What is the blood pressure value of human body?

First of all, it should be clear that people's blood pressure is not a relatively fixed value like weight or height, but is constantly changing. People's blood pressure should increase when they are excited, nervous and exercising, but it should decrease when they drink, bathe and smoke. Medical experiments have proved that the blood pressure of normal people fluctuates during the day. People have the lowest blood pressure during sleep, and the highest blood pressure is from 8 am to 10. Normal people's systolic blood pressure (high pressure) changes between 20-40 mmhg, and diastolic blood pressure (low pressure) changes between 10-20 mmhg. Even at night, people sleep. Some people say that the doctor's blood pressure is 80 to 20mmHg. But at home, the numbers measured by electronic sphygmomanometer are always different. In fact, the value measured by the electronic sphygmomanometer reflects the blood pressure value at the moment of human body measurement. As can be seen from the figure, people's blood pressure is constantly changing, and it is very rare to get the same blood pressure value from two measurements. Therefore, only by measuring blood pressure at the same time and in the same posture every day can we get comparable blood pressure values.

(2) The posture during measurement also affects the measurement results. The results showed that the blood pressure decreased by about 8mmHg when the measured position increased 10cm relative to the heart height, and increased by about 8mmHg when the height decreased 10cm.

(3) The relationship between electronic sphygmomanometer and medical mercury sphygmomanometer. The mercury sphygmomanometer adopts Coriolis sound method, and the electronic sphygmomanometer adopts oscillometric method. Coriolis sound method is to listen to the sound of blood flow in blood vessels through a doctor's stethoscope, and oscillometric method is to measure the vibration of blood flow on blood vessel wall. Although the measurement principle is different, the test result is the same in theory. In fact, because each doctor's auditory reaction speed is different, sometimes there is a big error because the blood pressure reading is not recorded immediately during the measurement. Therefore, every doctor's measurement will also produce errors, and the queuing of electronic sphygmomanometer is the difference between people. In addition, doctors often miss some mistakes and take integers. For example: 128mmHg, 13 1mmHg, which are all pronounced by doctors as 130mmHg. The electronic sphygmomanometer displays whatever value it measures, and users report that it is always low at home and high when going to the hospital. This is called white hypertension. That is to say, in front of the doctors in the hospital, you will unconsciously feel a certain degree of anxiety, tension and mental stress, which will raise your blood pressure, while putting Songhua River at home will lower your blood pressure, which is a true reflection of your blood pressure. Based on the above phenomena, people feel that the electronic sphygmomanometer is inconsistent with the blood pressure measured by the doctor, but it is not accurate. In fact, according to the irrigation regulations, the electronic sphygmomanometer must undergo clinical trials before it can obtain a production license. For example, Panasonic brand electronic sphygmomanometer produced by Detong Matsushita Electric Co., Ltd. has been clinically tested in China-Japan Friendship Hospital, Friendship Hospital and Fuwai Medical Hospital. The results show that there is no significant difference between the blood pressure measured by electronic sphygmomanometer and that measured by doctors with stethoscope.

(4) The measurement errors of upper arm electronic sphygmomanometer and wrist electronic sphygmomanometer are large and always come from human body structure. The arterial blood vessels in the upper arm and wrist are almost the same in thickness, that is, in diameter. Usually, the diameter of arterial blood vessels in the upper arm is 4.2 to 6mm, and the diameter of arterial blood vessels in the wrist is 4.2 to 5 mm. Moreover, the design accuracy and manufacturing accuracy of electronic sphygmomanometer are the same, and the inspection specifications of each set are the same when leaving the factory. So there are no obvious mistakes in principle. So why do people still report that there is an error between the arm and the wrist? As far as we know, most of them reflect low arm position and high wrist position. This is still a question of attitude measurement. (For example, is the position of the arm cuff tied too high? Too loose? Or is it too tight? )

(1) There is a lot of subcutaneous fat in the upper arm, which leads to the cuff being tied too loosely or too tightly. Too loose or too tight, the measured blood pressure will be low (too tight will make the blood flow poor, too loose blood pressure will make the blood vibration can not be completely transmitted to the cuff, and the blood pressure will be low). The appropriate degree is that after the cuff is rolled up, one finger should stretch freely between the cuff and the arm.

