Wake up one night, many people have high blood pressure? Blood pressure ≥140/90 mm Hg has been the diagnostic standard of hypertension.
On November 13th, the Clinical Practice Guide of Hypertension in China was issued, which lowered the diagnostic criteria of hypertension in adults and changed the original 140/90 mm Hg to ≥130/80 mm Hg.
After the standard was lowered, many people who were at the previous critical value became hypertensive!
Why did the diagnostic criteria of hypertension change?
Professor Zhao Dong, director of the Epidemiology Research Office of anzhen hospital, Beijing, introduced at the online press conference on November 13th, "The guideline revised the diagnostic standard of hypertension to ≥ 130/80mmhg, which is not only supported by sufficient international and domestic evidence-based medical evidence, but also the people with blood pressure levels of 130-139mmhg and/or 80-89mmhg are mostly young and middle-aged. Lowering the diagnostic standard reflects the concept of moving forward the defense line and strengthening the initial prevention, otherwise we will miss reducing hypertension.①
What about people with blood pressure of 130/80~140/90?
The diagnostic threshold of adult hypertension has been lowered from 140/90 mm Hg to 130/80 mm Hg, which means that some people suddenly become hypertensive. According to the new standard, it is estimated that there will be more than 600 million adult hypertensive patients in China, compared with the previous estimate of 245 million.
"I think (after the implementation of the new standard) more young and middle-aged patients may be diagnosed." Hu Dayi, chief physician of Cardiovascular Department of Peking University People’s Hospital, was interviewed by national business daily on November 13th. At present, there are many young patients with hypertension in China, and the unhealthy lifestyles associated with it include lack of exercise, heavy drinking, unhealthy diet and obesity.②
However, Professor Hu Dayi said that for young and middle-aged patients with hypertension whose blood pressure is between 130/80mmhg and 140/90mmhg, it is suggested that drugs should not be used immediately, but five prescriptions that can effectively control hypertension should be adopted, namely, drug prescription, exercise prescription, nutrition prescription, mental, psychological and sleep prescription, and smoking cessation and alcohol restriction prescription.②
Guo Yifang, vice president of Hebei Provincial People’s Hospital, said in an interview with 21st century business herald on November 13th that although it is predicted that there will be 600 million more patients, only 22% of them need medication, and most of them don’t need medication. Only through active lifestyle intervention, blood pressure can be restored to the ideal range, such as controlling diet, losing weight and gaining muscle, eating less salt and quitting smoking and drinking.③
The new guidelines recommend that patients with high cardiovascular risk actively start antihypertensive drug therapy, and patients with low cardiovascular risk can undergo lifestyle intervention for 3-6 months. If blood pressure is still not up to standard, antihypertensive drug therapy can be started.④
Manage high blood pressure, and the new guide gives these practical suggestions!
The new edition of "Guidelines for Clinical Practice of Hypertension in China" has made important adjustments to the antihypertensive targets of different groups of people, and we have summarized seven points that everyone is concerned about:
1. Insist on blood pressure monitoring.
Rest quietly for 3-5 minutes before measuring blood pressure. Avoid strenuous exercise, drinking alcohol, drinking caffeinated drinks and smoking 30 minutes before taking blood pressure.
When measuring, sit in a chair with a backrest, put your feet flat on the ground and don’t cross your legs. The upper arm is flat on the desktop, and the center of the cuff of the sphygmomanometer is kept at the same level as the heart.
When measuring blood pressure for the first time, the blood pressure of both upper arms should be measured, whichever side is higher.
It is recommended to measure blood pressure once every morning and once every night. For patients with hypertension, it is recommended to measure blood pressure before taking medicine, before breakfast and after emptying bladder in the morning. It is recommended to measure blood pressure before dinner at night, and within 1 hour before going to bed when conditions do not permit.
Take at least two consecutive blood pressure readings for each measurement, with an interval of 1-2 minutes, and take the average of the two readings. If the difference between the first and second blood pressure readings is greater than 10mmhg, it is recommended to take the third measurement and take the average of the last two readings.④
2. Replace common salt with low sodium salt.
The guideline points out that excessive sodium intake and insufficient potassium intake are one of the important risk factors for hypertension.
Less sodium: it is recommended that the daily salt intake of each person should not exceed 5 grams, and low sodium salt can be used. The results of SSaSS research based on Chinese people show that compared with common salt, the risk of stroke, major cardiovascular risk and all-cause death in the low-sodium salt replacement group (about 75% sodium chloride and 25% potassium chloride) decreased by 14%, 13% and 12%, respectively.
Potassium: Pay attention to eating more foods rich in potassium, including fresh fruits and vegetables, low-fat dairy products, nuts and bean products.④
Table from Dietary Guidelines for China Residents 2016⑤
3. Try the DASH diet mode.
DASH diet is a dietary pattern designed for hypertension, the core of which is high calcium, high potassium, high magnesium and high dietary fiber, limiting saturated fatty acids, ensuring rich unsaturated fatty acids, limiting sugary drinks and sweets and reducing salt intake.
