Throughout the history of medical development, medical [common sense], which seems to be taken for granted, has often gone through tortuous and long exploration and research. There are many similar examples, such as today’s theme: [Hypertensive Patients Need Hypotension].
It is also common sense today that hypertension should be lowered. However, in the middle of the last century, the common view of people (including the medical profession) was still: [After arteriosclerosis, higher blood pressure is needed to allow blood to pass through narrow blood vessels, so hypertension is an important compensation for people and should not be intervened.]
Due to such misconception, the vast number of hypertension patients failed to receive necessary antihypertensive treatment and eventually became victims of hypertension complications, including Franklin Roosevelt, the then US President who led the US through the Great Depression and World War II into a prosperous future.
President Roosevelt’s blood pressure was recorded to rise for many years, up to 188/105 mmHg, and he often felt headaches. However, according to the medical standards at that time, his personal doctor insisted that [the president was not ill and was in good health].
As a result, you, the supreme leader of the world’s richest country, have been exposed to hypertension for a long time, and gradually developed symptoms and signs such as dyspnea, abdominal distension, mild cyanosis, and chest X-rays showing [enlarged heart shadow] after overwork. In March 1944, just as preparations for the Normandy landings were underway, the president finally fell down and was hospitalized due to [heart failure].
Hypertensive hypertensive heart disease heart failure is one of the typical progression processes of chronic complications of hypertension. But doctors at that time did not realize this.
After a series of symptomatic treatments, President Roosevelt’s heart failure symptoms were relieved, but his blood pressure soared further, reaching 240/130 mmHg.
A year later, on April 12, 1945, just as Roosevelt was sitting tight and the painter was depicting a watercolor portrait, he suffered a sudden cerebral hemorrhage and died that night, leaving the world with an unfinished portrait of Roosevelt (see picture) and endless regrets.
[Kill Roosevelt], Nazi Germany’s dream but impossible goal, [Hypertension] was easily achieved. This made Hitler overjoyed. He said: “The miracle I expected earlier happened. We haven’t lost this war yet!” ]
Three years after Roosevelt’s death, His successor, President Truman, signed the National Heart Act, The establishment of the National Heart Institute, And earmarked funds for epidemiological studies of heart disease. One of the greatest studies in modern medical history: Framningham’s study finally made its debut. The study included more than 5,000 people, followed up for decades, and shifted the focus from treatment to prevention of diseases. Many important medical conclusions came out one after another, such as: [Smoking, obesity, hypertension and high cholesterol are risk factors for heart disease], [hypertension is risk factor for stroke], etc.
[Hypertension] is finally no longer considered as a normal physiological change, but must be effectively and scientifically controlled and managed.
The latest < < 2014 Guidelines for Adult Hypertension Treatment > > suggests that the treatment target for hypertension patients should be less than 140/90 mmHg, and the elderly over 60 years old can be relaxed to 150/90 mmHg. The initial drugs include ACEI drugs, ARB drugs, calcium channel blockers, thiazide diuretics, etc.
It has become common sense that diabetes needs to reduce blood sugar and hypertension needs to reduce blood pressure. However, we must not forget that the formation of these medical [common sense] has condensed too much painstaking efforts of human beings and even paid the price of life. We should be glad to have these [common sense] and strive to contribute more scientific [common sense] to future generations so as to live up to our predecessors and be worthy of this life.
Author: Zhang Zheng