The other day, I measured a new patient's blood pressure, which was 120/80, and told her I wanted to get those numbers down more. "But Doctor," she protested, "why should they be lower? They're perfectly normal!"

    I explained to her that, yes, national guidelines set "normal" blood pressure at 120/80, but I consider that standard to be arbitrary. I believe your target blood pressure level can be determined only within the context of your other cardiovascular risk factors. For instance, my patient has diabetes and high cholesterol and is overweight, so I'd like to see her blood pressure at 110/70 or even lower.

    The concept of "normal" blood pressure is one of the major misconceptions many people have about hypertension. If you're among the 73 million Americans who have high blood pressure, here are a few others you should know about:

    Myth: Cholesterol matters more than blood pressure.

    The reverse more often is true. If you have high cholesterol but your ratio of HDL ("good) to LDL ("bad") is healthy, or if your cholesterol particles tend to be large, your risk of heart attack is not great. High blood pressure, however, is always putting stress on your blood vessels, including those supplying your heart with blood. This stress makes it easier for the bad LDL cholesterol particles to penetrate the inner lining of your vessel walls, where they accumulate and form plaque that eventually leads to heart attack and stroke.

    Myth: If you have hypertension, you should measure your blood pressure every day.

    Once a week is often enough. Although home measuring devices help patients manage their blood pressure, they can also encourage overuse. Damage occurs over years, not days or weeks. Keep track of your average blood pressure over many months, and give this information to your     doctor whenever you go for a visit.

    Myth: If you're hypertensive and feeling poorly, it's probably because your blood pressure is elevated.

    This is almost never the case. Whatever is causing your symptoms is elevating your blood pressure, not the other way round. When you don't feel well or have pain, whether from a virus or a minor sprain, your body releases adrenaline, which causes your blood pressure to rise. If you don't feel well, don't take your blood pressure. You'll worry needlessly.

    Myth: A bad headache could mean your high blood pressure is about to cause a stroke.

    This widely held misconception dates to the time of President Franklin Roosevelt, who died in office in 1945 from a massive cerebral hemorrhage after reporting, "I have a terrific headache." Roosevelt, who was in poor health, had stratospheric blood pressure, in the range of 260/150. Among the many factors that contributed to his condition was the fact that none of today's safe, effective medications were available to him. Today, patients virtually never develop the changes in their hearts and blood vessels that ultimately killed Roosevelt. In 30 years of medical practice, I've never seen a patient receiving proper treatment suffer a hypertensive emergency like his.

    n dispelling these myths, I don't mean to minimize the importance of being vigilant about monitoring your blood pressure. Just know that, as part of a regimen that includes a healthy lifestyle and medications when necessary, worry should play no part.

    — Maintain a healthy weight; lose pounds if you are overweight. 
    — Be more active. (I recommend 20 minutes of interval training every day.) 
    — Choose foods low in sodium. 
    — Drink alcohol in moderation (two drinks daily for men, one for women).

    一天，我為一個新病人測量血壓，120/80，并告訴她，我希望她的血壓能再降低些 她有些不樂意“大夫，為什么要降？我的血壓完全正常啊！ ” 

    我解釋說，國家指導“正常”血壓是120/80。但我認為，標準是死的。我相信您的目標血壓水平維持在患心血管病風險范圍之內(nèi)。舉個例子來說，我的病人有糖尿病和高膽固醇和肥胖，所以我認為她的血壓在110/70或更低一些會比較好。

    “正常”血壓的概念是一個重大誤解。如果您是是7300萬美國高血壓患者之一，你應(yīng)該了解下面的幾點認識誤區(qū)：

    誤解一：膽固醇比血壓更危險。 

    顛倒過來說還可以。如果您膽固醇高，但您的 HDL （高密度脂蛋白）（“好） ， LDL （低密度脂蛋白）（ ”壞）是健康的，或者說如果您的膽固醇微粒大，患心臟病的風險就不是很大。高血壓是血管的壓力高，包括那些給你的心臟提供的血壓。這種高壓力使壞的LDL膽固醇微粒更容易滲透到血管內(nèi)壁，在那里沉積并形成栓塞，最終導致心臟病發(fā)作和中風。

    誤解二：如果你有高血壓，應(yīng)每天量血壓。 
    
    每周量一次就行。雖然家用血壓計可以幫助患者測量自己的血壓，還可能導致使用過度。損害是慢慢發(fā)生的，不是幾天或數(shù)周。堅持數(shù)月記錄您的平均血壓，并把這一信息在就診時告知您的醫(yī)生。

    誤解三：如果你有高血壓和感覺不好，可能是因為您的血壓升高。 

    不是那回事。無論什么癥狀都會使血壓增高，而不不是其他的什么。當你感到不適或有疼痛，無論是病毒或輕微扭傷，你的身體就會釋放腎上腺素，從而導致血壓上升。如果你感覺不好，不要擔心你的血壓。你的擔心是不必要的。

    誤解四：頭疼可能是血壓高，會導致中風。 

    這種廣泛的誤解的時間要追溯到羅斯福總統(tǒng)，1945年，他死在了辦公室，報告說由于大規(guī)模腦出血。健康狀況不佳的羅斯福說“我頭很痛”他的血壓范圍260/105。綜合各種因素，即使現(xiàn)在安全，有效的藥物對他也無濟于事。如今，患者的心臟和血管幾乎不會發(fā)展到象羅斯福那樣的情況。在30多年的醫(yī)療實踐中，我從來沒有見過一位接受適當治療的高血壓患者發(fā)生像他那樣的情況。

    消除這些誤解，并不是減少監(jiān)測自己的血壓的警惕性。只是讓你了解，必要時包括健康的生活方式和藥物治療也是健康養(yǎng)生的一部分，擔心是沒有用的。

    -保持健康的體重;過于肥胖就減減肥。 
    -積極鍛煉。 （我建議每天進行20分鐘間歇有氧鍛煉。 ） 
    -選擇低鈉（鹽）食品。 
    -飲酒適量（ 男子每天2杯，女性1杯） 。