Hypertension medical dissertation review

In the field of medicine, hypertension is the most common chronic disease and the most important risk factor for cardiovascular disease. The following is what I have compiled for you about hypertension medical dissertation, welcome to read and refer to!

Hypertension medical paper 1

An introduction to hypertension health guidance

Abstract: Hypertension is an important chronic disease that jeopardizes the physical and mental health of human beings, and its prevalence in the middle-aged and elderly populations, it is the most important hazardous factor causing cardiovascular accidents and strokes, and at the same time, it also triggers chronic occlusive peripheral vascular disease and congestive heart failure, renal failure and aneurysms. According to the results of three large-scale national hypertension census, China's age over 65 years of age in the population suffering from hypertension is about 35%, of which 67.5% of the patients' blood pressure is not under control, and the reasons for this include arbitrary increase or decrease in the amount of medication, not regular medication, arbitrary change of medication, in order to measure the blood pressure or regular medication for a period of time after the blood pressure is normal to stop taking the medication, the performance of the symptoms of the medication when the medication, and so on, the emergence of the medication - stopping the medication - the medication cycle. The cycle of medication taking - stopping - medication taking. Therefore, in the care and treatment of hypertensive patients not only need to consider its causes and clinical symptoms, but also take into account the individual patient's situation, to develop a targeted and appropriate health guidance program for individual patients with hypertension, and effectively carry out health education, so as to improve the self-care awareness of patients with hypertension and adherence to the treatment.

Keywords: hypertension; health guidance

1 Concept of hypertension

Hypertension is the persistent elevation of systolic and/or diastolic blood pressure in the arteries of the body circulation.

2 Diagnostic criteria for hypertension

At present, China adopts the internationally standardized diagnostic criteria, that is, under non-pharmacological conditions, two or more consecutive non-same-day repeated measurements of blood pressure values up to the systolic blood pressure of ?140 mmHg and/or diastolic blood pressure of ?90 mmHg.

3 Grading of hypertension

3.1 How to grade hypertensionHypertension is divided into three categories: (1) primary arterial blood pressure (PAP), (2) secondary arterial blood pressure (SBP) and (3) diastolic blood pressure (DP). etiology is divided into: ① primary hypertension (hypertension) 95% of hypertension belongs to this situation, generally middle-aged and elderly people's hypertension is this kind of hypertension, antihypertensive treatment to protect the vital organs on the line; ② secondary hypertension (symptomatic hypertension) accounted for 5% of the most common is the kidney is not good for the patient.

3.2 According to the different degrees of blood pressure elevation, hypertension is divided into 3 levels. Critical hypertension: systolic blood pressure 140~150mmHg; diastolic blood pressure 90~95mmHg; hypertension level 1 (mild): systolic blood pressure 140~159mmHg; diastolic blood pressure 90~99mmHg; hypertension level 2 (moderate): systolic blood pressure 160~179mmHg; diastolic blood pressure 100~109mmHg; hypertension level 3 (severe): systolic blood pressure? Systolic simple hypertension: systolic blood pressure 140mmHg; diastolic blood pressure <90mmHg. Note: If the patient's diastolic blood pressure and systolic blood pressure belongs to different grades, the higher grade shall prevail; systolic simple hypertension can also be divided into 1, 2, 3 according to the level of systolic blood pressure. Hypertension is a major threat to the health of modern people. Experts pointed out that 90% of hypertension is primary hypertension, can not find a clear cause of the disease, in addition, there are 10% is caused by other diseases of hypertension, such as pregnancy toxicosis, endocrine diseases, renal diseases, aortic diseases and intracranial diseases, etc., will trigger varying degrees of high blood pressure. When treating the latter, it is important not to use antihypertensive drugs, but to treat the primary disease first. For primary hypertension, patients need to be prepared for a life-long "fight".

