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Is the blood pressure normal “everything is good”?wrong!Jama’s latest research “anti -routine” …

The old Dong’s blood pressure has not been able to do normally. Every time he still brags with his old friends, his body is great, the cardiovascular health is very healthy, and you don’t worry about your children.

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However, if blood pressure is normal, do you really don’t have to worry about cardiovascular?

In order to figure out this matter, John Hopkins Cardiovascular Disease Prevention Center carried out a study. It was prepared to have the risk of cardiovascular disease with cardiovascular disease without other factors. The “anti -routine” is higher.

The relationship between systolic blood pressure and cardiovascular risk is really “anti -routine”

This study included a total of 1457 patients with porridge -free hardening diseases, including 223 (15.3%) Chinese patients. The average age of the subject is 58.1 years old, and its average blood pressure is 111.3/67.5 mmHg.

A subject with risk factors with cardiovascular disease itself is not included in research, including subjects with abnormal blood lipids, diabetes, hypertension, or antihypertensive drugs, smoking. The impact of mixed factors, focusing on the impact of exploring systolic pressure on cardiovascular diseases, such as coronary heart disease, stroke or other porridge hardening cardiovascular disease.

The entire tracking period of the study is 14.5 years on average.

The researchers performed a baseline coronary calcification measurement and found that nearly one -third of the subjects detected coronary calcification. We know that the emergence of coronary calcification reminds the appearance of sub -clinical porridge.

In other words, even if there is no hypertensive value in the traditional sense, the higher the blood pressure subject with normal blood pressure, the higher the proportion of patients with coronary calcification (CAC) or diffuse coronary calcification.

It can be seen that the researchers put the patients with normal blood pressure in accordance with the shrinkage, group group, and the contraction pressure increased by 10 mmHg every 10 mmHg. The group’s 19.7%rose to 40.8%of the 120-129 mmHg group.

So after 14.5 years of tracking, what kind of discovery did the researchers have?

After adjustment of factors such as age, gender, race, diastolic pressure, total cholesterol, high-density lipoprotein cholesterol (HDL-C), fasting blood sugar, income, education level, and pre-diabetes, The risk of cardiovascular disease will also increase with increased compression.

Although the researchers tried to find the “critical value” of the systolic blood pressure that increased the risk of cardiovascular disease, research did not find such a threshold.

Therefore, we have such a question that the lower the contraction voltage does not cause hypotension, the better the risk control of cardiovascular disease?

We contacted Professor Seamus Paul Whelton in the study and discussed this issue. Of course, research also pointed out that the prevention of cardiovascular disease is not just for systolic blood pressure, including blood glucose, blood lipids, smoking and other factors, which will affect the clinical ending. Therefore, research also proposes the concept of “comprehensive risk factors control”.

When we talk about the relationship between blood pressure and coronary porridge -shaped hardening cardiovascular disease, why is systolic blood pressure instead of diastolic pressure related? What do you think of its mechanism?

The height of systolic blood pressure and diastolic pressure is related to the increased risk of cardiovascular disease. However, compared with diastolic blood pressure, systolic blood pressure may be a stronger risk factor. Because the shrinkage pressure measures the blood pressure in the heart cycle of the heart cycle, the absolute pressure of the systolic blood pressure is much higher than the blood pressure in the diastolic stage. Compared with diastolic blood pressure, the absolute pressure of systolic blood pressure may be more likely to cause vascular damage and atherosclerosis.

For low-density lipoprotein cholesterol (LDL-C), now we start to put forward the view of “lower the better”. Do you think it is also suitable for blood pressure (except hypotension)?

Our research results show that reducing systolic blood pressure is more beneficial to health patients who have not received blood pressure. Therefore, it is important to let patients know that they should maintain healthy blood pressure through diet, exercise, and change their lifestyle.

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If this is the case, when talking about “wide risk factors control”, if the lifestyle changes cannot work, will you reduce the threshold of starting taking antihypertensive drugs? How will you balance more stringent blood pressure control and avoid hypotension?

In this study, we did not study drug treatment. I suggest to follow the 2017 ACC/AHA blood pressure treatment guide, and its proposed target blood pressure is <130/80 mmHg. Treatment should also be based on the patient's cardiovascular disease risk and part of the discussion of doctors. If the patient develops dizziness, dizziness, or other hypotension symptoms when taking antihypertensive drugs, discuss the adjustment of antihypertensive drugs with the arapist.

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