What Is Labile Hypertension?
Senile hypertension refers to those who are older than 65 years old and whose blood pressure value has continuously or not exceeded the standard blood pressure diagnostic criteria more than 3 times on the same day, that is, systolic blood pressure 140mmHg (18.6kPa) and / or diastolic blood pressure 90mmHg (12kPa).
Senile hypertension
- Senile hypertension refers to those who are older than 65 years old and whose blood pressure value has continuously or not exceeded the standard blood pressure diagnostic criteria more than 3 times on the same day, that is, systolic blood pressure 140mmHg (18.6kPa) and / or diastolic blood pressure 90mmHg (12kPa).
- When the heart ejects, the aorta cannot be fully inflated, and the sudden increase in blood volume in the artery cannot be buffered, which leads to an increase in systolic blood pressure and a relatively low diastolic blood pressure.
- 1 High prevalence and high pulse pressure in isolated systolic hypertension
- The prevalence of senile hypertension is high, accounting for about 50%, most of which are simple systolic hypertension
- Common cause
- (1) The elderly prefer foods high in sodium. Because the elderly have impaired taste
- (2) abdominal fat accumulation and
- Nursing
- 2. According to the 24h dynamic blood pressure change rule, it is more appropriate to measure blood pressure at 06:00, 12:30, and 16:00. Elderly patients are susceptible to internal and external factors that make blood pressure fluctuate greatly. Therefore, blood pressure should be measured once at 21:00 before bedtime, which not only provides a basis for taking antihypertensive drugs at night, but also can know the blood pressure of patients at night.
- 3. As the elderly are prone to orthostatic and post-prandial hypotension, if patients have dizziness and tremor instability, they should be highly vigilant in nursing. Patients who get up in the morning and emotional excitement can easily cause high blood pressure. To prevent it beforehand, get up for activities, defecation, and washing with the assistance of a nurse. The nurses must be accompanied when going out for inspection and treatment. Patients with dizziness, headache, nausea, vomiting, and numbness in the limbs are early warnings for cerebral hemorrhage. Nursing staff should order the patient to stay in bed and get in touch with the doctor, prepare emergency medicines and equipment, and prepare tracheal intubation and tracheotomy as soon as possible. Package for timely rescue of patients.
- 4. Hypertension is a psychosomatic disease. Psychosocial factors have an important impact on the occurrence, development, outcome and prevention of disease.
- Hypertensive patients are more introverted, emotionally unstable, anxious and depressed, sensitive interpersonal relationships, and paranoid than healthy people; psychophysiological research suggests that mental stress can cause hypertension. Psychological imbalance can promote the occurrence of cardiovascular disease, and cardiovascular disease itself can further cause psychological tension. Nursing patients with hypertension should start from the patient's social environment, physical state and psychological factors. At the same time of drug treatment, through psychological counseling, relaxation therapy, listening to music, interest cultivation, hypnotic cues and other psychological treatments, the antihypertensive effect is obvious. Patients should strengthen self-cultivation, maintain optimism, learn health-care methods that are beneficial to health, eliminate social and psychological tension and stimulus, maintain stability of the internal environment, and achieve the purpose of treating and preventing hypertension.
- 5. Health education is a social activity that imparts health knowledge and cultivates healthy behaviors. With the change of medical model and health concept, most patients need not only general life care, but also health knowledge, as well as understanding their own health status, disease treatment and prognosis. The course of hypertension is long and the progress of the disease varies. Most of them are benign slow processes, but they are an important pathogenic factor for the heart, brain, and kidney. Active prevention and treatment can stop the damage of hypertension to target organs. So health education is especially important.
- Daily life precautions
- B. Maintaining the standard weight. Clinical practice proves that at least 60% of obese or overweight people develop hypertension. The prevalence of hypertension in obese people is three times that of normal-weight people in the same age group. For every 12.5 kg increase in body weight, systolic blood pressure can increase by 10 mmHg, and diastolic blood pressure can increase by 7 mmHg. Conversely, weight loss and blood pressure will decrease accordingly, which can increase the effect of antihypertensive drugs. Therefore, patients with hypertension should gradually control their weight within the standard range, and the weight loss of 1kg per week is appropriate. Reduce your intake of fats and carbohydrates in your daily diet to maintain a standard weight.
- C. A reasonable diet uses a low-sodium, low-fat, low-cholesterol, low-sugar diet, eats more vegetables and fruits, and eats more fiber foods to properly supplement protein and develop a good diet. It can reduce blood pressure and prevent heart, brain, and kidney disease. occur.
- a protein intake According to research, animal protein has protective effects on cerebral blood vessels. Survey data showed that 55.7% of patients with hypertension had insufficient protein intake, while milk intake was severely insufficient. It shows that people do not know enough about milk. Milk contains 8 essential amino acids required by the human body; the cholesterol content of milk fat is lower than that of meat and eggs, and the casein contained in it is easy to digest and absorb; the calcium content is particularly rich, which is an ideal supplement for elderly patients. According to the survey, the patient's intake of eggs was relatively excessive, and some patients consumed 5 eggs per day. Although eggs are high-quality protein, the cholesterol content in egg yolk is very high, you can take 3 whole eggs a week. Proper protein supplementation for patients with hypertension should be based on low-fat milk, fish, poultry, and lean meat.