4 health guidance content

4.1 to establish good habits ① to maintain regularity of life, to develop the habit of working and resting on time, to ensure that moderate activity and adequate sleep; ② to quit some bad habits, such as smoking, drinking, hard to defecate and sedentary television, etc., to clearly inform the patient of such bad habits are more likely to lead to hypertension and its causes of complications. Encourage them to quit smoking and establish a regular life, regular and irrational defecation, and for those who are constipated, instruct them to prevent constipation. Instruct patients to keep warm to prevent colds and prevent cardiovascular and cerebrovascular diseases, etc.; ③Control patients' salt intake: salt intake should be no more than 5g/d, and it is best to use low-calorie, low-fat light food to ensure adequate protein, and use more fresh fruits and vegetables that are rich in calcium and potassium. Diet should be coarse and fine grains, eat less and more meals; ④ Obese patients with hypertension should strictly control or reduce their weight. Obesity is a risk factor for the progression of hypertension, and attention should be paid to reducing weight, restricting the amount of food, eating less and more meals, and increasing the amount of daily activities. Dietary principles are based on low salt, low cholesterol and low fat.

4.2 Reasonable medication guidance ① irregular medication or ideological attention to patients, focusing on medication irregularity may produce harm, while urging patients to establish a good habit of medication; ② hypertensive patients often need to continue to take medication or lifelong medication for treatment, patients should be instructed to comply with the doctor's instructions to take medication on time and in accordance with the dosage, and remember not to arbitrarily increase or decrease the amount of medication or stop using. At the same time to tell the patient the dose of drugs taken, method, time, name, precautions, safety, side effects and other knowledge and corresponding measures, etc.; ③ In addition to acute hypertension, lowering blood pressure to a few days, weeks, gradually lowering blood pressure for the best, especially the elderly and patients with a history of hypertension for many years, the body has adapted to the current level of high blood pressure, a sudden lowering of blood pressure rather than beneficial.

4.3 Psychological factors guide the acceleration of the pace of social life, work pressure increases, people continue to be in a state of tension, sudden psychological stress response, may be very likely to trigger peripheral vasoconstriction, tachycardia, etc., the patient's cardiovascular system has a serious adverse effect, resulting in a number of cardiovascular diseases. Hypertensive patients are often emotionally unstable, nervous, agitated, anxious, over-fatigued, etc., which will prompt further sympathetic nerve excitation in the body, the body produces a large amount of cortisol, 5-hydroxytryptophan, vasopressin, catecholamines and other secretions to increase, the above substances will prompt the patient to spasm of the small arteries, so that the vasoconstriction of blood vessels, heartbeat accelerated, blood pressure increased significantly. Therefore, it is particularly important to instruct hypertensive patients to make reasonable and appropriate arrangements for their work, study, life and rest time, and to maintain a better state of mind and mood for their condition, so they should be easy-going and open-minded.

5 hypertension rest and exercise guidance

Should pay attention to rest, avoid exertion, in addition to active treatment and maintain an optimistic mood, but also in the stabilization of the condition of the active fitness for their own physical condition after exercise should pay attention to the gradual and orderly progress, long-term persistence. It is recommended that at least 30min/d aerobic exercise can make the physical condition improve gradually. When choosing exercise methods, hypertensive patients should not choose strenuous and exercise program with large amount of exercise. Walking and jogging are good methods of exercise. Exercise intensity: Maintain a moderate degree of below, i.e., pulse (220-age), or quiet heart rate +20 beats. The degree of conscious exertion is slightly tired and slightly sweaty; it is appropriate to have no discomfort and can be conversational. Exercise duration: at least 3~5 times/w, preferably accompanied by someone, in case of discomfort, timely consultation. Less than 2d/w exercise effect is not good, more than 5d/w exercise effect no longer increase.

5.1 Teaching patients to measure their own blood pressure Self-measurement of blood pressure is the measurement of blood pressure at home or in other settings. Self-measurement of blood pressure provides relatively more valuable information about blood pressure in daily life situations and is an important complement to the diagnosis of blood pressure. The diagnostic value of blood pressure is generally higher than the self-measurement value. It is recommended that patients measure their own blood pressure for 3d/w, once in the early morning and once in the evening at 7-8 pm, taking the average of the first three measurements.