(2) Wrist sphygmomanometer has less subcutaneous fat on the wrist, which makes it easier to bind the cuff, and it is not easy to cause it to be too loose or too tight, but the posture during measurement will affect the measured value. Experiments show that when the wrist rotates outward, it is easy to be nervous and raise blood pressure. The user's manual requires the wrist to stretch naturally when measuring, but the average customer always turns his wrist outward unconsciously when doing it according to the user's manual, which leads to measurement errors. Therefore, when measuring, the wrist should naturally stretch about 45 degrees according to the requirements of the instruction manual. After noticing the above points, there will be no obvious difference between the upper arm electronic sphygmomanometer and the wrist electronic sphygmomanometer.

(c) Patients with peripheral paralysis (usually caused by diseases such as diabetes and arteriosclerosis). ) There may be a big error in the blood pressure measurement of the wrist and upper arm, so it is recommended to use the arm electronic sphygmomanometer.

(d) When standing, some people have large measurement errors, so it is recommended not to stand and test.

Respondent: woshi 008- assistant level 311-2519: 22.

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Normal blood pressure: systolic blood pressure

1999 domestic diagnostic and classification standard of hypertension adopted by the world health organization and the world hypertension union: ideal blood pressure: systolic blood pressure.

Respondent: Zhu Juan Jinshi was born in grade 911-2519: 28.

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China mean normal blood pressure reference value (mmHg)

Age systolic blood pressure (male) diastolic blood pressure (male) systolic blood pressure (female) diastolic blood pressure female

16-20 1 15 73 1 10 70

2 1-25 1 15 73 1 10 7 1

26-30 1 15 75 1 12 73

3 1-35 1 17 76 1 14 74

36-40 120 80 1 16 77

4 1-45 124 8 1 122 78

46-50 128 82 128 79

5 1-55 134 84 134 80

56-60 137 84 139 82

6 1-65 148 86 145 83

Hypertension is a common cardiovascular disease, and it is also an important risk factor for major human death diseases such as coronary heart disease and cerebrovascular disease. Obesity, smoking, excessive salt intake, lack of activity and psychological stress are risk factors for hypertension. Medical research shows that 75% of hypertension and its complications can be prevented and controlled through early prevention, early stable treatment and healthy lifestyle. The government regards 65438+ annual 10 8 as "National Hypertension Day", so our aim is to popularize the knowledge of hypertension prevention and improve the health level and quality of life of the whole nation.

Why is blood pressure difficult to control?

What does it mean that blood pressure is difficult to control? At present, there are dozens of antihypertensive drugs in six categories. If the drugs are selected reasonably, the blood pressure of most patients can be controlled within the ideal or normal range. However, even if a few hypertensive patients take three or more antihypertensive drugs, including diuretics, and the dosage and time of each drug are sufficient, their blood pressure is still 140/90mmHg or above, which is called intractable hypertension, which is also commonly known as blood pressure is difficult to control. Hypertension patients are prone to a series of cardiovascular diseases. But if blood pressure is controlled, the incidence of these diseases will be greatly reduced or even avoided. Therefore, in the face of hypertensive patients whose blood pressure is difficult to control, we must go to the hospital in time to let the doctor analyze and find out the reasons and further adjust the treatment. According to our clinical experience, blood pressure is difficult to control for the following reasons:

■ Accompanying symptoms of patients with hypertension, such as weight gain, high salt, alcoholism and nervousness, have not been eliminated in time.

■ The reason why secondary hypertension has not been treated. Because it can't be treated according to the cause, of course, hypertension is also difficult to control. Here, I also remind hypertensive patients and their families that their blood pressure is difficult to control. To provide doctors with detailed medical history, we must find an expert engaged in clinical research of hypertension for systematic diagnosis and treatment.

