概述

What is hypertension? A Mayo Clinic expert explains.

Learn more about hypertension from nephrologist Leslie Thomas, M.D.

Hi. I'm Dr. Leslie Thomas, a nephrologist at Mayo Clinic. In this video, we'll cover the basics of hypertension. What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Hypertension means high blood pressure. A blood pressure measurement includes two numbers. Those numbers are the systolic blood pressure and the diastolic blood pressure. Because of the pumping action of the heart, the pressure within the arteries cycles between a higher pressure and a lower pressure. The higher pressure occurs during the contraction of the heart's left ventricle. The higher pressure is known as the systolic blood pressure. The lower pressure occurs during the relaxation of the heart's left ventricle. This lower pressure is referred to as the diastolic blood pressure.

Who gets it?

Hypertension is a very common condition affecting up to 40% of adults. It is one of the most common conditions for which medications are prescribed. Most people with hypertension have primary hypertension. How primary hypertension develops is not entirely understood. However, it has felt to result from many inherited and environmental factors that interact in complex ways within the body. Risks for the development of primary hypertension include family history, advancing age, obesity, high sodium diet, alcohol consumption and physical inactivity. In cases of hypertension in which a specific cause is identified, the term secondary hypertension is used. Many potential causes of secondary hypertension exist. These causes include certain prescription or over-the-counter medications, kidney disease, certain endocrine disorders, or a significant narrowing of the aorta or a kidney artery.

What are the symptoms?

Rarely, an individual with very high blood pressure may have symptoms. These symptoms might include shortness of breath, blurry vision or headache.

How is it diagnosed?

Hypertension can be diagnosed by performing careful and repeated measures of the blood pressure. Blood pressure categories include normal blood pressure, defined as a systolic pressure less than 120, and a diastolic pressure less than 80. Elevated blood pressure is defined as a systolic pressure 120 to 129, and a diastolic pressure less than 80. Hypertension is defined as systolic pressure greater than or equal to 130, or a diastolic pressure greater than or equal to 80.

How is it treated?

Treatment of hypertension involves lifestyle modification alone or in combination with antihypertensive medication therapy. For individuals with certain common conditions, including cardiovascular disease, chronic kidney disease, and diabetes mellitus. Certain medications may be more advantageous to use compared to other medications. Deciding upon the best blood pressure to target, when to start antihypertensive medication therapy, and which specific medication or a combination of medications to utilize is highly individualized and informed by many factors.

What now?

You and your care team can work together to create the best treatment plan for you. No matter what methods you decide on. There are plenty of reasons to be optimistic about managing your hypertension. If you'd like to learn even more about hypertension, watch our other related videos or visit mayoclinic.org. We wish you well.

高血压是一种常见状况,血流对动脉壁长期施压,久而久之可能导致心脏病等健康问题。

血压取决于心脏的泵血量以及动脉血流承受的阻力大小。心脏泵送的血越多,动脉越窄,血压就越高。血压读数以毫米汞柱(mm Hg)为单位。结果包括两个数值。

  • 最高读数(收缩压)。第一个数值也就是高压值,测量心脏跳动时动脉的压力。
  • 最低读数(舒张压)。第二个数值也就是低压值,测量心跳之间动脉的压力。

高血压可能存在多年却没有任何症状。未经控制的高血压很可能引发严重健康问题,包括心脏病发作和卒中。幸运的是,高血压很容易被发现。一旦发现自己患有高血压,请与医生合作,以控制症状。

症状

大多数高血压患者没有任何体征或症状,即使血压读数高至危险程度。

有些高血压患者可能会头痛、呼吸短促或鼻出血,但这些体征和症状并非高血压独有,而且通常要在高血压达到严重程度或危及生命时才会出现。

何时就诊

您可能需要在例行医生看诊过程中测量血压。

从 18 岁开始,至少每两年让医生为您测量一次血压。如果您的年龄在 40 岁或以上,或者您为 18 岁到 39 岁且存在较高的高血压风险,请医生每年为您测量一次血压。

通常应该同时检查双臂的血压,以确定是否有差异。使用尺寸合适的袖带十分重要。

如果已经被诊断出患有高血压,或有其他导致心血管疾病的风险因素,医生可能会建议提高测量血压的频率。3 岁及以上的儿童通常会在每年体检时测量血压。

如果不经常看医生,可以在卫生资源市场或社区的其他地方免费检查血压。还可以在一些商店里找到免费测量血压的仪器。

公共血压计,比如药房里的血压计,可以提供有关血压的有用信息,但它们可能有一些局限性。这些仪器的准确性取决于多个因素,例如正确的袖带尺寸和仪器的正确使用。请咨询医生使用公共血压计的建议。