5.2 Correct and on-time blood pressure measurement Changes in body position or food digestion have a certain degree of influence on the blood pressure measurement value, therefore, the blood pressure should be measured after 1h of meals, after 30min of smoking or quoting coffee or strong tea, and after 5min of resting or sitting. Since different positions, such as lying, standing and sitting, can also cause changes in blood pressure measurements, it is recommended that blood pressure be measured in the standing position. In the hot summer months or when the room temperature is high, the actual measurement of blood pressure is also affected to a certain extent, and in this case, the measurement of blood pressure needs to take into account the ambient temperature and other factors.

Summary

Hypertension is a long-term, frequent chronic disease, but also one of the psychosomatic diseases, patients need to maintain a firm perseverance, optimism and confidence in overcoming the disease. It is particularly important to provide comprehensive and integrated health guidance to patients with hypertension. Through detailed health guidance, patients and their families can be prompted to have a comprehensive and correct understanding of the disease, and have comprehensive knowledge of prevention and health care, so as to achieve the purpose of controlling blood pressure, reducing complications and improving the quality of life.

Hypertension medical dissertation 2

An introduction to the causes of hypertension

Hypertension has a variety of causes, the most important of which is now widely recognized as the cause of hypertension is genetic, after the investigation of the family of hypertension, the chances of the progeny of hypertension is very high, which is supposed to be related to their own genes. Causes of hypertension and acquired factors, such as the improvement of people's standard of living in recent years, the level of diet is also rising, psychological pressure, drugs and other factors so that the incidence of hypertension is increasing year by year, the age of the younger and younger, in order to more effective prevention of hypertension, the author on the formation of high blood pressure reasons to talk about their own views.

1 The etiology and pathogenesis of primary hypertension have not been fully understood, in recent years, with the development of physiology, genetics, neuroendocrinology and molecular biology, as well as the establishment of a rat model of spontaneous hypertension, many studies have reached the molecular level. At present, the mosaics of Page's theory are more comprehensive, and it is believed that hypertension is not caused by a single factor, but by a variety of factors that interact with each other.

1.1 Genetic factors. About 75% of patients with primary hypertension have hereditary qualities, and there is often a concentration of hypertensive patients in the same family. Primary hypertension is believed to be a polygenic genetic disease. Hypertensive patients and those with a family history of hypertension and normal blood pressure have transmembrane electrolyte transport disorders, and there is a hormone-like substance in their serum that inhibits Na+/K+-ATPase activity such that the sodium-potassium pump function is reduced, leading to increased intracellular Na+ and Ca2+ concentrations, enhanced SMC contraction of the arterial wall, increased adrenergic receptor density, and enhanced vascular reactivity. All of these contribute to elevated arterial blood pressure. Recent studies have found that there may be 15 defects in the angiotensin (AGT) gene, with occasional defects seen in normotensive individuals and hypertensive patients having the same variant in all 3 specific sites on the AGT gene. A brother or sister with hypertension may acquire the same copy of the AGT gene from their parents. Hypertensive patients with this genetic defect have higher than normal plasma angiotensinogen levels.

1.2 Personality factors Hypertension has been found to be closely related to personality and psychology. People who are easily impatient, easily angry, and easily agitated are prone to hypertension. These manifestations make the body's adrenaline, norepinephrine, dopamine and insulin secretion significantly higher than normal. These substances excite the nervous system, increase the heart rate and constrict blood vessels. Blood pressure rises, and over time, people are prone to hypertension.

1.3 Excessive psychological pressure is also a factor in the occurrence of hypertension. Social and economic development, resulting in increasingly fierce competition, work pressure, interpersonal tension, so that people's nerves are often in a tense state, it is easy to cause excessive sympathetic excitability. The performance of the work of the fire, tachycardia (> 80 times / min), resulting in increased blood pressure. This situation is prevalent in society, but also induced a variety of diseases at the root, people in the busy life to learn to release pressure, in order to stay away from a variety of diseases.

2 Dietary and lifestyle habits

2.1 Drinking large amounts of alcohol

With the improvement of people's standard of living, drinking has become very common in every household, but drinking large amounts of alcohol is indeed the root cause of inviting diseases, long-term large amounts of alcohol, more than 40% of the people will have high blood pressure. And it is easy to have a stroke. Excessive drinking is also prone to induce stroke, myocardial infarction, hypertension, alcoholic liver disease, pancreatitis, femoral head necrosis and other diseases.

