Most scholars believe that long-term hypertension can cause vitreous degeneration, decreased elasticity and increased brittleness of cerebral arteries. Vascular wall tension is lost, and cellulose necrosis occurs, which leads to spindle or spherical aneurysms in local arteries under the impact of blood pressure, and blood can also invade the vascular wall to form dissecting aneurysms. When blood pressure suddenly rises, the aneurysm ruptures and causes bleeding. Hypertension can also cause cerebral arteriole spasm, leading to ischemia, hypoxia, necrosis and bleeding of distal brain tissue.
Hypertensive cerebral hemorrhage is one of the most serious complications of hypertension. It is common in 50-70 years old, with a little more males, and it is easy to occur in winter and spring, especially in patients with obvious hypertension or arteriosclerosis. Patients with cerebral hemorrhage often have sudden onset due to emotional excitement and sudden exertion. If the treatment is not timely, the early mortality rate is very high, and most survivors have sequelae such as dyskinesia, cognitive impairment and dysphagia.
Male hypertension is uncontrollable, smoking after meals and sudden cerebral hemorrhage.
Case: Patient xxx, male, 46 years old, with a history of hypertension 10 years. His blood pressure was slightly higher before, so he didn't pay attention. Later, his blood pressure kept rising and he had to rely on drugs to control it. But there is a bad habit of smoking after meals.
One day recently, the patient went to the balcony to smoke after eating, and suddenly felt a severe headache in the middle of smoking. He rested on the sofa for a while, but he didn't relieve himself and was weak. His family found that the situation was not good and quickly sent the patient to the hospital for treatment. After preliminary examination, it was found that the blood pressure was as high as 180/97mmHg, and the consciousness was blurred. Doctors initially thought it was a brain lesion. Do CT examination immediately and be diagnosed as cerebral hemorrhage. After rescue, the bleeding point was controlled and then sent to ICU for follow-up treatment.
The doctor said that hypertensive cerebral hemorrhage mostly occurs at the age of 50-70, usually during activities and emotional excitement. Before bleeding, there is no warning. Half of the patients had severe headache, common vomiting, and blood pressure increased significantly after bleeding. Clinical symptoms usually peak in a few minutes to a few hours. Hemiplegia caused by hemorrhage of basal ganglia, thalamus and internal capsule is a common early symptom. A few cases have seizures, often local; Severe cases will soon turn into confusion or coma.
Hypertension patients, despite taking medicine, smoke after meals, resulting in poor blood pressure control, and even greater fluctuations, leading to cerebral vascular rupture and bleeding. As the saying goes, "a cigarette after a meal is better than a fairy", but in fact, a cigarette after a meal may seriously endanger human health and even life. Because when we are full, a lot of blood in the body is concentrated in the stomach, and the blood circulation is more active at this time. Harmful substances in cigarettes will also be over-absorbed, which will stimulate the blood vessels and nerves of the body and cause blood pressure instability. Thereby inducing cerebral hemorrhage.
What are the main factors of essential hypertension?
1, genetic factors. Nearly 60% patients with essential hypertension have family history, and nearly 30~50% patients have genetic background. Studies have shown that polygene inheritance is an important factor causing hypertension family aggregation. Long-term living environment and diet are also the reasons for the gathering of hypertensive families;
2, long-term smoking. Cigarettes can raise blood pressure. Because cigarettes contain "nicotine", it will not only make the brain dependent and addicted. Nicotine can also stimulate the adrenal gland to release a lot of catecholamine and adrenaline, leading to abnormal contraction and spasm of its own blood vessels and accelerated heartbeat. Over time, smooth muscle degeneration and intimal thickening of arteriole wall gradually developed into hypertension and arteriosclerosis. The data show that smoking a cigarette every day increases systolic blood pressure10-30 mmhg;
Step 3 drink. Studies have shown that a small amount of long-term drinking will cause a slight increase in blood pressure, while excessive drinking will significantly increase blood pressure. Although alcohol will cause a short-term drop in blood pressure during metabolism in the body, it is mainly related to the characteristics of alcohol dilating blood vessels. However, when alcohol is completely metabolized, blood pressure will rebound again. At the same time, alcohol can also cause vascular endothelial damage, and then induce hypertension and atherosclerosis;
4, high sodium diet. In fact, it is the sodium ion contained in salt that causes the blood pressure to rise. Excessive intake of any high-sodium food will cause a metabolic burden on the kidneys, leading to a large accumulation of sodium ions in the body, which will gradually develop into water and sodium retention, increased blood volume and blood pressure fluctuation. In addition to salt, there are various condiments, potato chips, instant noodles, noodles, cakes and so on. They are all high-sodium foods and should be eaten less;
5. Emotional instability. Emotion will affect the changes of hypertension, such as long-term life stress, mental stress, emotional fluctuation, etc., which will cause blood pressure fluctuation. Because emotions interact with endocrine and neurological functions. Severe mood swings will stimulate the secretion of angiotensin, leading to accelerated heartbeat and vasodilation. Repeatedly, it will develop into abnormal spasm of arterial blood vessels and increase blood pressure. Studies have shown that people's blood pressure generally rises after meals. If you are emotional and agitated at this time, it will induce an increase in blood pressure, cause abnormal contraction of brain blood vessels, and accelerate the occurrence of cerebral hemorrhage.
6, cold stimulation. Cold weather can lead to an increase in blood pressure through several mechanisms: it can activate the sympathetic nervous system and the renin-angiotensin aldosterone system, leading to contraction of peripheral blood vessels and skin blood vessels and an increase in heart rate, thus increasing blood pressure; Inhibit the production of vasodilators such as nitric oxide and promote the increase of blood pressure; Activating endothelin system in vivo is helpful to raise blood pressure. In particular, sudden inhalation of cold air will cause coronary artery spasm and easily induce angina pectoris, myocardial infarction and aortic dissection. Cold stimulation can also induce stroke.
In addition, human blood is concentrated in the stomach after meals. If you take a bath immediately after a meal, the blood vessels will expand rapidly, but the blood can't keep up, which will cause great pressure on the blood vessels and increase the burden on the heart. It is likely to fall into a coma while taking a shower, leading to cerebral hemorrhage.