Respiratory System: Wan Qiang Feng Yongxiao

Respiratory System: Wan Qiang | > Feng Yongxiao
Cardiovascular System: Cao Jingyu | > Yang Binfeng
Hypertension: Wei Aiqing | > Chen Guangyan
Digestive System: Xue Wenhan | > Yang Binfeng
|
Urinary System: Zhang Guiqiong |
Gynecological Diseases: Zhang Chouchou | > Feng Yongxiao
Endocrine System: Qi Li | Wang Xin, Wang Jing
|
Hematological Diseases: Peng Yanyan |
Tumors: Huang Bangrong |
Autoimmune Diseases: |
Chen Guangyan |
Contents
Introduction / 001
Chapter 1: Physiology and Pathology of Hypertension 005
Chapter 2: Diagnosis and Treatment of Hypertension I 016
Chapter 3: Professor Pei Zhengxue’s Integrated Chinese and Western Medicine Treatment for Hypertension / 062
Chapter 4: Historical and Contemporary Schools of Thought on Hypertension / 090
Chapter 5: Special Types of Hypertension I 105
Introduction
Hypertension refers to a clinical syndrome characterized primarily by elevated arterial blood pressure in the systemic circulation (systolic or diastolic pressure)—specifically, systolic pressure ≥ 140 mmHg and diastolic pressure ≥ 90 mmHg—and may be accompanied by functional or organic damage to organs such as the heart, brain, and kidneys. Hypertension is the most common chronic disease and the primary risk factor for cardiovascular and cerebrovascular diseases.
Normal blood pressure fluctuates within a certain range depending on internal and external environmental factors. In the general population, blood pressure tends to rise gradually with age, especially systolic pressure; however, after the age of 50, diastolic pressure begins to decline, leading to an increased pulse pressure.
In recent years, as people’s understanding of the multiple risk factors for cardiovascular disease and the importance of protecting target organs such as the heart, brain, and kidneys has deepened, the diagnostic criteria for hypertension have also been continuously adjusted. It is now recognized that patients with the same blood pressure level face different risks of developing cardiovascular disease, hence the concept of blood pressure stratification—that is, patients with different levels of cardiovascular risk should aim for different optimal blood pressure ranges. Blood pressure values and risk factor assessments are the main basis for diagnosing hypertension and formulating treatment plans; therefore, the goals of hypertension management vary from patient to patient. When treating patients, physicians refer to standard guidelines and, based on individual circumstances, determine the most appropriate blood pressure range for each patient, implementing targeted therapeutic measures. In addition to lifestyle improvements, it is recommended to use long-acting antihypertensive medications for 24-hour blood pressure control. Besides assessing clinic blood pressure, patients should also pay attention to monitoring and managing their morning blood pressure at home to keep blood pressure under control and reduce the incidence of cardiovascular and cerebrovascular events.
Currently, hypertension health management is divided into three levels: (1) Self-health management. Individuals are primarily responsible for maintaining their health; they should practice self-health management, enhance health literacy and self-care awareness, regularly monitor their health status, screen and assess risk factors, take targeted preventive measures, and promptly evaluate the effectiveness of health management. It is encouraged that people aged 18 and above be aware of their own blood pressure. In communities where conditions permit, household blood pressure measurement should be promoted, and hypertensive patients should be encouraged to keep a “blood pressure diary,” regularly recording their blood pressure and pulse rate. The “Internet + Blood Pressure Management” model should also be piloted and promoted. Residents measure their blood pressure themselves and upload data using smart terminal devices, thereby combining household self-health management with remote physician management. (2) Standardized management by primary healthcare institutions. Family doctors serve as gatekeepers of residents’ health; primary healthcare institutions, led by family doctor teams, conduct standardized management for populations at high risk of hypertension and for hypertensive patients. Resident health records should be established, and high-risk groups should undergo screening, intervention, and evaluation. For those already diagnosed with hypertension, active antihypertensive treatment should be provided to prevent complications, improve prognosis, and enhance quality of life. Regular follow-up visits should be conducted to track blood pressure levels, medication usage, adverse reactions, and other risk factors such as heart rate, blood lipids, blood sugar, and body weight, along with corresponding interventions and clinical management. Based on whether patients’ blood pressure meets the target, tiered management should be implemented, with particular emphasis on patients whose blood pressure fails to reach the target, in order to improve blood pressure control rates. (3) Focused management by higher-level medical institutions. Relying on existing national, provincial, municipal, and county-level chronic disease prevention and control agencies as well as hypertension-specific medical consortium resources, tertiary hospitals, secondary hospitals, and primary healthcare institutions can form regional hypertension management teams. For patients whose blood pressure control is poor at the primary level and whose management outcomes are unsatisfactory, referral to higher-level medical institutions for focused management can be carried out through a tiered diagnosis and treatment mechanism. At the same time, higher-level medical institutions provide technical support and training for long-term monitoring and management of primary-level hypertension patients, and conduct quality control and evaluation of hypertension health management work. See the table below.
Classification and Definition of Blood Pressure Levels