New watching focus of the new guide of hypertension

New watching focus of the new guide of hypertension
New watching focus of the new guide of hypertension
The ill rate of hypertension of our country of Wang Wen, Professor of Fu Wai Hospital,Chinese Academy of Medical Sciences increases continuously, estimate, increase blood pressure 10 million of patient newly every year, the whole country suffer from number, have 200 million at least now. 70% of the brain soldiers in our country neutralize the morbidity of 50% of the myocardium infarction and relate to hypertension. Have already included hypertension in community's public health service category during the new medical reform, have narrated hypertension community's management content mode, procedure too in the new guide, for hypertension at the basic level to prevent and cure, consult. Prevent and cure the principle to direct against Chinese crowd's characteristic according to the research in recent years, it has several characteristics that hypertension of our country has illness coming on: First of all, our country is the high salt diet country, high sodium low potassium is a main characteristic. Investigated in 2002, our country takes in 12 grams of salt every day each person on average, required more than 1 time higher for 5 grams of salt for each person more than WHO in the whole country. Chinese sodium / potassium take in the proportion than more than one time higher in American-European countries. The diet of high salt is the important environmental factor of causing domestic hypertension and brain apoplexy, emphasize this in the new guide, and in drug therapy chapter careful to recommend the intersection of limit and salt take precautions against feasible measure of hypertension. Secondly, our country is the sending area of height of apoplexy of a brain, the morbidity of apoplexy of brain is 5 times that of morbidity of coronary heart disease. And the proportion of the two of American-European developed country is basically 1:1. It is obvious, the main complication of hypertension of our country is the apoplexy of brain, the goal of treating hypertension is to prevent the brain soldier from neutralizing heart disease, but the main one is to prevent the apoplexy of brain. Asian-Pacific formation research including 13 crowds in China shows, the crowd blood pressure level of our country is in close relation with coronary heart disease incident of apoplexy of brain, the western crowd is older that blood pressure of the crowd in East Asia raises and compares with relation of the apoplexy of brain, coronary heart disease incident, raise 10mmHg systolic pressure each time, the brain soldier happens and neutralize the event risk of the heart stem to increase by 53% and 31% respectively to the crowd in East Asia, and the western crowd only increases by 24% and 21%. Step down goal discusses relevant discipline while the guide is made jointly, the influence tested by ACCORD, INVEST,etc., to endangering the patient's blood pressure goal dispute bigger high. For this reason, revise the committee and utilize more than one year, unite special societies such as diabetes, kidney trouble, dept. of neurology, old department,etc. and hold the seminar many times in guide, reach common understanding in most expert opinions finally: In cases the patient can tolerate, it is up to standard to step down progressively. The general hypertension patient blood pressure goal lt; 140/90mmHg; gt; 65 -year-old blood pressure goals of the elderly lt; 150/90mmHg, to young people, general diabetes, general coronary heart disease, the chronic kidney trouble patient's blood pressure goal lt; 130/80mmHg; Goal lt of blood pressure behind the apoplexy of brain; 140/90mmHg. Long old diabetes to course of disease, coronary artery seriously narrow coronary heart disease, kidney trouble, dual side serious narrow patient's blood pressure goals of arterial carotis are relaxed appropriately as lt in end latter stage; 140/90mmHg; Coronary heart disease and advanced age the patient's diastolic pressure lt; Should step down prudently and observe the condition closely at the 60mmHg. The special crowd sets up the chapter to canvass clinic one by one specially, a lot of hypertension patients, with other dangerous factors or diseases at the same time. As to these special crowds, it is different to some extent that the treatment of hypertension goes from administration to the goal. The new guide has carried on the single introduction to them too, involve old hypertension, pregnant hypertension, hypertension accompany the intersection of brain and apoplexy, hypertension amalgamate 13 special crowd such as being in heart failure. What deserves to be mentioned is, study in recent years to reveal, 43% of the children's hypertension will develop into adult's hypertension 20 years later, so the newly-increased juvenile's hypertension chapter of the guide. Some province and city investigations show, the ill rate of hypertension of preschool child of our country is 2%- 4%, the school-ager is 4%- 9%. It is the main dangerous factor that juvenile's hypertension takes place to be fat. So, the guide has emphasized that carried on the importance of health education and healthy life to this kind of child while as a child. In addition new guide dangerous to divide layers of index into, intervene idea, the intersection of treatment and the intersection of medicine and the intersection of person who choose and respect synthetically in patient, has revised according to the latest result of study in recent years, in order to make the prevention and cure of hypertension safer, effectiver, rationaller.


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