I saw such a patient in the outpatient clinic on Tuesday afternoon. She was 58 years old, Ms. Liu, and her blood pressure was measured at 160. A doctor recommended that she take antihypertensive drugs, but she was unwilling to take them. Because you have read my articles and watched my videos, you want to ask me if there is any way to do it without taking medicine. A month ago, he came to me and I told him that if he really had high blood pressure, he had to control it and choose a healthy life first. If that didn't work, he would have to take medicine in the end. But first we have to diagnose hypertension. Recently, Ms. Liu had some family problems. Her child was hospitalized due to a car accident. Not only did she have to cook and deliver meals to the child every day, but she also couldn't sleep well at night. So I decided not to let her take antihypertensive drugs for the time being, and suggested that she go home to rest and improve her sleep. If her blood pressure can return to around 140 after sleep improvement, she doesn't need to take medicine for the time being. But if her blood pressure is still higher than 140 after sleep improvement, she can come to the inpatient department to see me at any time without registering. Today she came to see me again with her blood pressure record. She has recorded her blood pressure in detail every day for a month. Most of the time, it was below 140. Occasionally, it was 154, but only once. She said her son had surgery and was discharged from the hospital. He is sleeping well now and his blood pressure is much better. She came today to ask if I have high blood pressure. I said, at present, although your blood pressure was high in the past few days, it is not hypertension. Our blood pressure can rise in many situations, such as when we have poor sleep, insomnia, are emotionally excited, depressed, drink a lot of alcohol, hold our urine, exercise, or feel pain, etc. In these situations, the measured blood pressure may exceed 140/90; but we cannot diagnose hypertension based on the blood pressure being higher than 140/90 at this time. Let’s see what is the definition of hypertension? Without taking antihypertensive drugs, the blood pressure in the clinic was measured three times on different days, and the high pressure was ≥140mmHg and (or) the low pressure was ≥90mmHg. In other words, whether the high pressure is higher than the normal value or the low pressure is higher than the normal value, any one of them is high blood pressure, or both are high. 1. The blood pressure must be higher than 140/90 on three different days; 2. You cannot take medicine, which means that you can only make the judgment without taking antihypertensive medicine; 3. Measure blood pressure with an accurate sphygmomanometer and the correct measurement method, and exclude blood pressure measured in situations such as poor sleep, insomnia, emotional excitement, depression, after drinking a lot of alcohol, when holding urine, during exercise, when in pain, etc. When measuring blood pressure during the first outpatient visit, it should be measured at least twice, with an interval of 1 to 2 minutes. If the difference is ≤ 5 mmHg, the average of the two measurements should be taken; if the difference is > 5 mmHg, it should be measured again and the average of the three measurements should be taken. If you are still not sure whether you have hypertension after measuring your blood pressure, we recommend dynamic blood pressure monitoring, that is, 24-hour blood pressure monitoring to further assess whether you have hypertension. The diagnostic criteria for hypertension after ambulatory blood pressure monitoring are: Average high/low blood pressure 24h ≥ 130/80mmHg; ≥ 135/85 mmHg during the day; ≥120/70mmHg at night. You cannot simply diagnose hypertension and prescribe medication for the patient based on a single high blood pressure event or without looking for the cause of the high blood pressure! |
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