dangerous moments of high blood pressure

Core clew: patients with high blood pressure because long-term blood pressure is bigger, the blood vessels in the spasticity, so that blood vessel elasticity decreased, and the brittleness increases, if at this time due to some reason contributing to increased blood pressure suddenly, is easy to cerebral hemorrhage, cerebral vascular rupture and causing this for patients with high blood pressure, is undoubtedly the most fatal blow. Therefore, patients with hypertension should try to avoid a sudden rise in blood pressure, especially under the following circumstances, should be more cautious. Due to the long-term pressure on blood vessels, blood vessels are in a spasm state in patients with hypertension, resulting in decreased vascular elasticity and increased brittleness. If blood pressure rises suddenly due to some reason at this time, it is easy to cause cerebral vascular rupture and cerebral hemorrhage, which is undoubtedly the most fatal blow for patients with hypertension. Therefor

Summary of international hypertension guidelines 2020ISH

 

Purpose of the guidelines

To fulfill the mission of "improving the global burden of elevated blood pressure", the international society of hypertension (ISH) has developed a practical guideline for the management of hypertension for adults aged 18 and above. Referring to the latest guidelines published recently and strictly reviewed, the ISH Guidelines Committee has condensed the specific contents with evidence-based support and has customized two management standards of "basic standard" and "best standard" in practical form, so that clinicians, nursing staff, and community health workers can adopt them in the case of lack of resources or sufficient resources.

The best standard refers to the evidence-based management standard stated in recent guidelines and summarized in this paper. The basic standard is set in consideration of the fact that the best standard is not always feasible. Therefore, the basic standard is actually the minimum standard. Since the standard is the most practical one, it can not be distinguished from the most basic one.

Definition of hypertension

In line with most mainstream guidelines, hypertension was defined as the office systolic blood pressure ≥ 140 mmHg and/or the consulting room diastolic blood pressure ≥ 90 mmHg after repeated measurements. Table 1 shows the classification of hypertension based on the office blood pressure, and table 2 provides the criteria for defining ambulatory blood pressure and home blood pressure for hypertension; these blood pressure definitions apply to all adults (> 18 years old). This classification of blood pressure aims to match the treatment with the corresponding blood pressure level.

Cardiovascular risk factors

Cardiovascular risk assessment should be carried out in all patients with hypertension. A simple scoring scale based on blood pressure level and other risk factors can be simplified according to the method proposed in ESC / ESH guidelines.

Other risk factors

➤ high blood uric acid (S-UA) is common in patients with hypertension. Symptomatic patients [gout and S-UA > 6 mg/dl (0.357mmol / L)] should adjust their diet and use drugs that affect urate (Losartan, Bates, atorvastatin) or drugs that reduce urate.

➤ it must be considered that patients with hypertension complicated with chronic inflammatory disease, COPD, mental illness, unsafe or stressed lifestyle have increased cardiovascular risk and need to effectively control blood pressure.

Treatment of hypertension: improving lifestyle

Improving lifestyle is also the first line of antihypertensive treatment. Improving lifestyle can also enhance the efficacy of antihypertensive therapy. Specific measures to improve lifestyle include the following aspects

Drug treatment of hypertension

The drug treatment strategy recommended here (Figure 2-4) is basically consistent with the latest American and European guidelines.

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