【Fan Submission】Mr. Zhang (pseudonym), 34 years old, has always been praised for his health and vitality, but he suddenly collapsed during a morning run and passed away despite medical treatment. His family and friends found it hard to accept the sudden death of such a young and robust person. According to his family, Mr. Zhang had previously visited the hospital for high blood pressure, and the doctor told him, “If your blood pressure is normal, you don’t need to take antihypertensive medication regularly. Pay attention to your lifestyle habits and slowly adjust, and you will be fine.”
This advice raised doubts among Mr. Zhang’s family members. They believed that if medication had been used earlier, this tragedy could have been avoided. In response, Dr. Wang stated that based on Mr. Zhang’s condition at the time and the absence of other cardiovascular risk factors, his advice aligned with medical guidelines. However, educational materials indicate that only when blood pressure remains stable below 140/90 mmHg and there are no other cardiovascular risk factors may there be no need for antihypertensive medication. The doctor mentioned that not monitoring blood pressure and not taking antihypertensive medication before going for a morning run was a significant factor leading to a cerebral hemorrhage.
Mr. Zhang’s wife, Ms. Chen (pseudonym), is now calling for stricter medical guidance to prevent similar tragedies from happening again. She stated, “This sudden death is hard to accept. With stricter medical guidelines, perhaps such incidents can be prevented.” Ms. Chen has contacted several hypertension and cardiovascular disease experts, started sharing popular science knowledge about hypertension on social media and within the community, particularly focusing on guidelines for when to take antihypertensive medication.
I. Hypertension and Morning Runs
Hypertension refers to the sustained rise in blood pressure, exceeding 140/90 mmHg. It is a common modern-day disease and a major risk factor for cardiovascular and cerebrovascular diseases. With increased life stress, irregular routines, and dietary changes, many young people have joined the ranks of hypertension patients.
While morning runs are considered a healthy form of exercise, for hypertensive patients, vigorous exercise may trigger heart disease, cerebrovascular accidents, etc., especially without prior regular exercise.
II. Is It Really Okay Not to Take Medication?
The treatment of hypertension is multifaceted, not just relying on antihypertensive drugs. Indeed, for some hypertensive patients, doctors may advise them not to rush into medication but to control blood pressure through lifestyle adjustments. However, this does not mean that all hypertensive patients can go without medication.
Hypertensive patients who meet the following criteria may not need immediate antihypertensive medication:
1. Mild hypertension:
When diagnosed with hypertension for the first time, if the blood pressure falls within the range of mild hypertension and the patient does not have other comorbidities, doctors may suggest attempting to control blood pressure through lifestyle changes.
2. Absence of target organ damage:
Even if blood pressure is high, if after examination, target organs such as the heart, brain, kidneys, etc., do not show damage or functional abnormalities, doctors may adopt a wait-and-see approach, recommending the patient to improve lifestyle habits.
3. No complications:
If the patient does not have comorbidities such as diabetes, coronary heart disease, heart failure, etc., immediate medication may not be necessary.
4. Temporary hypertension:
Under certain circumstances such as stress, anxiety, temporary physical labor, etc., blood pressure may temporarily rise. In such cases, if blood pressure returns to normal after a period of observation, medication may not be necessary.
5. Lifestyle intervention:
For patients willing and able to adjust their lifestyle habits, such as improving diet, increasing exercise, quitting smoking and alcohol, losing weight, reducing salt intake, etc., doctors may suggest trying these methods for a period to observe changes in blood pressure.
III. Doctor’s Advice
1. Increased cardiovascular risk:
Hypertension leads to constant high-pressure impact on blood vessels, which over time may cause vessel hardening, narrowing, leading to myocardial infarction, cerebral infarction, or cerebral hemorrhage. This emphasizes the importance of well-controlled blood pressure.
2. Importance of lifestyle:
There is a common misconception among many that simply taking antihypertensive medication controls hypertension. Lifestyle changes play an indispensable role in this treatment. Controlling diet, reducing intake of high-salt, high-fat, high-sugar foods; moderate exercise for physical exertion and relaxation; maintaining regular sleep patterns; and adjusting emotions rationally to avoid excessive anxiety and suppression. All these contribute to maintaining stable blood pressure levels.
3. Exercise should be individualized:
Exercise is a double-edged sword for hypertensive patients. Moderate exercise can help control blood pressure, but intense exercise may be harmful for some patients. Especially for those who have been inactive for a long time and suddenly engage in intense exercise, it may increase the burden on the heart and brain, leading to adverse events. Hypertensive patients should seek medical advice when choosing the type of exercise and adjust according to their physical condition.
Health is everyone’s responsibility. For chronic diseases like hypertension, we must not be complacent or blindly follow trends. Depending on our own physical condition and combining medical advice, we should choose appropriate treatment plans to safeguard our health.
