Guidelines for analyzing acquired factors that induce hypertension and their risk control

What factors easily lead to hypertension?

Besides being influenced by genetic factors, blood pressure is greatly affected by acquired factors.

Hypertension is a "lifestyle disease," closely related to unhealthy lifestyle habits such as high-sodium diets, alcohol consumption, overweight, and obesity.

During China's second national hypertension survey in 1979-1980, the prevalence of hypertension was 7.73% [the standard at that time was systolic blood pressure ≥141 mmHg and/or diastolic blood pressure ≥91 mmHg].

In the third national sample survey in 1991, if the standard used in the second survey [systolic blood pressure ≥141 mmHg and/or diastolic blood pressure ≥91 mmHg] was still applied, the prevalence was 11.88%. From 1980 to 1991, the prevalence of hypertension in the Chinese population increased by 4.15%, an absolute increase of 54%.

Why is this? With the improvement of living standards, people's physical activity has decreased, their weight has increased, and their blood pressure has also risen. Internationally recognized risk factors for hypertension include being overweight, a high-salt diet, and moderate to heavy alcohol consumption. Epidemiological studies in my country have also confirmed a significant correlation between these three factors and the development of hypertension. Therefore, controlling weight, limiting salt intake, reducing alcohol (ethanol) intake, and increasing exercise can all reduce the chances of developing hypertension.

What other diseases can cause high blood pressure?

If you have high blood pressure, don't forget to rule out secondary hypertension. Approximately 10% of patients have elevated blood pressure as a symptom of other diseases. If it is determined that the high blood pressure is caused by these diseases and they are effectively treated, blood pressure will naturally decrease accordingly.

Causes and main characteristics of secondary hypertension: According to recent reports, the most common cause of secondary hypertension is kidney disease, including renal parenchymal hypertension and renovascular hypertension, followed by sleep apnea syndrome, pheochromocytoma, and primary aldosteronism. Certain medications, such as licorice, ephedrine nasal drops, oral contraceptives, steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), cocaine, amphetamines, erythropoietin, and cyclosporine, can also cause elevated blood pressure.

The main manifestations of these diseases are as follows, and diagnosis can be made through the following examinations:

(1) Renal parenchymal hypertension: Urinalysis will show changes such as hematuria and proteinuria.

(2) Renovascular hypertension: Vascular ultrasound can provide a preliminary diagnosis; renal arteriography may be necessary to confirm the diagnosis.

(3) Sleep apnea syndrome with hypertension: Often presents with obesity, snoring, and complete cessation of airflow through the mouth and nose for more than 10 seconds during sleep, recurring more than 30 times, or a low ventilation index (a decrease of >50% from baseline). Of course, a definitive diagnosis requires appropriate examinations.

(4) Primary aldosteronism: In addition to hypertension, it may also present with muscle weakness, paroxysmal flaccid paralysis, periodic paralysis, etc.

(5) Pheochromocytoma: May present with episodic headache, palpitations, excessive sweating, and elevated blood pressure. During an attack, urinary catecholamines and their metabolites are elevated.

(6) Cushing's syndrome: Typical body type is central obesity, moon face, and buffalo hump. A 24-hour hydrocortisone level greater than 110 nmol/L (40 ng) suggests this disease.