■ Influence of hypertensive renal damage on the treatment of hypertension Patients with hypertension are prone to renal damage, which is the cause of hypertension. Therefore, if patients with hypertension are not treated promptly and effectively, it is easy to cause renal function damage. At this time, if diuretics are used unreasonably, too much water and salt in the body cannot be excreted, which will aggravate high blood pressure and make it difficult to control blood pressure.

■ The blood pressure measured by "white coat hypertension" in the doctor's office is always higher than normal, and even several drugs are difficult to control normal patients. It is normal to measure blood pressure at home, and at the same time, check that there is no serious damage to important organs such as heart, brain and kidney, which is medically called "white coat hypertension".

■ Invasive malignant hypertension This is a special type of hypertension, so you must find a doctor for timely diagnosis and treatment.

■ Improper antihypertensive treatment ① The patient did not insist on taking the medicine; ② The drug dose is too small or the interval time is too long, so the therapeutic effect cannot be achieved; ③ Unreasonable drug selection or improper combination of drugs. In fact, people who are dissatisfied with blood pressure control due to improper treatment do not belong to the category of intractable hypertension.

Six misunderstandings in the treatment of hypertension

Hypertension is mostly treated by family. Although this method is convenient, there are many misunderstandings in the actual treatment process, which must be paid attention to.

One of the misunderstandings: estimate the level of blood pressure by self-feeling. The severity of symptoms in patients with hypertension must be directly proportional to the blood pressure level. Some patients have high blood pressure but have no symptoms. On the contrary, some patients have only slightly increased blood pressure, but the symptoms are obvious. This is because everyone has different tolerance to the increase of blood pressure, and the degree of organ damage is sometimes not necessarily equal to the level of blood pressure. Therefore, it is often wrong to estimate the level of blood pressure by self-feeling, and it is also easy to delay treatment. The correct way is to take the initiative to measure blood pressure regularly, at least twice a week.

Myth 2: Stop taking medicine as soon as your blood pressure drops. After patients take antihypertensive drugs for a period of time, their blood pressure drops to normal, that is, they stop taking drugs themselves; Results After a short time, the blood pressure increased again, so it was necessary to use drugs to reduce blood pressure, which not only failed to achieve the therapeutic effect, but also caused serious cardiac, cerebral and renal complications, such as cerebral hemorrhage. The correct method of taking medicine is that the blood pressure drops after taking medicine, and the medicine can be continued at the maintenance dose; Or adjust the drug under the guidance of a doctor, instead of stopping the drug completely.

Myth 3: Taking traditional medicine. Studies have shown that the blood pressure of hypertensive patients changes the most after waking up in the morning, which can increase by 2 ~ 5 kPa in a few minutes, and then decrease by itself after noon. This law of blood pressure changes makes patients prone to stroke in the morning and at night. (Cerebral hemorrhage is easy to occur in the morning, and cerebral ischemia is easy to occur at night. The traditional method of taking medicine three times a day does not take into account the changing law of patients' blood pressure, but only considers lowering blood pressure blindly, which leads to unsatisfactory blood pressure control in the morning and low blood pressure in the afternoon and evening. The new method of taking medicine every morning is 1 time. It can effectively prevent the drastic change of blood pressure after waking up in the morning, so that the blood pressure is in a relatively balanced state, so the effect is better.

Myth 4: Blood pressure is too fast and too low. Some hypertensive patients want their blood pressure to drop as soon as possible, which is wrong. Because too fast or too low blood pressure will make patients feel dizzy and weak, and it will also induce serious consequences such as cerebral thrombosis.

Myth # 5: Don't blindly pursue normal blood pressure, it depends on the specific situation. Older people over 60 years old have different degrees of arteriosclerosis, so the increase of blood pressure is beneficial to the blood supply of heart, brain, kidney and other organs. Regardless of the age and the patient's specific situation, blindly demanding that the blood pressure be reduced to a "normal" level will inevitably affect the function of the above organs, but it is not worth the candle. The correct way is to lower the blood pressure to an appropriate level according to the patient's age and organ function, especially for the elderly, and not to excessively lower the blood pressure.

