血压难控因素的中医认识及辨治体会

Uncontrolled factors of blood pressure in essential hypertension: from "patient's high blood pressure" to "hypertensive patient"

高血压是心脑血管疾病最主要的危险因素,已成为全球重大公共卫生问题。控制血压可以大大减少或延缓并发症的出现,减少心脑血管风险的发生。然而,临床上依然存在即使增加降压药物的种类和剂量,降压疗效依然不佳的现象。究其原因,除常见的药物因素、饮食因素、运动因素等之外,常可找到严重干扰降压的诱因,即"血压难控因素"。近年来,血压难控因素备受关注,包括失眠、便秘、情绪、外感等。临床发现,诱因一旦找到,给予恰当的辨证论治,血压往往能迅速下降,降压药物的种类和剂量也随之减少。近年来,"血压难控因素"的防治逐渐受到业内关注,这与当前对高血压病的认识不谋而合因此,高血压病的防治策略不应仅仅着眼于"患者的高血压"本身,而应更加关注"高血压的患者"。加强对"血压难控因素"的认识及治疗,可能正是中医药治疗高血压病的优势所在。

Hypertension is a significant medical and public health issue which puts an enormous burden on health care resources and the community. It is a chronic medical condition in which the systemic arterial blood pressure （BP） is elevated. Serious complications including cardiovascular and cerebrovascular diseases would be preventable if the rise in BP with age could be prevented or diminished. The majority of hypertensive patients require long-term treatment. Oral antihypertensive drugs, lifestyle modification including exercise and dietary modification are milestones for hypertension therapy. However, the control rate of hypertension hasn＇t reached the expected requirements currently. ＂Three lows＂ status quo, just low awareness, low treatment, and low control, are still the major problems confronting modern medicine. Recently, uncontrolled factors of blood pressure are widely concerned, which include insomnia, constipation, mood disorders, exogenous, etc. What＇s more, the control strategies of hypertension should not only pay close attention to ＂patient＇s high blood pressure＂, but also to ＂ hypertensive patient＂. Therefore, the treatment of uncontrolled factors of blood pressure plays an important role in hypertensive therapy, which could be further research priorities.