Hypertension care tips

There is no one-size-fits-all formula for high blood pressure care. The core principle is "taking medication as prescribed by the doctor, combined with lifestyle adjustments that match the individual's physical condition + regular blood pressure monitoring." Any folk prescription or health product that claims to "cure hypertension" cannot be trusted. Currently, mainstream medical methods can only control but not cure. With good care, you can have the same quality of life and lifespan as normal people.

I have been doing chronic disease management in the community for almost 6 years. The most common problem I encounter is that patients reduce or stop taking medicine without permission. They always feel that "the medicine is only half of the poison. Once the blood pressure is stable, there is no need to take it." To be honest, the risk of side effects of antihypertensive drugs is much lower than the damage to the heart, brain, and kidneys caused by long-term high blood pressure. Don’t let the small gain go unnoticed. In fact, there is no completely unified standard for blood pressure reduction targets in the academic community. The 2023 version of the Chinese Hypertension Guidelines recommends that people over 65 years old can relax to <150/90mmHg. However, many cardiovascular experts have suggested that if the patient tolerates it and does not have low blood pressure reactions such as dizziness and fatigue, it is best to lower it to <140/90mmHg. Aunt Zhang from our community was 72 years old and had a history of lacunar cerebral infarction. She secretly reduced her antihypertensive medication to half a tablet. Her blood pressure soared to 170 and she was still holding on at home. Finally, she felt dizzy and fell and was sent to the hospital. Later, the doctor set a goal for her to stabilize at around 135/85. ； Uncle Li, a 71-year-old from the same community, has no other underlying diseases and likes to climb mountains in the suburbs. The doctor just relaxed it to within 150/90. After all, if the blood pressure drops too low, it is easy to faint due to insufficient blood supply during exercise. It is true that not everyone should meet the same standard.

Many people think that everything will be fine after taking medicine, so they just eat pickles and drink white wine, but their blood pressure still soars. This is a problem that they have not kept up with their lifestyle adjustments. Let’s talk about eating salt first. Many older people have been eating heavy food all their lives. It is simply unrealistic to suddenly let them eat salt-free vegetables. There are currently two adjustment ideas in the nutrition field: one is to gradually reduce salt, add 1 gram less salt in cooking every day, and slowly reduce the taste. Most people can adapt to it in one or two months. ； The other is to switch to low-sodium salt, but here is a warning. Patients with renal insufficiency, especially patients with potassium excretion disorders, must not switch to low-sodium salt casually, otherwise it will easily lead to hyperkalemia and the risk is very high. There is no need to force yourself to walk 10,000 steps a day for exercise. If your knees are bad, just do Tai Chi or practice Baduanjin. If you really don’t have the conditions to go out, you can wipe the table and mop the floor at home twice. Moving is better than lying down.

Let’s not make excuses. It is true that some people have lower blood pressure after drinking less than half a glass of red wine. This is because alcohol temporarily dilates blood vessels, and when it is metabolized, blood pressure will rebound even higher. The current global mainstream hypertension guidelines recommend that it is best to completely quit drinking. If you really can’t quit, then control the amount. The daily alcohol consumption should not exceed 25g for men and 15g for women, which is less than half a cup of fruit wine. Don’t think that “a small amount of drinking nourishes blood vessels”. That is really a misunderstanding. There used to be an Uncle Wang in our jurisdiction. His blood pressure was usually well controlled, but he loved to play mahjong. Last time, he got so excited that he fainted on the mahjong table and was sent to the emergency room. In situations like this, where you are easily emotionally aroused, you should pay more attention to yourself and avoid getting distracted.

As for blood pressure monitoring, there is really no need to make it an "hourly check-in". I met an old man a while ago. He was very anxious when he was diagnosed with high blood pressure. He measured his blood pressure once an hour. If it was higher, he quickly added half a pill. As a result, his blood pressure suddenly went up and down, and he was almost hospitalized. Later, the doctor asked him to put away the blood pressure monitor, and he would wake up every morning and lie down to measure it once every day. It became stable within a week. If the blood pressure is stable for a long time, it is enough to measure it 1-2 days a week, once in the morning and evening. If you have just adjusted the medicine, you can measure it every day. Note that the cuff should be at the same height as the heart when measuring. Don't hang your arms when measuring, otherwise the value may differ by more than 10mmHg.

All in all, high blood pressure is an "old friend" that needs to live with you peacefully. Don't be too used to it, and don't be too afraid of it. Just communicate with your doctor in charge and find a rhythm that suits you. There are so many rules and regulations that you must abide by.