2.2 Smoking

Smoking is also an important factor leading to high blood pressure, now many young people in order to play cool from a very young to start smoking, in fact, this is a very bad phenomenon, the country has begun to explicitly prohibit smoking. Smoking in the coronary heart disease risk percentage of 32%, second only to high blood pressure (about 35%), high blood pressure is the most important coronary heart disease causative factors. Not only that, smoking is also prone to stroke, cerebrovascular lesions and other various cardiovascular diseases, so you want to stay away from cardiovascular diseases must quit smoking.

2.3 Eat a lot of salt

Chinese people's diet is generally more salty, salt will not only increase blood pressure, but also damage the inner wall of the blood vessels, damage to the endothelial cells, damage to the small blood vessels of the hazards of the visible salt has become a recognized killer. So the prevention of hypertension, salt reduction has been imperative.

2.4 The results of the study on the effect of cooking oil on high blood pressure show that cooking with sunflower oil has a higher risk of causing high blood pressure, while consuming olive oil helps to keep one's blood pressure healthy. Even though olive oil is generally recognized as a good cooking oil for health, repeated use of used olive oil can still have adverse health effects the more polymers there are in the cooking oil, the more likely it is to cause high blood pressure in those who consume it.

The results of the study showed that people who had high blood lipids were less likely to develop high blood pressure after using olive oil than after using other types of cooking oil. Olive oil produces fewer polymers than other types of cooking oils for the same repeated use. This indicates that olive oil deteriorates more slowly than other oils. Therefore, it is recommended that people use olive oil in cooking whenever possible, and that they do not reuse used oil more than three times at the most.

Since olive oil is more expensive, many people still prefer other cheaper cooking oils, or blends. However, in order to maintain healthy blood pressure, especially for those with a high prevalence of hypertension, it is still a good idea to spend a little more money on health in the long run.

So, it is recommended to treat fried food to adhere to the principle of moderation, cooking oil should not be used over and over again, in the choice of cooking oil do not covet a moment's cheap, after all, for us, health is priceless, to maintain a healthy body, in order to better enjoy life. 2.5 Eat well, lack of exercise

The improvement of people's living standards, the level of diet is also rising, vegetables, fruits, meat and other diets have become more and more diversified, but the busy life of the people generally lack of exercise, which is why more and more people produce obesity, and the probability of obese people suffering from high blood pressure will be very large. According to clinical statistics: the likelihood of hypertension in people who are not obese is 15%, while the likelihood of hypertension in obese people is as high as 40%.

3 Now is an Internet-rich era, and large-scale network games have become the favorite of the children, over-indulgence in online games not only delay the children's schooling, but also seriously affect the children's health, especially hypertension, it is easy to find these children who play games all day long. Although many parents try to stop their children from overindulging in games, it still does not help. High blood pressure and children playing games seem and distant, but in fact has a very close relationship.

3.1 Hypertension used to be a disease of the elderly, but now more and more become younger and younger, so the probability of children and young people suffering from hypertension is also very high, the main reason for children to suffer from high blood pressure is the emotional tension, it is clear that, if the long-term playing of games to make the child's emotional tension, according to the U.S. public **** Health Center scientists found that video games and children's hypertension has a close link. According to scientists at the Center for Public **** Health, video games are closely linked to high blood pressure in children. When children play video games, the magnitude of the increase in blood pressure is also much larger; parents with high blood pressure or heart disease children play video games, than those whose parents have normal blood pressure children's blood pressure rises faster and more.

3.2 Children are in the stage of growing body, brain, central nervous system is in the development of imperfect period, it is easy to be excited, for the fragile children's nerves, long time by the stimulation of video games, will make the cerebral cortex excitation and inhibition imbalance, easy to be in the subcortical vascular relaxation center to form vascular contraction of nerve impulses dominated by the excitation of the foci, caused by systemic spasm of the small arteries and the peripheral resistance, resulting in increased blood pressure. The result is an increase in blood pressure.