Myth 6: relying solely on antihypertensive drugs instead of comprehensive treatment. There are many causes of hypertension, and comprehensive measures are needed to treat it, otherwise the ideal therapeutic effect can not be achieved. The correct way is not only to choose the right medicine, but also to pay attention to the combination of work and rest, eat less salt, participate in cultural and sports activities properly, avoid emotional excitement, ensure adequate sleep, and obese people should lose weight.

Relationship between hypertension and coronary heart disease?

Coronary heart disease is one of the important diseases that endanger human health. It is due to various harmful factors that damage coronary endothelial cells, leading to coronary atherosclerosis, further narrowing or even occlusion of blood vessels, angina pectoris, myocardial infarction and even sudden death. Hypertension, hyperlipidemia, hyperglycemia and smoking are the four major culprits of coronary heart disease.

(1) Hypertension is an independent risk factor of coronary heart disease: A large number of studies show that hypertension can damage arterial endothelium and cause atherosclerosis, and accelerate the process of atherosclerosis. The higher the blood pressure level, the more severe the arteriosclerosis, and the higher the risk of death from coronary heart disease.

(2) Hypertension can cause myocardial infarction: When there is coronary artery disease, elevated blood pressure may cause atherosclerotic plaque rupture, thrombosis and coronary artery obstruction, which may lead to acute myocardial infarction. Therefore, controlling hypertension can prevent coronary heart disease, reduce the incidence of coronary heart disease and prevent accidents.

What's the difference between hypertension medication?

I often hear old people sigh: people are old and sick, and they can't do without taking medicine. If they take too many drugs, they are afraid of problems. This ambivalence puzzles more and more elderly people.

One day, several old patients who were regularly followed up in the hypertension clinic met in the waiting room. The topics that old people talk about are often inseparable from their own diseases. They naturally communicated which doctor they saw and which medicine they took. Chatting, the old people are suspicious: they all have high blood pressure, why do doctors prescribe the same drugs? So they elected Zhang Laobo as the representative and invited me to give a lecture. I readily agreed to spend time with them to analyze everyone's situation and drug use and dispel their doubts.

When accompanied by other diseases, medication should be paid more attention to.

Elderly hypertensive patients often suffer from other diseases at the same time, such as diabetes, hyperlipidemia, coronary heart disease, kidney disease and so on. If hypertension is not well controlled, it will aggravate these diseases and even lead to fatal consequences such as heart failure, stroke and renal failure. Therefore, when treating hypertension, specialists should not only consider the influence of antihypertensive drugs on other diseases, but also consider the influence of drugs for treating other diseases on hypertension. Different conditions, the first choice of drugs are also different, there are several common situations.

1. When patients have diabetes, ACEI is the first choice. However, ACEI has the side effect of causing cough. Therefore, during the period of use, if cough occurs and has nothing to do with infection, antibiotics or antitussive drugs are ineffective, angiotensin ⅱ receptor antagonists, such as losartan, valsartan and irbesartan, can be replaced, but the renal function should be monitored regularly according to the doctor's advice.

2.ACEI and diuretics are the first choice for patients with heart failure.

3. For patients with prostatic hypertrophy, receptor yin stagnation agents, such as terazosin and doxazosin, are preferred, which can not only lower blood pressure, but also treat prostatic hypertrophy, killing two birds with one stone.

4. Patients with renal insufficiency can choose ACEI, Benazepril (Lotensin) and Fosinopril (Monroe) under the guidance of doctors.

Which antihypertensive drugs should not be used when accompanied by other diseases?

1, with diabetes, hyperlipidemia, hyperuricemia or gout, thiazide diuretics or compound preparations containing such drugs, such as Zhenju Jiangya Tablet, Kaifu Five Tablets and Compound Jiangya Tablet, should not be used; It is also inappropriate to choose large doses of α receptor blockers, such as betaloc and atenolol, so as not to affect glucose and lipid metabolism.

2. Beta blockers, verapamil and diltiazem are prohibited when hypertension is complicated with degree II or above atrioventricular block.

