For most elderly people with hypertension, summer is a tough season. Not only because of the hot weather and low air pressure, but also because of poor sleep and irritability, many patients will have unstable blood pressure, chest tightness and discomfort, and may even cause more serious cardiovascular diseases. So, in the hot summer, what changes will happen to the cardiovascular system of elderly patients with hypertension? What aspects need special attention? What methods can help elderly friends stabilize blood pressure and prevent serious diseases of the cardiovascular system?
Temperature rises, blood pressure drops? The fluctuation of blood pressure in summer needs vigilance.
Blood pressure fluctuates with the change of seasons, and it is the lowest in summer.Research shows that there is a seasonal variation rhythm of human blood pressure regardless of region, race, age, gender and health status. Generally speaking, blood pressure is the highest in winter and the lowest in summer. It is speculated that it is because of the high temperature and heat in summer that human blood vessels relax, the peripheral blood vessel resistance decreases and the blood flow speed increases. In addition, high temperature also leads to an increase in perspiration. With perspiration, more sodium ions will be eliminated, and the load on the kidneys will be relatively reduced, resulting in low blood pressure in summer. For patients with hypertension, especially elderly patients, the blood pressure changes more with the seasons than normal people because of the poor regulation function of blood vessels.
There will be abnormal non-dipper fluctuations in blood pressure at night in summer.In 24 hours a day, human blood pressure does not remain stable and constant, but presents a fluctuating trend of "dipper blood pressure". That is, the two peaks of blood pressure "two peaks and one valley", the first one appeared at 6-mdash in the morning; At 10 o’clock, the second one appeared at 4 pm & mdash; At 8 o’clock, under normal circumstances, I am in a low blood pressure state when I sleep at night. However, in summer, due to factors such as warm environment, long sunshine time and prolonged outdoor daily activities, the sleep quality may be affected, which may lead to autonomic nervous dysfunction, vagus nerve excitement and vasoconstriction after falling asleep, which will lead to an increase in blood pressure at night and a "non-dipper fluctuation" in blood pressure. If blood pressure stays in this state for a long time, it will aggravate the original hypertension and may also cause more serious cardiovascular diseases.
The incidence of cardiovascular diseases increased significantly in summer.On the basis of blood pressure fluctuation in summer, high temperature and heat make human sympathetic nerve excited and heart rate accelerated. At the same time, in order to cope with high temperature and high consumption, the human body will also enhance myocardial contractility, increase basal metabolic rate and increase myocardial oxygen consumption. When the cardiovascular system is overloaded, it is easy to cause serious cardiovascular diseases.
How to manage the blood pressure of elderly hypertensive patients in summer?
Adhere to regular monitoring of blood pressure.Because elderly hypertensive patients usually have low blood pressure in summer, accompanied by abnormal non-dipper blood pressure increase at night, it is more necessary to monitor blood pressure regularly. For example, monitor blood pressure regularly in the morning, afternoon and before going to bed and make records. In the event of dizziness, palpitation, shortness of breath, weakness and other discomfort symptoms, it is also necessary to measure blood pressure immediately. If the blood pressure is significantly different from the usual monitoring value, such as more than 5-mdash; 10mmHg, or the physical discomfort has not been relieved for a long time, you need to get in touch with the doctor as soon as possible and adjust the antihypertensive drugs after the doctor’s evaluation.
Do not reduce or stop taking drugs at will.In summer, some elderly hypertensive patients who are often worried about blood pressure find that their blood pressure has dropped by themselves before taking antihypertensive drugs, so they will reduce their medication or even stop taking them without authorization. On the contrary, some patients find that when their blood pressure rises, they will immediately increase their own drugs. These practices are not desirable.Generally speaking, in elderly hypertensive patients, when systolic blood pressure changes more than 20mmHg or more than 160mmHg, and diastolic blood pressure changes more than 10mmHg or more than 100mmHg, it is necessary to contact a doctor to adjust medication.Some patients are prone to non-dipper hypertension at night in summer, which may also be related to the reduction of drugs in summer. When this happens, it is also necessary to contact the doctor in time, and increase or decrease the drugs reasonably and appropriately under the guidance of the doctor to avoid the occurrence of serious cardiovascular and cerebrovascular diseases.
