Detailed Explanation of Blood Pressure Knowledge: Identification and Management of Borderline and False Hypertension

Hypertension: With the continuous improvement of people's medical and health care knowledge, everyone is paying more and more attention to their health. Many people are also very concerned about whether their blood pressure is normal and whether they have hypertension.

If an adult's systolic blood pressure is ≥160 mmHg and diastolic blood pressure is ≥95 mmHg, it is considered hypertension; blood pressure values ​​between these two, i.e., systolic blood pressure of 141-159 mmHg and diastolic blood pressure of 91-94 mmHg, are considered borderline hypertension. When diagnosing hypertension, blood pressure must be measured multiple times. At least two consecutive measurements with an average diastolic blood pressure of 90 mmHg or higher are required for a definitive diagnosis. A single elevated blood pressure reading is insufficient for a diagnosis, but follow-up observation is necessary.

What factors are related to blood pressure formation? Firstly, it is affected by the mean circulatory filling pressure, which refers to the pressure at all points in the blood vessels reaching a uniform value when there is no heartbeat. This value is approximately 6 mmHg in normal individuals. In addition, the blood pressure is closely related to the heart's pumping action and peripheral vascular resistance; the higher the peripheral vascular resistance, the higher the arterial blood pressure.

The WHO recommends the following blood pressure standards: Systolic blood pressure ≤ 140 mmHg; Diastolic blood pressure ≤ 90 mmHg.

Borderline hypertension: Also known as borderline hypertension, borderline hypertension is characterized by a systolic blood pressure of 140–160 mmHg and a diastolic blood pressure of 90–95 mmHg. This condition is characterized by slightly elevated blood pressure, without organic damage to vital organs such as the heart, brain, and kidneys, but it is prone to developing into hypertension.

Clinical observations show that approximately 71.5% of people with borderline hypertension are likely to develop hypertension, compared to only 11.1% of those with normal blood pressure. Their complications, such as cerebral hemorrhage, cerebral thrombosis, coronary heart disease, and mortality rate, are similar to those of hypertensive patients and significantly higher than those of normal individuals. Because it lacks early organic damage and specific symptoms and signs, it is easily overlooked. Prevention of this type of hypertension is the same as for general hypertension, but the key is to control sodium intake, ideally to less than 5 grams per day, while increasing potassium intake, such as by eating more fruits and vegetables. In addition, regular physical exercise is important, and calcium channel blockers may be taken long-term if necessary.

Pseudohypertension: Pseudohypertension refers to a false increase in blood pressure caused by arterial calcification. If blood pressure is only slightly elevated, no end-organ damage is found, and/or the patient rapidly develops symptoms of decreased blood volume or hypotension after taking antihypertensive medication, pseudohypertension should be suspected. Its diagnosis requires the Ossin test: inflate the cuff until the mercury column exceeds the level at which the sound disappears, then palpate the brachial artery. If the artery is easily palpable at this point, pseudohypertension is confirmed. Before considering treatment, it is important to maintain the blood pressure of these patients at a slightly elevated level.