3.3 Excessive stimulation of the game will cause disorders of the vegetative nervous system, malfunctioning of regulation, causing changes in the body fluid endocrine hormones. Sympathetic nerve excitation prompts the adrenal medulla to secrete too much adrenaline and norepinephrine, leading to increased blood pressure. Prolonged spasm of small arterial vessels and poor blood circulation lead to organ ischemia, especially when renal ischemia, glomerular paraglomerular cell secretion of renin increases, and enters the body circulation after the action of the angiotensinogen, the formation of angiotensin Ⅰ and Ⅱ, which aggravates the systemic spasm of small arteries. At the same time, it will also promote the aldosterone secretion increase, sodium and water retention, so that the blood volume increases, so that the blood pressure stubbornly rise.

As you can see, the game has its advantages and disadvantages, moderate play games can make people relax, if the long-term play, it will seriously affect the child's health, and even bring hypertension disease, parents must be stopped. If one of the parents suffers from high blood pressure, parents must learn to regulate the child's emotions, so as not to trigger high blood pressure in the body.

4 Due to improper medical treatment caused by hypertension, clinical usually called drug hypertension. There are several types of drugs that cause hypertension in the clinic.

4.1 Hormonal drugs: such as prednisone, dexamethasone, methyl or propyl testosterone. These drugs can cause sodium retention, leading to increased circulating blood volume and hypertension. Thyroid hormone drugs, on the other hand, can excite the nervous system, causing an increase in blood pressure.

4.2 Oral contraceptives: such as estradiol, on the one hand, can cause plasma vascular tension, prompting vasoconstriction, elevated blood pressure, on the other hand, because of its role as a saline corticosteroid, so it can be a direct effect on the renal tubules and cause sodium retention and elevated blood pressure.

4.3 Analgesic drugs: such as anti-inflammatory pain, inflammatory pain, such as Xikang, POTASONE, etc., in addition to causing sodium retention, but also inhibit the synthesis of prostaglandins, so that the vasoconstriction of blood vessels tends to lead to high blood pressure.

4.4 Other drugs: such as epinephrine, norepinephrine, Ritalin, doxorubicin and the Chinese medicine licorice. In addition, certain antihypertensive drugs can also cause hypertension, such as the commonly used methyldopa, guanethidine, etc., when injected intravenously has the potential to cause hypertension. It is worth noting that, when taking antihypertensive drugs eugenol, if eating food containing tyramine, such as cheese, animal liver, chocolate, milk, red grapes, etc., the blood pressure not only does not fall, but will greatly increase, and even hypertensive crisis, cerebral hemorrhage; and suddenly stop using some antihypertensive drugs, such as cardiac glycosides, chloroquat chloride, methyldopa and so on, can also cause the same serious consequences.

It can be seen? The drug is three times poisonous? The high blood pressure patients must avoid the use of the above drugs, if they have to use, must grasp the degree of moderation, hope that the majority of patients in the clinic try to use other methods of treatment, do not overly rely on medication, so as not to lead to the development of the disease in the opposite direction.

These bad habits believe that many people have, and these habits are very likely to cause high blood pressure, I hope that we can correct these shortcomings in time, away from high blood pressure.

Hypertension medical dissertation 3

A brief discussion of anti-hypertensive treatment of elderly hypertensive patients

Abstract: Purpose: To summarize the characteristics of hypertension in the elderly. METHODS: 120 cases of primary hypertension in the elderly admitted to our hospital were analyzed. RESULTS: The patients all reached the initial target blood pressure, most mild hypertensive patients in grade 1 needed to apply 1 or 2 antihypertensive drugs, and a few needed to apply 3 drugs in combination to reach the initial target blood pressure; a few moderate hypertensive patients in grade 2 needed to use 2 antihypertensive drugs in combination, and most needed to apply 3 drugs in combination to reach the target blood pressure. Conclusion: Grasping the indications of medication and actively treating with medication can improve patients' quality of life and reduce complications.

