypertensive drugs are a very important part in the treatment of hypertension, which can help us control the blood pressure level to reach the standard and reduce complications. So for patients with hypertension, once diagnosed, it is recommended to start using antihypertensive drugs. However, for patients with secondary hypertension and a few patients with primary hypertension, blood pressure can be controlled by treating basic diseases or lifestyle intervention. At this time, you can temporarily stop using antihypertensive drugs.
Hypertension is a syndrome characterized by the continuous increase of blood pressure level beyond the normal range, which may be accompanied by complications of target organs such as heart, brain and kidney. At present, hypertension is mainly divided into two categories: primary hypertension and secondary hypertension. Secondary hypertension has a definite cause. After active treatment of basic diseases, blood pressure can often be lowered or even cured. Therefore, long-term medication is generally not required.
Essential hypertension is the most common type of hypertension, accounting for more than 90%. Its specific pathogenesis is not clear, which is caused by many factors such as heredity and environment. At present, there is no radical cure for essential hypertension. Because the blood pressure of patients with essential hypertension continues to rise, in order to lower blood pressure, it is generally necessary to take medicine for a long time while improving lifestyle to stabilize blood pressure.
Of course, for the following patients with essential hypertension, antihypertensive drugs can also be temporarily not used, such as: ① Newly diagnosed patients with essential hypertension, whose blood pressure level does not exceed 160/ 100mmHg, and there are no cardiovascular risk factors or complications, can undergo simple lifestyle intervention for up to three months first, and if their blood pressure can be controlled, they can continue lifestyle intervention, otherwise they need to start using antihypertensive drugs immediately. ② Complications such as heart failure occurred, and the blood pressure level continued to drop.
If you have secondary or tertiary hypertension, or have other organ diseases, then medication is necessary. For patients with first-degree hypertension, if the blood pressure is still higher than normal after controlling the risk factors for three months, then drug treatment is also necessary.
It depends on the situation, according to the types of diseases such as hypertension.
There are three types of hypertension: 1. Hypertension 1 grade refers to systolic blood pressure140–159 mmhg and/or diastolic blood pressure 90–99 mmhg. 2. Hypertension Grade II refers to systolic blood pressure160–179mmhg and/or diastolic blood pressure100–109mmhg. 3. Hypertension Grade III refers to systolic blood pressure 180mmHg or above and/or diastolic blood pressure 1 10mmHg or above.
After understanding the above types of hypertension, let's see if we need to take medicine.
1. If it is first-degree hypertension, there are no other symptoms such as dizziness and headache, and there are no other chronic diseases, such as diabetes, heart disease, encephalopathy and carotid plaque. At this time, you can not take medicine. Give yourself three months to improve by adjusting your lifestyle, such as moderate-intensity exercise for half an hour to an hour every day, light diet, especially not too salty, and eat more fruits and vegetables. If you stick to this lifestyle for three months and your blood pressure rises instead of falling, you need to go to the hospital. The doctor will prescribe antihypertensive drugs suitable for you according to your specific situation. If blood pressure drops after three months, you can continue to adhere to a good lifestyle without other discomfort, and you don't need to take medicine for the time being.
2. If it is hypertension 1 level and complicated with other chronic diseases, heart diseases, brain diseases, etc. , or hypertension level 2 or hypertension level 3, you should take antihypertensive drugs. Only by controlling blood pressure stably can cardiovascular accidents be reduced. Moreover, after taking the medicine, you must not stop taking it yourself. Take blood pressure regularly and go to the hospital for reexamination regularly. The doctor will give you more or less drugs according to your condition.
Hypertension can be big or small. Only by controlling blood pressure stably and reducing cardiovascular accidents can the quality of life be the same as that of normal people.
Most patients with hypertension need to take antihypertensive drugs, and most of them need to take them for life. In addition, 1 can cure a few patients with hypertension, and antihypertensive drugs can be stopped. For example, some patients with grade 2 1 hypertension caused by primary aldehyde can completely recover their blood pressure after changing their lifestyle for three months. The blood pressure of hypertensive patients has been stable to normal for a long time, and some patients can carefully reduce or even stop using antihypertensive drugs under the guidance of doctors. If your hypertension does not belong to 1 2 3, then simply take antihypertensive drugs for life.