Let’s Talk About Hypertension

每次你去到医生的办公室的时候，你的医学博士背带在你的上臂，以测试你的血压的膨胀套筒。你可能已经通过这个程序走了这么多次，你不给它第二个想法。我们在这里要告诉你应该。血压高（HBP）把你的心脏健康的风险和，令人叹为观止，有二分之一的美国成年人拥有它。现在，我们有您的关注，我们也提醒指出，HBP往往是高度可治疗。请继续阅读，我们将告诉你如何帮助遏制它对你的身体最重要的肌肉的威胁。

什么是高血压，无论如何？

Let's first begin withhow the heart functions。随着每次心跳，心脏泵富含氧气的血液到身体的其他部分在一个持续的，持续的生命周期。力或压力性收缩是什么让你的血液流过你的动脉和静脉。

There are two types of pressure that get generated:

1. Systolic, which is the pressure when your heart beats
2. 舒张，这是心跳之间的血压

一个健康的血压读数被写出这样的：120/80毫米汞柱（毫米汞柱），在顶部具有收缩号码和下面的舒张数。大声说出来，你会听到：“120比80”。只有当你的号码秒杀高于129（收缩压）和向上勾的80（舒张压），你正在进军高血压a.k.a。高血压（HBP）-territory。（更多关于这些数字如何打破在短短位）。

你的血压会上升,当你活跃。它goes down when you chill out. It’s highest in the morning when you wake up and lowest when you sleep. These types of fluctuations occur normally. However, when it’s continually above normal, you have a problem.

为什么？由于HBP可以做伤害了很多。这株和僵硬的血管，它可以使你的心脏更加努力地工作比它应该和能够导致一系列心脏疾病的，其中一些相当严重。

如何高血压把我在危险中为心脏病？

If you have HBP, you may not feel any different than you ever did, or even suffer the consequences for years. But over time you’re at increasing risk for developing four major heart problems. They are:

心脏衰竭

艰苦的工作是HBP你的心脏的要求可能会导致其中的一部分变粗，这种情况称为左心室肥厚。当发生这种情况你的心脏可以不再功能尽可能有效地它曾经，而使之无法充足的血液量泵到你的身体的其余部分。

Coronary Artery Disease (CAD)

CAD最常发展为动脉粥样硬化的结果，一个过程，其中的脂肪物质称为斑块你的动脉壁上堆积。这可能会导致它们增厚和变硬，然后限制血液的流动。动脉粥样硬化的病因不明，但HBP是主要嫌疑人，因为随着时间的推移高血压损害动脉，使他们更容易产生牙菌斑堆积，从而导致CAD。所以，这是一个有点恶性循环的怪圈。（如吸烟和高胆固醇的其他危险因素是比较大的问题了。）未经检查，CAD可导致心脏病发作。

Stroke

HBP is the leading cause of stroke, mostly because of the damage it does to the blood vessels. It not only raises the risk that plaque will rupture, it also increases the odds that blood clots will form in the heart. Both circumstances can block blood flow to the brain causing an ischemic stroke. The strain from HBP also can weaken blood vessels and make them prone to bursting. If this happens in the brain, it’s called a hemorrhagic stroke.

Chronic Kidney Disease (CKD)

HBP harms the arteries that supply your kidneys with blood, leaving them unable to filter your blood sufficiently. It also makes them less able to produce aldosterone, the very hormone that helps control blood pressure. According to the American Heart Association, HBP is the second-leading cause of kidney failure.

What Causes High Blood Pressure in the First Place?

If you have HBP, you’re hardly alone. According to the Centers for Disease Control and Prevention (CDC), nearly half of all adults in the U.S. have hypertension or take a medication (sometimes more than one) to manage it. Only one-quarter of them have it under control.

