Nursing measures for preventing cerebral hemorrhage due to high blood pressure

Stabilizing blood pressure within a safe range, avoiding high-risk triggers that can cause blood pressure to rise suddenly, and identifying early warning signs before an attack - if these three things are done well, the risk of cerebral hemorrhage related to hypertension can be reduced by more than 80%. This is the most practical conclusion I have drawn from having stayed in the Department of Neurology for 4 years and following up on nearly a thousand patients with hypertension.

The 52-year-old Uncle Zhang who was admitted last month is a typical negative example. He was diagnosed with high blood pressure three years ago. He took antihypertensive medicines only when he remembered. He usually took one pill when his blood pressure was high. If it was normal, he immediately stopped taking the medicine. On the weekends, he drank half a kilogram of white wine at a party with his old comrades. Playing mahjong at night, he fell to the ground when he got up to go to the toilet. He was sent for a CT scan, which showed 32ml of basal ganglia bleeding. Although he was rescued, he still suffered from hemiplegia on the left side of his body. If he could control his blood pressure well, this kind of thing could be completely avoided.

Many people think that everything will be fine after taking antihypertensive drugs. In fact, this is not the case at all. You must first find out whether your blood pressure is really stable. I have seen too many elderly people using wrist blood pressure monitors. If the arm is thicker, the error can be as much as 20mmHg. The measured number cannot be referenced at all. It is best to use the upper arm type. When measuring, the arm is at the same level as the heart. Don't cross your legs to measure, otherwise the value will not be accurate. The timing of the test is also important. The most accurate one is to test it once in the morning when you are lying still, without drinking water or taking medicine, and again half an hour before going to bed at night. Don’t take the test just after shopping and climbing up the stairs. If the value is too high, you will scare yourself. If the value is too low, you will easily become paralyzed.

The misunderstanding about taking medicine can really be said for three days and three nights. Many people follow the trend and say that "antihypertensive medicines harm the liver and kidneys" and stop taking them for a while. This is really harmful. A while ago, a patient told me that he drank celery juice to lower his blood pressure. He stopped taking the medicine for three months, and when he came for a follow-up checkup, his blood pressure was 190/110. I immediately asked him to stay in the hospital for observation, because I was afraid that his blood vessels would burst if he went out and got excited. In fact, the current mainstream antihypertensive drugs have very low side effects. Compared with the risk of long-term fluctuations in blood pressure that may damage blood vessels or even cause cerebral hemorrhage, the side effects are almost negligible. Of course, there are also different clinical opinions here: if some elderly patients have many underlying diseases and poor liver and kidney function, they really need to adjust the dosage according to the doctor's advice, and cannot blindly copy other people's medication plans. After all, everyone has different tolerances, so don't adjust the medication blindly by yourself.

After stabilizing basal blood pressure, you must also avoid pitfalls that cause blood pressure to suddenly spike. For example, many people like to go out early in the morning to dance square dances and buy groceries before dawn in winter. When the cold wind blows, the blood vessels shrink and the blood pressure rises suddenly. Every year, there are 30% more patients with cerebral hemorrhage in winter than in summer. This is the reason. There are also triggering factors that I have seen too many times: straining hard when constipated, quarreling with others to the point of trembling with anger, staying up until two or three in the morning, drinking high-strength liquor, and squatting and standing up violently. There is also a point that has been controversial for a long time: can patients with high blood pressure exercise? The traditional view is that you should rest more and exercise less to avoid raising blood pressure. However, the latest "China Hypertension Prevention and Treatment Guidelines" clearly states that as long as the blood pressure is stable below 140/90mmHg, you can do moderate-intensity exercises such as brisk walking, Tai Chi, and Baduanjin. On the contrary, it can help restore the elasticity of blood vessels. However, you should avoid exercises that require sudden force such as weight lifting and pull-ups while holding your breath. ； If you are a patient with cerebrovascular malformation or aneurysm, you should be more cautious. It is best to see a doctor for evaluation before deciding whether to exercise.

You don’t need to go too extreme in your diet. Don’t listen to those rumors about being completely vegetarian. Just control the amount of salt in a beer bottle cap every day. There is a lot of invisible salt in pickled vegetables, soy sauce meat, and takeaways. Last time, a patient said that he did not add salt when cooking at home. As a result, he ate half a bag of pickled mustard every day, and his blood pressure could not be lowered. After asking, he found out that it was a problem with the pickled mustard. There are now two schools of thought. One school believes that patients with high blood pressure should completely avoid animal fats and not even touch lean meat. The other school believes that eating about one or two pieces of lean pork and fish every day can supplement high-quality protein and is good for blood vessel walls. I personally prefer the latter. Being completely vegetarian can lead to malnutrition and reduced immunity, which is not worth the gain.

Finally, I have to say something to my heart’s content. If you suddenly experience numbness on one side of your face, can’t hold a cup, suddenly speak with a big tongue, see double images, or have a headache that feels like you’ve been hit with an axe, and feel nauseous and want to vomit, don’t think “I’ll just take a rest.” Call 120 immediately. The golden time for rescuing cerebral hemorrhage is 3-6 hours after the onset of the disease. The longer it is delayed, the worse the prognosis will be. Last year, there was a 68-year-old aunt who suddenly felt numbness in her left hand when she woke up in the morning. She thought it was due to pressure during sleep. She lay down for two hours before calling her child. When the child was delivered, he had already suffered a brain herniation. In the end, he was not rescued. Now she thinks about it and feels sad.

In fact, after all, the care of high blood pressure to prevent cerebral hemorrhage is really not a profound knowledge. It just means doing these daily small things solidly and not taking any chances. After all, your blood vessels are like the rubber water pipes at home. They work with overpressure every day, and you often freeze them and scald them. No matter how strong the pipe is, it will burst one day, right? It is much more cost-effective to have more snacks at ordinary times than to be admitted to ICU for rescue in the event of an accident.