As our country’s medical progress progresses, the branches of medicine are becoming more and more detailed. There are more and more specialties and sub-specialties being branched out, and the benefit is that doctors can devote their limited energy to one direction, hoping to do it more accurately. The problem that arises is that when a friend of a patient goes to the hospital to see a doctor, he doesn’t know which department he should be admitted to? I don’t know what kind of doctor to look for. Moreover, the doctor’s comprehensive professional knowledge is not broad enough. Everything has two sides. Dr. Zhang will talk to everyone about which department should high blood pressure be admitted to? Which department should I go to for medical treatment?

First of all, we should have an understanding of the hospital we are going to. For example, if we go to a large tertiary-level hospital for treatment, we should make an appointment online or register in other ways in advance to avoid not having an appointment and wasting time. At this time, for patients with hypertension, we should choose cardiovascular medicine. If the hospital is stronger, it may have a hypertension specialist in the cardiology department, and then it will be designated as a hypertension specialist.

And if we go to secondary hospitals, such as county hospitals, etc. The hospital most likely does not have a Department of Cardiovascular Medicine, but we can choose the Department of Internal Medicine, and generally there is no need to register in advance. If in addition to high blood pressure, we have other diseases, such as cervical spondylosis or eye diseases, you also need to prepare the numbers of other related departments in advance and strive to visit multiple departments in one hospital to solve multiple problems. You cannot rely on one cardiologist to solve all your problems. So, I hope you prepare in advance.

In addition to understanding the hospital, we also recommend that you understand the traffic conditions, collect all relevant information, and go to the hospital in advance to wait for treatment, so that you can see a doctor calmly.

It depends on what level of hospital it is.

Some large hospitals or large specialized hospitals will have hypertension departments, which are of course specialized in treating high blood pressure and are definitely the most professional in treating high blood pressure.

If there is no hypertension department in these large hospitals, then please go to the cardiovascular department to diagnose and treat hypertension. Because hypertension is considered a cardiovascular disease, it is mostly diagnosed and treated by cardiovascular physicians. However, some hypertension is secondary hypertension and may require diagnosis and treatment in endocrinology and other departments.

If it is a medium-sized hospital, there is no detailed division of specialties, only internal medicine, surgery, obstetrics and gynecology, pediatrics, etc. In this case, you should go to the internal medicine department to see high blood pressure.

If it is a township health center or community clinic, the professional classification may be more coarse-grained, or there are only a few doctors in the clinic with some specialties, so anyone can see it.

Under normal circumstances, it is not necessary to go to large hospitals, especially specialist hospitals, to diagnose and treat high blood pressure. Diagnosis and treatment can be done in general hospitals. If the blood pressure is seriously elevated, or drug treatment is ineffective, or secondary hypertension is suspected, you need to go to a higher-level hospital for treatment.

For your reference.

Hypertension is one of the most common chronic diseases and the most important risk factor for cardiovascular and cerebrovascular diseases. It is mainly characterized by an increase in systemic arterial blood pressure (systolic blood pressure and/or diastolic blood pressure) (systolic blood pressure 140 mmHg, diastolic blood pressure 90 mmHg), which may be accompanied by functional impairment of the heart, brain, kidneys and other organs. Clinical syndrome of sexual impairment.

Therefore, it is very critical that hypertension can receive regular professional treatment.

Of course, more than 90% of high blood pressure is essential hypertension, that is, it is simply an increase in blood pressure. At this time, when we go to a large hospital to register for treatment, we can check in advance whether there is any cardiovascular disease. Is there an independent hypertension clinic in the internal medicine department? If there is, then the hypertension clinic is the most professional. If there is not, then the cardiovascular medicine department is relatively professional.

