Is it called hypertension if the diastolic blood pressure is high?

Written by Li Hai Wen

Cardiology

Updated on October 20, 2024

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High diastolic pressure, which is an increase in diastolic pressure, is also considered hypertension when the diastolic pressure exceeds 90mmHg.

If you have hypertension, it is essential to have a formal medical examination at a hospital, such as blood tests for lipids and glucose to check for diabetes and hyperlipidemia. Blood tests are also done to evaluate liver and kidney functions, to see if there are any kidney diseases causing the increase in blood pressure.

Additionally, under the guidance of a doctor, conduct ambulatory blood pressure monitoring to observe the overall situation of blood pressure increase within 24 hours. Based on the results of the blood tests and ambulatory blood pressure monitoring, determine whether antihypertensive medication is needed and which type of medication to use.

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Causes of pregnancy-induced hypertension

There are many reasons that can lead to the occurrence of hypertensive disorders during pregnancy. Normally, due to reasons related to the mother herself or being under the age of 18 or over 35, the risk of developing hypertensive disorders during pregnancy may increase. Additionally, dietary and environmental influences such as a high-salt diet, excessive fatigue, and mental stress can lead to the development of pregnancy-induced hypertension. In some cases, after the development of pregnancy-induced hypertension, it may trigger diseases in other organ systems, leading to severe issues with the placenta, causing complications such as placental abruption, hypoalbuminemia, and cerebrovascular accidents.

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Symptoms of Hypertension in Pregnant Women

During pregnancy, if a pregnant woman develops high blood pressure, initially there are no symptoms, because at the beginning the blood pressure just slightly exceeds 140/90mmHg. If the high blood pressure is only temporary, it generally does not affect the woman's body and therefore, she may not experience any symptoms. As the condition progresses, the symptoms of high blood pressure can cause physical harm to the woman, likely damaging the kidneys and causing proteinuria. The loss of protein can lead to edema in women, and as a result, many women's initial symptoms will appear as generalized swelling, which does not improve with rest. By measuring blood pressure and urinary protein, symptoms of hypertension in pregnant women can be detected. In the later stages of the disease, hypertension may sometimes be accompanied by dizziness, indigestion, and mild pain in the lower abdomen, which are all symptoms of hypertension in pregnant women.

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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.

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Intensive Care Unit

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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.

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What to eat for high blood pressure

Patients with hypertension need to regularly take antihypertensive medication to bring their blood pressure within the normal range. In daily life, dietary adjustments should be made, avoiding foods high in fats such as fatty meat from animals, offal, fried foods, and sweets. Instead, consume more vegetables high in dietary fiber, vitamins, and trace minerals. Suitable vegetables for people with hypertension include celery, spinach, mung bean sprouts, black fungus, water chestnuts, onions, carrots, winter melon, and Chinese cabbage.