Blood pressure in the systemic circulation is referred to as blood pressure (BP). Blood pressure is the pressure exerted on the blood vessel wall when blood flows in the blood vessels. It is the driving force that pushes blood to flow in the blood vessels. When the ventricles contract, blood flows from the ventricles into the arteries. At this time, the pressure of blood on the arteries is the highest, which is called systolic blood pressure (SBP). When the ventricles relax, the elasticity of the arteries shrinks, and the blood continues to flow forward slowly, but the blood pressure drops. The pressure at this time is called diastolic blood pressure (DBP).
Average normal blood pressure reference value for Chinese people (mmHg)
| age | Systolic blood pressure (male) | Diastolic blood pressure (male) | Systolic blood pressure (female) | Diastolic blood pressure (female) |
| 16—20 | 115 | 73 | 110 | 70 |
| 21—25 | 115 | 73 | 110 | 71 |
| 26—30 | 115 | 75 | 112 | 73 |
| 31—35 | 117 | 76 | 114 | 74 |
| 36—40 | 120 | 80 | 116 | 77 |
| 41—45 | 124 | 81 | 122 | 78 |
| 46—50 | 128 | 82 | 128 | 79 |
| 51—55 | 134 | 84 | 134 | 80 |
| 56—60 | 137 | 84 | 139 | 82 |
| 61—65 | 148 | 86 | 145 | 83 |
Hypertension: An abnormal increase in arterial blood pressure above normal.
Systolic blood pressure: When the ventricles contract, the aortic pressure rises sharply and reaches its highest value in the middle of the systolic period. The arterial blood pressure value at this time is called systolic blood pressure, also known as "high blood pressure".
Diastolic blood pressure: When the ventricles relax, the aortic pressure drops. The lowest value of arterial blood pressure at the end of diastole is called diastolic blood pressure, also known as "low pressure".
Pulse pressure: the difference between systolic pressure and diastolic pressure.
Mean arterial pressure: the average value of arterial blood pressure at each moment in a cardiac cycle, approximately equal to diastolic pressure plus 1/3 pulse pressure.
KPa: Kilopascal, usually used to express blood pressure values.
mmHg: millimeters of mercury. When people use a mercury sphygmomanometer to measure blood pressure, the height of the mercury column "millimeters of mercury" is used to indicate the level of blood pressure.
1mmHg (millimeters of mercury) = 0.133kPa (kilopascals)
7.5mmHg (millimeters of mercury) = 1kPa (kilopascal)
Ideal blood pressure: systolic pressure <120mmHg and diastolic pressure <80mmHg.
Normal blood pressure: systolic pressure should be <130mmHg and diastolic pressure should be <85mmHg.
Upper limit of normal blood pressure or pre-hypertension: systolic blood pressure is 130~139mmHg and/or diastolic blood pressure is 85~89mmHg.
Hypertension: systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg.
Hypotension: systolic blood pressure ≤ 90 mmHg and/or diastolic blood pressure ≤ 60 mmHg.
Borderline hypertension: systolic blood pressure is 140-160 mmHg (18.6-21.3 kPa), and diastolic blood pressure is 90-95 mmHg (12.0-12.6 kPa).
Blood lipids are the general term for neutral fats (triglycerides and cholesterol) and lipids (phospholipids, glycolipids, sterols, steroids) in plasma, which are widely present in the human body. They are essential substances for the basic metabolism of living cells. Generally speaking, the main components of blood lipids are triglycerides and cholesterol, among which triglycerides participate in energy metabolism in the human body, while cholesterol is mainly used to synthesize cell plasma membranes, steroid hormones and bile acids.
Lipids contained in plasma are collectively referred to as blood lipids. Although the plasma lipid content accounts for only a very small part of the total body lipids, both exogenous and endogenous lipid substances need to enter the blood to circulate between various tissues. Therefore, blood lipid content can reflect the lipid metabolism in the body. After consuming a high-fat meal, the plasma lipid content increases significantly, but this is temporary and usually returns to normal after 3 to 6 hours. When testing blood lipids, blood is often collected 12 to 14 hours after a meal, so that the true situation of blood lipid levels can be more reliably reflected. Since increased plasma cholesterol and triglyceride levels are related to the occurrence of atherosclerosis, these two items have become the key items of blood lipid determination.
Short-term hunger can also cause a temporary increase in blood lipid levels due to the mobilization of a large amount of stored fat. This is why it is not difficult to understand why when you go to the hospital to check your blood lipids, the doctor asks you not to eat anything else after dinner and to fast for 12 hours before drawing blood. [1]
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Main types
Blood lipids mainly include
(1) Cholesterol (abbreviated as Ch) accounts for about 1/3 of the total lipids in plasma. It exists in two forms: free cholesterol and cholesterol esters. Free cholesterol accounts for about 1/3, and the remaining 2/3 is esterified with long-chain fatty acids to form cholesterol esters.