3, the elderly heart rate is faster, such as 1 10 times per minute or more, do not choose short-acting dihydropyridine antihypertensive drugs, such as nifedipine, which can induce angina pectoris or myocardial infarction.

4, constipation, depression or orthostatic hypotension, can not choose clonidine.

5. Patients with depression should not use reserpine and compound preparations containing such drugs, such as compound antihypertensive tablets.

Antihypertensive drug combinations and drug contraindications

When some antihypertensive drugs are used together, the adverse reactions will multiply and cause serious consequences, so we should pay special attention to them.

1. Zhenju Jiangya Tablet contains thiazide diuretics, and should not be used together with indapamide (Shoubisan), Compound Jiangya Tablet, Kefu and other diuretics, otherwise it will aggravate hypokalemia and even lead to serious arrhythmia and death.

2.β receptor block should not be combined with verapamil, because both of them can inhibit sinus node and atrioventricular node, which may lead to sudden death.

3.β receptor block should not be combined with diltiazem (Tianerxin), otherwise it may cause atrioventricular block and reduce cardiac function.

There is no contradiction between calcium supplementation and taking antihypertensive drugs.

Is there a contradiction between taking nitrendipine, a calcium antagonist, and supplementing calcium needed by the body at the same time in hypertensive patients?

Calcium is an essential element for human body. People get about 100 mg of calcium from food every day, 99% of which is combined with phosphorus and deposited in bones. Calcium is the most basic raw material for human bones. Calcium also has many important physiological functions. It is found that insufficient intake of calcium salt, especially the decrease of blood potassium, the increase of blood sodium level, or the long-term excessive consumption of sodium salt will cause the increase of blood pressure. Therefore, in order to prevent and treat hypertension, appropriate calcium supplementation should be emphasized.

So why are antihypertensive drugs calcium antagonists? Is this not contradictory to calcium supplementation?

It turns out that a very small part of calcium in human body exists in vascular endothelial cells and myocardial cells, and its content is very small, but it has very important physiological functions. If the calcium ion in these cells increases, it will obviously cause vasoconstriction and myocardial contractility to strengthen, leading to an increase in blood pressure. Especially the continuous contraction of arterioles, is the direct cause of hypertension. Calcium antagonists can inhibit extracellular calcium ions from entering cells, so they can effectively lower blood pressure. However, they have no effect on the content of calcium in blood and will not antagonize other physiological effects of calcium. Therefore, it is not contradictory for hypertensive patients to take calcium antagonists and supplement calcium at the same time. If the patient supplements calcium according to the doctor's advice, it will also help to prevent and treat hypertension. Of course, this does not mean that all patients with hypertension need calcium supplementation.

Eating more salt will raise blood pressure.

The main component of salt is sodium chloride. Both sodium ion and chloride ion exist in extracellular fluid, and potassium ion exists in intracellular fluid, which is in equilibrium under normal conditions. When sodium ions and chloride ions increase, due to the change of osmotic pressure, extracellular fluid increases, sodium and water are retained, intercellular fluid and blood volume increase, and cardiac blood volume, ventricular filling volume and output increase, which can increase blood pressure.

With the increase of sodium ion in extracellular fluid and the increase of sodium ion concentration gradient inside and outside the cell, the sodium ion in the cell also increases and the cell swells. After the smooth muscle cells of arteriole wall expand, on the one hand, it can narrow the lumen and increase the peripheral resistance; On the other hand, the reactivity of arteriole wall to vasoconstrictive substances (such as adrenaline, norepinephrine and angiotensin) in blood increases, causing arteriole spasm, increasing systemic arteriole resistance and raising blood pressure.

At present, many international data on the relationship between salt and hypertension show that salt intake or urinary sodium excretion (indirect sodium intake) is positively correlated with hypertension, that is, the more salt intake, the higher blood pressure level. Domestic research also shows that the salt intake of northerners is higher than that of southerners, and the incidence of hypertension is also higher in the north and lower in the south.

