How to break the blood pressure when you are young
With changes in lifestyles, hypertension is no longer the "patent" of middle-aged and elderly people, and the trend of "younger" people with hypertension is obvious.
The survey shows that the prevalence of hypertension in the 35-44-year-old population is about 14.1%, and more and more young people are becoming the "reserve" for hypertension patients.
What are the characteristics of youth hypertension?
Symptoms are not typical, more than those found during physical examination or accidental measurement; most (more than seven adults) have mild hypertension; mainly increased diastolic blood pressure, systolic blood pressure is usually normal or slightly increased; combined with overweight/obesity, metabolic disorders The proportion is high; the understanding of the hazards of the disease is insufficient, the treatment rate is low, and the control rate is lower; the life expectancy is long, and the life-long cardiovascular disease risk is higher.
Why do you have high blood pressure when you are young?
In addition to genetic, environmental and other factors, most young hypertensive patients have increased sympathetic nerve activity, which further activates the renin-angiotensin system, which is manifested by increased blood pressure and often faster heart rate.
Studies have found that as many as 64% of hypertensive patients aged <40 years old have hyperactive sympathetic nerves.
The stronger the activity of the sympathetic nervous system and the faster the heart rate, the higher the risk of cardiovascular and cerebrovascular diseases.
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How to choose antihypertensive drugs for young hypertension?
Beta blockers are the only antihypertensive drugs that can both lower blood pressure and slow down heart rate. They are the preferred antihypertensive drugs for young hypertensive patients. They are especially suitable for patients with obvious sympathetic nerve activation (such as resting heart rate> 80 beats/ Points) patients.
Currently commonly used clinical β-blockers include bisoprolol, metoprolol, labetalol, etc., but they are contraindicated in combined bronchial asthma, acute heart failure, severe sinus bradycardia, and high-grade atrioventricular block Stagnant patients.
In addition, renin-angiotensin system blockers such as angiotensin-converting enzyme inhibitors (pristine drugs) or angiotensin receptor antagonists (sartan drugs) can also be used as a first-line drop in young hypertension Pressure medicine, especially suitable for patients with diabetes and proteinuria.
Text/Xiang Wei Liu Fang (Beijing Tsinghua Chang Gung Memorial Hospital)
Precautions for antihypertensive treatment of young hypertensive patients:
1. Poor medication compliance and easy to miss taking, give priority to using long-acting antihypertensive drugs once a day.
2. Labetalol hydrochloride is preferred for young female patients who are pregnant or planning to become pregnant.
3. Closely monitor blood pressure and heart rate during medication, and observe for any adverse reactions such as fatigue, chills in the extremities and decreased libido.
4. Long-term use of β-blockers should not be stopped suddenly, and the dosage should be adjusted according to the doctor's advice.
5. Patients with poor blood pressure control or high-risk cardiovascular disease should start a combined antihypertensive treatment program.
6. Patients with diabetes or metabolic syndrome should be cautious when using β-blockers and diuretics in combination.