If someone asks you, how high is blood pressure to be considered high blood pressure? The most accurate answer is actually: it is difficult to give an accurate answer.
The "lethal power" of high blood pressure is greater than most people think. Coronary heart disease, myocardial infarction, cerebral infarction and other serious diseases that are audible and discolored may be induced by it, but in life, we seem to be accustomed to it. Think of it as a "state".
Mental stress and excessive exercise can cause blood pressure to rise; some people have blood pressure exceeding the standard all year round, but there is no discomfort. So, is high blood pressure a disease?
It sounds like this is not a problem at all. Many people think that hypertension is certainly a disease! You see, high blood pressure is so harmful, and antihypertensive drugs are even more diverse, and as long as a person detects high blood pressure, the doctor will definitely tell him, "Take medicine on time."
Taking medicine to treat diseases, hypertension is of course a disease.
And not only you, but many doctors also think so. Even if you read the most rigorous medical textbook, it will tell you-if the blood pressure rises steadily beyond a certain range, it is a definite disease called hypertension.
But in my opinion, if you think so, think of high blood pressure simply. Because whether it is the cause of the disease, the cause of the disease, or the treatment ideas, and the attitude towards it, hypertension is different from the disease in the conventional sense.
Using the model of "hypertension is a disease" to understand it will affect our understanding of it, which in turn affects prevention and treatment ideas.
Standards are artificial regulations
So, did you find that the standards for high blood pressure and conventional diseases are different. Its diagnostic criteria are completely artificially prescribed and are constantly changing. The regulations of different countries may not be the same.
More like the inevitability of aging
In addition, judging from the incidence of hypertension, it is difficult to define it as a disease. A disease in the conventional sense always has a cause.
For example, the new crown pneumonia is caused by the invasion of the new crown virus. If all the viruses are killed, people will recover. And high blood pressure, not exactly like this.
A statistics based on 90 countries around the world shows that the incidence of hypertension is about 31% for people aged 40 to 49; 45% for 50 to 59 years old; and more than 60% for 60 to 69 years old.
Data from the United States shows that by the age of 75, it is as high as 90%; and over 85 years old, the incidence of hypertension is almost 100%, and it is difficult to find people without high blood pressure.
What does this mean? This means that with age, the incidence of hypertension is getting higher and higher. So high as long as your life is long enough, high blood pressure is an event that must be experienced.
You said, what kind of disease does everyone get at a certain age? If everyone will get it, is it still a disease?
Enter an unstable environment
Finally, there is the danger of high blood pressure.
The diseases we usually talk about have clear and direct harm. Take the example of new coronary pneumonia. The new coronavirus continues to attack the human lungs, which can cause breathing difficulties and even organ failure.
This is not the case with high blood pressure. For our body, the increase in blood pressure is nothing new, and it is completely acceptable.
Whether it's running or being nervous during a speech, or even urinary urgency or constipation, blood pressure can rise. We don't know how many times our blood pressure will rise every day, but this is nothing, our body can easily cope with it.
However, although transient hypertension has no direct harm, if the blood pressure rises for a long time, it will aggravate the possibility of various complications in the human body. What are they? I will count them one by one.
First, it damages blood vessels. Long-term elevated blood pressure impacts the blood vessel wall, causing continuous physical damage to the blood vessel.
Specifically, after the blood vessel wall feels the continuous increase in blood pressure, in order to prevent yourself from being broken through, it will make yourself stronger through hyperplasia. We call this ability "vascular reconstruction".
It stands to reason that vascular reconstruction is to protect the blood vessels, but everything has advantages and disadvantages. The thick blood vessels appear to be strong, but they also become stiff and insensitive, which results in slower blood pressure regulation.
At the same time, the proliferating blood vessels do not grow outwards, but grow into the lumen, which makes the inner diameter of the blood vessels smaller. All of this means that the elasticity of the reconstructed blood vessels is getting worse, the inner diameter is getting thinner, and the blood pressure is naturally higher and higher.