(2) Triglycerides, also known as neutral fat (abbreviated as TG), account for about 1/4 of the total plasma lipids.
(3) Phospholipids (abbreviated as PL) account for about 1/3 of the total plasma lipids, mainly including phosphatidylcholine, cephalin, serine phospholipids, neurophospholipids, etc., of which 70% to 80% are phosphatidylcholine.
(4) Free fatty acids (FFA), also known as non-esterified fatty acids, account for about 5% to 10% of the total plasma lipids and are the main source of energy for the body.
Lipids themselves are insoluble in water. They must combine with proteins to form lipoproteins in order to exist in the plasma in a dissolved form and flow through the blood to all parts of the body. Under normal circumstances, ultracentrifugation can separate plasma lipoproteins into four types: chylomicrons (CM), very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Zone electrophoresis can also divide plasma lipoproteins into four types: CM, pre-β (Pre-β), β, and α lipoproteins. Protein and lipid content in various plasma lipoproteins (weight %)
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Related standards
Normal range of blood lipids
The ideal value of low-density lipoprotein cholesterol control standard should be <130mg/dL; the critical value is 130-159mg/dL; and an excessively high value refers to low-density lipoprotein cholesterol >160mg/dL.
(1) Plasma total cholesterol control standard. The ideal value should be <200 mg/dL; the critical value is 200-239 mg/dL; the excessive value refers to plasma total cholesterol >240 mg/dL.
(2) Low-density lipoprotein cholesterol control standard. Its ideal value should be <130 mg/dL; the critical value is 130-159 mg/dL; the excessive value refers to low-density lipoprotein cholesterol>160 mg/dL.
(3) Plasma triglyceride control standard. The ideal value should be <200 mg/dL; the critical value is 200-239 mg/dL; the excessive value refers to the plasma triglyceride level >240 mg/dL.
(4) High-density lipoprotein cholesterol control standard. Its ideal value should be >50mg/dL; the critical value is 35-50mg/dL; the dangerous value is <35mg/dL.
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Treatment method
The fluctuation range of blood lipid content in normal people is relatively large, that is to say, the difference in blood lipid content between normal people is also very large. It seems unreasonable to judge pathological changes based on the level of one or two blood lipid components. Although blood lipids only account for a small part of the body's lipids, changes in blood lipids can basically reflect the state of lipid metabolism in the body. Blood lipids will change greatly in the case of dietary changes, strenuous exercise and illness. When eating a high-fat diet, blood lipid content increases significantly, and even forms a milky color, but it gradually returns to normal after 3 to 6 hours. Therefore, in clinical testing of blood lipids, blood is drawn on an empty stomach in the morning to reflect the actual level of blood lipids in patients.
Changes in blood lipids are mainly related to the amount of fat in the body and the use of fat depots by the body, and reflect the body's fat metabolism to a large extent. Some people have compared the plasma lipid content of obese and normal people, proving that the blood lipid content of obese people is significantly higher than that of the normal group, but only about 30% of them exceed the normal range, which is more than 1 times higher than that of non-obese people. In addition, it is also proved that as the degree of obesity increases, the blood lipid content shows an upward trend. This also explains why the incidence of atherosclerosis, coronary heart disease, cerebral thrombosis, hypertension, and hyperlipidemia is high in obese people. Therefore, preventing the body from "getting fat" and obese people actively losing weight are of great benefit to physical health.
It is worth pointing out that people even refuse to eat fatty foods due to fear of increased blood lipids, which is very unfair. Take cholesterol for example. In addition to LDL cholesterol, which is closely related to atherosclerosis, there is also HDL cholesterol, which can be converted into important physiological functions and plays an important role in the body. HDL, for example, is converted into bile salts, which helps digestion and absorption of fat; it is converted into adrenal cortex hormones to regulate metabolism; it is converted into sex hormones (estrogen and androgen), which regulate fertility and metabolism, etc. This type of cholesterol mainly comes from fatty foods, which means that a reasonable intake of "fat"
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Hyperlipidemia
Hyperlipidemia refers to elevated levels of cholesterol or triglycerides in plasma. It is a common disease. Except for a few cases caused by systemic diseases (secondary hyperlipidemia), the vast majority are caused by genetic defects (or interactions with environmental factors) (primary hyperlipidemia).
The clinical manifestations of hyperlipidemia mainly include two aspects:
(1) Xanthomas caused by lipid deposition in the dermis;
(2) Atherosclerosis caused by lipid deposition in the vascular endothelium leads to coronary heart disease and peripheral vascular disease. Since the incidence of xanthomas is not very high in hyperlipidemia, and the occurrence and development of atherosclerosis takes a long time, most patients with hyperlipidemia do not have any symptoms or abnormal signs. Hyperlipidemia is often discovered during blood biochemical tests (measuring blood cholesterol and triglycerides).