- b Fat intake Hypertension patients should limit fat intake, especially animal fat intake. Because animal fats contain more saturated fatty acids, they can increase blood cholesterol, while plant fats contain more unsaturated fatty acids, which can lower blood cholesterol. When the ratio of unsaturated fats to saturated fatty acids in the diet (P / S)> 1, the effect of lowering blood pressure it is good. The fat supply is only 40 g to 50 g per day. Cholesterol should be limited to 300 mg per day. Soybean oil, vegetable oil, peanut oil, and sesame oil all contain vitamin E and more linoleic acid, which has a certain effect on preventing vascular rupture. Avoid animal viscera, brain, fat, shellfish, animal fat, etc. Fat-reducing foods include hawthorn, shiitake mushrooms, garlic, onions, sea fish, mung beans and so on. Shiitake mushrooms, oyster mushrooms, black fungus, white fungus and other fungal foods are rich in nutrients and have good effects on the prevention and treatment of hypertension.
- c. The intake of potassium, sodium, and chlorine has data indicating that the intracellular Na + content increases and the K + content decreases in patients with essential hypertension. Increased Na + content will cause Na + retention in the body, increase circulating blood volume, activate the renin-angiotensin system, increase angiotensin and increase sympathetic nerve activity, make small blood vessels spasm and contract, and increase total peripheral resistance, thereby increasing blood pressure. Rise. Therefore, a low-salt diet is a dietary principle that patients with hypertension should follow. It should be controlled at 3 g to 5 g daily. Patients with severe hypertension should use 1 g to 2 g of salt or 5 ml to 10 ml of soy sauce. According to experiments, high sodium and no chlorine at the same time do not cause blood pressure to rise, and chlorine alone without sodium has little effect on blood pressure. Why is it that the sodium salt that does not contain chlorine is not likely to cause blood pressure to rise? This is likely because there is no chlorine It's related to the difficulty of expanding blood volume. Both sodium bicarbonate and sodium glutamate are chlorine-free additives. High potassium diets are less likely to develop hypertension than low potassium diets. According to clinical experimental studies, in patients with hypertension, increasing potassium intake can lower blood pressure. On the contrary, if K + is depleted in the body (such as diarrhea), it will cause increased blood pressure.This may be because high K + is related to the inhibition of angiotensinogenase release, which counteracts the response of angiotensin II to blood pressure, and also reduces vasoconstriction and dilates blood vessels Total peripheral resistance decreases, which lowers blood pressure. Experiments have also shown that K + can also prevent stroke. Therefore, for patients with hypertension, in addition to taking potassium-containing preparations under the guidance of a doctor, ingesting foods high in potassium in the diet is a safe, effective and optimal way to supplement potassium. Hypertensive patients should eat tomatoes, pineapples, bananas, oranges and other vegetables and fruits with high potassium content, and should avoid eating salty foods and pickled products, preserved eggs and foods with high sodium content.
- d Calcium intake Calcium is closely related to the occurrence of many diseases, especially osteoporosis and hypertension that are common in the elderly. Due to the lack of long-term calcium intake, and the ability to absorb and retain calcium is reduced, bone decalcification causes osteoporosis. Calcium deficiency is associated with the incidence of hypertension. Studies have shown that high calcium diets can reduce blood lipid levels, and the mechanism is that dietary calcium can interfere with intestinal lipid metabolism. The effects of calcium supplementation on blood pressure: first, diuretic effect and cell membrane stability, reducing sympathetic nerve tension; second, increasing the level of calcitonin in the circulation, which is a powerful vasodilator. Therefore, patients with hypertension should take 1 g of calcium daily. Eat more calcium-rich foods, such as milk, fish, shrimp, walnuts, red dates, fungus, seaweed, etc., in order to achieve the purpose of preventing osteoporosis, lowering lipids and blood pressure.
- e Dietary fiber intake Dietary fiber has a variety of important physiological functions, among which it mainly affects cholesterol metabolism. As dietary fiber can inhibit the absorption of cholesterol, it is beneficial to prevent the occurrence of arteriosclerosis. At the same time, there is a laxative effect, which will help to reduce weight. Therefore, patients with hypertension should be encouraged to eat more coarse grains, miscellaneous grains, and more vegetables and fruits, especially green leafy vegetables, cabbage, waterweed, and celery.
- D. Smoking cessation and alcohol restriction: Let patients with hypertension fully understand the importance of smoking cessation and alcohol restriction and take action. Smoking can increase blood pressure, even if taking antihypertensive drugs, it will affect the efficacy. Cardiovascular benefits can be seen after quitting smoking for a year. Excessive drinking can cause high blood pressure, and moderate drinking can lower blood pressure. Ethanol should be controlled not to exceed 30 ml / d, which is equivalent to 720 ml / d of beer.