Physical Signs of High Blood Pressure

According to a survey by the Ministry of Health and Welfare, one in three Taiwanese people over the age of 40 suffer from high blood pressure; but 3% to XNUMX% of them do not know that they have it.hypertension.
Clarify the myths about high blood pressure, grasp the correct concepts, and protect your own health in advance.

Myth 1: Since I can’t find the cause of my high blood pressure, it must be related to my physical constitution. This is the same reason why some people are taller than others and some are more prone to allergies. There is no need to control it. Lowering it would actually be bad.

Wrong. Hypertension needs to be controlled to reduce the risk of serious complications to blood vessels and vital organs.

Chen Zhihong, professor of internal medicine at the National Cheng Kung University School of Medicine, said that more than 90% of hypertension is "primary hypertension" without a clear cause, which is related to age, gender, genetics and other factors. However, whether it is primary or secondary hypertension caused by other diseases (such as hyperthyroidism), if it is not treated, the damage to important organs such as the brain, heart, and kidneys will continue. Blood pressure should be maintained at normal levels to avoid serious complications. The impact of long-term high blood pressure slowly injures blood vessels and organs. Once laughing, raging or in extremely cold weather, it may cause stroke or myocardial infarction, or even sudden death and other accidents.

The Mayo Clinic in the United States points out that if high blood pressure is not controlled, it will cause damage to the main organs of the body:

■Arteries: High blood pressure may cause the thickening of the arterial intima, hardening of the blood vessels, thickening and narrowing of the arterial walls; it may also damage the arterial walls to form plaques or aneurysms. If aortic dissection or rupture occurs, it will be more serious than myocardial infarction, and the patient may even die before surgery.

■Heart: High blood pressure increases arterial resistance, causing the left ventricle to work harder to pump blood. Over time, the left ventricle will become enlarged, leading to heart failure; the coronary arteries that supply blood to the heart become hardened, increasing the risk of angina pectoris and myocardial infarction.

■brain：High blood pressure causes cerebral blood vessels to rupture and bleed, or blood clots block blood flow to various parts of the brain, which is the main cause of stroke.

■Kidneys: High blood pressure can worsen kidney blood circulation, damage kidney function, and cause kidney failure.

■Eyes: Causes retinal disease, severe cases may lead to blindness.

■Metabolic syndrome: High blood pressure often brings with it two other bad friends – high blood sugar and high blood lipids, which can easily develop into diabetes, heart disease, and stroke in the future.

Therefore, everyone should know their blood pressure. If it exceeds 120/80 mmHg (millimeters of mercury), or if symptoms such as headache, dizziness, nosebleed occur, you should be more careful about whether your blood pressure is high.

Myth 2: I just turned 40 and my blood pressure is 130/85 mmHg. It shouldn’t be a big deal, right?

Wrong. If your blood pressure is 130/85 mmHg, your chances of developing cardiovascular disease in the future will increase by two times.

The hypertension treatment guidelines classify systolic blood pressure of 120-139 and diastolic blood pressure of 80-89 mmHg as prehypertension. These people are twice as likely to develop cardiovascular disease in the future as those with normal blood pressure. Therefore, if the blood pressure is 130/85 mmHg, if there are no risk factors such as diabetes, heart disease, or previous stroke, you should adjust your lifestyle to control your blood pressure.

Cardiovascular physicians point out that no matter how good or effective the blood pressure-lowering drug is, its average blood pressure-lowering effect is about 8 mmHg, and its effect on a healthy lifestyle is no less than taking a blood pressure drug.

Good lifestyle habits that can help improve high blood pressure include:

■Weight loss: Losing weight has a significant effect on lowering blood pressure. Maintain BMI within the range of 18.5 to 24.

■Adopt the Dietary Approaches to Stop Hypertension (DASH) diet: The focus is on eating more whole grains, vegetables and fruits, low-fat products, foods rich in unsaturated fatty acids, and less high-cholesterol, high-fat and overly salty foods.

■Exercise: Various aerobic exercises are helpful in controlling blood pressure. Walking is convenient and effective, and it is best to walk for 30 minutes every day.

■Quit smoking: Smoking increases the accumulation of bad cholesterol in blood vessels, causing arteriosclerosis, and causes blood vessels to contract and narrow, increasing the risk of cardiovascular disease.

