High blood pressure prevention reference

Currently, in response to the three different needs of mass prevention, grassroots clinical, and academic research, the core pool of authoritative references recognized in the field of hypertension prevention mainly consists of 5 Chinese and foreign guidelines/consensus and 2 large-scale cohort study results covering the Chinese population. References in subdivided fields can be extended as needed based on the core pool, without the need to blindly pile up literature.

To be honest, I have been working in community chronic disease management for 6 years. Whether I am providing prevention training to village doctors or providing science popularization to residents who come for consultation, the standard item at the bottom of the box is always the "China Guidelines for the Prevention and Treatment of Hypertension (2023 Revised Edition)". This version is not the kind of paper document that simply says "eat less salt and exercise more". All the intervention suggestions in it have been adapted to the reality: for example, a 2g standard salt spoon conversion method is provided for northern high-salt eating areas, a "hidden high-salt food list" is made for office workers who eat takeout every day, and even the duration of the blood pressure-lowering effect of mass sports such as square dancing and brisk walking is clearly marked. What’s interesting is that regarding the scope of application of low-sodium salts, the guidelines clearly indicate that people with renal insufficiency should avoid it. However, when the department was discussing cases last year, a young doctor took out the results of the low-sodium salt intervention cohort study in rural China released by the New England Journal of Medicine in 2021 and proposed that as long as the frequency of blood potassium monitoring is increased to once every two months, patients within CKD stage 2 can also use low-sodium salts to reduce blood pressure fluctuations. This idea is currently still being piloted in small-scale clinical trials and has not yet been incorporated into formal guidelines.

If you are doing preventive science for young and middle-aged working people, you don’t need to read the general guidelines. The “Expert Consensus on Prevention of Hypertension among Young and Middle-aged People in China” published by the “Chinese Journal of Cardiovascular Disease” in 2024 is the most accurate one. I met several 28- and 29-year-old programmers when I was doing free clinics for Internet companies. After staying up until 2 o'clock for a week, their systolic blood pressure rushed directly to 145. According to the old standard, they would only get more rest. Now compare it to the consensus of "stay up" "Layered Intervention Plan for Blood Pressure Fluctuation after Night", the rules for them are to stay up no more than twice a week, and take a 1-hour lunch break after each stay up, without taking medicine. After 3 months of follow-up, it basically fell back to below 130. The adaptability is much higher than the general guideline.

If academic research needs to be benchmarked against international standards, the "Guidelines for the Prevention and Control of Hypertension in Adults" released by the WHO in 2021 will definitely not be avoided, but here is a reminder: do not blindly copy European and American standards. For example, European and American guidelines generally recommend that the blood pressure target for all people should be set below 130/80mmHg. my country’s 2023 version of the guidelines has relaxed it to 140/90mmHg for people over 65 years old and without underlying diseases. Previously, the old director Keli specifically Take the data from the Chinese Elderly Hypertension Cohort Study published in The Lancet in 2022 as evidence: the risk of cerebral infarction induced by hypoperfusion among the elderly in my country is 32% higher than that of white people in Europe and the United States. Blindly controlling blood pressure to a low level is more likely to be dangerous. This is also the current mainstream consensus in the domestic cardiovascular field.

Many ordinary residents ask me how to avoid pitfalls when checking references. I generally suggest not to believe the so-called "foreign studies" marked in the "home remedies to reduce blood pressure" articles in the circle of friends. If you really want to check for reliable content, you can either go to the official website of the Cardiovascular Disease Branch of the Chinese Medical Association to find public guidance documents, or go to CNKI to search for "Hypertension Prevention Guidelines/Consensus." Contents of core journals with an impact factor greater than 10 are basically reliable. I met an aunt before and asked about the article "Drink celery juice to lower blood pressure" in Moments. I found her a 2023 experimental study in the "Journal of Chinese Food Science": Apigenin does have the effect of assisting in lowering blood pressure, but to reach the effective dose, you need to eat more than 10 pounds of celery every day. Drinking that cup of celery juice cannot even reach one-tenth of the dose. After hearing this, the aunt laughed and said that she would never buy hundreds of boxes of celery juice health products again.

There are currently many studies on the correlation between intestinal flora, emotional stress and hypertension in cutting-edge fields. Most of them are published in the sub-journals of Nature and Circulation. If you are doing cutting-edge research, you can read it. For ordinary people to prevent it, it is enough to follow the guides mentioned above. There is no need to pursue new concepts that have not yet been implemented.