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Five Misunderstandings about Blood Lipids
"High blood lipids" and "abnormal cholesterol" are caused by a lifestyle of eating more and moving less. Many people regard high blood lipids and abnormal cholesterol as "rich diseases" caused by eating more and moving less. Professor Zhou Yujie pointed out that abnormal cholesterol is not a simple lifestyle disease. Although it has a certain relationship with diet and exercise, it cannot be solved by just abstaining from food and exercising more. Among the factors that lead to cardiovascular and cerebrovascular diseases, mainly coronary heart disease, risk factors such as age, gender, and family history of coronary heart disease cannot be changed. Among the factors that can be changed, the main cause of serious harm is abnormal cholesterol, especially high LDL-C (low-density lipoprotein). In addition, suffering from hypertension, diabetes, and smoking habits are also important factors that lead to cholesterol deposition and induce coronary heart disease. Many thin people with low weight and strict vegetarians think that they will never have problems with high blood lipids and abnormal cholesterol. In fact, as long as they have the above risk factors, they may develop coronary heart disease.
Hyperlipidemia means high triglycerides, which means high blood viscosity and slow blood flow. Blood lipids are the general term for lipids contained in the blood, which mainly include cholesterol and triglycerides. The main cause of serious harm is abnormal cholesterol, especially high LDL-C (low-density lipoprotein). Studies have shown that the increase in triglycerides has not been associated with an increased relative risk of coronary heart disease and ischemic cardiovascular disease. If there are too many low-density lipoproteins in the blood and they are deposited on the walls of arterial blood vessels, atherosclerotic plaques will form. Stenosis or rupture of blood vessels with plaques will directly lead to acute myocardial infarction, stroke and even sudden death. Therefore, low-density lipoprotein cholesterol is currently the most important blood lipid detection indicator, not triglycerides.
It is normal if there is no "arrow" on the physical examination test sheet. Nowadays, many people pay special attention to the cholesterol index in the physical examination results, but few people find that they have abnormal cholesterol problems because there is no "arrow" on the test sheet. Why are the statistics of epidemiologists so high? Professor Zhou Yujie said that the blood lipid treatment values ??and target values ??of the general population and patients with diseases such as coronary heart disease or diabetes, or who have had myocardial infarction or stroke, are different from the normal values ??shown on the test sheet. Their blood lipid target values ??are more stringent and must be lower than the reference value on the blood lipid test sheet, that is, the "bad" cholesterol LDL-C must be lower than 80mg/dL or 2.1mmol/L. The cholesterol index of key populations, that is, men over 40 years old, postmenopausal women, obese people, people with xanthomas, people with dyslipidemia and family history of cardiovascular and cerebrovascular diseases, cannot only refer to the indicator "not higher than 3mmol/L" on the test sheet. If conditions permit, such people should test their blood lipids once a year.
Abnormal cholesterol is a chronic problem, and even if it does not meet the standard, it will not cause any major problems. In the eyes of many people, abnormal cholesterol is a chronic problem, just like high blood pressure and diabetes, which will not cause major health problems in a short time. In fact, cardiovascular and cerebrovascular diseases, mainly coronary heart disease, are often inseparable from atherosclerosis, and its characteristics are: chronic progression, acute mutation, and inflammation throughout the process. "Bad" cholesterol slowly deposits on the inner wall of the artery to form atherosclerotic plaques, which narrow and block the blood vessels. Moreover, these plaques are like "time bombs" that may rupture at any time, leading to acute myocardial infarction and stroke. If not controlled as soon as possible, young patients will also suffer from the consequences of plaque rupture. In recent years, there are many young and middle-aged people among film and television stars who have suffered sudden cardiovascular and cerebrovascular diseases. In a report published in 2004, in just 15 years, the death rate of male residents in Beijing aged 35 to 44 due to coronary heart disease increased by 111%, and the death rate of women aged 45 to 54 increased by 40%.
Health care products can soften blood vessels and reduce blood viscosity, and they have no side effects. The effect of some health care products currently used by the public on lowering cholesterol is unclear. Many Chinese medicines do have a certain effect as treatment for hyperlipidemia. Many Chinese medicines for lowering blood lipids have been proven to be very effective through clinical trials, and have advantages that Western medicines do not have in improving the cardiovascular and cerebrovascular status of patients, such as the fourth-generation Jiangzhining Granules.
For patients with refractory hyperlipidemia, the medical community generally recognizes that statins are the leading drugs for cholesterol-lowering treatment. Under the strict guidance of clinical physicians, the efficacy and safety of statins are guaranteed.