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Hypertension
The difference between hypertensive encephalopathy and malignant hypertension
Hypertensive encephalopathy and malignant hypertension are two critical conditions that can occur in patients with hypertension, both triggered by a sudden and drastic increase in blood pressure in a short period. Literally, hypertensive encephalopathy focuses on the severe rise in blood pressure in a short term, causing some damage to the nervous system. The main mechanism is due to the too rapid increase in blood pressure over a short period, exceeding the self-regulation range of cerebral blood vessels. At this time, the pressure in the cerebral vessels increases sharply, causing the components of the blood in the cerebral vessels to spill over into the brain tissue, manifesting some neurological symptoms, mainly severe headache, dizziness, nausea, vomiting, seizures, convulsions, and even herniation of the brain, all due to brain edema and intracranial hypertension. Malignant hypertension covers a broader range than hypertensive encephalopathy. Besides the neurological symptoms mentioned above, it also affects other systems, such as acute proteinuria, renal failure, and acute heart failure, focusing on the impact on multiple systems throughout the body, including the brain. Hypertensive encephalopathy is more focused on the reactions in the brain, so these two conditions have a common pathogenesis but focus on different aspects.
What is the standard for high blood pressure?
The standard for hypertension is a systolic pressure of 140 mmHg or higher and a diastolic pressure of 90 mmHg or higher. Whether it is systolic or diastolic pressure, if either exceeds the normal range, it is considered hypertension. People with hypertension need to actively undergo antihypertensive treatment. Long-term effective control of blood pressure to meet standards is necessary to reduce the harm caused by elevated blood pressure to the body. If high blood pressure is not effectively controlled, long-term elevated blood pressure can cause damage to the heart, brain, and kidney target organs, and even lead to severe cardiovascular and cerebrovascular complications, thus severely affecting the patient's health and even endangering the patient's life.
How to monitor blood pressure in hypertensive crisis
If a patient experiences a hypertensive crisis, it is recommended that they use an electrocardiogram monitor. This can effectively monitor changes in the patient's heart rate, blood pressure, and pulse. If there is a rise in blood pressure, it can be immediately observed. The occurrence of a hypertensive crisis is very dangerous and can lead to complications, potentially causing damage to liver and kidney functions, and leading to cardiovascular and cerebrovascular events. In particular, it is prone to causing cerebral hemorrhage or coronary heart disease. In such cases, it is crucial to actively use antihypertensive drugs to control symptoms. Regarding diet, it is important to maintain a light diet, especially limiting sodium intake, in order to control the phenomenon of high blood pressure in patients.
Difference between hypertensive encephalopathy and malignant hypertension
The difference between hypertensive encephalopathy and malignant hypertension can be discerned from their names, indicating they are different conditions. Hypertensive encephalopathy refers to a condition where blood pressure rises sharply in a short period, with diastolic pressure exceeding 120 mmHg and systolic pressure exceeding 200 mmHg. This dramatic increase in blood pressure causes cerebral vasospasm and increased cerebral perfusion pressure, leading to various manifestations of cerebral edema, primarily severe headache, nausea, vomiting, seizures, and even brain herniation. The emphasis is on the rapid rise in blood pressure over a short term and its impact on the brain, specifically cerebral edema. Malignant hypertension also involves a rapid increase in blood pressure to extremely high levels over a short period. However, the focus of malignant hypertension is on the impact on multiple organs throughout the body, including the brain, but also severely affecting the heart, potentially causing acute left heart failure and pulmonary edema. In the kidneys, it can lead to acute renal failure, characterized by reduced urine output or anuria. Thus, malignant hypertension emphasizes the effects on multiple vital organs, whereas hypertensive encephalopathy focuses primarily on the impact on the brain and central nervous system. Hence, there are some distinctions between the two conditions.
How to treat hypertensive encephalopathy
The treatment goal for hypertensive encephalopathy is mainly to rapidly reduce blood pressure to a reasonable range. Typically, intravenous antihypertensive drugs are administered to decrease blood pressure by 20%-25% within the first hour, followed by oral antihypertensives or continued intravenous treatment to further reduce it to a more reasonable level. Hypertensive encephalopathy often accompanies cerebral edema, and patients may experience increased intracranial pressure. At this point, it is necessary to administer dehydrating agents such as mannitol to treat the cerebral edema. If the patient experiences seizures, which can cause an increase in blood pressure or difficulty in reducing blood pressure, sedative anticonvulsant drugs must be administered to control the seizures. If the patient shows signs of heart failure, diuretic treatment should be initiated. Additionally, high concentration oxygen therapy under high pressure should be administered, which can be delivered through nasal cannula. If nasal oxygen therapy is ineffective, non-invasive ventilation or even intubation with invasive ventilation may be used to provide high concentration positive pressure oxygen therapy.
What vegetables should be eaten for high blood pressure?
Hypertension is a common disease in our daily life. What vegetables should people with hypertension eat? Pay attention to the following aspects: First, eat less salty food, especially pickled foods, such as salted pork, cured meat, and pickled fish products; these should be consumed in moderation. Second, eat more vegetables and fruits, such as celery, bitter melon, cabbage, and tomatoes. These vegetables are very helpful for our health. Likewise, fruits such as apples and pears, which are rich in Vitamin C, also assist in maintaining good health.
Is high diastolic pressure considered high blood pressure?
If the diastolic blood pressure exceeds 90 mmHg, hypertension should also be considered. Patients with a high diastolic blood pressure who do not actively undergo hypotensive treatment can suffer long-term damage to target organs such as the heart, brain, and kidneys, as well as severe hypertensive complications. For patients with high diastolic blood pressure, it is also necessary to adopt effective lifestyle adjustments and choose clinically frontline antihypertensive drugs for long-term treatment. Only by effectively controlling elevated diastolic pressure in the long term can severe target organ damage and hypertensive complications be avoided, thus improving the clinical prognosis for patients with hypertension.
How to prevent high blood pressure
The main methods to prevent hypertension are as follows: 1. Maintain a balanced diet, avoid long-term excessive intake of sodium salt, and make sure to consume plenty of fresh vegetables and fruits to supplement adequate amounts of potassium salt and dietary fiber; 2. Regularly participate in sports and physical labor, maintain an active lifestyle, avoid a sedentary lifestyle, and prevent significant weight gain; 3. Combine work with rest to avoid repeated fatigue and staying up late; work should be flexible, and ensure sufficient sleep at night; 4. Maintain a good mood, avoid frequent emotional fluctuations, and also avoid long-term mental overstrain; 5. Do not smoke and avoid excessive drinking.
The difference between hypertensive nephropathy and renal hypertension
Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.
How to lower high blood pressure
Patients with hypertension need to adopt a comprehensive approach to reduce their blood pressure, primarily comprising two aspects: On one hand, they should regulate their lifestyle for treatment purposes, which includes maintaining a long-term low-salt and low-oil diet, consuming more vegetables and fruits, regularly engaging in physical exercises and labor, keeping a healthy weight level, avoiding fatigue, not staying up late at night, and maintaining a good emotional state. On the other hand, suitable antihypertensive medications should be chosen based on the specific conditions of the patients and used long-term. If necessary, a combination of antihypertensive drugs may be required. Effective control of blood pressure can only be achieved by combining lifestyle adjustments with medication.