The incidence of hypertension among adults in China exceeds 20%, but the effective control rate is less than 30%. What is even more frustrating for doctors is that in recent years, there has been a trend of younger people developing hypertension, with many individuals under 45 also being affected, and the effective control rate among the younger population is even lower.
Why is the control rate of hypertension so low?
The reason for the low control rate is that the treatment of hypertension cannot rely solely on medication; it also requires lifestyle interventions to achieve effective control. While medication treatment has been widely accepted by many affected individuals, lifestyle interventions are often difficult for others to accept. Lifestyle interventions require significant changes in diet and habits, making it challenging for many individuals to adhere to. After all, it is difficult for our brains to make the right choice between immediate comfort and the distant threat of consequences.
However, in real life, the disasters caused by hypertension are not as distant as we might imagine. Dr. Zhang often encounters young individuals who have been hospitalized due to complications arising from hypertension, with some even losing their lives as a result.
What are the harms caused by uncontrolled hypertension on the body?
If hypertension is not well controlled, it can harm various organs throughout the body.
Heart: Poor blood pressure control poses two main risks to the heart. The most common risk is the damage to the inner lining of the heart’s blood supply arteries due to elevated blood pressure, leading to the formation of atherosclerotic plaques on the vessel walls, causing arterial narrowing and triggering coronary heart disease. In some cases, these plaques can rupture, resulting in acute myocardial infarction. Moreover, elevated blood pressure necessitates more forceful contractions by the heart to pump blood throughout the body, leading to left ventricular hypertrophy, myocardial fibrosis, and serious complications such as atrial fibrillation and heart failure, making hypertension significantly harmful to the heart.
Stroke: Hypertension can lead to stroke, including both ischemic and hemorrhagic events. Ischemic conditions such as cerebral infarction are often caused by hypertension-induced atherosclerosis, vessel narrowing, and clot formation, leading to impaired blood supply to the brain. Additionally, high blood pressure, arterial stiffness, and increased vascular pressure can easily cause brain hemorrhage. Dr. Zhang has encountered a 45-year-old hypertension patient who suffered from hemorrhagic stroke. Whether ischemic or hemorrhagic, stroke is a disease with high disability, mortality, and treatment costs, with unimaginable consequences once it occurs.
Kidneys: Prolonged uncontrolled hypertension can severely damage the kidneys. Elevated blood pressure can cause glomerular lesions, reducing the glomerular filtration rate, leading to the retention of metabolic waste in the body and triggering various abnormalities. Research indicates that continuous elevation of blood pressure for 5 years can result in kidney damage, and over 10 years, various symptoms of renal insufficiency may manifest. Lifelong dialysis may be required to sustain life, significantly impacting the quality of life.
Eye Diseases: Prolonged hypertension can cause visual impairment and, in severe cases, blindness. Affected individuals may struggle to read, watch TV, watch movies, or even drive, significantly disrupting daily life.
Peripheral Blood Vessels: Long-term hypertension can cause atherosclerosis in the limbs, leading to impaired blood supply. In severe cases, it can even cause arterial occlusion, tissue ischemia, and necrosis, necessitating amputation.
Many individuals may find Dr. Zhang’s warnings exaggerated. Some may cite examples of individuals with high blood pressure for decades without any complications. Dr. Zhang sincerely wants to clarify that this is a survivor’s bias. For most people, such luck is rare, and even for those fortunate few, the absence of symptoms does not mean their internal organs remain undamaged, they simply have not exceeded their body’s compensatory limits yet.
How should hypertension be systematically treated?
The treatment of hypertension involves lifestyle interventions and medication. For individuals with stage 1 hypertension, lifestyle interventions alone may suffice to normalize blood pressure. However, those with stage 2 hypertension must take antihypertensive medicines, and many may need to take two or more types of antihypertensive drugs to maintain normal blood pressure levels.
Lifestyle interventions include reducing salt intake. Individuals with hypertension should not consume more than 6 grams of salt per day, ideally not exceeding 3 grams, roughly equivalent to half a bottle cap. Moreover, one should be cautious of hidden salt in daily foods like soy sauce, pickles, and snacks, as excessive intake of these items can result in excess sodium intake. Maintaining a healthy weight is crucial, as excessive weight is a leading cause of hypertension in young individuals, and some find their blood pressure returning to normal once their weight is within a healthy range. Abandoning unhealthy habits such as smoking, excessive drinking, staying up late, and irregular lifestyles can also raise blood pressure. Maintaining a calm demeanor is essential, as prolonged periods of tension, anxiety, and depression can activate the sympathetic nervous system, causing increased heart rate, vasoconstriction, and elevated blood pressure. These negative emotions can also lead to increased renin secretion, contributing to hypertension. Therefore, individuals with hypertension must adjust their mindset to prevent negative emotions from arising.
Antihypertensive medication: Currently, there are 5 classes of antihypertensive drugs in our country, each with its unique characteristics. Different individuals may require different antihypertensive medications, so it is crucial for hypertension patients to take antihypertensive drugs under medical guidance, avoiding arbitrary drug changes. It is important to note that antihypertensive drugs do not lead to drug resistance; there is no need to switch medications at intervals. Furthermore, changing antihypertensive drugs can easily trigger blood pressure fluctuations and unnecessary complications.
In conclusion, hypertension is a severely harmful condition to health. Poor blood pressure control can easily lead to heart disease, stroke, kidney damage, vision impairments, peripheral arterial occlusion, and even the risk of amputation. The incidence of hypertension in China has exceeded 20%, yet the effective control rate is less than 30%. This is often due to a focus solely on medication treatment, while lifestyle interventions are often overlooked. The treatment of hypertension must be comprehensive and systematic; otherwise, achieving good blood pressure control can be challenging.
That’s all regarding the question “What complications can poorly controlled hypertension cause?”. If you agree with Dr. Zhang’s perspective, feel free to like, share, or leave a comment. Your support is appreciated, and your questions and opinions are welcomed in the comment section as they are essential to my creative inspiration. Thank you for your assistance. I am Dr. Zhang Wei, the extraordinary doctor. See you next time.
Reference
1. Wang Z, Chen Z, Zhang L, et al. Status of Hypertension in China: Results from the China Hypertension Survey, 2012 – 2015. Circulation. 2018; 137(22): 2344 – 2356.
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