The blood supply to the brain of hypertensive patients with cerebral artery stenosis is insufficient. If their blood pressure decreases quickly in this occasion, the blood supply can only reach the trunk and branches of the cerebral arteries and brain tissues far from the cerebral artery branches will experience ischemia, thereby resulting in stroke (Ischemic stroke).
An example: A patients has a hypertension history of 20 years. Two days ago he felt dizzy and his blood pressure was 165/100mmHg after the measurement. He hurried to take out two nifedipine tablets for sublingual administration. Half an hour later, his blood pressure was decreased to 120/70 mmHg, while he suddenly felt that his right limbs were weak and he was unable to talk. This patient was suffering from a stroke, for which the direct reason was his exceedingly low blood pressure. Then why does improper decreasing of blood pressure result in stroke?
Decreasing blood pressure to normal levels (120/80 mmHg) is not suitable for all people with high blood pressure. For hypertensive patients who have been suffering from cerebral artery stenosis or atherosclerosis for a long time, decreasing blood pressure to normal can lead to dizziness and palpitation in patients with mild conditions and stroke in patients with severe conditions. This is because the blood supply to the brain tissues is achieved by pressure and flow rates. When a person is standing upright, his brain is in a high position, and a certain level of blood pressure is required for the blood vessels to ensure the blood supply. Therefore, it is recommended that people with high blood pressure should pay attention to the following aspects:
1. Patients with long-term high blood pressure, high blood sugar and hyperlipemia had better go to hospital for Neck Vascular Color Doppler Ultrasound and Cerebral Angiography. If patients are found to develop carotid or vertebral artery stenosis and sclerosis, their blood pressure cannot be lowered to normal levels, but to a slightly higher level. Doctors should provide guidance on the concrete level of blood pressure based on patients’ general conditions.
2. When patients with high blood pressure manifest such symptoms of cerebral ischemia as dizziness, palpitation and limb weakness when they are standing or walking, they should not rush to take antihypertensive drugs, especially the sublingual administration of nifedipine should be forbidden. Patients should measure their blood pressure at this time and go to hospital for diagnosis and treatment in time.
Blood pressure goals for elderly
The greater the pulse pressure is, the more risks there will be
Narrow the pulse pressure without non antihypertensive drug
Systolic hypertension in elderly (SBP > 160 mmHg, DBP < 90 mmHg)
Decreased systolic pressure can better indicate the actual effects of blood pressure control
Drugs for complications of hypertension in the elderly
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