Often, when conducting preoperative visits with hypertensive patients and inquiring about the details of hypertension, patients tell us that although they have a history of hypertension in the past, their blood pressure is now normal after antihypertensive treatment, indicating that they no longer have hypertension. Some patients believe that if their blood pressure becomes normal after taking antihypertensive medication, they no longer need to continue taking it or monitor their blood pressure. Upon hearing this, I feel it is necessary to provide educational information to the hypertensive population. Therefore, in such cases, I spend extra time before surgery providing guidance.
In our country, the prevalence of hypertension is increasing year by year. Many hypertensive patients, due to lack of prominent symptoms in their daily lives, only discover their hypertension during medical examinations or when they experience symptoms like headaches, dizziness, fatigue, palpitations, or even a stroke, indicating that they have already had the condition for many years.
Due to insufficient knowledge about hypertension among the public, the awareness, treatment rate, and control rate of hypertension are relatively low. Prolonged hypertension leads to a high incidence of stroke, hemiplegia, heart failure, hypertensive nephropathy, and even death.
Normal blood pressure in individuals fluctuates slightly with environmental changes, and blood pressure levels gradually increase with age, especially the systolic pressure. The goal of lowering blood pressure is not only to maintain it at a moderate level but also to protect the vital organs such as the heart, brain, and kidneys. Different hypertensive patients have varying targets, measures, and medications for lowering blood pressure. Not everyone’s blood pressure should be below 140/90 mmHg. Generally, young people, as well as patients with diabetes or kidney disease, should aim for a blood pressure below 130/80 mmHg, while in elderly individuals with decreased vascular elasticity due to arteriosclerosis, a target of below 150/90 mmHg can be considered, or even below 140 mmHg if tolerated.
Whether individuals are low-risk, moderate-risk, or high-risk hypertensive patients, many believe that once their blood pressure is normal, everything is fine, and they no longer need to worry about their blood pressure or medication. However, hypertension requires long-term management and monitoring.
There are specific considerations when taking medication for hypertension. It is not appropriate to stop taking medication just because blood pressure is normal or to resume medication only when blood pressure increases again. Some individuals only take one or a few types of medication throughout the year or do not regularly monitor their blood pressure. Additionally, hypertension can be influenced by seasons, weather, sunrise, and sunset. In colder weather, blood vessels constrict, leading to a slight increase in blood pressure. In summer, blood vessels dilate, potentially lowering blood pressure, necessitating adjustments in medication for hypertensive patients according to seasonal variations. In the morning, with the transition from sleep to wakefulness and increased hormone levels, blood pressure can rapidly rise, increasing the risk of cardiovascular accidents. Therefore, it is generally recommended to take antihypertensive medication in the morning.
In addition to medication, controlling sodium intake, avoiding oily foods, weight management, increased physical activity, and maintaining a positive emotional state are all supportive measures for lowering blood pressure. Even after blood pressure has returned to normal with medication, if the medication is stopped without medical advice, blood pressure may fluctuate significantly due to environmental, temporal, or emotional factors. The majority of hypertensive patients experiencing complications are a result of inadequate blood pressure monitoring and suboptimal control.
In conclusion, lowering blood pressure is a long-term chronic process that requires patients to accept this condition. Gradual and consistent blood pressure reduction, long-term and continuous treatment with appropriate doses, and refraining from abruptly discontinuing medication or switching medications haphazardly are essential.
For our health’s sake, it is crucial to attentively listen to the advice provided by doctors!
