The colder the weather, the greater the blood pressure fluctuations are likely to be. Therefore, in the cardiovascular medicine department in winter, there are always many patients who come to seek help with self-reported "uncontrolled blood pressure".

Zhang Yi, director of the Hypertension Center and chief physician of the Department of Cardiovascular Medicine of the Tenth People's Hospital Affiliated to Tongji University, told reporters: "Middle-aged and elderly patients often ask, why are the blood pressure values different from those measured continuously? Why does the blood pressure vary from device to device? How to choose high blood pressure medication? This shows that many people still have misunderstandings about measuring blood pressure and controlling blood pressure. ”

Why can't I measure my blood pressure at home?

Lao Li walked into the outpatient clinic angrily and took out two blood pressure monitors from his handbag, "This is what my son bought from the Internet, one is expensive and the other is cheap, and the results are not accurate, and they are different from those measured in the hospital, doctor, you can help me see, what is the reason?" Zhang Yi looked at the two blood pressure monitors, the product information was complete, and the quality was no problem. I see that the blood pressure monitor is fine, maybe the measurement method is wrong. Zhang Yi said with a smile.

"When measuring blood pressure, the most correct posture is to sit calmly in a chair with a backrest for 3 minutes, during which time you cannot speak, with your feet flat on the ground, measuring your arms on a supported table, and keeping the cuffs of your arms at the same height as your heart. If you measure in winter, don't roll up your sleeves and tightly wrap your upper arms, as this will affect the value. Zhang Yi told Lao Li that many patients think that blood pressure measurement in the hospital is more standard, but in fact, it may not be. The hospital environment is noisy, and some patients are nervous as soon as they arrive at the hospital. There is a type of high blood pressure called "white coat hypertension", which means that if the value is high in the hospital, it will be normal when you go home. This kind of hypertension cannot be diagnosed immediately as hypertension, so it is recommended to do ambulatory blood pressure monitoring, or measure blood pressure at home, and insist on writing a "blood pressure diary" to record your blood pressure for a week or a month.

The inaccurate measurement of blood pressure at home may be related to the product, such as the upper arm and wrist, which may be different; It may also be related to the timing of the measurement, and blood pressure may fluctuate at different times of the day. Zhang Yi said that the fasting blood pressure before taking medicine in the early morning is the most important thing in the day, and we generally recommend that we measure blood pressure on an empty stomach before getting up in the morning to take medicine, then take antihypertensive drugs, and finally eat breakfast.

Generally speaking, it is recommended to measure blood pressure 10-0 times, and it may not be accurate to measure it only once. If the first and second blood pressure measurements are close and the difference is less than 0 mmHg, there is no need for another test; If the difference between the two is more than 0 mmHg, a third blood pressure test is recommended. But don't measure your blood pressure too often, some people measure their blood pressure more than a dozen times a day, but they are prone to anxiety.

As for the choice of blood pressure monitor, Zhang Yi said that as long as it is a regular brand, it can be. Electronic sphygmomanometer is a mainstream product for hospital and home use, and the most recommended is the home upper arm electronic sphygmomanometer. Mercury sphygmomanometers are not suitable for home measurements because they are demanding, difficult to maintain, and present a risk of mercury contamination.

Is high blood pressure related to snoring?

How much blood pressure is considered high blood pressure? Zhang Yi said that although there was a controversy in the medical community about the diagnostic criteria for hypertension a few years ago, 80/0mmHg is still basically unified as the standard for diagnosing hypertension in clinical practice. However, a systolic blood pressure of 0 mmHg and a diastolic blood pressure of 0 mmHg or less are ideal.

At the Digital Hypertension Management Center of Shanghai Tenth Hospital, Zhang Yi opened a hypertensive precision treatment clinic to help patients clarify whether they have hypertension and what drugs they should choose. "There are many choices of high blood pressure medicines, and there are generally two criteria for whether it is good or not, the first is to take medicine at a fixed time every day, and blood pressure can be effectively controlled at a normal level; The second is that the patient is not uncomfortable after taking this medicine. "At present, many antihypertensive drug options belong to "one pair of shoes fits all feet", which does not distinguish the specific cause of hypertension for each person; However, it is more desirable to find the main cause of the individual's blood pressure increase, and carry out targeted drug selection to achieve precise treatment. In addition, long-term elevated blood pressure itself will damage organs such as the heart, brain, kidneys, and large blood vessels, and it is also necessary to pay attention to protecting organs while lowering blood pressure when choosing drugs, and even to achieve a reversal of organ damage.

