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The other day, I measured a new patient's blood pressure, which was 120/80, and told her I wanted to get those numbers down more. "But Doctor," she protested, "why should they be lower? They're perfectly normal!"
I explained to her that, yes, national guidelines set "normal" blood pressure at 120/80, but I consider that standard to be arbitrary. I believe your target blood pressure level can be determined only within the context of your other cardiovascular risk factors. For instance, my patient has diabetes and high cholesterol and is overweight, so I'd like to see her blood pressure at 110/70 or even lower.
The concept of "normal" blood pressure is one of the major misconceptions many people have about hypertension. If you're among the 73 million Americans who have high blood pressure, here are a few others you should know about:
Myth: Cholesterol matters more than blood pressure.
The reverse more often is true. If you have high cholesterol but your ratio of HDL ("good) to LDL ("bad") is healthy, or if your cholesterol particles tend to be large, your risk of heart attack is not great. High blood pressure, however, is always putting stress on your blood vessels, including those supplying your heart with blood. This stress makes it easier for the bad LDL cholesterol particles to penetrate the inner lining of your vessel walls, where they accumulate and form plaque that eventually leads to heart attack and stroke.
Myth: If you have hypertension, you should measure your blood pressure every day.
Once a week is often enough. Although home measuring devices help patients manage their blood pressure, they can also encourage overuse. Damage occurs over years, not days or weeks. Keep track of your average blood pressure over many months, and give this information to your doctor whenever you go for a visit.
Myth: If you're hypertensive and feeling poorly, it's probably because your blood pressure is elevated.
This is almost never the case. Whatever is causing your symptoms is elevating your blood pressure, not the other way round. When you don't feel well or have pain, whether from a virus or a minor sprain, your body releases adrenaline, which causes your blood pressure to rise. If you don't feel well, don't take your blood pressure. You'll worry needlessly.
Myth: A bad headache could mean your high blood pressure is about to cause a stroke.
This widely held misconception dates to the time of President Franklin Roosevelt, who died in office in 1945 from a massive cerebral hemorrhage after reporting, "I have a terrific headache." Roosevelt, who was in poor health, had stratospheric blood pressure, in the range of 260/150. Among the many factors that contributed to his condition was the fact that none of today's safe, effective medications were available to him. Today, patients virtually never develop the changes in their hearts and blood vessels that ultimately killed Roosevelt. In 30 years of medical practice, I've never seen a patient receiving proper treatment suffer a hypertensive emergency like his.
n dispelling these myths, I don't mean to minimize the importance of being vigilant about monitoring your blood pressure. Just know that, as part of a regimen that includes a healthy lifestyle and medications when necessary, worry should play no part.
— Maintain a healthy weight; lose pounds if you are overweight.
— Be more active. (I recommend 20 minutes of interval training every day.)
— Choose foods low in sodium.
— Drink alcohol in moderation (two drinks daily for men, one for women).
一天，我为一个新病人测量血压，120/80，并告诉她，我希望她的血压能再降低些 她有些不乐意“大夫，为什么要降？我的血压完全正常��！ ”
我解释说，国家指导“正常”血压是120/80。但我认为，标准是死的。我相信您的目标血压水平维持在患心血管病风险范围之内。举个例子来说，我的病人有糖尿病和高胆固醇和肥胖，所以我认为她的血压在110/70或更低一些会比较好。
“正常”血压的概念是一个重大误解。如果您是是7300万美国高血压患者之一，你应该了解下面的几点认识误区：
误解一：胆固醇比血压更危险。
颠倒过来说还可以。如果您胆固醇高，但您的 HDL （高密度脂蛋白）（“好） ， LDL （低密度脂蛋白）（ ”坏）是健康的，或者说如果您的胆固醇微粒大，患心脏病的风险就不是很大。高血压是血管的压力高，包括那些给你的心脏提供的血压。这种高压力使坏的LDL胆固醇微粒更容易渗透到血管内壁，在那里沉积并形成栓塞，最终导致心脏病发作和中风。
误解二：如果你有高血压，应每天量血压。
每周量一次就行。虽然家用血压计可以帮助患者测量自己的血压，还可能导致使用过度。损害是慢慢发生的，不是几天或数周。坚持数月记录您的平均血压，并把这一信息在就诊时告知您的医生。
误解三：如果你有高血压和感觉不好，可能是因为您的血压升高。
不是那回事。无论什么症状都会使血压增高，而不不是其他的什么。当你感到不适或有疼痛，无论是病毒或轻微扭伤，你的身体就会释放肾上腺素，从而导致血压上升。如果你感觉不好，不要担心你的血压。你的担心是不必要的。
误解四：头疼可能是血压高，会导致中风。
这种广泛的误解的时间要追溯到罗斯福总统，1945年，他死在了办公室，报告说由于大规模脑出血。健康状况不佳的罗斯福说“我头很痛”他的血压范围260/105。综合各种因素，即使现在安全，有效的药物对他也无济于事。如今，患者的心脏和血管几乎不会发展到象罗斯福那样的情况。在30多年的医疗实践中，我从来没有见过一位接受适当治疗的高血压患者发生像他那样的情况。
消除这些误解，并不是减少监测自己的血压的警惕性。只是让你了解，必要时包括健康的生活方式和药物治疗也是健康养生的一部分，担心是没有用的。
-保持健康的体重;过于肥胖就减减肥。
-积极锻炼。 （我建议每天进行20分钟间歇有氧锻炼。 ）
-选择低钠（盐）食品。
-饮酒适量（ 男子每天2杯，女性1杯） 。