However, some patients are treated in county-level hospitals or even smaller hospitals. At this time, there may not even be a department of cardiovascular medicine. At this time, we only need to go to the department of internal medicine. This is already considered to be the best among our hospitals. Professionals treat high blood pressure. For example, if you go to a community hospital to see a doctor, you will be treated the same way by everyone. They are basically general practitioners and cannot be said to be professional. They are at least doctors who know a lot about high blood pressure. We will give you correct advice and opinions. There is no need to choose which doctor to see when you see a doctor in a community hospital.

But note that if you belong to the 10% of secondary hypertension, hypertension is only one of the clinical manifestations of the disease, and blood pressure can be temporarily or permanently elevated.

For example, if you have high blood pressure during pregnancy, you still have to go to a specialized obstetrics and gynecology department at this time. Some cases are divided more finely, and you can just go to the obstetrics department;

For example, some people have renal artery disease. For renal hypertension caused by stenosis, tumors on the kidneys and other adrenal gland problems, you must see a nephrologist who is more professional at this time;

Another example is that your hypertension is caused by endocrine diseases, such as primary Hyperaldosteronism, etc., at this time endocrinologists are professional;

For example, there are some congenital aortic stenosis, at this time you may have to see a cardiologist;

Of course, there are also some patients with high blood pressure who need to see the neurology department or be transferred directly to the neurosurgery department, because some tumors in the brain can also cause blood pressure to rise;

However, for ordinary hospitals, if they encounter For patients with high blood pressure, it is usually recommended that you go to the cardiovascular department to rule out whether it is primary or secondary hypertension. Depending on the situation, you will be referred to a doctor in a professional department. For example, in a hospital with limited conditions, that is There is no need to transfer, cardiology is the most professional. For patients with simple hypertension, there is no need to go to a big hospital. At present, the treatment of hypertension is relatively mature in this aspect, and there are unified guidelines for the use of high blood pressure drugs. There is no need to go to a big hospital to squeeze out the blood. People, but delayed the opportunity to see a doctor.

Doctors who are more professional in the treatment of hypertension are in these departments: 1. The larger tertiary hospitals are cardiovascular medicine departments (referred to as cardiology departments), and some also have hypertension departments, which is more major,. 2. If it is a general hospital in an urban area or a hospital in a county, most of them are secondary hospitals. In recent years, most of these hospitals have cardiovascular medicine departments. Those that do not have a clear cardiovascular medicine department are generally called internal medicine (that is, hypertension and respiratory and digestive diseases). In terms of? See all internal medicine diseases).

In the past, treatment of hypertension was mainly done by general internal medicine departments. Now, as the technical level becomes higher and higher, the division of labor becomes more and more detailed. Now most hospitals have specialized cardiovascular medicine departments to provide better treatment for hypertension. It is more professional and has a higher technical level

At present, hospitals are divided into more and more subdivisions. In general, hospitals are divided into internal medicine, surgical departments, and systems. As far as the internal medicine system is concerned, there are cardiology, gastroenterology, and cardiology. Internal medicine, respiratory medicine, neurology, endocrinology, nephrology, etc. The Department of Cardiology, Neurology, and Nephrology can all treat hypertension. Some tertiary hospitals also have specialized hypertension departments, which are a sub-department of cardiology.

In addition, in medical student textbooks, the chapter on hypertension is explained by cardiologists.

Therefore, hypertension is generally examined and treated in cardiology.

However, because patients with high blood pressure can develop complications of the heart, brain, kidneys and other organs, some patients with high blood pressure seek treatment in neurology, nephrology, etc. with stroke and renal insufficiency as their first symptoms. Therefore, doctors from these two departments also have some experience in treating hypertension. If refractory hypertension occurs and blood pressure is difficult to control, they may seek help from a cardiologist.

In general, if high blood pressure is accompanied by damage to related organs, you need to see a cardiology department to delay further damage to the organs.

Pay attention to health and pay attention to cardiovascular Dr. Xu!

Hypertension is currently the disease with the highest incidence in my country. According to statistics from "China Chronic Diseases and Nutritional Status 2020", 27.5% of adults in my country currently have hypertension, which means that nearly 300 million people have hypertension. patient.