Can people who eat more salt get high blood pressure? The answer is no, the results show that about 20% people in the crowd will get high blood pressure if they eat too much salt, which is called salt sensitive person in medicine, while most (about 80%) normal people will not get high blood pressure if they eat a little salt. But at present, it is impossible to distinguish between salt sensitive person and sensitive person. Therefore, from the perspective of preventing hypertension, we should pay attention to properly controlling salt intake and changing the habit of "heavy mouth" in diet.

For patients with hypertension, salt restriction is also beneficial. Practice has proved that simple salt restriction may restore blood pressure to normal in patients with early hypertension or mild hypertension. For patients with moderate to severe hypertension, limiting salt intake can not only improve the efficacy of other antihypertensive drugs, but also reduce the dosage of antihypertensive drugs, which can greatly reduce the side effects and drug costs of antihypertensive drugs. Therefore, salt restriction is beneficial from the perspective of preventing hypertension and treating patients with hypertension.

Misunderstanding of hypertension

Does anaemic person not get high blood pressure?

Anemia usually means that the hemoglobin concentration, red blood cell count and/or hematocrit in peripheral blood are lower than the lowest values of normal people of the same age and gender, while hypertension is a common cardiovascular disease, which means that blood pressure exceeds the normal standard. Anemia and hypertension are two completely different concepts, and there is no causal relationship between them.

Thin people don't have high blood pressure?

Overweight is an important and independent risk factor for hypertension, but the pathogenesis of hypertension involves many factors, including heredity, environment, anatomy, adaptability and neuroendocrine system. Therefore, whether you are overweight or thin, you should check your blood pressure regularly, and you should not be blindly optimistic.

Blood pressure is the highest at noon every day?

For a long time, people have been influenced by the idea that blood pressure is the highest at noon, but it is not. 24-hour ambulatory blood pressure monitoring shows that the blood pressure of normal people and hypertensive patients changes in a "two peaks and one valley" day and night, that is, the peak is at 8-9 am and 4-6 pm, and the trough is at 2-3 am.

Characteristics of hypertension in China

1, mental workers are higher than manual workers.

2. The northern region is higher than the southern region.

3. Cities are higher than rural areas.

4. The family history is obvious, and the family history with hypertension is higher than that without hypertension.

5. The high-salt diet is higher than the low-salt diet.

6. Those who have tobacco and alcohol hobbies are higher than those who have no tobacco and alcohol hobbies.

7. Overweight people are above normal weight.

8. Workers who have been engaged in mental stress for a long time are higher than other workers.

The position of lifestyle in the treatment of hypertension

In recent years, there are two important documents about the treatment of hypertension, namely, the new report of JNC and the treatment guidelines of WHO. The former pays more attention to the non-drug treatment of hypertension than before, while the latter stratifies the risk of hypertension patients and determines the treatment strategy according to the stratification. Both emphasize that lifestyle improvement (advocating healthy eating habits, losing weight, quitting smoking, reducing alcohol intake, limiting sodium and increasing physical activity) is applicable to all patients.

Randomized controlled trials in patients with hypertension confirmed that reducing the daily sodium intake from 180mmol( 10.5 g) to 80 ~ 100 mmol (4.7 ~ 5.8 g) can reduce the systolic blood pressure by about 4 ~ 6 mmhg on average. In clinical practice, we found that excessive salt intake is often a cause of intractable hypertension, and salt restriction therapy is more important for elderly patients with hypertension.

Another study found that in obese hypertensive patients, losing 5 kg can lower blood pressure. DASH (diet method to stop hypertension) research shows that there are a lot of fruits and vegetables in the diet. Replacing foods rich in saturated fatty acids with low-fat dairy products will lower blood pressure more than other dietary studies. The benefits of improving diet structure are not only lowering blood pressure, but also reducing the mortality of cardiovascular diseases and cancer. TONE research shows that salt restriction and weight loss can make a considerable number of elderly people with hypertension safely stop taking antihypertensive drugs. This is consistent with the theory that the benefits of antihypertensive therapy mainly lie in lowering blood pressure itself. The research results have a good guiding significance for doctors' clinical practice.