Mr. Shang, who is 30 years old, has a history of hypertension for 0 years, has been taking medicine regularly, but the blood pressure control is not ideal, and there is no systematic assessment of early cardiovascular organ damage, so Zhang Yi prescribed him a one-week home "blood pressure diary" and "early cardiovascular organ damage assessment" package. The results showed that the patient's blood pressure fluctuated around 0-0/0-0mmHg in the 0-week blood pressure diary, and due to long-term hypertension, the ratio of urine trace protein to urine creatinine reached 0mg/g, which was higher than the normal standard of 0mg/g. Based on the patient's blood pressure and urine microprotein levels, Zhang Yi adjusted the antihypertensive medication for him. After three months of treatment, the patient's blood pressure not only reached the target, but also the urine trace protein was reduced, achieving the therapeutic effect of lowering blood pressure and organ protection.

There is also a 4-year-old Mr. Zhao, who is obese and found that his blood pressure has increased for more than 0 months, and he has not been able to find the reason. "Do you snore in your sleep?" The doctor seemed to ask casually, but Mr. Zhao didn't understand, "I snore badly, but what does this have to do with high blood pressure?" ”

"Maybe that's the root of your high blood pressure!" Zhang Yi prescribed a "Hypertension Etiology Examination Package" for Mr. Zhao, which basically ruled out secondary hypertension, but found that his elevated blood pressure was related to metabolic and nocturnal sleep apnea syndrome (OSAS). "We equipped the patient with a mask for positive pressure breathing to improve the hypoxia at night, and encouraged him to lose weight, low-salt diet, after 1 months of intervention, the patient's antihypertensive medication was reduced from 0 to half a pill, until later he did not need to take antihypertensive drugs at all." Zhang Yi said that in the etiological treatment of hypertension, lifestyle intervention is very important, and some hypertension with a clear cause can even be cured.

Can "blood pressure foods" lower blood pressure?

Dietary intervention is also a topic of concern for many patients with high blood pressure. People often ask in the outpatient clinic, "Doctor, does eating this food have a blood pressure lowering effect?" "They were very interested in "10 Best Foods to Lower Blood Pressure, Have You Eaten It?" "Antihypertensive Diet Therapy That Doesn't Cost Money, Quickly Transfer to Parents" and other articles are convinced. Zhang Yi encountered many patients' children complaining, "My dad believed in celery to lower blood pressure, and took celery as a life-saving medicine every day, I wanted to ......vomit when I saw celery" "My blood pressure is a little high, my mother asked me to drink celery juice and bitter gourd juice, and only I know my bitterness!" ”

Blood pressure is indeed related to diet, but there is no single food that can clearly lower blood pressure; The only antihypertensive drugs that have a definite antihypertensive effect are available. Zhang Yi told reporters that most of the so-called "blood pressure foods" are partial generalizations, and more importantly, the overall diet and lifestyle improvement.

Therefore, don't blindly follow the trend, especially because you believe that food can lower blood pressure, so you stop the drug or reduce the amount of medicine without authorization, which is very dangerous, it is easy to lead to abnormal fluctuations and increases in blood pressure, and if the blood pressure remains high, it is easy to induce complications such as arteriosclerosis, coronary heart disease, and stroke.

"Patients with high blood pressure should have a reasonable diet, not to grasp a certain food to eat every day and eat it every day, but to make the whole diet in a low-fat, low-salt, high-calcium and low-calorie state through reasonable collocation, so as to lower blood pressure." For example, saltier foods contain a lot of sodium salt, which can raise blood pressure, Zhang said. Foods high in potassium can promote the excretion of sodium and play a certain role in lowering blood pressure. Therefore, it is recommended to use high potassium and low salt when cooking at home, and try to eat less heavy-tasting takeaways. (Reporter Zuo Yan)