Daily management and prevention of hypertension
Daily Management
Lifestyle intervention is a reasonable and effective treatment for any hypertensive patient at any time, and its purpose is to lower blood pressure, and control other risk factors and clinical conditions.
All hypertensive patients should participate in self-management to varying degrees, take the initiative to prevent and treat hypertension, and have good compliance in taking antihypertensive drugs.
If possible, patients can use an upper arm automatic sphygmomanometer that has passed international standard certification to measure their blood pressure, record the blood pressure measurement results truthfully, and provide them to medical staff as a reference for treatment during follow-up.
Home Care
- In daily family life, patients with hypertension should pay attention to regular blood pressure measurement, a proper work and rest schedule, and a combination of work and rest.
- Take medications continuously according to doctor's orders, and do not change or stop medications at will.
- Pay attention to proper exercise, and arrange meals and bowel movements properly.
Issues Needing Attention
Lifestyle intervention, especially nutrition and exercise intervention, plays an important role in the prevention and treatment of hypertension.
Nutritional guidance
- Healthy diet: adhere to plant-based food, moderate animal food, and achieve food diversity and appropriate energy supply ratio of the three major nutrients.
- Control energy intake: Maintain a healthy weight, the total energy of daily diet should be to achieve or maintain a healthy weight, and pay attention to the maintenance of muscle mass.
- Limit sodium intake: gradually reduce the daily salt intake to less than 5g.
- Ensure the intake of fresh vegetables and fruits. Daily vegetable intake should not be less than 500g, and fruit intake should be 200g to 350g.
- Reduce the intake of saturated fatty acids and cholesterol.
- Limit alcohol consumption or do not drink alcohol.
- Patients with hypertension and multiple diseases can adopt the corresponding disease dietary guidelines.
- Dietary taboos: Reduce sodium salt intake, and gradually reduce the daily salt intake to <5g. In daily life, you can use a "salt control spoon" to measure. It should be noted that in daily life, you also consume other high-sodium condiments (MSG, soy sauce, etc.), pickled products, snacks, etc., all of which need to be controlled.
Exercise Guidance
Adhere to regular exercise, mainly aerobic exercise, and moderate-intensity aerobic exercise for at least 150 minutes per week. At the same time, ensure moderation and gradual progress.
Exercise Recommendations
Precautions for exercise for patients with hypertension
- Strengthen blood pressure monitoring;
- Specific groups of people must undergo additional exercise tests and carry out corresponding exercise training according to the test results under the guidance of a doctor;
- Avoid holding breath during exercise;
- Relax fully after exercise;
- Pay attention to the interaction between drugs and exercise. Patients taking beta-blockers are more suitable to use subjective exertion or speech tests to measure exercise intensity.
Contraindications for exercise training in patients with hypertension
- Patients with hypertension should follow the doctor's advice to choose the appropriate type and intensity of exercise when they have the following conditions;
- Resting electrocardiogram shows obvious ischemia, myocardial infarction, or other acute cardiovascular events within 2 weeks;
- Unstable angina;
- Uncontrolled arrhythmias;
- Severe aortic stenosis or other valvular diseases;
- Decompensated heart failure;
- Acute pulmonary embolism or pulmonary infarction;
- Acute hyperthyroidism;
- Acute myocarditis or pericarditis;
- Acute thrombophlebitis;
- Other disabilities that hinder safety and exercise;
- Electrolyte abnormalities;
- Obstructive hypertrophic heart disease, maximum left ventricular outflow tract pressure gradient at rest> 25mmHg;
- Aortic dissection.
Other lifestyle interventions
- Control weight to keep BMI <24, waist circumference <90cm for men and <85cm for women;
- Quit smoking completely and avoid passive smoking;
- Do not drink or limit alcohol;
- Maintain moderate or high-intensity aerobic exercise 5 to 7 times a week, each time for 30 to 60 minutes. If you are assessed as having high-risk factors for cardiovascular and cerebrovascular diseases, you need to undergo a professional assessment before exercise;
- Reduce mental stress and maintain psychological balance.