This is not only caused by high blood pressure, but in turn it will further increase blood pressure, causing blood pressure to enter an uncontrollable positive feedback, which is getting higher and higher.
Moreover, by damaging blood vessels, continuous high blood pressure can indirectly damage the organs that rely on blood vessels for blood supply.
The specific principle is this: long-term high-pressure shock will cause damage to the endothelial cells on the blood vessel wall, and the body's immune system will come to help after realizing that it is injured here.
Just like a wound on our skin, the immune system will come to help stop the bleeding and sterilize it. However, the immune system does not repair this damage. Instead, the immune factors attack the wound for a long time, increasing the inflammation on the blood vessel wall.
Over time, it will greatly increase the chance of plaque forming in the blood vessels.
Plaque occurs on the blood vessels of the heart, which can lead to coronary heart disease; when it occurs on the blood vessels of the brain, it can lead to stroke; when it occurs on the blood vessels of the kidneys, it causes renal function decline; when it occurs in the blood vessels of the eyes, it can cause retinal hemorrhage , Vision loss, etc.
Therefore, to some extent, hypertension is more like a risk factor for these diseases than the disease itself.
How to define the standard of hypertension
After understanding the above, instead of treating hypertension simply as a disease, we can understand the various ideas of preventing, reversing, and treating hypertension in medicine.
For example, since hypertension is not a disease in the conventional sense, but an inevitability of aging, then we must determine its diagnostic threshold from the general law of blood pressure changes throughout the life cycle, and this threshold should also be relative personality化的.
First of all, the biggest factor affecting the threshold is age.
As mentioned earlier, the older the age, the higher the incidence of hypertension, so age itself is a risk factor for elevated blood pressure. When you are young, your blood pressure must be low; when you are older, you can relax the indicators.
For example, 25 to 35 years old, the satisfactory blood pressure should be 115/75, so as to leave room for the blood pressure increase caused by aging.
Before the age of 40, try not to exceed 120/80. Between the ages of 40 and 50, blood pressure generally increases, but the normal should be maintained at 125/80; before the age of 55, it should be under 135/85.
By the age of 65, staying at 140/90 is good. Because on the one hand, there is a high probability that the cerebrovascular is narrowed and hardened at this time. If the blood pressure is too low, the blood supply to the brain may be insufficient; on the other hand, even if the blood pressure is a little higher, it is not enough to accumulate real organ damage in a limited life.
In Japan, where aging is obvious, the Society of Hypertension even gives a blood pressure target of 150-160/90mmHg for 70 to 79 years old, and 170/90mmHg for 80 to 89 years old.
Secondly, define the blood pressure boundary value cannot leave the basal blood pressure.
Basal blood pressure is the average level of your blood pressure as an adult. Some people are born with low blood pressure, maybe only 90/60; some people are closer to the average, around 120/80 . This is your basic blood pressure.
The low point and high point of the basal blood pressure is not a big problem, because it is the steady state of your blood vessel adaptation, but if you leave this steady state too far, injury will inevitably occur.
Generally speaking, elevated basal blood pressure, systolic blood pressure exceeding 20mmHg, diastolic blood pressure exceeding 10mmHg, are also important indicators for judging hypertension. Regardless of the current blood pressure, as long as it exceeds this increase, the risk of stroke and coronary heart disease will more than double.
Finally, the threshold of blood pressure must meet the minimum value of its own blood supply.
I just said that when you are young, the lower your blood pressure, the better. But if it is low, there must be a bottom line. The bottom line is to meet the blood supply needs of oneself and to be able to fully complete the blood pressure required for work and life.
If the blood pressure standard is lowered blindly, individuals may not be able to keep up their energy all day due to insufficient blood supply, which will also increase unnecessary medical burden for society.
Every time I see the lowering of the blood pressure threshold, I think of my teacher Professor Han Qide's words "People are dissatisfied with modern medicine not because she has not done anything, but because she does not know when."
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