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Hypertension
Difference between hypertensive encephalopathy and malignant hypertension
The difference between hypertensive encephalopathy and malignant hypertension can be discerned from their names, indicating they are different conditions. Hypertensive encephalopathy refers to a condition where blood pressure rises sharply in a short period, with diastolic pressure exceeding 120 mmHg and systolic pressure exceeding 200 mmHg. This dramatic increase in blood pressure causes cerebral vasospasm and increased cerebral perfusion pressure, leading to various manifestations of cerebral edema, primarily severe headache, nausea, vomiting, seizures, and even brain herniation. The emphasis is on the rapid rise in blood pressure over a short term and its impact on the brain, specifically cerebral edema. Malignant hypertension also involves a rapid increase in blood pressure to extremely high levels over a short period. However, the focus of malignant hypertension is on the impact on multiple organs throughout the body, including the brain, but also severely affecting the heart, potentially causing acute left heart failure and pulmonary edema. In the kidneys, it can lead to acute renal failure, characterized by reduced urine output or anuria. Thus, malignant hypertension emphasizes the effects on multiple vital organs, whereas hypertensive encephalopathy focuses primarily on the impact on the brain and central nervous system. Hence, there are some distinctions between the two conditions.
How to treat hypertensive encephalopathy
The treatment goal for hypertensive encephalopathy is mainly to rapidly reduce blood pressure to a reasonable range. Typically, intravenous antihypertensive drugs are administered to decrease blood pressure by 20%-25% within the first hour, followed by oral antihypertensives or continued intravenous treatment to further reduce it to a more reasonable level. Hypertensive encephalopathy often accompanies cerebral edema, and patients may experience increased intracranial pressure. At this point, it is necessary to administer dehydrating agents such as mannitol to treat the cerebral edema. If the patient experiences seizures, which can cause an increase in blood pressure or difficulty in reducing blood pressure, sedative anticonvulsant drugs must be administered to control the seizures. If the patient shows signs of heart failure, diuretic treatment should be initiated. Additionally, high concentration oxygen therapy under high pressure should be administered, which can be delivered through nasal cannula. If nasal oxygen therapy is ineffective, non-invasive ventilation or even intubation with invasive ventilation may be used to provide high concentration positive pressure oxygen therapy.
What vegetables should be eaten for high blood pressure?
Hypertension is a common disease in our daily life. What vegetables should people with hypertension eat? Pay attention to the following aspects: First, eat less salty food, especially pickled foods, such as salted pork, cured meat, and pickled fish products; these should be consumed in moderation. Second, eat more vegetables and fruits, such as celery, bitter melon, cabbage, and tomatoes. These vegetables are very helpful for our health. Likewise, fruits such as apples and pears, which are rich in Vitamin C, also assist in maintaining good health.
Is high diastolic pressure considered high blood pressure?
If the diastolic blood pressure exceeds 90 mmHg, hypertension should also be considered. Patients with a high diastolic blood pressure who do not actively undergo hypotensive treatment can suffer long-term damage to target organs such as the heart, brain, and kidneys, as well as severe hypertensive complications. For patients with high diastolic blood pressure, it is also necessary to adopt effective lifestyle adjustments and choose clinically frontline antihypertensive drugs for long-term treatment. Only by effectively controlling elevated diastolic pressure in the long term can severe target organ damage and hypertensive complications be avoided, thus improving the clinical prognosis for patients with hypertension.
How to prevent high blood pressure
The main methods to prevent hypertension are as follows: 1. Maintain a balanced diet, avoid long-term excessive intake of sodium salt, and make sure to consume plenty of fresh vegetables and fruits to supplement adequate amounts of potassium salt and dietary fiber; 2. Regularly participate in sports and physical labor, maintain an active lifestyle, avoid a sedentary lifestyle, and prevent significant weight gain; 3. Combine work with rest to avoid repeated fatigue and staying up late; work should be flexible, and ensure sufficient sleep at night; 4. Maintain a good mood, avoid frequent emotional fluctuations, and also avoid long-term mental overstrain; 5. Do not smoke and avoid excessive drinking.
The difference between hypertensive nephropathy and renal hypertension
Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.
How to lower high blood pressure
Patients with hypertension need to adopt a comprehensive approach to reduce their blood pressure, primarily comprising two aspects: On one hand, they should regulate their lifestyle for treatment purposes, which includes maintaining a long-term low-salt and low-oil diet, consuming more vegetables and fruits, regularly engaging in physical exercises and labor, keeping a healthy weight level, avoiding fatigue, not staying up late at night, and maintaining a good emotional state. On the other hand, suitable antihypertensive medications should be chosen based on the specific conditions of the patients and used long-term. If necessary, a combination of antihypertensive drugs may be required. Effective control of blood pressure can only be achieved by combining lifestyle adjustments with medication.
Can high blood pressure be hereditary?
Hypertension has a certain level of heritability, and research indicates that if parents have hypertension, their children’s risk of developing this condition significantly increases. Of course, genetic factors are only one of the reasons for the development of hypertension. The presence of genetic factors does not necessarily lead to hypertension; postnatal environmental factors are also very important. Maintaining good lifestyle habits over time, including healthy dietary habits, regular physical exercise, reasonable weight control, and a positive mindset can help prevent hypertension. Moreover, even without a family history of hypertension, poor lifestyle habits can still lead to the development of the condition.
Normal blood pressure, high blood pressure, and low blood pressure ranges.
Normal adult systolic blood pressure is between 90-139mmHg, and diastolic pressure is between 60-89mmHg. When the systolic pressure exceeds 140mmHg and the diastolic pressure exceeds 90mmHg, this condition is medically referred to as hypertension. When the systolic pressure is below 90mmHg and the diastolic pressure is below 60mmHg, this condition is medically referred to as hypotension. Regardless of whether it is hypertension or hypotension, it often causes symptoms in patients, such as headache, dizziness, and fatigue. Therefore, whether it is hypertension or hypotension, one should visit the hospital's department of cardiology for a formal examination. The doctor will assess the situation on-site to determine if treatment is necessary and how to administer it.
How is hypertensive nephropathy treated?
Long-term hypertension can lead to abnormal kidney structure and function, also known as hypertensive nephropathy. Once hypertensive nephropathy is diagnosed, comprehensive treatment measures are often adopted, including both pharmacological and non-pharmacological treatments. In terms of non-pharmacological treatment, patients should maintain a low-salt diet in their daily life, focusing on a light diet, with a daily salt intake of about 4 grams. Regarding pharmacological treatment, the main goal is to control the patient's blood pressure and reduce urinary protein. Medications that can be used include angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists. Any of these medications can be chosen and used long-term to control blood pressure, protect kidney function, and reduce urinary protein. (Medications should be used under the guidance of a physician, and self-medication should be avoided.)