Keywords: essential hypertension, treatment, experience

Hypertension is the most common cardiovascular disease in China. With the change of people's living standards and dietary structure, its prevalence is increasing year by year. The prevention and treatment of hypertension has become an important issue for medical workers all over the world.

1 Objects and methods

1.1 Objects.

120 cases of elderly hypertensive patients admitted to our hospital, all of them meet the diagnostic criteria of hypertension set by WTO. Among them, 78 cases were male and 42 cases were female; age 60-79 years old, average (68?8) years old; disease duration 5-20 years, average (2?7) years; all of them were slowly progressive hypertension. Among them, 51 cases (41.8%) were grade 1 (mild) and 69 cases (58.2%) were grade 2 (moderate).Of the 120 cases, 63 cases (52%) were pure systolic hypertension, i.e., systolic blood pressure?160 mmHg (1 mmHg=0?133 kPa) and diastolic blood pressure<90 mm Hg.Secondary hypertension was excluded.

1.2 Treatment.

1.2.1 Efficacy judgment criteria to reduce blood pressure, so that the blood pressure to return to normal (<140/90 mm Hg) or ideal level (<120/80 mm Hg). In middle-aged and young patients (<60 years old), patients with hypertension combined with diabetes or kidney disease should have their blood pressure reduced to less than 130/80 mm Hg. In the elderly, it should be reduced to at least normal (140/90 mm Hg).

1.2.2 Treatment Methods The treatment methods used are basically based on drug therapy.

1.2.2.1 Diuretics include thiazides, potassium-sparing diuretics, and labeled diuretics. Thiazides are commonly used, including hydrochlorothiazide, but long-term use can cause a decrease in blood potassium and increase in blood glucose, blood uric acid, blood cholesterol, diabetes mellitus and hyperlipidemia patients should be cautious, and patients with gout are prohibited. ② potassium-preserving diuretics: commonly used drugs are amphotericin, spironolactone (Antibiotics) and so on. It can cause hyperkalemia, should not be combined with ACEI, and is prohibited in renal insufficiency. (iii) Diuretics: rapid diuresis, commonly used drugs are furosemide, tolatimide and so on. When renal insufficiency is applied more, but need to pay attention to low blood potassium, hypotension. ④Additionally introduced diuretic antihypertensive agent indapamide 25 mg, once a day, with diuretic and vasodilator effect, can effectively lower blood pressure, but long-term application can cause hypokalemia.

1.2.2.2 ? -receptor blockers this class of drugs has a good antihypertensive and antiarrhythmic effect, and can reduce myocardial oxygen consumption, suitable for mild and moderate hypertension, especially the faster heart rate of young and middle-aged patients, for the combination of coronary heart disease, angina pectoris and hypertension after myocardial infarction is more applicable. For the treatment of hypertension, most of the varieties with cardiac?1 selectivity, long-acting or slow-release are used, such as metoprolol 25 to 50 mg, 1 to 2 times a day; or bisoprolol 2.5 to 5.0 mg, 1 time a day. It is contraindicated in patients with heart block, asthma, chronic obstructive pulmonary disease and peripheral vascular disease. At the same time, this class of drugs has adverse effects on sugar and lipid metabolism, which should be taken into account when using. Long-term application should not be suddenly discontinued, so as to avoid a sudden rise in blood pressure.

1.2.2.3 Calcium antagonists can be used in moderate to severe hypertension, especially in systolic hypertension in the elderly. Calcium antagonists are verapamil, deltamethasone (non-dihydropyridine) and dihydropyridine 3 groups of drugs, the first 2 groups have the effect of inhibiting myocardial contraction and autoregulation and conduction. They should not be used in patients with heart failure, sinus node hypoplasia, or heart block. Dihydropyridines (e.g., nifedipine) act mainly by blocking vascular smooth muscle calcium channels, which can cause vasodilatation, and at the same time cause sympathetic activation, which is unfavorable to the prevention of coronary heart disease. However, extended-release, controlled-release or long-acting preparations of dihydropyridines, which significantly reduce the above side effects, can be used for long-term treatment. Nifedipine controlled-release tablets 30 mg once daily; or amlodipine 5 mg once daily; or felodipine extended-release tablets 5 mg once daily.