Daily Monitoring
Home blood pressure monitoring requires the selection of appropriate blood pressure measuring instruments, and it’s recommended to use the upper arm home automatic electronic blood pressure monitors certified by international standards. Wrist blood pressure monitors, finger blood pressure monitors, and mercury column blood pressure monitors are not recommended for home blood pressure monitoring.
Electronic blood pressure monitors should be calibrated regularly during use, at least once a year. For patients with newly diagnosed hypertension or patients with unstable blood pressure, it is recommended to measure blood pressure every morning and evening, 2 to 3 times each time, and take the average value; it is recommended to measure blood pressure for 7 consecutive days at home, and take the average blood pressure of the last 6 days for treatment evaluation.
If blood pressure is controlled steadily and meets the standard, you can self-measure blood pressure 1 to 2 days a week, once in the morning and once in the evening; it is best to self-measure blood pressure with a sitting posture at a fixed time after getting up in the morning, before taking antihypertensive drugs and breakfast, and after urination.
Record the date, time, and blood pressure readings of each blood pressure measurement in detail, rather than just recording the average value. In this way, you can provide the doctor with a complete blood pressure record as much as possible during the follow-up visit. For patients with high mental anxiety, self-measurement of blood pressure at home is not recommended.
Follow-up visit
- For patients with high normal values or stage 1 hypertension, low-risk, medium-risk, or taking only one medication, conduct a follow-up visit every 1-3 months;
- For patients whose blood pressure is within the target and stable, conduct a follow-up visit once a month;
- Patients who have taken at least 3 antihypertensive drugs but whose blood pressure is still not within the target should consider going to a hypertension department for diagnosis and treatment.
Issues Needing Attention
Traveling by plane
It is not that patients with hypertension can’t travel by plane, but they should pay more attention to their blood pressure. When the plane is flying safely, they can try to stand up and walk around, avoid eating too many snacks with high salt content, avoid drinking alcohol, and take sedatives. When traveling, they need to take antihypertensive drugs with them in case of emergency.
Sex life
The blood pressure of patients with hypertension is already higher than that of ordinary people. Blood pressure will increase further during sex life. Therefore, it is necessary to control sex life to the minimum of physiological needs and avoid excessive sex. If chest pain, headache, dizziness, shortness of breath, and other phenomena occur, they should stop immediately.
Pregnancy
After pregnancy, women with hypertension are prone to severe pregnancy-induced hypertension syndrome, which will seriously threaten the health of the fetus and the mother. It is recommended that female patients with hypertension undergo a comprehensive evaluation by a doctor before preparing for pregnancy.
On the one hand, the blood pressure level should be controlled to meet the standard, and on the other hand, they should adjust to taking safe drugs. Pregnancy can only be started after obtaining permission by medical evaluation, and be very cautious during pregnancy and closely monitor blood pressure to ensure the success rate of pregnancy.
Blood donation
When donating blood, the blood pressure must be lower than 180/100mmHg. A clinical diagnosis of hypertension does not mean that one is ineligible to donate blood, but donating blood can’t relieve hypertension.
How to Prevent
- For people with a family history of hypertension or high-risk factors, it is very important to prevent hypertension. The main preventive measure is to maintain a healthy lifestyle.
- Exercise can improve the blood pressure level. People without hypertension and patients whose blood pressure is stably controlled at the target level should exercise at least 5 days a week, including walking, jogging, cycling, or swimming, and should perform at least 150 minutes of moderate aerobic exercise and 75 minutes of intensive exercise per week. High-risk patients need to undergo professional evaluation before exercise.
- Reduce stress or avoid stress. Developing strategies to manage stress can help control blood pressure.
- Quit smoking. Smoking increases blood pressure, and quitting smoking can reduce the risk of hypertension, heart disease, and other metabolic diseases.
- Healthy diet. Avoid large amounts of alcohol, drugs, and unhealthy foods of high salt, high sugar, and high fat.