Hypertension | low pressure can’t drop down, how to do?

Many young and middle-aged hypertension patients encountered in the outpatient department showed simple elevated low pressure, and some patients’ high pressure was controlled to normal by drug therapy, but the low pressure could not be controlled and they were distressed and tangled!

Blood pressure is divided into systolic blood pressure and diastolic blood pressure, high pressure is systolic blood pressure, the so-called low pressure is diastolic blood pressure. Systolic blood pressure is normal, diastolic blood pressure rises more than 90 mmHg, clinical terminology is called simple diastolic hypertension.

What is the low pressure and high pressure?

Patients with simple diastolic hypertension are mostly young and middle-aged, which is a common type of hypertension among white-collar workers.

Domestic studies show that the prevalence rate of patients with simple diastolic hypertension is 4.4%, which is less than that of patients with simple systolic hypertension (7.6%) and systolic diastolic hypertension (7.4%), and the prevalence rate in the north is higher than that in the south.

Foreign studies show that the prevalence rate of simple diastolic hypertension among young people is 10.6%. The onset age of simple diastolic hypertension is earlier, with the onset peak between 35 and 49 years old.

Elevated diastolic blood pressure is extremely harmful to young and middle-aged people and significantly increases the risk of coronary heart disease. For untreated patients, 11-year follow-up studies show that the risk of cardiovascular events in patients with simple diastolic hypertension increases by more than 75%.

Therefore, young people should not feel that they are far away from hypertension. They should also measure their blood pressure once a year to find and control it early.

Elevated diastolic blood pressure is related to bad living habits such as smoking, drinking, unhealthy diet and sympathetic nerve excitation.

Patients with elevated diastolic blood pressure often show obesity, which is accompanied by elevated metabolic indexes such as blood lipid, blood sugar and uric acid. Simply put, fat people, especially young fat people, are more likely to suffer from diastolic hypertension. For these patients, not only should blood pressure be controlled well, but also blood lipid and blood sugar should be controlled well. A healthy lifestyle is especially important.

Multi-pronged Pressure Reduction

Step 1 Lose weight

Most of the patients with clinically encountered diastolic blood pressure increase are obese and overweight. Weight loss is fundamental. Studies show that for every 5.1 kg weight loss, systolic blood pressure and diastolic blood pressure decrease by 4.4 mmHg and 3.6 mmHg respectively.

2. Low-salt diet

Salt restriction is the basis for hypertension treatment. Sodium intake is reduced to 5g/day, systolic blood pressure and diastolic blood pressure are reduced by 10.2 mmHg and 2.6 mmHg respectively. China’s dietary guidelines recommend that sodium intake should not exceed 6g per day, the World Health Organization recommends that sodium intake should not exceed 5g per day, and the American Heart Association recommends that sodium intake should not exceed 3.75 g per day.

China’s per capita salt intake exceeds the standard by more than twice, and the salt limit target is relatively conservative. Healthy adults should consider controlling it to less than 5g per day.

3. Appropriate potassium supplement

Potassium can resist the adverse effects of sodium. Studies show that 780 mg of potassium per day reduces systolic blood pressure and diastolic blood pressure by 4.9 mmHg and 2.7 mmHg respectively.

Hypertension patients should eat more fresh green leafy vegetables, fruits and bean products rich in potassium. Beans are the most rich in potassium, with 1300 milligrams of potassium per 100g. The second is nuts containing 600 milligrams of potassium per 100g.

Vegetables and fruits are not only rich in soluble dietary fiber, but also rich in potassium (spinach, cabbage and coriander contain 550 milligrams of potassium per 100g, bananas, papaya and jujube contain 300 milligrams of potassium per 100g). After food is processed, some of the potassium will be lost, so it is best to eat fresh fruits and vegetables.

4. The Healthiest Hypotensive Diet-DASH Diet

DASH Diet was elected the healthiest diet for 5 consecutive years. DASH Diet emphasizes sufficient intake of vegetables, fruits and low-fat dairy products, adds whole grains, poultry, fish and nuts, and ensures intake of potassium, magnesium, calcium and plant fiber. Control the amount of red meat, desserts, sugary beverages, saturated fat and cholesterol, and replace saturated fat with unsaturated fatty acids. (Click to learn more: DASH Diet)

DASH diet is nutritious and can prevent hypertension and diabetes, especially in lowering blood pressure, which is beneficial to heart health.

After 8 weeks of dietary intervention with DASH, systolic and diastolic blood pressure decreased by 11.4 mmHg and 5.5 mmHg, respectively.

Step 5: Encourage abstinence

The more you drink, the higher your blood pressure. Excessive drinking not only increases the level of hypertension, but also increases the risk of stroke.

More than 3 doses of alcohol at a time will lead to temporary blood pressure increase, and repeated excessive drinking will lead to long-term blood pressure increase. Reducing to moderate drinking within 2 weeks can reduce systolic blood pressure by 2 ~ 4 mmHg and diastolic blood pressure by 1 ~ 2 mmHg respectively (1 serving of alcohol is equivalent to 355 ml of 5-degree beer, 150 ml of 12-degree wine or 45 ml of 40-degree spirits).

It is not recommended that people with hypertension drink alcohol and encourage them to stop drinking as much as possible. Long-term heavy drinkers should gradually reduce the amount, and sudden withdrawal of alcohol is at risk of severe hypertension. Those who cannot stop drinking should not drink too much. It is recommended that men should not drink more than 2 portions of alcohol and women should not drink more than 1 portion of alcohol every day.

6. Campaign

Adhering to aerobic endurance exercise every day can reduce systolic blood pressure and diastolic blood pressure by 6.9/4.9 mmHg. Even if short-term low-intensity exercise is carried out every day, the death risk of hypertension patients can be reduced by 20%.

7. Medication

At present, the guidelines do not explicitly recommend drugs for simple diastolic hypertension, Clinically, long-acting calcium antagonists such as amlodipine, felodipine and nifedipine controlled-release tablets are generally preferred to dilate peripheral blood vessels. Patients with faster heart rate can combine receptor antagonists such as betaloc sustained-release tablets and bisoprolol to slow down heart rate and reduce diastolic blood pressure more obviously.

It is suggested that medication should be carried out under the guidance of doctors on the basis of lifestyle intervention.

Responsible Editor: Zhang Jingyuan