How to care for early-stage hypertension patients?

How to care for early-stage hypertension patients?

1. Lifestyle intervention. Implement the four measures advocated by the previously mentioned healthy lifestyle, and observe the decrease in blood pressure. If after 6 to 12 months of active lifestyle intervention, the systolic pressure is still ≥140mmHg or the diastolic pressure is ≥90mmHg, medication should be started. Otherwise, it is considered that the lifestyle intervention is effective, continue the intervention and closely monitor the changes in blood pressure, no need for anti-hypertensive drugs.
2. Treat related diseases. If early-stage patients are accompanied by diabetes, hyperlipidemia, gout, coronary heart disease, etc., corresponding treatments should be given. The target blood pressure value should be adjusted lower, usually lowering the systolic pressure by 10-20mmHg and the diastolic pressure by 5-10mmHg,Strive to achieve systolic blood pressure ≤ 120-130mmHg or diastolic blood pressure ≤ 80-85mmHg.
3. Drug-induced hypotension. Use anti-hypertensive drugs to control the blood pressure within the above target values.

How to self-care for confirmed patients?

1. Persist in lifestyle interventions.
2. Follow the four principles of standard treatment: maximize, rationalize, consider and persist. That is, try to reduce blood pressure to the normal target value through anti-hypertensive drugs; rational drug use, whether adding or reducing drugs, should be carried out under the guidance of doctors to avoid unnecessary complications; consider the treatment of other risk factors, protect the main organs from damage, and persist in treatment. Hypertensive patients usually need to take medication for life. Once hypertension treatment begins, it should not be interrupted arbitrarily.
3. Visit the doctor on time. After starting anti-hypertensive treatment, patients should regularly see the doctor according to their blood pressure levels and risk levels. If the patient’s blood pressure is only slightly elevated or within the normal range and there are no other risk factors, they only need to take one medication, and can visit the doctor once every 6 months. For more complicated cases, the interval should be shorter. If the blood pressure does not reach the target after 6 months of treatment, it is recommended to go to a hypertension specialist clinic. High-risk patients should visit the doctor every 3 months or shorter.
4. Monitor blood pressure and various risk factors, and keep good records. The treatment period for general hypertension patients is likely to be decades long, and the treatment plan may change many times, including the choice of drugs. It is recommended to record detailed information about the drugs used and their efficacy.

How to self-care for hypertension combined with diabetes?

Patients with type 2 diabetes have a higher incidence of hypertension than normal individuals, reaching up to 55.4%. Once a diabetic patient has hypertension, they are considered to be moderately high-risk and should take the following measures:

1. Active lifestyle intervention.
2. Initiation of medication.

• Keep blood pressure below 120/90mmHg.
• Preferably use long-acting anti-hypertensive drugs, while ensuring that the chosen medication does not affect glucose metabolism. Consider using small doses of long-acting diuretics or alpha-adrenergic blockers. Other options include calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor antagonists.

How to self-care for hypertension with renal impairment?

Patients with hypertension combined with renal impairment or microalbuminuria should pay special attention to the following:

1. More strict control of blood pressure. Aim for a level of 125/75mmHg.
2. Strive for a stable blood pressure reduction, without excessive urgency. Simultaneously monitor changes in renal function.
3. Any type of anti-hypertensive medication can be selected.