If you have high blood pressure and go to the hospital, which department should you go to?

Many people arrive at the hospital and find that there is no hypertension department among the department options (except for a few very large hospitals that have hypertension centers). As a person with high blood pressure, which department should I go to for treatment?

This can be divided into three situations: one is simple hypertension, the other is hypertensive emergency, and the other is complications of hypertension.

1. Simple high blood pressure

If you find that your blood pressure is high and exceeds 140/90mmHg three times on different days, and there is no obvious headache, dizziness, nausea, or vomiting Wait for symptoms.

The corresponding department at this time is cardiology.

Some people must be wondering, doesn’t cardiology treat heart disease? That's true, but hypertension itself is a cardiovascular disease. Regardless of whether hypertension belongs to cardiology, hyperlipidemia also belongs to cardiovascular medicine.

Our blood pressure is divided into systolic blood pressure, which is high pressure, and diastolic blood pressure, which is low pressure; systolic blood pressure is the pressure of blood on the inner wall of blood vessels when the heart contracts; diastolic blood pressure is the pressure generated by the elasticity of blood vessels when the heart relaxes. Hypertension is closely related to many cardiovascular diseases, such as hypertensive heart disease, heart failure, coronary heart disease, arrhythmia and other diseases, which all belong to the Department of Cardiovascular Medicine.

So for simple high blood pressure, we should go to the cardiovascular department, or call the cardiology department for treatment. Find out what tests are done and what you can do to lower your blood pressure.

2. Hypertensive emergency

Severe hypertension, such as high pressure 200mmHg or low pressure 120mmHg.

At this time, some patients may have headaches, nausea and vomiting, and acute cerebral edema. Then some patients may have high blood pressure, cerebrovascular disease, or heart disease. We treat it as It's called a hypertensive emergency.

It is best to go to the emergency department at this time.

There are also cases of hypertensive subemergency, with blood pressure reaching 200mmHg, but they don’t have these symptoms, they just feel it. We call it subemergency.

Hypertensive emergencies must be treated intravenously, with intravenous infusion to control blood pressure, because sometimes after taking a pill, the patient may vomit

out, or the blood pressure will pass through Oral medication is not ideal for lowering the blood pressure, either too slowly or too quickly, so it is best to go to the emergency room and infuse blood pressure as quickly as possible to lower the blood pressure to a safe level within a certain period of time.

Blood pressure drops very quickly, which can cause some problems. Therefore, we give intravenous infusions in hypertensive emergencies. Infusions can control the concentration and speed of antihypertensive drugs, which can better and effectively reduce blood pressure. blood pressure.

3. Complications of high blood pressure have appeared

The biggest harm of high blood pressure is the complications of hypertension.

If you have coronary heart disease, angina pectoris, myocardial infarction, heart failure, or arrhythmia, you will naturally go to the cardiovascular department. Of course, for acute left heart failure and acute myocardial infarction, you must first call 120 and go to the emergency department. , a cardiovascular physician will provide emergency consultation.

If cerebral infarction occurs, you should go to a neurology department or a neurology department. (Of course, you usually have to go to the emergency room first)

If there is a cerebral hemorrhage, you should go to neurosurgery or brain surgery. (Of course, you usually have to go to the emergency room first)

If you have renal insufficiency or renal failure, you should go to the nephrology department.

If aortic dissection occurs, you should go to the emergency department first, and then a thoracic or cardiac surgeon will come to the emergency department for rescue.

If nosebleeds occur, first go to the otolaryngology department to stop the bleeding and at the same time go to the cardiology department to reduce blood pressure.

If vision loss occurs, you should see an ophthalmologist, have your eyes checked, and then see a cardiovascular department.

In short, in the early stage of hypertension, simple hypertension should be diagnosed and treated by cardiovascular medicine; hypertensive emergencies or hypertensive crises should be diagnosed and treated by emergency departments; and complications of hypertension should be treated in relevant departments.

