Whether the new standard hypertensive patients should take medicine

   According to the new diagnostic criteria, the number of hypertensive patients in China will increase from 245 million to 435 million, an increase of at least 100 million people, which means that nearly 1/3 of the country’s population will become hypertensive patients.
   In the past, the cardiovascular risk stratification of hypertension was divided into four types: low risk, intermediate risk, high risk and very high risk, but now it is simplified to high risk and non-high risk. For front-line clinicians, the simpler the stratification standard, the more operable It is beneficial to determine the timing of antihypertensive treatment for hypertensive patients as soon as possible. The doctor will combine the patient’s physical indicators and other comprehensive factors to carry out the necessary non-drug intervention and drug treatment. In other words, new patients do not need all medications, and most of them can restore blood pressure to the ideal range through active lifestyle intervention.
   It is recommended to start antihypertensive drug therapy immediately for patients whose cardiovascular risk stratification is high risk, including the following three situations: 1. Systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, it is recommended to start antihypertensive drug therapy immediately ; 2. Systolic blood pressure 130-139 mm Hg and/or diastolic blood pressure 80-89 mm Hg with clinical complications, it is recommended to start antihypertensive drug treatment; 3. Systolic blood pressure 130-139 mm Hg and/or diastolic blood pressure 80 ~89 mm Hg, with target organ damage or >3 cardiovascular risk factors, antihypertensive drug therapy can be initiated.
   Patients with cardiovascular risk stratification as non-high risk, that is, systolic blood pressure of 130-139 mm Hg and/or diastolic blood pressure of 80-89 mm Hg, with 0 to 2 cardiovascular risk factors, can live for 3 to 6 months. If the systolic blood pressure is still ≥ 130 mm Hg and/or the diastolic blood pressure is ≥ 80 mm Hg, consider starting antihypertensive drug therapy.
   “For example, for younger patients with few risk factors and no target organ damage, lifestyle intervention can be performed for 3 to 6 months first. If blood pressure is still not up to standard, then consider starting antihypertensive drug treatment.” Hunan University of Traditional Chinese Medicine Zeng Ying, deputy chief physician of the Cardiovascular Department of the First Affiliated Hospital, introduced that although the diagnostic value of high blood pressure has been lowered, the number of people with high blood pressure has increased, and the cost of early treatment may slightly increase, but it is used for subsequent treatment of serious complications, such as stroke. , myocardial infarction, renal insufficiency and other high cost of treatment will be greatly reduced, and significantly improve the quality of life of patients and prolong their life.
   For hypertensive patients, lifestyle intervention is very important. Including diet intervention, exercise intervention, stress reduction intervention, weight loss intervention, smoking cessation and alcohol restriction and comprehensive lifestyle intervention.