你的医生很可能将无法查明为什么你有高血压的原因。这是因为随着HBP案件多达95％的人没有已知的原因。如果你属于这一类庞大的，你有什么作为primary hypertension。Among the much, much smaller number of people who do have a known cause, their HBP is known as次级高血压因为它是由一个潜在的，或已经存在，卫生条件引起的。

这些潜在的次级的原因包括：

• 糖尿病，这损害动脉，可导致动脉粥样硬化，进而起坐HBP风险

• Chronic kidney disease and other illnesses that affect the kidneys, which causes the vessels around the kidneys to narrow or harden, forcing the heart to pump harder and raising BP

• 原发性醛固酮增多症, which is when your adrenal glands (located near your kidneys) produce too much of the hormone aldosterone, forcing your heart to work harder, leading to HBP

• Obstructive sleep apnea，这是一种疾病，病因反复，间断呼吸而你的睡眠，短暂发作将长期紧张你的心脏，提高BP

• Thyroid problems,当甲状腺产生太民大h or too little of the thyroid hormone, straining the heart and leading to HBP

• Birth defects，如主动脉，其中从心脏引离主容器危险变窄缩窄，使HBP-这可能是先天性心脏疾病存在的所述第一指示

• Preeclampsia，这会导致孕妇血压突然尖峰，导致惊厥，严重的并发症，导致癫痫发作，并提出那些谁拥有它在整个生命高血压的风险较高

什么是高血压的危险因素？

虽然HBP的确切原因仍然是一个谜在大多数情况下，风险因素是很容易找到。幸运的是，他们大多是你的力量控制，这意味着你的心脏的命运可能在你自己的手中很大程度上在于中。它们包括：

Excess Weight

If you’re overweight or obese, your body requires your heart to pump more blood to supply it with oxygen and other essential nutrients. This extra work adds to the pressure on the walls of your blood vessels.

缺乏运动

定期流汗更有效地让你的心脏工作，要求每分钟心跳少泵足够的血液量。但是，如果你是一个沙发土豆，你的心脏可能有跳动更快跟上需求。这意味着你的心脏的工作更加努力，把更多的压力，你的血管。

Smoking

With every drag you take, the chemicals you inhale move through your lungs and into your bloodstream, where they damage your blood vessels along the way. Over time, this tough-to-kick habit significantly ups your risk of heart disease. Research suggests that vaping also raises blood pressure in a similar way—a good reason to avoid e-cigarettes, too.

High Salt Diet

过量的钠导致流体潴留。在你的血管额外的流体意味着你的心脏必须更加努力地工作，将其移动你的身体周围，队内血压。

低钾饮食

当你没有得到足够的钾，发现像菠菜，香蕉，酸奶，豆类，金属钠循环在你的血液水平升高的食物。

Overindulging in Alcohol

我们知道，晚餐小酒是很好的。但超过酒精的推荐涨停可以提高你的血压。目前的指导方针建议不超过每天喝一杯酒的女性和两名男性。甲饮料是酒5盎司玻璃，12盎司普通啤酒，酒或1.5盎司。

压力太大

你的身体释放血液pressure-boosting hormones during times of stress. Too much stress, or not managing it well, also makes it harder to keep other HBP risk factors in check, like eating a poor diet, drinking too much alcohol, smoking, and losing sleep.

What Risk Factors for Hypertension Are Beyond My Control?

重要的是要专注于你所能做的，以防止或更好地管理HBP。但一些风险因素无法退出或提高。它们包括：

年龄

Your likelihood of HBP goes up as you get older. Why? The arteries begin to stiffen starting around age 55 in both women and men. This results in rising systolic (the top number) blood pressure, while diastolic BP tends to go down (likely because as we age the arteries stiffen and don’t spring back as well between heartbeats).

遗传学

HBP also may be passed down to you from your parents. In fact, at least a third—and potentially up to half—of all cases of HBP have a genetic component.

种族

非裔美国人有高血压的高风险比白人，这可能是由于糖尿病和肥胖率较高，或使美国黑人盐更敏感，根据美国心脏协会的基因。

What Are the Symptoms of High Blood Pressure?