Li Haiyan, the chief nurse of Cardiovascular Department of PLA General Hospital, suggested in the Health Times in July 2021 that for Chinese people, the dietary pattern of hypertension could be used for reference. In the diet:
Cereals can be whole wheat pasta, oats and brown rice, and excellent rice flour, cakes, sweets and fried foods can be reduced or avoided;
Meat can be lean pork, beef and mutton, peeled poultry (chickens, ducks and geese), fish (deep-sea fish, such as salmon), shrimp and eggs.
Eat fruit instead of processing it into juice or drinking candy-flavored drinks;
Vegetables can be seasonal vegetables such as spinach, celery, oily wheat and cabbage;
Dairy products can be fat-free or defatted, low-fat dairy products;
Pay attention to calories when eating nuts, and choose small portions and salt-free ones;
Oils can be rapeseed oil, olive oil and corn oil to reduce or avoid the intake of lard, cream and butter.⑥
4. Do aerobic exercise for at least 30 minutes every day.
The new guidelines recommend that hypertensive patients with blood pressure less than 160/100mmhg should take moderate or high-intensity aerobic exercise for 30-60min every 5-7 days a week, and do resistance strength exercises 2-3 times a week.
Moderate intensity aerobic exercise:
30-60 minutes/day, 5-7 days/week, reaching 50%-70% of the maximum heart rate.
Such as cycling, swimming, walking, running, badminton, table tennis, aerobics, group sports and other aerobic sports.
In addition, Tai Chi and Qigong can also help lower blood pressure.
Resistance strength exercise:
90-150 minutes/week, 50%-80% of the maximum load at one time, 6 exercises/group, 3 groups, 10 repetitions.
Such as dumbbells, sandbags and elastic belt.
Equidistant grip strength training:
2 minutes each time, 4 times in total, with an interval of 1 minute each time, 3 days a week.
Attention should be paid to avoid bowing your head and holding your breath during exercise. Patients with hypertension who cannot complete the recommended amount due to physical reasons should increase all kinds of physical activities as much as possible according to their own conditions.
Previously, Europe issued a consensus document on personalized exercise prescription for the prevention and treatment of hypertension. The consensus recommended aerobic exercise as a first-line physical activity for patients with hypertension, which can help reduce the average systolic blood pressure by 4.9-12.0 mm Hg and the diastolic blood pressure by 3.4-5.8 mm Hg.⑦
5. Control your weight and waistline.
The guidelines point out that overweight and obesity are important risk factors for hypertension. The best goal is to reach the ideal weight, the body mass index is 18.5-23.9 kg/m2, and the waist circumference is controlled to less than 90 cm for men and less than 80 cm for women.
When controlling weight, it is suggested that the daily calorie should be limited to ≤500-750 kcal, and the exercise mode should be moderate to high-intensity aerobic exercise for 30-60 minutes every day, 5-7 days/week, reaching 60%-90% of the maximum heart rate.④
6. Be sure to quit smoking and limit alcohol.
Do not smoke, quit smoking completely, and avoid passive smoking. If you drink alcohol, you should reduce your alcohol intake. Men ≤ 20g/day, women ≤ 10g/day. It is best to give up drinking.④The safest drinking amount is 0, that is, no drinking.
7. Reduce stress in your life.
The intense pace of work and life, heavy ideological pressure, emotional excitement, anxiety and frequent overtime and staying up late will make the nervous system and hormone levels in the human body adjust abnormally, leading to faster heartbeat and increased vascular tension, which is another common cause of high blood pressure.⑧
The new guidelines suggest that you should breathe slowly and regularly before going to bed every day (preferably with the help of professional breathing equipment), and the target breathing frequency is < 10 times/minute, 15 minutes/time, and > 40 minutes per week.④
In addition, meditate for 20 minutes twice a day; And spending 30 minutes a day doing yoga three days a week also helps to relieve stress.④
This article is synthesized from:
① On November 13th, 2022, People’s Daily Health Client published the Clinical Practice Guide of Hypertension in China, and the diagnostic standard of hypertension was revised to ≥ 130/80mm Hg.
② 2022-11-14 national business daily’s "I suddenly became hypertensive", a new hypertension standard was released, and experts: More young and middle-aged patients may be diagnosed! 》
③ 2022-11-14 21st century business herald "Adjustment of diagnostic criteria," Wake up overnight "? 》
④ National Cardiovascular Center, etc. Clinical Practice Guide of Hypertension in China.
https://rs.yiigle.com/yufabiao/1432110.htm
⑤ China Nutrition Society. Dietary Guidelines for China Residents 2016.
⑥ Nutrition Prescription for Patients with Chronic Diseases published by Health Times on July 30th, 2021.
⑦Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Pre ventive Cardiology (EAPC) and the ESC Council on Hypertension
Today 2021-11-01 Guo Yifang heart frontier "How did hypertension happen? Pay attention to these ten reasons! 》
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