病因

高血压可分为两种类型。

原发性(特发性)高血压

大多数成年人的高血压并无明确病因。这类高血压叫做原发性(特发性)高血压,往往会在多年内逐渐发展。

继发性高血压

有些人的高血压系由基础医疗状况引起。这类高血压称为继发性高血压,与原发性高血压相比,往往会突然出现并导致高压升高。多种状况和药物均有可能导致继发性高血压,包括:

  • 阻塞性睡眠呼吸暂停
  • 肾脏疾病
  • 肾上腺肿瘤
  • 甲状腺问题
  • 与生俱来(先天性)的某些血管缺陷
  • 某些药物,例如避孕药、感冒药、减充血剂、非处方止痛药和一些处方药
  • 非法药物,例如可卡因和苯丙胺

风险因素

导致高血压的风险因素很多,包括:

  • 年龄。随着年龄增长,罹患高血压的风险升高。大约 64 岁以前,高血压在男性中更为常见。65 岁以后,女性则更有可能患高血压。
  • 种族。高血压在非裔人口中特别常见,发病年龄通常早于白人。非裔患者也更容易出现严重的并发症,例如卒中、心脏病发作和肾衰竭等。
  • 家族病史。高血压往往会在家族中遗传。
  • 超重或肥胖。体重越重,就需要更多血液才能为组织提供氧气和营养物质。随着流经血管的血液量增加,动脉壁所承受的压力也会增加。
  • 没有积极锻炼身体。不爱运动的人往往心率更高。心率越高,心脏每次收缩时的工作量越大,动脉所受的压力就越大。缺乏体育锻炼还会增加超重的风险。
  • 吸烟。吸烟或咀嚼烟草不仅会立即使血压暂时升高,烟草中的化学物质还会损坏动脉壁的内膜。这可能导致动脉变窄,增加患心脏病的风险。二手烟也会增加患心脏病的风险。
  • 饮食中的盐(钠)含量过高。饮食中含钠过多会使液体在体内积聚,这会增高血压。
  • 饮食中的钾含量过少。钾有助于平衡细胞中的钠含量。维持适当的钾平衡对于良好的心脏健康至关重要。如果没有从饮食中获取足够的钾,或者由于脱水或其他健康问题而导致钾流失过多,血液中可能因此会聚集过多的钠。
  • 饮酒过量。长期大量饮酒会损害您的心脏。女性一天喝一杯以上、男性一天喝两杯以上可能会影响血压。

    如果饮酒,请莫贪杯。对于健康成人来说,女性每天最多喝一杯酒,男性每天最多喝两杯。一杯酒的定义为 12 盎司啤酒、5 盎司葡萄酒或 1.5 盎司 40 度的烈性酒。

  • 压力。压力大可导致血压暂时升高。与压力有关的生活习惯,例如多吃、吸烟或饮酒,会导致血压进一步升高。
  • 某些慢性病。某些慢性病也可能增加高血压风险,例如肾脏疾病、糖尿病和睡眠呼吸暂停。

有时,怀孕也可能导致高血压。

虽然高血压在成人中最为常见,但儿童也可能面临这种风险。有些孩子是因肾脏或心脏问题而引起高血压。但是,不健康饮食和缺乏运动等不良生活习惯正在导致越来越多的孩子罹患高血压。

并发症

高血压对动脉壁产生的过大压力会损坏血管和器官。血压越高且不加以控制的时间越长,损伤就越大。

未经控制的高血压会导致并发症,包括:

  • 心脏病发作或卒中。高血压可能造成动脉硬化增厚(动脉粥样硬化),继而可能导致心脏病发作、卒中或其他并发症。
  • 动脉瘤。血压升高可能导致血管削弱和隆起,形成动脉瘤。如果动脉瘤破裂,可能造成生命危险。
  • 心力衰竭。要在血管中压力更高的的情况下泵送血液,心脏必须更加努力工作。这会导致心脏的泵腔壁变厚(左心室肥大)。最终,增厚的心肌勉为其难,竭力泵送充足血液以满足身体需要,这可能导致心力衰竭。
  • 肾脏中的血管变弱和变窄。这可能妨碍这些器官正常工作。
  • 眼部血管增厚、变窄或破裂。这可能导致视力减退。
  • 代谢综合征。这种综合征是一组身体新陈代谢紊乱,包括腰围增加、甘油三酯类升高、高密度脂蛋白(HDL)胆固醇(“好”胆固醇)降低、高血压和胰岛素水平升高。这些病症会增大患糖尿病、心脏病和卒中的风险。
  • 记忆或理解问题。未经控制的高血压还可能会影响思考、记忆和学习能力。记忆或概念理解问题在高血压患者中更为常见。
  • 痴呆症。狭窄或阻塞的动脉会限制血液流向大脑,导致某种类型的痴呆症(血管性痴呆)。如果卒中阻断血液流向大脑,也可能导致血管性痴呆。

July 01, 2021
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