Losing Weight Is One Of The Most Effective Ways To Lower Blood Pressure，why Blood Pressure Can’t Drop

Mr. Lin, a 56-year-old male, usually has the habit of smoking, and his weight is higher than the standard. His BMI value is 32kg/m2. Mr. Lim usually suffers from high blood pressure and is treated at the clinic. Although he is very active in quitting smoking and losing weight, he tries to follow the principle of less salt and less oil in his daily diet. After using diuretics, calcium ion blockers, and angiotensin receptor antagonists in the clinic, the blood pressure was still around 172/120mmHg, so the doctor added another blood pressure-lowering drug, but the side effect of the drug - hirsutism, was Mr. Lim could not bear it, so he was referred to a medical center for further evaluation.

After a series of examinations, including abdominal computed tomography and 24-hour blood pressure monitoring, etc., Mr. Lin was diagnosed with essential stubborn hypertension, and both renal arteries of Mr. Lin were unblocked, so the doctor and Mr. Lin jointly Discussed renal arterial sympathetic cautery as an alternative to treating his resistant hypertension.

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Before the operation, Mr. Lin still took blood pressure-lowering drugs regularly. On the day of Mr. Lin’s renal artery sympathetic nerve cauterization, the doctor first administered local anesthetics to Mr. Lin’s groin and performed a percutaneous puncture of the femoral artery. . During the process, Mr. Lin felt abdominal pain and reacted to the doctor. The doctor gave Mr. Lin some analgesics to relieve Mr. Lin's discomfort. Renal artery sympathetic nerve electrocautery takes about 1 to 2 hours. After the operation, Mr. Lin lay down and rested in the ward, and used a compression belt to stop the bleeding. Due to the good wound recovery, Mr. Lin was discharged from the hospital the next day after the operation. When he was discharged from the hospital, Mr. Lin's blood pressure medicine remained at the original therapeutic dose.

Resistant hypertension

For those patients whose blood pressure is not well controlled, about 10 to 15% of patients still have poor blood pressure control after removing adjustable interfering factors, such as inappropriate prescriptions, non-compliance with doctor's orders, and incorrect blood pressure measurement methods Do your best. For this kind of patient, we call it resistant hypertension.

Clinical definition: When using more than three antihypertensive drugs containing diuretics, and the drug has reached the maximum dosage, but still cannot reduce the blood pressure to the target value, we call it "refractory hypertension".

For patients with stubborn hypertension, although we can add more types of antihypertensive drugs, more drugs relatively mean that the interaction and side effects between drugs will increase, so blindly increasing the use of antihypertensive drugs is harmful to patients It's not the best treatment. Therefore, we need to seek other treatment methods.

In recent years, due to the advancement of cardiac catheterization technology, electrical cautery using cardiac catheterization has been introduced clinically to block the role of renal sympathetic nerves in order to control refractory hypertension. Before we delve further into this topic, let's look at the relationship between the sympathetic nerves of the kidneys and hypertension.

What do the kidneys have to do with high blood pressure? How to avoid high blood pressure every day?

Kidneys and high blood pressure

Since the kidney distributes a lot of sympathetic neurons, the neural network formed by these sympathetic nerves is densely distributed in the renal blood vessels, glomeruli, and renal tubules. Physiologically, the sympathetic nerves of the kidneys are responsible for regulating the secretion of a hormone called renin, which regulates the reabsorption of sodium ions and water through angiotensin and aldosterone, and controls blood flow and blood pressure in the kidneys.

The sympathetic nerves of the kidneys regulate:

◆Secretion of renin

◆Reabsorption of sodium and water

◆Renal blood flow

Discussing the pathophysiological mechanism of hypertension must mention the renin-angiotensin-aldosterone system (Renin-angiotensin-aldosterone system). So renin plays a very important role in the cause of high blood pressure.

Many antihypertensive drugs used clinically are related to the regulation of the renin-angiotensin-aldosterone system. Therefore, some scholars set out to study whether blocking the sympathetic nerve of the kidney can reduce the reabsorption of sodium ions and water, thereby improving blood pressure control. This treatment method has been continuously improved, and now it has been developed to use the electric cauterization catheter to perform electric cauterization of the renal artery sympathetic nerve, which has opened up another brand-new way for the treatment of intractable hypertension.

How to prevent kidney problems in blood pressure?

Many hypertensive patients can lower their blood pressure and keep it within a healthy range through lifestyle changes, such as quitting smoking and alcohol, maintaining a healthy weight, eating a low-salt and low-fat diet, regular exercise, and managing emotions and stress. These all help to prevent the occurrence of high blood pressure and avoid the deterioration of high blood pressure.