This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Blood pressure is divided into systolic and diastolic blood pressure, high blood pressure is systolic blood pressure, low blood pressure is diastolic blood pressure, hypertension is defined as office systolic blood pressure of 140mmHg and/or diastolic blood pressure 90mmHg without the use of antihypertensive drugs, in addition, when systolic blood pressure is 140mmHg and diastolic blood pressure is 90mmHg, it is called simple systolic hypertension, and when systolic blood pressure is 140mmHg and diastolic blood pressure is 90mmHg, it is called simple diastolic hypertension, everyone knows, Hypertension is an important risk factor for cardiovascular and cerebrovascular diseases, and its terrible thing is that it damages the structure and function of important organs such as the heart, brain, and kidneys, and eventually leads to the failure of these organs, whether it is an increase in systolic blood pressure or an increase in diastolic blood pressure, which will increase the risk of target organ damage and cardiovascular and cerebrovascular events.
Simple systolic hypertension is more common in elderly patients, manifested as increased systolic blood pressure, decreased diastolic blood pressure, increased pulse pressure, large fluctuations in blood pressure, prone to orthostatic hypotension and postprandial hypotension, abnormal blood pressure circadian rhythm, simple diastolic hypertension is more common in young and middle-aged people, the prevalence is lower than that of simple systolic hypertension, increased diastolic blood pressure is related to smoking, drinking, obesity, sitting, unhealthy diet and other bad lifestyle habits and sympathetic nerve excitation, and there is clinical evidence that systolic blood pressure is reduced10 A reduction in 20 mmHg or diastolic blood pressure of 5 to 6 mmHg is associated with a reduction in mortality from stroke, coronary heart disease, and cardiovascular disease by % and 20%, respectively, and a reduction in heart failure by more than 50% over 3 to 5 years, so it is equally important to control systolic and diastolic blood pressure.
For patients with hypertension, lifestyle intervention is a crucial part of hypertension, mainly including promoting a healthy lifestyle, eliminating habits that are not conducive to physical and mental health, and should run through the whole process of hypertension, including a low-salt diet, sodium intake of no more than 5g per day, appropriate potassium supplementation, increasing the intake of fresh green leafy vegetables, fruits and soy products, reasonable diet, balanced diet, emphasizing adequate intake of vegetables, fruits, and low-fat dairy products, adding whole grains, poultry, fish and nuts, and controlling red meat, intake of animal offal, fatty meat, desserts, sugary drinks, quit smoking and alcohol, adhere to aerobic endurance exercise every day, lose weight, reduce mental pressure, maintain a balanced mentality, and through lifestyle intervention, blood pressure can be lowered and the risk of cardiovascular and cerebrovascular complications can be reduced.
Finally, in terms of drugs, for patients with simple systolic hypertension, dipine, sartan, puli antihypertensive drugs, diuretics and receptor antagonists such as metoprolol and bisoprolol can be considered, for patients with simple diastolic hypertension, the main influencing factors of diastolic blood pressure are peripheral arteriolar resistance and heart rate, that is, the higher the peripheral arteriolar resistance, the faster the heart rate, the higher the diastolic blood pressure, and it is recommended that long-acting antihypertensive drugs that dilate the peripheral arterioles, such as amlodipine, nifedipine controlled-release tablets, etc., Patients with a fast heart rate can be combined with receptor antagonists such as metoprolol, bisoprolol, carvedilol, etc., carvedilol can also dilate peripheral arterioles and reduce peripheral vascular resistance, such drugs can slow down the heart rate, and have a synergistic effect with long-acting dipine antihypertensive drugs.
In short, simple systolic hypertension is more common in the elderly, and simple diastolic hypertension is more common in young and middle-aged people, both of which can affect the prognosis of hypertension and increase the risk of target organ damage and cardiovascular complications. Patients with simple systolic hypertension can choose dipine, sartan, pril antihypertensive drugs, diuretics and receptor antagonists such as metoprolol and bisoprolol, patients with simple diastolic hypertension can choose long-acting antihypertensive drugs such as amlodipine and nifedipine controlled-release tablets, and patients with fast heart rate can combine receptor antagonists such as metoprolol, bisoprolol and carvedilol.