It should be pointed out that hypertension needs lifelong treatment. During the period of drug reduction or withdrawal according to the "Regulations", it is necessary to measure blood pressure repeatedly to ensure that blood pressure remains below a certain level. If the drug is stopped blindly or intermittently, the damage to the target organ will be aggravated.

TONE's research object is mild patients, excluding a high proportion of patients with other risk factors in the population. TONE's results are only preliminary. In the actual treatment of hypertension, which patients can stop taking drugs? How to make a specific exit plan needs further study.

What is the relationship between hypertension and microalbuminuria?

Urine examination for patients with hypertension is helpful to understand the degree of renal damage. However, in order to clarify the relationship between hypertension and kidney diseases, traditional urine detection methods have the disadvantage of poor sensitivity. In recent years, some hospitals have developed some new and sensitive methods to determine urinary microalbuminuria, N- acetyl-β-oxyglucose diol (NAG), retinol-binding protein (RBP), urinary immunoglobulin G(IgG) and so on, which can detect subclinical microalbuminuria at an early stage. It is beneficial to the early diagnosis and treatment of hypertension complicated with renal damage or diabetic nephropathy.

(1) Microalbuminuria means that the excretion of albumin in urine exceeds 20 micrograms per minute or 30 milligrams in 24 hours. Urinary microalbuminuria is closely related to blood pressure. The incidence of microalbuminuria is about 5% in mild hypertension. The principle of microalbumin in hypertensive patients with significantly increased blood pressure (>170-180/100 mmhg) is universal and serious. The mechanism is that glomerular internal pressure and filtration fraction increase during hypertension, which causes abnormal function and structure of glomerular basement membrane. Therefore, patients with hypertension will have microalbuminuria only if their blood pressure increases significantly.

(2) In patients with diabetes mellitus, the glomerular mesangial basement is thickened due to the abnormal change of glomerular basement membrane charge. The permeability to albumin increased, and only the glomerular filtration rate increased in the early stage of diabetic nephropathy. Only in this way can microalbuminuria appear and blood pressure gradually increase. Compared with hypertensive patients, the blood pressure of diabetic patients is also170-180/100 mmhg. The average urinary albumin excretion of diabetic patients is 100 times higher than that of hypertensive patients. Therefore, urinary microalbumin excretion rate is more sensitive and important for evaluating early diabetic nephropathy. When hypertension complicated with diabetes mellitus, urinary albumin excretion increases linearly and the prognosis is poor.

(3) Many clinical drug studies take the excretion of microalbumin as an index to observe the protective effect of drugs on kidney, such as the new international APRIE test of invertase inhibitor Lotine, and the treatment of various patients with renal failure. In addition to the most commonly used urinary microalbumin excretion to reflect glomerular lesions, NAG and RBP are also indicators to reflect renal tubular function. NAG is an enzyme, mainly derived from renal proximal convoluted tubule epithelial cells. RBP is a binding protein, and its content reflects the renal tubular reabsorption function. When they increase, it indicates that renal tubular reabsorption function is impaired due to hypertension or diabetes. Up to now, urinary microalbumin excretion is not only used to detect renal lesions, but also considered as an independent index to predict the damage of small blood vessels in patients with hypertension, which is more sensitive than the changes of fundus retina.

Reasons why it is difficult for obese people to recover after losing weight.

2. Obesity plays an important role in the occurrence and maintenance of hypertension through volume load, insulin resistance, increased sympathetic nerve activity, changes in peripheral resistance vessels, changes in renin-angiotensin system and atrial natriuretic peptide, and differences in steroid hormones.

It is found that the blood sugar, insulin and C-peptide values of obese people are significantly higher than those of non-obese people. Genetic factors and overweight have additive effects on insulin resistance, insulin resistance or hyperinsulinemia.

Responder: Total Feces-Trainee Magician II 1 1-25 20:02

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Normal blood pressure: systolic blood pressure

1999 domestic diagnostic and classification standard of hypertension adopted by the world health organization and the world hypertension union: ideal blood pressure: systolic blood pressure.

Defendant: kenji sun- Assistant II 12-6 22:45.

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