Hypertension is divided into primary hypertension (related to heredity) and secondary hypertension (caused by certain diseases). Long-term hypertension will cause a series of pathological changes such as heart, brain, kidney, blood vessels and fundus. Secondary hypertension is mainly treated for the primary disease.
The difference between systolic and diastolic blood pressure is called pulse pressure difference. In daily life, the normal pulse pressure difference is 30-40 mm Hg. If the pressure difference is greater than 60 mm Hg, it is said that the pressure difference is too large, and if it is less than 20 mm Hg, it is said that the pressure difference is too small.
1) Any factor that can affect systolic and diastolic blood pressure can affect pulse pressure difference. When the stroke output increases, the systolic blood pressure is very high, but the diastolic blood pressure changes little, which leads to the increase of pulse pressure difference; Conversely, when the stroke output decreases, the systolic blood pressure decreases and the pulse pressure difference decreases. Slow heart rate, prolonged diastolic ejection time, decreased diastolic arterial residual blood volume, decreased diastolic blood pressure and increased pulse pressure difference; On the contrary, when the heart rate increases, the diastolic pressure increases and the pulse pressure difference decreases.
2) Common diseases that cause excessive pulse pressure difference include aortic valve insufficiency, aortic sclerosis, hyperthyroidism, severe anemia, rheumatic heart disease, syphilis heart disease, partial congenital heart disease, hypertensive heart disease and bacterial pericarditis. Common diseases that cause the decrease of pulse pressure difference include massive pericardial effusion, constrictive pericarditis, severe mitral stenosis, aortic stenosis, severe heart failure, peripheral circulation failure, shock and obesity, and increased or combined blood viscosity.
3) The common pulse pressure difference is too small, which is mostly caused by the decrease of systolic blood pressure (high pressure), including physiological factors and pathological reasons. The former is emaciated or weak, and the latter is seen in shock, myocardial infarction, cardiac insufficiency, pericardial tamponade, adrenal cortex hypofunction and other diseases. The organic diseases that cause the decrease of pulse pressure difference include pericardial effusion, constrictive pericarditis, severe mitral stenosis and aortic stenosis.
4) Treatment of pulse pressure difference is too large or too small, mainly due to treatment. For example, aortic valve insufficiency caused by excessive pulse pressure difference must be solved by heart surgery; The treatment of pulse pressure difference is too small, such as heart failure, which is caused by heart failure, hyperlipidemia and diabetes, and mainly adopts lipid-lowering and glucose-lowering treatment. When the pulse pressure difference is obviously reduced, all kinds of organic diseases should be ruled out first. If the cause cannot be clearly found after detailed examination, it should be considered as a decrease in constitutional blood pressure (mainly systolic blood pressure). To treat constitutional hypotension, besides strengthening physical strength and proper nutrition, it is also necessary to prevent dizziness or falling when standing upright. The medicine can be oryzanol, vitamins, etc. , play a role in regulating autonomic nervous function. Don't be too concerned about the small pulse pressure difference without discomfort, because it won't have much impact on health.
The increase of pulse pressure difference in the elderly is a common phenomenon, which is caused by the decrease of vascular elasticity due to different degrees of vascular sclerosis in the elderly. There is no need to panic, but what needs to be clear is the pulse pressure difference and the degree of increase. Long-term adaptive blood pressure level should be properly considered when treating essential hypertension in the elderly. If there is no diabetes, kidney disease, etc. The blood pressure target can be slightly higher than the normal blood pressure value 140/90 according to the actual situation. You should also consider whether your blood pressure measuring instrument is a medical sphygmomanometer and whether the method is correct. If this is ruled out, it is certain that the blood pressure is not ideal after taking the medicine. It is suggested to change the regimen or adjust the dosage.
Question 2: What should I do if the pulse pressure difference is large? Q: I am 80 years old, and I have such a problem, that is, the pulse pressure difference is large. Diastolic pressure is often only 40~50 mm Hg, while systolic pressure is often as high as 150~ 180 mm Hg, accompanied by arrhythmia (premature beats). What treatment should be taken? Zhang Xu, Xiangxiang City: Your situation is not special. Many elderly hypertensive patients have symptoms similar to yours, mainly caused by weakened arterial elasticity. Young people have good blood vessel elasticity. After bleeding, the heart pump meets the blood vessel wall with good elasticity, and the blood vessel wall expands greatly. Therefore, the systolic blood pressure caused by cardiac contraction, which is what we call high pressure, can be buffered to a certain extent so that the high pressure will not be too high. But low pressure depends on the elasticity of blood vessels to maintain pressure, so the low pressure of young people can be high. However, the blood vessel wall of the elderly is relatively stiff. So when the heart contracts and pumps blood, it can make the systolic blood pressure rise very high. However, due to the poor elasticity of blood vessels, the low blood pressure of the elderly is often not high or even very low. The most common cause of poor vascular elasticity in the elderly is atherosclerosis. For the elderly hypertensive patients aged 80 years and above, there has always been a clinical dispute about whether antihypertensive treatment should be carried out and to what level. Recent research shows that the elderly over 80 years old should at least reduce their systolic blood pressure to 150 mm Hg (there is little research at home and abroad on whether the reduction can bring benefits).
