How to manage blood pressure in patients with coronary artery disease?
We are committed to protecting lives and extending our services with love, and will regularly provide you with information on the prevention, treatment and health care of heart and critical illnesses.Hypertension is a common disease. When blood pressure rises, some patients will experience discomfort such as dizziness and headaches, while others will not feel any discomfort until their blood pressure is measured. Long-term elevated blood pressure can lead to serious cardiovascular and cerebrovascular diseases. Therefore, when elevated blood pressure is detected, it is important to seek medical consultation and treatment in a timely manner to control blood pressure as early as possible in order to reduce the harmful effects of hypertension on the body.
Hypertension is also one of the most important risk factors for coronary heart disease, and hypertension and coronary heart disease can often co-exist. As hypertension increases the load on the heart and causes pathological thickening of the heart muscle, it increases myocardial oxygen consumption and impairs coronary microcirculation, which reduces coronary blood supply and makes myocardial ischaemia more likely to occur when combined with coronary artery disease. Therefore, patients with hypertension combined with coronary artery disease have a greater need for reasonable blood pressure control to prevent the occurrence of cardiovascular disease.
Patients with coronary artery disease combined with hypertension need to have their blood pressure monitored regularly. Blood pressure monitoring can be done in a medical facility or at home, using an upper-arm medical electronic sphygmomanometer, and is usually done twice a day, in the early morning and late evening, for several days, weeks, months or even years, to keep track of blood pressure control. If blood pressure is not well controlled, or if it fluctuates significantly, ambulatory blood pressure testing can also be performed to accurately reflect the true blood pressure level.
It is now generally accepted that patients with coronary artery disease combined with hypertension should be initiated on pharmacological antihypertensive therapy with a target value of <130/80 mmHg. In patients over 80 years of age, blood pressure should be controlled to less than 150/90 mmHg. A diastolic blood pressure of no less than 60 mmHg is recommended.
The treatment of patients with coronary artery disease combined with hypertension can be achieved through non-pharmacological and pharmacological treatment. Non-pharmacological treatment refers to a full range of lifestyle interventions, including: dietary interventions, restricting sodium intake, abstaining from alcohol and actively reducing weight; moderate exercise, choosing an appropriate exercise programme while avoiding triggering angina; mood regulation, relieving tension and anxiety; and smoking cessation.
In terms of medication, patients with coronary artery disease combined with hypertension should be controlled medically under the advice of a cardiologist. It is now believed that specific types of antihypertensive drugs can reduce the long-term harm of coronary artery disease, especially in patients who have had a myocardial infarction, and by combining multiple drugs with antihypertensive effects, cardiac function can be greatly improved. Therefore, when blood pressure permits, cardiologists may use drugs with antihypertensive effects in such patients, where the doctor’s concern is not only about the antihypertensive effect of the drug, but also about the protective effect of the drug on the heart.
In conclusion, hypertension should be treated as early as possible to reduce the risk of hypertension leading to coronary heart disease; and patients with coronary heart disease combined with hypertension should pay more attention to blood pressure control, together with pharmacological and non-pharmacological treatments, to reduce the impact of hypertension on the heart.