■Limit alcohol consumption: A small amount of alcohol can slightly lower blood pressure, but drinking more than that can significantly increase the risk of hypertension. The Taiwan National Health Institute recommends that healthy people should not drink more than 10 grams of alcohol a day, which is about a bottle of beer or 120cc of red wine.

■ Get enough sleep: Stress and insomnia will cause your blood pressure to rise. Only when you get enough sleep can your blood pressure be stable.

Myth 3: It doesn’t matter if the high blood pressure (systolic pressure) is a little higher, because it is more important for the low blood pressure (diastolic pressure) to be normal.

Wrong. Diastolic blood pressure is just as important as systolic blood pressure. Especially after the age of 50, systolic blood pressure is more important than diastolic blood pressure.

For hypertensive patients over 50 years old, it is more important to control systolic blood pressure than diastolic blood pressure to reduce the risk of cardiovascular disease. Ideally, blood pressure should be controlled below 140/90 mmHg. For patients with diabetes or kidney disease, the requirements are stricter and should be controlled below 130/80 mmHg.

Myth 4: Hypertension medications can be adjusted on your own, so you don’t need to take them if your blood pressure is normal.

Wrong. Hypertension should be treated as a chronic disease and controlled throughout life. Blood pressure is normal one or two days after stopping medication because the drug is still effective, and it will still rise afterwards.

Many patients know they have high blood pressure but avoid treatment because they think, "I have to take medicine for the rest of my life and become a medicine addict." Therefore, they delay treatment as long as possible and are reluctant to seek medical attention. Dr. Chen Zhihong often advises patients to take good treatment, "You don't have to take medicine for the rest of your life. Taking medicine for the rest of your life can reduce the risk of heart disease and stroke."

Or some patients act as their own doctors and take the medicine once every two days instead of once a day. If the blood pressure is normal or slightly high the next day or for a few consecutive days and there is no discomfort, they can simply stop taking the medicine.

Blood pressure is normal a few days after stopping medication because the drug is still effective in maintaining blood pressure. When the drug concentration disappears completely, blood pressure will rise again and return to uncontrolled hypertension. The chance of complications in the future is also high. Moreover, if some drugs are stopped suddenly, blood pressure may rebound and heart rate may increase, which is even more dangerous.

Therefore, the correct dosage reduction should be determined by the doctor. It is not about lengthening the interval between medications, but about changing from one pill to half a pill, or switching to other types of antihypertensive drugs.

Myth 5: Since everyone in the family has high blood pressure, it’s okay for the husband to share his medicine with his wife.

Wrong. Treatment for high blood pressure needs to be tailored to the individual.

Dr. Chen Zhihong said that in diagnosing and treating hypertension, it is necessary to consider the patient's age, gender, whether he smokes, has diabetes, heart disease, kidney disease and other problems; and to assess whether hypertension has caused damage to the patient's heart, kidneys, brain, blood vessels and other important organs; and then decide which mechanism of action drug to use. The ultimate goal is to reduce the incidence of cardiovascular disease and kidney disease and make it a personal blood pressure treatment.

Therefore, even if two patients have the same blood pressure of 150/100 mmHg, it is possible that patient A only needs to lower his blood pressure, but patient B also needs to consider the problem of heart enlargement, and the treatment methods are different. Patients should never take other people's antihypertensive drugs just to save trouble.

Myth 6/The fewer pills of high blood pressure medicine you take, the better, and the side effects will be much fewer.

Not necessarily. The current trend in hypertension treatment is indeed to take long-acting drugs once a day, but most hypertensive patients need two or more antihypertensive drugs to achieve the ideal blood pressure value.

Hypertension medications are improving rapidly. Choosing long-acting antihypertensive drugs that slowly release their effects and are taken once a day can increase patients' willingness to take them long-term. However, most hypertensive patients still need two or more antihypertensive drugs to control their blood pressure within the ideal range.

Some patients often complain that they experience side effects such as dizziness, dry cough, flushing, and impotence after taking antihypertensive drugs. It is best to tell the doctor at the next visit, because many good antihypertensive drugs are covered by Taiwan's National Health Insurance. If you really feel uncomfortable, the doctor can change the prescription. Never stop taking the medicine on your own.