Question 3: What is the big pressure difference? What if the pressure difference is large?
First, what is a large pressure difference?
After the elasticity of aorta decreases, when the heart pumps blood, the aorta can't completely expand, and the artery
The sudden increase in blood volume is not buffered,
Blood pressure on the arterial wall will suddenly rise,
also
That is, the high pressure suddenly increases;
When the heart relaxes,
The aorta does not contract elastically enough.
Promoting blood flow and maintaining blood pressure will lead to hypotension. High pressure rises, low pressure falls.
Low, one liter and one drop, resulting in an increase in pressure difference.
Large pressure difference is probably the manifestation of arteriosclerosis.
Especially the elderly need to pay attention,
pulse pressure
The increase of the difference indicates that the elasticity of the artery is poor, that is, the structure and function of the artery wall are damaged and the wall is hardened. one
Under normal circumstances, the pressure difference between high pressure and low pressure is
40 ~ 50 mm Hg
, usually greater than
60 mm Hg
,
It is called the increase of pulse pressure, which is less than
20 mm Hg
This is called pulse decompression and pressure difference exceeding.
50 mm Hg
along with
It is generally believed that there are atherosclerotic plaques in patients' arteries. Pressure difference equals
85 mm Hg
compare
Pulse pressure difference is equal to
65 mm Hg
happen
Myocardial infarction and stroke
The danger of
grow
10
%
Most importantly, the probability of cardiovascular and cerebrovascular accidents in the former is obviously greater than that in the latter.
The large blood pressure difference mainly includes
Three reasons
：
?
Suffering from hypertension and arteriosclerosis, the elasticity of arterial wall is weakened;
?
Suffering from hypertension for a long time leads to overload operation of the myocardium, which leads to enlargement or movement of the heart.
Valve insufficiency;
?
Suffering from hyperthyroidism or severe anemia.
A large blood pressure difference indicates that blood vessel elasticity is poor and easy to obtain.
Arteriosclerosis, blood vessels
Embolism, cerebral infarction, atherosclerosis, coronary heart disease
And other diseases, therefore, the pressure difference.
This growth cannot be ignored.
The main therapy is dietotherapy.
.
Second, diet therapy.
1
Control energy intake
Advocate eight points full, quit smoking and limit alcohol.
Advocate eating complex sugars, such as starch and corn, and eat less glucose, fructose and sucrose, which
Glucocorticoid belongs to monosaccharide, which is easy to cause blood lipid increase.
Eat propolis.
Flavonoids and various bioactive components contained in propolis,
can
It can significantly remove the deposits on the inner wall of blood vessels, purify blood and reduce blood viscosity; Simultaneously improve
The elasticity and permeability of blood vessels can soften blood vessels, optimize blood circulation system and effectively target middle-aged and elderly people.
Cardiovascular and cerebrovascular diseases that are easy to occur in young people.
2
Limit the intake of fat
When cooking, choose vegetable oil and eat more marine fish, which contains unsaturated fatty acids.
Oxidizing cholesterol, thereby lowering plasma cholesterol, prolonging platelet aggregation and inhibiting.
Thrombosis can prevent stroke and contain more linoleic acid, which can increase the elasticity of microvessels.
It has a certain effect on preventing vascular rupture and hypertension complications.
Fasting lard and animals
Vegetable oil, pork belly, processed sausage.
three
Moderate intake of protein
The daily protein of patients with hypertension is per kilogram of body weight.
1g
Suitable. Eat every week
2-3
Protein, a secondary fish, can improve the elasticity and permeability of blood vessels, increase urinary sodium excretion, and thus reduce
Blood pressure. If hypertension is complicated with renal insufficiency, the intake of protein should be limited.
Yi Shi
pig
Lean meat, white fish, eggs, milk, dairy products, bean products.
four
Eat more foods rich in potassium and calcium and low in sodium.
Such as potatoes, eggplant, kelp, lettuce and so on. Foods with high calcium content include milk, yogurt and shrimp.
Skin. Eat less broth because the increase of nitrogen extract in broth can promote the increase of uric acid in the body.
