High blood pressure prevents cerebral hemorrhage

If people with high blood pressure want to prevent cerebral hemorrhage, the core thing is to keep their blood pressure stable within a reasonable range for a long time, and at the same time avoid triggering factors that can cause blood pressure to rise suddenly. By doing these two things, clinical data shows that more than 90% of hypertension-related cerebral hemorrhages can be completely avoided.

Lao Zhou, an emergency patient I received during my rotation in the Department of Neurology last month, is a typical counter-example. He is a 42-year-old Internet operation and maintenance man. He was diagnosed with high blood pressure 5 years ago. He always feels that he is young and has no symptoms. He never takes medicine until he thinks about it. He stayed up for 48 hours a while ago to catch up on the version. After a long night, I fell to the ground when I stood up in the morning to get a glass of water. When I was sent to the hospital, my systolic blood pressure had soared to 210mmHg. CT showed that the basal ganglia had ruptured into the ventricle. I had to lie in the ICU for a week before I was out of danger. Now my left arm and leg are still weak.

Why is high blood pressure so easy to cause cerebral hemorrhage? To put it bluntly, it is not difficult to understand. Our blood vessels are originally like latex tubes with moderate elasticity. If the blood pressure is high for a long time, the blood vessel walls will be impacted by excessive pressure all year round, which will gradually cause fibrosis and become brittle. Aneurysms the size of millet grains will also easily grow at the bifurcation of the blood vessels, just like the bulges from old tires. They are fine at ordinary times and nothing happens. One day, the pressure suddenly rises and ruptures with a "bang". This is how cerebral hemorrhage occurs.

Having said this, someone must ask, how low is the blood pressure considered safe? There are mixed opinions online now. Some say it must be lowered to below 130/80mmHg to meet the standard. Some say that for the elderly, it is enough to lower it to 140/90mmHg. If it is too low, blood supply to the brain will be insufficient. Both of these statements are actually correct. There is no unified standard answer - if you are under 65 years old and do not have problems such as carotid artery stenosis or insufficient blood supply to the brain, try to keep your blood pressure within 130/80mmHg to reduce the burden on your blood vessels. ； But if you are over 80 years old, or if your carotid artery stenosis is found to be more than 70%, there is really no need to stick to the 130 standard. It is safer to maintain your systolic blood pressure at 140-150mmHg. Blindly lowering your blood pressure will make you dizzy and fall down, which is not worth the gain.

Many people have a misunderstanding, thinking that taking antihypertensive medicine every day is equivalent to entering a safe. This is not true. I have seen too many patients who had just taken antihypertensive medicine in the morning, drank half a catty of liquor with their old man at noon, and were sent here with their heads in their hands in the afternoon. ； Some were angry with the children at home, and when they slapped the table, they were unable to speak directly. When the blood pressure was measured, it was 190 mmHg, and they were already bleeding. Oh, by the way, the emergency department in our department is always busy during the days when the temperature drops every autumn and winter. On the day of the beginning of winter last year, we admitted 7 patients with cerebral hemorrhage in one night. They were all elderly people with a history of hypertension. When the temperature dropped, the blood vessels contracted and the blood pressure quietly increased. I didn’t take it seriously and didn’t ask the doctor to adjust the dosage of the medicine. Then something happened.

I used to go to outpatient clinics with Director Li from Shenwai. He always talked about a few inconspicuous little habits with the hypertensive patients who came to see him, saying that they were more effective than any expensive health care products. For example, keep a palm-sized electronic blood pressure monitor in your pocket at all times. If you suddenly feel your head swells, your temples throb, or your face feels hot, don't hold on and say it's okay. Find a place to sit down and measure your blood pressure. If your systolic blood pressure exceeds 160mmHg, quickly take half of it. Take Topril, rest for 10 minutes and feel stable before moving again. Don't stand up suddenly, don't lift heavy objects, and don't struggle when you are constipated. These small movements that can cause abdominal pressure and blood pressure to rise suddenly may really be the last straw that breaks the blood vessels. By the way, don’t believe those folk remedies on the Internet that “eating celery and drinking bitter melon juice can replace antihypertensive drugs.” These foods are at most auxiliary. If you really want to control blood pressure, you have to take medicine as prescribed by your doctor. Don’t risk your own life by trying folk remedies.

Some people also ask whether people with high blood pressure can exercise? There are many theories, some say that exercise can lower blood pressure, and some say that exercise can easily burst blood vessels. In fact, it depends on the situation. If you want to run 100 meters, lift barbells, or do bungee jumping, which is very explosive and exciting, it will definitely not work. Your blood pressure will go up instantly. ； But usually taking a walk after eating, doing Tai Chi, or doing slow-paced radio exercises. This kind of gentle exercise can actually help improve blood vessel elasticity and stabilize blood pressure. If you just stayed up late the day before, or if your blood pressure is over 150 that day, don't insist on running five kilometers to check in. It's purely a risk to yourself.

In fact, after all, it is not that mysterious to prevent cerebral hemorrhage from high blood pressure. You don’t need to check the information every day and be afraid, and don’t take it lightly just because you are young. It’s enough to pay more attention to your body’s signals, measure your blood pressure regularly, follow your doctor’s instructions and adjust your medications, and avoid those minefields that can easily cause your blood pressure to skyrocket. Oh, by the way, if you have a history of hypertension for more than 10 years, you can add a cerebrovascular MRA during your annual physical examination to see if there are any "little bulges" that have not exploded. If you detect them in advance and deal with them in advance, you can also nip the risk in the bud.