Hypertensive patients, please be careful! Beware of the "invisible killer" aortic dissection "coming uninvited"

Hypertension is a cardiovascular disease that we are very familiar with. According to statistics, the number of people suffering from hypertension in China has reached 245 million, which means that 1 in every 4 adults suffers from hypertension! The prevalence of hypertension among residents over 18 years old is 25.2%! Among them, 1% to 2% of patients will experience hypertension crisis!

Among the complications of hypertension, there is an extremely dangerous disease - aortic dissection . Do you know what it is? How dangerous is it? In this issue, we specially invited Jiang Bin, director of the Department of Cardiovascular Medicine of Changsha Taihe Hospital, to talk about aortic dissection.

1. What is aortic dissection?

This starts with the aorta, which is the largest blood transport channel in the human body and also the blood vessel that bears the greatest pressure in the human body.

A normal aorta is composed of three layers, including the intima, the media and the adventitia . The three layers fit tightly together, firmly stabilizing the inner and outer walls of the aorta and allowing blood to stay in the blood vessels.

However, if the aortic intima is torn , the blood in the aortic cavity enters the media layer from the tear, forming a dissection hematoma, which then extends and peels off along the aortic wall. This is called aortic dissection. In simple terms, aortic dissection can be understood as: a blood vessel is torn and bleeding .

2. Why does hypertension lead to aortic dissection?

There are many causes of aortic dissection, among which high blood pressure is the most important risk factor for aortic dissection . Long-term high blood pressure can damage the aortic wall, gradually thinning and becoming brittle, making it prone to tearing.

Relevant data show that patients with hypertension enter the high-risk age group for aortic dissection 10 to 15 years after the onset of the disease. Therefore, strict control of blood pressure can effectively reduce the occurrence of aortic dissection .

Director Jiang Bin said: "If patients with hypertension have poor blood pressure control for a long time and suddenly experience persistent tearing pain in the chest and back, accompanied by profuse sweating, and the pain cannot be relieved after taking nitroglycerin, they should be alert to the possibility of aortic dissection. The symptoms of aortic dissection are complex and changeable, and the electrocardiogram manifestations are atypical. When high blood pressure is found and accompanied by persistent chest pain that does not ease, you must seek medical attention in time! "

3. How dangerous is aortic dissection?

Once blood rushes into the arterial wall, it will tear all the way along the aortic wall. Depending on the tearing direction, we divide aortic dissection into two types: type A and type B.

(1) Type A aortic dissection

If the dissection tears toward the heart, it will cause the blood flow of the dissection to break into the pericardium, which may cause pericardial tamponade ; if the dissection tears to the opening of the coronary artery, it may cause acute myocardial infarction . These situations are very dangerous and may cause the patient to lose the chance of rescue and die in a short time.

(2) Type B aortic dissection

If the dissection tears away from the heart, it will cause aortic blood supply obstruction and ischemia of the corresponding organs, thereby inducing cerebral infarction, intestinal ischemic necrosis, lower limb ischemia and other problems.

If aortic dissection is not diagnosed and treated promptly, the mortality rate will increase by 1% per hour within 48 hours of onset, reaching 70% in one week and as high as 90% in three months .

Aortic dissection is most common in the autumn and winter seasons each year, showing obvious seasonality, and the incidence rate is increasing year by year.

In addition, there is a trend of younger patients with aortic dissection. In the past, most patients were middle-aged and elderly people, but in recent years , many young people between the ages of 20 and 30 have suddenly suffered from aortic dissection.

4. Aortic dissection is so dangerous, how can we prevent it?

●Control your blood pressure

Hypertension and atherosclerosis are high-risk factors for aortic dissection. Therefore, patients with hypertension should monitor their blood pressure every day, take medication regularly, and keep their blood pressure at a stable level.

Improve your lifestyle

Do not stay up late, do not overeat, exercise moderately, quit smoking and drinking, etc. At the same time, you should also pay attention to avoid sudden force when bearing weight, forceful defecation, overeating, etc.; pay attention to keep warm when it is cold.

Regular physical examinations

It mainly includes chest X-ray and cardiac ultrasound examination.

●Seek medical attention promptly

If you experience severe chest pain of unknown cause, go to the hospital for examination in time to eliminate hidden dangers.

If you suddenly experience dull or tearing pain in the chest and back, which then moves downward, accompanied by symptoms such as pale face, profuse sweating, and cold skin , lie down immediately and call emergency services .

Changsha Taihe Hospital's emergency department has a chest pain center green channel, which enables patients to quickly complete medical care such as diagnosis, multidisciplinary consultation and emergency surgery, shortening the time from admission to effective treatment. Once aortic dissection is confirmed, surgical operation or interventional treatment can be performed early.

Source: Changsha Taihe Hospital

Follow @湖南医聊 to get more health science information!

(Edited by YT)