Hello, welcome back to the "Hypertension Medical Course." I am Jessica.
Previously, we mentioned that as we age, the incidence of hypertension
increases, far surpassing other diseases and becoming almost
inevitable. So, can it still be prevented? Moreover, 90% of
hypertension cases are primary, meaning the cause is unknown or
unclear—how can we prevent something like that?
Don’t worry. As discussed earlier, hypertension is essentially a
non-steady state. The progression from normal blood pressure to
prehypertension, to hypertension, and then to complications takes a
long time. This gives us the possibility of prevention. Doctors’
approach to hypertension prevention is not to eliminate the enemy
completely, but to fight a protracted battle with endgame
thinking—delaying the onset as much as possible. As long as blood
pressure doesn’t rise dramatically within our lifetime and doesn’t
cause significant harm, prevention is considered successful.
So, when we talk about prevention, it’s not about never developing
hypertension, but about delaying the transition to a non-steady state
for as long as possible by managing various risk factors.
From this perspective, as medical research on the development of
hypertension becomes clearer, I can confidently tell you that
hypertension is largely preventable.
What Are the Risk Factors for Hypertension?
To clarify which risk factors need prevention, we must first understand
what causes hypertension.
Hypertension can be divided into two types: primary (unknown or unclear
cause) and secondary (caused by a specific disease or condition).
Secondary hypertension is straightforward: a disease causes high blood
pressure; treat the disease, and blood pressure returns to normal. For
example, sleep apnea syndrome—snoring that leads to breathing pauses
and hypoxia—can sharply raise blood pressure. Statistics show that half
of these patients develop severe hypertension, greatly increasing
cardiovascular risk.
This type is easy to handle: screen with wearable devices that monitor
oxygen saturation during sleep, and see a doctor if there’s a problem.
Many people see improvement the day after treatment.
But this isn’t our focus. When we talk about prevention, we mainly
refer to primary hypertension, where the cause is unclear.
Although we don’t know the exact trigger, we do know the physiological
processes and outcomes, allowing us to deduce related factors. There
are three main pathways:
1. Sympathetic nervous system excitation, releasing hormones like
adrenaline and angiotensin, causing vasoconstriction and increased
blood pressure. Chronic stress, nicotine, and alcohol all contribute.
2. Excess sodium intake, leading to impaired renal sodium excretion.
More sodium in the blood increases blood volume and pressure.
3. Vascular changes—reduced elasticity, inflammation, plaques—raise
blood pressure. Age, high cholesterol, high blood sugar, obesity, and
PM2.5 air pollution are all involved.
How Can You Prevent Hypertension?
You might think these risk factors are too many to remember or manage.
Let’s break them down for practical action.
First, some are important but unchangeable, like age and genetics.
As mentioned, hypertension is almost an inevitable result of aging, and
genetics play a significant role. If neither parent has hypertension,
the child’s risk is only 3%; if one parent does, it rises to 28%; if
both do, it’s as high as 46%.
But while these internal factors matter, we can’t change them, so
don’t worry about them.
The good news is that lifestyle changes can compensate for genetic
disadvantages. For practical purposes, I divide modifiable factors into
three categories:
First, the easy ones: don’t smoke, don’t drink excessively, and avoid
coffee-based beverages.
Nicotine can raise blood pressure by 10–20 mmHg. So, avoid both active
and passive smoking.
Alcohol? Recent large studies confirm that the harm from alcohol in
wine far outweighs any antioxidant benefit. The risk depends solely on
alcohol intake. Moderate drinking (7–14 drinks per week) clearly raises
hypertension risk. Light drinking (under 7 drinks per week) hasn’t
shown a clear risk. A “drink” is about 250 ml of wine, one bottle of
beer, or 50 ml of low-proof liquor. If you must drink, keep it under 7
drinks per week.
What about coffee? Caffeine causes a temporary rise in blood pressure,
but most people adapt after their first cup. Pure coffee is fine.
However, coffee-based beverages (mochas, caramel macchiatos, instant
coffee) are problematic due to added sugar, cream, and even trans fats,
which harm blood vessels.
Next, those requiring some effort: air pollution, mainly PM2.5.
From 2007 to 2015, tracking 31 provinces in China showed that every 10
μg/m³ increase in PM2.5 raises systolic pressure by 1.3 mmHg and
diastolic by 1 mmHg, increasing hypertension risk by 14%. The
difference in PM2.5 between the cleanest and dirtiest regions can mean
an 18.2 mmHg difference in average blood pressure—almost enough to
cause hypertension.
You may not be able to choose your city, but you can reduce your
exposure:
- Pay attention to PM2.5 forecasts and avoid outdoor activities when
levels are high.
- Use air purifiers at home during poor air quality days.
- Wear anti-smog masks outdoors on bad days.
- When cooking, close the kitchen door to prevent PM2.5 from spreading
indoors. If possible, wear a mask while cooking—kitchen fumes are a
major source of indoor pollution.
The above are manageable. The next require more technical skill:
exercise, salt reduction, and stress management.
For example, how to exercise scientifically? Research shows exercise
clearly prevents hypertension, but which types, how long, and how
often? We’ll cover this in detail in Lesson 8.
How to control salt intake precisely? Excess salt raises blood
pressure, but how much is too much, and how can you reduce it? We’ll
discuss this in Lesson 7.
And what about stress relief? Which methods are effective—mindfulness,
meditation, yoga? Lesson 9 will explain.
In summary, hypertension prevention is all about endgame thinking:
always aiming to avoid cardiovascular disease, and adjusting daily
habits accordingly. While we may never completely defeat hypertension,
we can win the long-term battle.
Preview of the Next Lesson
Having covered prevention, it’s time to address treatment. Next, we’ll
start with a question everyone cares about: “Can hypertension be
reversed?”
I am Jessica. See you next time.
Key Points
For hypertension prevention, remember three things:
1. Endgame thinking: always focus on avoiding hypertension and
cardiovascular disease, and take all risk factors seriously.
2. What you can do yourself: don’t smoke, don’t drink excessively,
limit coffee-based drinks, avoid PM2.5, and maintain a healthy weight.
3. What to do under medical supervision: exercise appropriately,
control salt intake, and manage stress scientifically.
Comments
Post a Comment