In addition, increase the burden on the heart, liver and kidney.
five
Limit salt intake
Every day should be gradually reduced to
6g
Below, it is the ordinary beer bottle cap after removing the rubber pad, eat a bottle cap.
Salt.
The amount of salt mentioned here includes edible salt and sodium converted into salt in other foods.
Total amount. Appropriate reduction of sodium intake will help to lower blood pressure and reduce sodium in the body.
six
Eat more fresh vegetables and fruits.
Fresh vegetables (spinach, cabbage, carrots, tomatoes, pumpkins, cucumbers) shall not be less than
eight
Second, fruits (apples, oranges, pears, grapes, watermelons).
2
Until/very
four
Two.
Fasting bamboo shoots
.
seven
Appropriately increase seafood intake
Such as kelp, seaweed, seafood and fish.
eight
How jealous
Can be jealous, white vinegar, rice vinegar, old vinegar, etc. Soften blood vessels.
Avoid spicy (spicy)
Pepper, onion)
Kimchi, coffee
. ...& gt& gt
Question 4: The blood volume is high and it is difficult. What should she do? Why is the blood pressure difference high?
First, what is a large pressure difference?
After the elasticity of aorta decreases, when the heart pumps blood, the aorta can't completely expand, and the artery
The sudden increase in blood volume is not buffered,
Blood pressure on the arterial wall will suddenly rise,
also
That is, the high pressure suddenly increases;
When the heart relaxes,
The aorta does not contract elastically enough.
Promoting blood flow and maintaining blood pressure will lead to hypotension. High pressure rises, low pressure falls.
Low, one liter and one drop, resulting in an increase in pressure difference.
Large pressure difference is probably the manifestation of arteriosclerosis.
Especially the elderly need to pay attention,
pulse pressure
The increase of the difference indicates that the elasticity of the artery is poor, that is, the structure and function of the artery wall are damaged and the wall is hardened. one
Under normal circumstances, the pressure difference between high pressure and low pressure is
40 ~ 50 mm Hg
, usually greater than
60 mm Hg
,
It is called the increase of pulse pressure, which is less than
20 mm Hg
This is called pulse decompression and pressure difference exceeding.
50 mm Hg
along with
It is generally believed that there are atherosclerotic plaques in patients' arteries. Pressure difference equals
85 mm Hg
compare
Pulse pressure difference is equal to
65 mm Hg
happen
Myocardial infarction and stroke
The danger of
grow
10
%
Most importantly, the probability of cardiovascular and cerebrovascular accidents in the former is obviously greater than that in the latter.
The large blood pressure difference mainly includes
Three reasons
：
?
Suffering from hypertension and arteriosclerosis, the elasticity of arterial wall is weakened;
?
Suffering from hypertension for a long time leads to overload operation of the myocardium, which leads to enlargement or movement of the heart.
Valve insufficiency;
?
Suffering from hyperthyroidism or severe anemia.
A large blood pressure difference indicates that blood vessel elasticity is poor and easy to obtain.
Arteriosclerosis, blood vessels
Embolism, cerebral infarction, atherosclerosis, coronary heart disease
And other diseases, therefore, the pressure difference.
This growth cannot be ignored.
The main therapy is dietotherapy.
.
Second, diet therapy.
1
Control energy intake
Advocate eight points full, quit smoking and limit alcohol.
Advocate eating complex sugars, such as starch and corn, and eat less glucose, fructose and sucrose, which
Glucocorticoid belongs to monosaccharide, which is easy to cause blood lipid increase.
Eat propolis.
Flavonoids and various bioactive components contained in propolis,
can
It can significantly remove the deposits on the inner wall of blood vessels, purify blood and reduce blood viscosity; Simultaneously improve
The elasticity and permeability of blood vessels can soften blood vessels, optimize blood circulation system and effectively target middle-aged and elderly people.
Cardiovascular and cerebrovascular diseases that are easy to occur in young people.
2
Limit the intake of fat
When cooking, choose vegetable oil and eat more marine fish, which contains unsaturated fatty acids.
Oxidizing cholesterol, thereby lowering plasma cholesterol, prolonging platelet aggregation and inhibiting.
Thrombosis can prevent stroke and contain more linoleic acid, which can increase the elasticity of microvessels.
It has a certain effect on preventing vascular rupture and hypertension complications.
Fasting lard and animals
Vegetable oil, pork belly, processed sausage.
three
Moderate intake of protein
The daily protein of patients with hypertension is per kilogram of body weight.
1g
Suitable. Eat every week
2-3
Protein, a secondary fish, can improve the elasticity and permeability of blood vessels, increase urinary sodium excretion, and thus reduce
Blood pressure. If hypertension is complicated with renal insufficiency, the intake of protein should be limited.