This is an easy one:对于大多数人来说，没有症状。告诉的唯一途径，如果它的存在就是要测试。不过，如果你离开HBP未经处理的足够长的时间，它可能会导致你的心脏，眼睛和肾脏明显的破坏。当发生这种情况，你可能会遇到类似的症状：

• Shortness of breath由于心脏问题
• 视力问题ranging from blurriness to blindness from eye damage
• 肿胀通常在你的腿上或你的眼睛周围，由于肾损害

How long does that take? Often years, but the process gets accelerated if you have other health problems, such as diabetes and high cholesterol. Extremely high blood pressure may also cause:

• Headaches
• 鼻出血

怎么做医生诊断高血压？

因为症状是如此罕见，只有这样，才能知道你有HBP是你的血压在医生的办公室进行测试。你的医生会使用一种叫做血压计设备，设有一个充气管套，围绕你的上臂套。袖带装到一个规模，当它膨胀，它可以测量你的收缩压。它可以衡量您舒张压袖口慢慢放气。你的医生也可能会按听诊器听任何异常声音为你的血液流动。

You officially have HBP—your doctor may call it hypertension—when your readings are above normal during at least two visits to the doctor. However, many doctors will ask you to measure your own blood pressure using either a home monitor or with a 24-hour monitoring device your doctor lends you. Doing this will help confirm that your blood pressure remains high during the normal course of your day.

Why is this important? Many people have what’s calledwhite-coat hypertension，这意味着你的医生的办公室你的血压峰值，但恢复正常别处。例如，你的阅读可能会很高，当你有一个身体和正常的，当你使用该设备在您的药剂师或杂货店（但是请记住，乱办公室这些设备并不总是给出精确的读数）。

Then there’s the reverse phenomenon:隐匿性高血压, in which your numbers fall into the normal range at the doctor’s office but not when measured elsewhere, such as with an at-home BP monitor. About 10% of people with HBP have masked hypertension. An estimated 15% to 30% have white-coat hypertension.

Let’s look at the numbers. The American Heart Association provides the measurements that you should aim for, as well as the ranges that put you in the danger zone. All measurements are毫米汞柱。

• Normal:收缩压低于80低于120和舒张（下数）（上面的数字）
• Elevated (prehypertension):收缩期120至129和舒张压低于80
• High blood pressure (hypertension) stage 1:收缩期130至139或舒张80至89
• High blood pressure (hypertension) stage 2:收缩期140或更高或舒张90或更高
• Hypertensive crisis（马上打电话给医生）：收缩压高于180或更高和/或舒张压高于120

In addition to identifying HBP, your doctor also will examine you to see if your HBP has already taken a toll on your health. That means checking your eyes for signs of retinopathy (damage to the blood vessels in your retina which can lead to blindness) as well as testing your kidney and heart function.

What Is the Best Treatment for High Blood Pressure?

治疗开始频繁与单纯生活方式的调整，如果你的BP使您的升高或阶段1类，与否则非常低的在未来10年罹患心脏疾病的风险。就像风险因素上面把你HBP的十字线，减少这些危险因素可以帮助您使BP回落。

下面是从哪里开始：

Eat Well

Focus on foods that are good for you and avoid those that are not. Sounds obvious, right? But it’s helpful to have a plan. One that’s proven to benefit HBP is theDASH diet，或饮食方法停止高血压。这是你消耗低钠盐饮食，具有大量的水果，蔬菜，全谷物，以及其他对你有好处的食物，同时降低饱和脂肪，胆固醇量和钠。

行使

获得至少每星期150分钟的中度身体活动。，打破了每天约30分钟。选择一个你喜欢的，因为你会更容易坚持下去锻炼。更妙的是，挑几个类型的运动。品种不断有趣的事情。你的运动可以简单的系带你的运动鞋，散步，它可能只是作为服用降压药一样有效，根据2019英国运动医学杂志审查关于这个问题的科学研究。底线：只要动起来。

Lose Weight

The above two will help you with this one. For every two pounds you drop, your blood pressure will go down by about one point. That’s significant. If you need help losing weight, which we know is not easy, try apps like慧俪轻体orNoom。

Quit Smoking

它是如此很难做到，因为尼古丁是成瘾性。而且，我们知道，你们中许多人都试图打压吸烟超过一次的习惯，等等。不要放弃！有许多戒烟方法在那里，所以如果尼古丁口香糖确实不适合你的工作，也许催眠会。或补丁。最重要的是继续战斗对你的心脏和你的生活。如果你滑了尝试一种新方法。你可以这样做。你的心脏会感谢你的。如需帮助，请访问美国心脏协会stop smokingforever.

