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Treatment policy for myocardial infarction
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According to the 2009 edition of the Hypertension Treatment Guidelines of the Japanese Society of Hypertension, specific treatment methods should be changed depending on the degree of hypertension and the risk of cardiovascular diseases other than hypertension (diabetes, organ damage, etc.). It has been.
If CKD or metabolic syndrome is thought to be related to the cause of hypertension, it is essential to treat those causative diseases first.
Normally, treatment should be based on the root cause, but in reality, the cause of high blood pressure cannot be easily identified. In addition to CKD and other illnesses and genetic causes, the causes of hypertension are often due to daily lifestyle habits, so it is first necessary to implement the correct lifestyle habits.
According to the hypertension treatment guidelines of the Japanese Society of Hypertension, treatment should be performed as follows according to the low-risk group, moderate-risk group, and high-risk group.
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Hypertension treatment policy by risk group
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Low risk group
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If the systolic blood pressure is 140 mmHg or higher or the diastolic blood pressure is 90 mmHg or higher even after 3 months, we will start antihypertensive drug treatment.
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Moderate risk group
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If the systolic blood pressure is 140 mmHg or higher or the diastolic blood pressure is 90 mmHg or higher even after one month, we will start antihypertensive drug treatment.
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High risk group
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Immediately start antihypertensive drug treatment.
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Lifestyle improvement
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In many cases, although the direct cause of hypertension is unknown, lifestyle-related factors that induce high blood pressure include excessive intake of salt, lack of exercise, and excessive obesity.
We have found that it is effective to work hard to improve the following lifestyle habits. In particular, combined lifestyle habits such as saving alcohol, quitting smoking, and encouraging light exercise are more effective.
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How to improve your lifestyle
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Reduced salt
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Excessive salt intake can cause not only high blood pressure but also stomach cancer and heart disease, so reducing salt is absolutely necessary. The Japanese Society of Hypertension recommends a daily salt intake target of less than 10 g for normal Japanese, but less than 6 g for hypertensive patients.
Examples of salty foods include pickles, dried fish, shiokara, soups such as ramen and buckwheat, and soups. Besides, seasonings such as miso, soy sauce, and sauce naturally have a high salt content. If you want to prevent high blood pressure, the trick is to make the food lighter.
Active intake of vegetables and fruits is important for hypertensive patients, but it is not recommended for patients with severe renal impairment due to the risk of developing hypertensive (potassium)emia.
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Nutrients other than salt
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Potassium is a mineral that excretes excess salt in the body. To prevent high blood pressure, it is recommended to actively eat foods high in potassium. Potassium is abundant in fresh vegetables and fruits. Brown rice and rye bread are also high in potassium.
Excessive intake of high-sugar fruits should be avoided for obese and diabetic patients who require calorie restriction. It is also a good idea to refrain from cholesterol and saturated fatty acids and to eat fish aggressively.
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Weight loss
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From many studies, it is clear that obesity is a risk factor for hypertension. If you don't want to have high blood pressure, you first need to develop a lifestyle that keeps your normal weight.
To avoid metabolic syndrome, you need to limit your fat intake and maintain a proper weight. The goal is a BMI value of less than 25.
BMI = (weight kg) / ((height m) X (height m))
For example, if a person with a height of 160 cm weighs 60 kg, the BMI value is 23.4, which is a safe area, but if the weight increases to 70 kg, the BMI value becomes 27.3, which is very dangerous.
Obesity is not good for other lifestyle-related diseases, so it is explained in detail on the page of " Obesity ", which is an endocrine / metabolic disease. I think it will be helpful if you refer to it.
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Moderate exercise therapy
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Overeating and lack of exercise may be a major cause of overweight people. People who exercise regularly should not be obese and should have the right amount of fat, such as cholesterol. It can be said that it is unlikely to cause diabetes.
Generally, your blood pressure rises while you are exercising, but if you continue light aerobic exercise every day, you are less likely to get high blood pressure.
Exercise is intended for hypertensive patients without cardiovascular disease, and it is recommended to continue exercising for at least 30 minutes daily, centered on moderate intensity aerobic exercise. Recommended aerobic exercises include walking, light jogging, cycling and swimming.
Light exercise is important, but for people with high blood pressure, long-term contraction of muscles, such as weightlifting and pull-ups, is extremely dangerous because it results in breath-holding and anaerobic exercise.
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sobriety
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Alcohol intake should be limited to an appropriate amount. In terms of ethanol, the target is 20 to 30 mL / day or less for men and 10 to 20 mL / day or less for women.
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No smoking
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Smoking is said to cause blood vessels to constrict and cause high blood pressure. Try as hard as you can to quit smoking.
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bath
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It is also well known that the cold of winter is bad for high blood pressure. In the midwinter, manage the temperature of the bathroom and toilet. Avoid baths that are too hot, and take a slow bath at a slightly lukewarm temperature.
It is dangerous if the temperature difference between the bathroom and the changing room is large. People with high blood pressure are strictly prohibited from bathing in cold water or in the sauna.
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Stress relief
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Everyone is stressed, but high emotions raise blood pressure. To prevent high blood pressure, it is recommended to relieve stress early and relax the mind and body. You can relieve stress by bathing, aromatherapy, massage, immersing yourself in your hobbies, listening to your favorite music, playing with your pets, and more.
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Hypertension medication
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If your blood pressure does not reach the normal range due to lifestyle changes, you will need to be treated with medicines such as antihypertensive drugs. Once you start using an antihypertensive drug, you may have to continue it for the rest of your life, but as long as you continue to take it, you will be able to maintain a stable blood pressure.
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