The "two degrees" of antihypertensive therapy

 Core tip: Studies have shown that blood pressure is not as low as possible. In some cases, blood pressure and cardiovascular disease have a "J" or U" curve relationship, which means that blood pressure is too low or too high to cause heart disease. An increase in vascular disease.

　　 There are many benefits of antihypertensive therapy, and the concept of "hypertension is the last word" has been widely known. However, both doctors and patients need to grasp two "degrees" for antihypertensive treatment. If these two "degrees" are not well grasped, counterproductive results may occur.

　　 The first degree is the range, which is the range of lowering blood pressure. There was a period of time when people's concept of blood pressure reduction was "the lower the better", but recent studies have shown that this concept is wrong. Studies have shown that blood pressure is not as low as possible. In some cases, blood pressure and cardiovascular disease have a "J" or U" curve relationship, which means that blood pressure is too low or too high to cause cardiovascular disease. Increase. Therefore, the blood pressure goal should be "moderate enough." The grasp of this "degree" should be determined based on the overall cardiovascular risk level and on the principle of individualization.

　　 The second degree is speed, which is how long it takes to lower the blood pressure to the target value. Some people want to lower their blood pressure quickly after their blood pressure rises. As everyone knows, too fast a depressurization speed will cause serious consequences. The most typical example is that short-acting nifedipine tablets induce cerebral infarction. Studies have shown that its relative risk is increased by 60%. In clinical practice, we have also found that in patients with atherosclerosis, sometimes the blood pressure is lowered slightly faster, and the patient will have ischemic symptoms such as dizziness, fatigue, and angina pectoris. The harmfulness of excessive blood pressure reduction is obvious. Therefore, remember not to drop blood pressure quickly, and try to achieve a "soft landing" of blood pressure drop.

　　 In short, antihypertensive therapy must carefully grasp two degrees, and keep in mind that "excessiveness is not enough" and "hasty is not enough".