A Comprehensive Guide to Hypertension Treatment: Exercise, Medication, and Follow-up
Exercise Therapy
In addition to a reasonable diet, patients with hypertension should regularly engage in physical labor and exercise. This can promote calorie consumption, reduce excess fat, improve lipid and carbohydrate metabolism, control weight, strengthen the body, and enhance the cardiovascular system's stress resistance.
Currently, aerobic exercise is considered the best exercise prescription and a fundamental means of improving health. Examples include swimming, jogging, brisk walking, playing table tennis, playing croquet, climbing stairs, and Tai Chi. These activities are simple, convenient, and easy to maintain long-term. Each exercise session should last more than 30 minutes, at least 5 times a week. Exercise should reach a certain intensity; a simple calculation is that your age plus your heart rate during exercise equals 170.
If blood pressure cannot be controlled within the ideal range after a diagnosis of hypertension through diet and exercise therapy, active drug treatment should be initiated.
Drug Treatment
Many antihypertensive drugs are available, commonly including: diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers, and adrenergic receptor blockers. The choice of antihypertensive drug should be based on the patient's individual characteristics, such as blood pressure level, age, gender, and presence of complications.
One of the following can be used: long-acting calcium channel blockers, diuretics, ACEIs, or beta-blockers. Diuretics are generally not used in elderly patients with hypertension, diabetes, or hyperlipidemia to avoid affecting blood glucose and lipid metabolism.
Currently, there are six main classes of antihypertensive drugs used clinically, each with different mechanisms of action. It is generally not recommended to use drugs with different mechanisms of action or drugs with non-overlapping side effects in combination. Drug combinations should be selected and used under the guidance of a doctor and should not be changed arbitrarily.
Comprehensive Follow-up: Hypertensive patients should monitor their blood pressure frequently and adjust medication as needed to control blood pressure within the ideal range. Regularly monitor blood lipid and blood glucose levels, and examine the morphology and function of vital organs such as the heart, brain, kidneys, and eyes to detect damage early and treat it promptly, reducing the occurrence of serious complications. A comprehensive follow-up should be conducted at least once a year, including the following items:
(1) Disease course. For example, the duration of hypertension, time of initial consultation, and blood pressure level.
(2) Medication method. For example, whether the medication is monotherapy or combination therapy.
(3) Presence of risk factors. For example, men over 55 years of age, women over 65 years of age, smoking, total cholesterol greater than 5.2 mmol/L, diabetes, and a family history of early-onset cardiovascular disease.
(4) Presence of target organ damage. For example, left ventricular hypertrophy, proteinuria, elevated serum creatinine, carotid atherosclerotic plaques, and retinal artery stenosis.
(5) Presence of complications. For example, ischemic stroke, cerebral hemorrhage, transient ischemic attack, myocardial infarction, angina pectoris, coronary revascularization, heart failure, diabetic nephropathy, renal failure, retinal hemorrhage or exudation, and papilledema.
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