Yi Shi
pig
Lean meat, white fish, eggs, milk, dairy products, bean products.
four
Eat more foods rich in potassium and calcium and low in sodium.
Such as potatoes, eggplant, kelp, lettuce and so on. Foods with high calcium content include milk, yogurt and shrimp.
Skin. Eat less broth because the increase of nitrogen extract in broth can promote the increase of uric acid in the body.
In addition, increase the burden on the heart, liver and kidney.
five
Limit salt intake
Every day should be gradually reduced to
6g
Below, it is the ordinary beer bottle cap after removing the rubber pad, eat a bottle cap.
Salt.
The amount of salt mentioned here includes edible salt and sodium converted into salt in other foods.
Total amount. Appropriate reduction of sodium intake will help to lower blood pressure and reduce sodium in the body.
six
Eat more fresh vegetables and fruits.
Fresh vegetables (spinach, cabbage, carrots, tomatoes, pumpkins, cucumbers) shall not be less than
eight
Second, fruits (apples, oranges, pears, grapes, watermelons).
2
Until/very
four
Two.
Fasting bamboo shoots
.
seven
Appropriately increase seafood intake
Such as kelp, seaweed, seafood and fish.
eight
How jealous
Can be jealous, white vinegar, rice vinegar, old vinegar, etc. Soften blood vessels.
Avoid spicy (spicy)
Pepper, onion)
Kimchi, coffee
. ...& gt& gt
Question 5: What is the cause of excessive pulse pressure difference? Definition of excessive pulse pressure difference
Influencing factors: A pressure difference greater than 60 mm Hg is called excessive pressure difference, and any factor that can affect systolic and diastolic blood pressure can affect pulse pressure difference. Common diseases that cause excessive pulse pressure difference include aortic valve insufficiency, arteriosclerosis, hyperthyroidism, severe anemia, rheumatic heart disease, partial congenital heart disease and hypertensive heart disease. So go to the hospital for a comprehensive physical examination to see if there are any problems. For this kind of treatment, it is mainly due to the treatment.
Blood pressure refers to the pressure on the side wall of blood vessels when blood flows. Blood pressure is divided into systolic pressure and diastolic pressure, and the difference between systolic pressure and diastolic pressure is called "pulse pressure difference". For example, systolic blood pressure 120 mm Hg, diastolic blood pressure 80 mm Hg, and pulse pressure difference 40 mm Hg.
Generally speaking, the pulse pressure difference of normal people is 20~60 mm Hg (2.67 ~ 8.0 kPa). If it is greater than 60 mm Hg, the pulse pressure difference is too large, and if it is less than 20 mm Hg, the pulse pressure difference is too small.
Usually, when measuring blood pressure, people often only pay attention to the level of blood pressure, but seldom care about pulse pressure difference, but they don't know that pulse pressure difference has important clinical significance. So it's best to go to the hospital for a comprehensive physical examination to see if there are any problems.
Causes of excessive pulse pressure difference
Excessive pulse pressure difference is found in arterial valve insufficiency, arteriosclerosis, hyperthyroidism, severe anemia, rheumatic heart disease, partial congenital heart disease and hypertensive heart disease.
(1) Suffering from hypertension and arteriosclerosis, the elasticity of arterial wall weakened, systolic blood pressure increased and diastolic blood pressure decreased;
(2) Suffering from hypertension for a long time, leading to myocardial overload, heart enlargement or arterial valve insufficiency;
(3) Suffering from hyperthyroidism or severe anemia.
therapeutic method
Excessive pulse pressure difference has adverse effects on cardiovascular system, which should be paid attention to.
During the treatment, due to the decline of blood pressure regulation function in the elderly, antihypertensive drugs should be used from a small dose, and the treatment should be maintained after reaching an effective therapeutic dose, and then the dose should be adjusted according to the situation. Drugs such as enalapril, perindopril and nifedipine controlled release tablets. It has long-term effect, stable blood pressure reduction, little side effect and protective effect on cardiovascular and cerebrovascular diseases. Besides medication, maintaining a healthy lifestyle is also very important for the prevention and treatment of hypertension. Diet should be low in salt and fat, avoid mental disorders, control weight and exercise properly. At the same time, it is necessary to check whether blood sugar and blood lipid have increased and actively prevent them.
Daily adjustment
Besides medication, maintaining a healthy lifestyle is also very important for the prevention and treatment of hypertension. Diet should be low in salt and fat, avoid mental disorders, control weight and exercise properly. At the same time, it is necessary to check whether blood sugar and blood lipid have increased and actively prevent them.
