Hypertension高血压

Place · Level 3 · Condition

RAAS + 内皮 + 钠钾平衡 · 中国 2.5 亿患者 · DASH RCT · SPRINT 130/80 标准 · ACEi/ARB 一线

HTN · what + China

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高血压 · 定义 + 中国数字

The plain version first: the scary thing about high blood pressure isn't any single number — it's that over decades it silently wears down your vessels, heart, kidneys, and eyes, and most people feel nothing the whole time, which is why it's called "the silent killer". Below: the definition, the real numbers in China, and how blood pressure actually climbs.

Hypertension = sustained elevation of blood pressure that, over time → damage to cardiac, cerebral, and renal vasculature → MI / stroke / heart failure / kidney failure.

Diagnostic thresholds (2017 ACC/AHA update):

Normal: < 120 / 80 mmHgElevated: 120-129 / < 80Stage 1 hypertension: 130-139 / 80-89Stage 2 hypertension: ≥ 140 / 90Hypertensive emergency: ≥ 180 / 120 + organ damage
The SPRINT trial (2015 NEJM) moved the target from < 140/90 to < 130/80 (and < 120/80 in high-risk patients) — a clinical-guideline paradigm shift noted across the atlas.

Chinese epidemiology (Wang 2018 Circulation, national survey):

Prevalence 27.9% (~ 250 million patients)Awareness 51% / treatment 46% / control 16.8%"The silent killer": most patients are asymptomatic until complications appearSalt intake ~ 11 g/day (WHO recommends < 5 g) — China has one of the highest salt intakes worldwide
Why these numbers matter:

Cardiovascular deaths account for 40%+ of all-cause mortality in China (GBD 2019)The number-one modifiable risk factor for cardiovascular disease = hypertensionRaising the control rate from 17% to 50% (US / Japan level) → about 700,000-1,000,000 fewer deaths per year
Home BP monitoring:

Home measurement is preferred over office measurement (avoids "white-coat" + "masked" hypertension)Twice in the morning (1 h after waking) and twice before bed; take the averageUpper-arm electronic monitors are accurate; wrist and finger monitors are unreliableDiagnosis requires multiple measurements, not a single reading
How blood pressure rises (brief mechanism — next scene goes deeper):

1. Cardiac output ↑ (heart rate × stroke volume) — anxiety + hypervolemia + high sympathetic tone
2. Peripheral resistance ↑ — vasoconstriction + endothelial dysfunction + vascular stiffening
3. Blood volume ↑ — sodium retention + activation

Atlas connections: atherosclerosis (cardiovascular L4) + sleep-apnea (upper-airway collapse + HTN) + endocrine/metabolic-syndrome (second MetSyn criterion) + magnesium/relax (Mg and BP) + potassium-sodium/gradient (Na/K balance basics).

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本站提供科普与一般性建议，不替代医师诊断或处方；有症状或正在服药请咨询合格医师。 Educational content, not medical advice — consult a clinician for diagnosis or treatment.

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