1.2.2.4 Angiotensin-converting enzyme inhibitors (ACEIs) have been shown to have some antihypertensive effect on various degrees of hypertension. Trials have confirmed that ACEI can improve ventricular remodeling, reduce the rate of rehospitalization for heart failure and mortality, and significantly delay the deterioration of renal function, so it is particularly suitable for patients with hypertension with heart failure, left ventricular hypertrophy, post myocardial infarction, impaired glucose tolerance or diabetic nephropathy proteinuria and other comorbidities. It is contraindicated in hyperkalemia, pregnancy, and renal artery stenosis. The most common adverse reaction is dry cough, which can disappear after stopping the drug.

1.2.2.5 Angiotensin II receptor blocker indications are the same as ACEI, but there is no dry cough, the antihypertensive effect is smooth, and can be used in combination with most antihypertensive drugs, such as chloretzane 50 to 100 mg, 1 time / d; valsartan 80 to 160 mg, 1 time / d; Irbesartan 150 to 300 mg, 1 time / d; candesartan 8 to 16 mg, 1 time / d; timisartan 8 to 16 mg, 1 time / d; timisartan 8 to 16 mg, 1 time / d; timisartan 1 time / d; timisartan 1 time / d; timisartan 1 time / d.

2 Results

All patients achieved the initial target blood pressure. Of the 51 patients with grade 1 mild hypertension, 44 cases (85.5%) required one or two antihypertensive medications, and 7 cases (13.7%) required a combination of three medications to achieve the initial target blood pressure; 18 of the 69 patients with grade 2 moderate hypertension (25.9%) required a combination of three medications to achieve the initial target blood pressure; and 18 of the 69 patients with grade 2 moderate hypertension (25.9%) required a combination of three medications to achieve the initial target blood pressure. (25.9%) needed to combine 2 antihypertensive drugs, and 51 cases (73?9%) needed to combine 3 drugs to achieve the target blood pressure.

3 Discussion

The results suggest that 112 cases (93.3%) of the elderly hypertensive patients were able to reduce to normal blood pressure without any discomfort after treatment, but there were still 8 cases (6.6%) of patients with obvious cerebral insufficiency of blood supply due to the relatively low blood pressure, and 1 case was even complicated by cerebral thrombosis, and this proportion tended to increase with the aggravation of the degree of hypertension. Although the difference was not statistically significant, there was one case of cerebral thrombosis in patients with grade 2 moderate hypertension, and these patients (except for one case of cerebral thrombosis) had their discomfort disappeared after their blood pressure was raised by reducing the dose of the medication. This suggests that the symptoms are related to insufficient cerebral perfusion due to relatively low blood pressure. Most of the elderly primary hypertension has different degrees of atherosclerosis, arterial wall elasticity and lumen narrowing, increased circulatory resistance, accompanied by different degrees of complications, blood pressure fluctuation, easy to produce postural hypotension. Therefore, in the process of antihypertensive treatment, small-dose joint application of antihypertensive drugs with different mechanisms of action can significantly increase the efficacy of antihypertensive therapy, offset each other or significantly reduce the adverse effects, but also extend the duration of antihypertensive effect and strengthen the protection of target organs. Individualization of treatment target blood pressure, the drug starts from a small dose and proceeds slowly, especially for the elderly, the adverse effects brought about by rapid blood pressure lowering should be avoided. In the process of lowering blood pressure, pay attention to the response of the elderly, not only pay attention to adjust the magnitude of lowering blood pressure, but also to control the speed of lowering blood pressure, otherwise it will lead to the heart, brain, kidneys and other organs of the blood perfusion pressure is reduced, blood flow is slow, causing ischemia and thrombosis.

References

[1] Huang, P.. New progress in the treatment of hypertension in the elderly[J]. Chinese Journal of Geriatrics,2004,23(1):60-62

[2] Tang Jinghua, Ma Guangren. New advances in the pharmacologic treatment of hypertension in the elderly[J]. Chinese Journal of Clinical Medical Research,2006,12(13):1811-1814

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