管理压力

None of us can completely avoid stress in our 24-7, go-go world. But we can learn to better manage it. Try deep breathing exercises, daily meditation, yoga classes, or even talk therapy to benefit your blood pressure levels. Just remember: Taking time for self-care is as important as taking care of your kids, your job, and everything else! No guilt here, ok?

Get Quality Sleep

目的是让每个晚上从七到九个小时。如果你的伴侣告诉你，你打呼噜了很多，或者你发现自己醒来气喘吁吁，向医生咨询有关做一个睡眠研究。你可能有睡眠呼吸暂停，可你的血压和伤害你的心脏。

Limit Alcohol

Many of us unwind after a long work week with a drink or two—which, according to most research, is just fine. So enjoy your glass of wine or beer! It’s when you veer into heavy drinking, or too often exceed daily allowances, that your BP can spike.

What Are the Medications for Hypertension?

If you are in stage 2, or in stage 1 with an elevated risk of heart disease, you’ll need to make the above lifestyle modificationsand大概开始于至少一种降血压药物。

如果你的血压非常高，你需要什么所谓的联合治疗，或药物从两个不同类别的药物。你的医生有很多可供选择的方案。选择将取决于你的HBP的严重程度，以及潜在的健康状况你可能有，如糖尿病和心脏疾病。在所有的可能性，你的医生会尝试你在一个以上的药物或剂量确定什么工作最适合你。

Medications include:

ACE抑制剂

短为血管紧张素转化酶抑制剂，此类药物的防止你的身体从产生血管窄化和血压升压激素血管紧张素II。这些吃药往往规定的糖尿病人，因为它也有补肾益。

Angiotensin II Receptor Blockers

ARBs for short, they also prevent angiotensin II from narrowing your blood vessels, easing the strain on your heart.

β受体阻滞剂

These drugs slow your heart rate so that it does not have to work as hard. This lowers your blood pressure.

钙通道阻滞剂

这些帮助你的血管放松，使血液更容易流动。他们还通过减慢你的心脏速率降低血压，让你的心脏休息的机会。

噻嗪类利尿剂

Also known as water pills, these drugs help your kidneys flush sodium and excess fluids out of your body via your urine. Less fluid means less pressure on your blood vessels.

Treatments for Stage 2 HBP may involve combinations of the above classes, often in a single pill, such as a diuretic combined with a beta blocker or an ARB.

Up to one in six people with HBP have a treatment-resistant form of the disease, in which your blood pressure remains stubbornly high, even with lifestyle changes and medications. You may require several different drugs to get it under control. But truly resistant HBP is not common. It may be due to an underlying health condition that can be better managed, thus bringing your BP down. It also may be caused by a medication you’re taking for another health problem. Another possible explanation? You’re not taking your medication as directed, or you’ve had difficulty meeting your lifestyle goals, like weight loss and exercise. Your doctor can help you with that.

If your BP is considered a hypertensive crisis, that’s a medical emergency requiring admission to the intensive care unit of the hospital, where you will receive intravenous (I.V.) medications in an attempt to lower your BP quickly.

什么是生命像血压高？

它can mean some big changes. Medication may not be enough to keep your BP under control if you don’t make and maintain appropriate lifestyle changes, like eating a more nutritious diet and getting plenty of exercise. This becomes even more critical as you get older, as BP frequently becomes more difficult to manage as you age. You also must maintain your daily medication regimen.

你的治疗的重要组成部分可能将是一个家庭血压监测。由于HBP没有症状，只有这样，你就会知道你的努力都具有所期望的效果是衡量定期您的BP。你的医生会给你一个合适的时间表。使用这些在家读数鼓励坚持你的自我护理计划。如果它不会让步，与您的医生，谁可以推荐不同的药物或剂量讨论这个问题。

And, remember: It might seem like a lot of work to deal with a problem that doesn’t give you any obvious symptoms—for now, anyway. But trust us, lowering your blood pressure is the biggest gift you can give to you heart to keep it beating like a champ for years to come.