Cooling and heatstroke prevention are moderate and moderate.Summer heat can easily lead to autonomic nervous system disorder, so heatstroke prevention and cooling should be done well. Pay attention to adjust the temperature moderately, and remember that the temperature is too low or the temperature drops suddenly.When using air conditioning, it is best to keep the room temperature at 27℃— Around 28℃, the temperature difference between indoor and outdoor should not exceed 8℃.Because the temperature difference between hot and cold is large, blood vessels will relax and contract for a while, which will cause large fluctuations in blood pressure, which is not conducive to blood pressure control; Secondly, avoid blowing cold air directly into the air conditioner. It is recommended to ventilate frequently and breathe fresh air. In addition, bath water is a good way to dissipate heat. For example, swimming can not only take away excessive heat in the body, but also have the effect of cooling and removing summer heat. It can also consume excess nutrition, reduce blood fat and blood sugar, reduce fat storage and strengthen the body. Bathing in summer advocates taking a shower, the water temperature is moderate, and the time is controlled within half an hour to avoid soaking in hot water for a long time. Because long-term bubble will make skin capillaries dilate and lose water, resulting in blood viscosity, which may cause temporary ischemia of the brain, faint in severe cases, and even induce stroke.
There are measures for health preservation, and matters needing attention in summer life of elderly hypertensive patients
A low-salt diet.Low salt refers to the daily intake of salt not exceeding 5g, including the intake of hidden salt (pickles, chicken essence, soy sauce, etc.). At the same time, maintain a diet low in animal fat and rich in vitamins and cellulose, and increase the intake of potassium-rich foods (fresh vegetables, fruits and beans). People with good renal function can choose low sodium and rich potassium salt; People with renal insufficiency should consult a doctor before supplementing potassium. For the elderly who are prone to postprandial hypotension, the proportion of dietary components can be appropriately changed to reduce carbohydrate intake.
Drink water properly.In the high temperature environment in summer, the amount of water discharged from the human body can reach about 3300ml, and the amount of water discharged from the body is as high as about 6600ml during heavy exercise. The amount of drinking water needs to be adjusted according to the amount of excretion. Especially for the elderly, there is postprandial hypotension, and it is recommended to drink 350&mdash before meals; 480mL can reduce the postprandial blood pressure drop by 20mmHg and effectively reduce the occurrence of related symptoms.
Use alcohol and tobacco with caution.Smoking can lead to high blood pressure. After smoking a cigarette, the heart rate will increase by 5-20 beats per minute, and the systolic blood pressure will increase by 10-mdash. 25mmhg。 In addition, patients with hypertension are advised not to drink alcohol. If drinking alcohol, men’s daily alcohol intake is not more than 25g at most. Equivalent to wine less than 2— 3 Two, the beer is less than 250— 500mL or less than 0.5— 1 Liang. The amount of alcohol consumed by women is halved, that is, the daily alcohol intake is not more than 12.5g
Calm mood.Nervousness, irritability and emotional instability will all raise blood pressure. Patients can try to change their behavior, be calm and calm, and avoid emotional excitement, excessive tension and anxiety; When you have great mental stress, you can talk to friends and relatives, or release the pressure by participating in relaxed and enjoyable extracurricular activities. Cultivate one or two hobbies to live in the best and most comfortable environment.
Work and rest regularly.Life should be regular to prevent excessive fatigue. Go to bed early and don’t stay up late, guarantee 7-mdash every day; 9 hours of sleep, appropriate lunch break for 1 hour, to supplement the lack of sleep.
Moderate exercise.Proper exercise can improve the regulating function of nerves and blood vessels and effectively lower blood pressure. Older people can choose more soothing sports, such as Tai Ji Chuan, walking slowly, Mulan Boxing and so on. Try to keep it going every day for 30-mdash; 60 minutes of aerobic exercise, or at least 10 minutes at a time, totaling 30-mdash every day; 60 minutes of intermittent exercise.
It is best to choose exercise time in the evening when the temperature is relatively low.Although it is cool in the morning, the blood viscosity in the body is high at this time, which is prone to cardiovascular and cerebrovascular diseases and should not be exercised too much.Before exercise, it is necessary to appropriately extend the warm-up and recovery period. When exercising, we should pay attention to starting from a small amount of exercise, step by step, do what we can and persevere. Avoid changing body position too quickly and standing for a long time to reduce the occurrence of orthostatic hypotension. When the blood pressure response is abnormal and accompanied by symptoms, the systolic blood pressure does not rise but falls during exercise > 10mmhg, or the systolic blood pressure is too high > 220mmhg, it is not appropriate to exercise again. Especially when exercising in hot summer, you should replenish water in time. (Text/Department of Cardiology, Beijing Chuiyangliu Hospital
Gao Lei Pi Lin, Internship Editor/Huang Jiongrui)