Question 6: What is the reason for my high pressure difference recently? Generally speaking, the pulse pressure difference of normal people is 20~60 mm Hg (2.67 ~ 8.0 kPa). If it is greater than 60 mm Hg, the pulse pressure difference is too large, and if it is less than 20 mm Hg, the pulse pressure difference is too small. The main reasons for excessive pulse pressure difference are: (1) suffering from hypertension and arteriosclerosis, which weakens the elasticity of arterial wall, increases systolic blood pressure and decreases diastolic blood pressure; (2) Suffering from hypertension, which leads to overload operation of myocardium, enlargement of heart or insufficiency of arterial valve; (3) Suffering from hyperthyroidism or severe anemia. Hypertensive patients with excessive pressure difference have 1, and the blood vessels age rapidly. 2, blood vessels are fragile, it is necessary to improve the diet structure, pay attention to blood viscosity, and limit smoking. Although the pressure difference is great, you should pay attention to the fact that low pressure may lead to insufficient blood supply. In prevention and treatment, on the one hand, we should pay attention to non-drug treatment, including salt restriction (the daily intake of sodium chloride does not exceed 5-6 grams), low-fat diet, smoking ban, diabetes control, maintaining peace of mind and moderate exercise. On the other hand, medication, long-term treatment, starting with a small dose, combined medication when necessary, and persistence. At the same time, blood pressure and pulse should be measured frequently, and the diastolic pressure should not be lower than 60 mm Hg. Patients with normal cardiac function should have a pulse of not less than 50 beats/min at rest and should be checked regularly.
Question 7: What causes high pulse pressure difference to be one of the characteristics of hypertension in the elderly? With the increase of age, the progress of the disease course or the unsatisfactory long-term blood pressure control, the systolic blood pressure gradually increases and the pulse pressure difference gradually increases. The so-called pulse pressure difference refers to the difference between systolic pressure and diastolic pressure. The pulse pressure difference of normal adults is about 30 ~ 40 mm Hg. Due to aging and disease, the blood vessels of the elderly become stiff, the arteries lose elasticity and the compliance decreases. When the heart contracts, the aorta can't expand accordingly to buffer the pressure when the heart ejects blood, resulting in a sharp increase in systolic blood pressure. However, when the heart relaxes, the elastic resilience of the aorta weakens, and the blood flow that should be delivered cannot be fully delivered, resulting in low diastolic pressure, so the pulse pressure difference increases, and some people's pulse pressure difference can reach 100 mm Hg.
The large pulse pressure difference reflects that the elasticity of aorta is weakened and the stiffness is increased, and the blood pumped into aorta by the heart cannot be elastically adjusted, thus increasing the burden on the heart, which is one of the risk factors of cardiovascular events. We should actively prevent and control and take measures to control blood pressure.
1. The antihypertensive treatment of elderly hypertensive patients with large pulse pressure difference should be active and cautious. For example, in patients with blood pressure 160/60mmhg, the systolic blood pressure drops to 140mmhg, and the diastolic blood pressure may correspondingly drop to 50mmhg, which is too low. The blood supply to the heart is maintained by diastolic pressure, which is too low when it is lower than 60 ~ 65 mm Hg. Therefore, under the supervision of doctors, individualized treatment must be carried out according to the pathological changes of target organs, and the speed and extent of reduction must be mastered.
2. The treatment of elderly hypertensive patients with large pulse pressure difference should not only reduce blood pressure (systolic blood pressure), but also improve arterial compliance. The recommended drugs are: low-dose diuretics (hydrochlorothiazide, indapamide), calcium antagonists (nitrendipine, amlodipine) and angiotensin converting enzyme inhibitors (acei). Appropriate drug treatment should also strengthen health care and adjust and optimize lifestyle.
Question 8: Big blood pressure difference: What is the reason? For example, 80- 160 needs to understand first: hypertension will occur after vascular stenosis and sclerosis; Vascular stenosis and sclerosis are caused by changes in blood quality; The change of blood quality is caused by the imbalance of body organs; The root of body organ problems is caused by changes in nature; So there are so many people with high blood pressure (heart disease) today.
Hypertension, hypotension, palpitation, chest tightness, insufficient blood supply, myocardial ischemia, coronary heart disease, myocardial infarction, thrombosis, cerebral hemorrhage, dementia and Parkinson's disease are all symptoms of heart disease, but the symptoms will be different in the early, middle and late stages.
Tip: No matter what kind of disease needs to be cured! Rather than maintenance and control. Choosing the method to maintain and control diseases is not the progress of medicine, nor is it, let alone human civilization.