We have always promoted early prevention, early detection and early control, and we must avoid the occurrence of complications of hypertension. Once complications of hypertension occur, the disability and mortality rate will greatly increase, and you will regret it!

my country is a big country with over 100 million people suffering from hypertension. In the basic public health services promoted by the country, hypertension is one of the key diseases in chronic disease management. At present, even rural doctors are participating in this huge "health" project, which means that some rural doctors have some knowledge about the diagnosis and treatment of hypertension.

Judging from the author’s many years of experience working in primary hospitals, those who work in township health centers and community health service centers have received standardized medical education, studied cardiovascular medicine in second-grade and above general hospitals, and participated in off-the-job comprehensive care. Physician-trained physicians or general practitioners with intermediate or above professional titles still have some experience in the diagnosis and treatment of hypertension.

In county-level general hospitals, hypertension clinics of cardiovascular medicine departments are opened where conditions permit. The diagnosis and treatment of hypertension should be relatively professional. Counties with less favorable conditions do not have independent cardiovascular medicine departments and only have general internal medicine departments. The hospital will also have doctors who are better at cardiovascular medicine, and the hospital will promote and introduce them in prominent locations. A level of professionalism that meets the patient's basic needs.

When it comes to first-level hospitals in prefectures, cities and prefectures, except for some remote and ethnic minority areas, the cardiovascular medicine department should be relatively strong, and most of them have hypertension clinics. The professional level is very high.

Going further up, to provincial general hospitals and medical school-affiliated hospitals, the professional level of cardiovascular medicine should be the top level in the province or city where it is located.

In addition, traditional Chinese medicine hospitals and hospitals of integrated traditional Chinese and Western medicine at the municipal level and above also have cardiovascular medicine departments, and their professional level is also very high.

In short, when a hospital's internal medicine department develops business or is divided into secondary departments, the first priority is to consider cardiovascular medicine.

According to data, the number of patients with hypertension in my country has reached 270 million. This common chronic disease has brought many physical harms to many patients, and hypertension has gradually shown a trend among younger people. However, many people do not know the treatment and prevention of hypertension, as well as which department to go to for treatment. Hypertension is also classified, and different departments for high blood pressure treatment are also different.

Hypertension can be divided into two categories: primary and secondary. In the vast majority of patients, the cause of hypertension is unknown, which is called essential hypertension, accounting for more than 95% of all cases of hypertension; in less than 5% of patients, elevated blood pressure is a clinical symptom of certain diseases. The manifestation itself has a clear and independent cause, which is called secondary hypertension.

How to distinguish between two types of hypertension?

1. Essential hypertension refers to a systemic disease of unknown cause, characterized by increased arterial systolic and/or diastolic blood pressure, and often accompanied by pathological changes in the heart, brain, kidney and other organs. Hypertension is the most common cardiovascular disease. In my country, stroke is the most common complication in patients with hypertension, and the mortality and mortality rates are very high. The classification of high blood pressure is as follows

The above diagnostic criteria for high blood pressure must be based on the average value of two or more blood pressure measurements on different days without medication. An accidental increase in blood pressure cannot be diagnosed. For high blood pressure, further observation is necessary. Essential hypertension is related to many factors: gender, age (elderly > young), region (north > south), occupation, diet (high salt intake), heredity, obesity, smoking, mental and psychological factors, etc.

Therefore, essential hypertension usually requires a visit to a cardiology department.

2. Secondary hypertension refers to high blood pressure with a clear medical cause, accounting for 5%-10% of people with hypertension. With the in-depth research on hypertension and the improvement of diagnostic technology, this The proportion is gradually increasing, and secondary hypertension accounts for a larger proportion of refractory hypertension. 1. Diagnosis of primary hypertension requires excluding secondary hypertension 2. If the cause can be eliminated, hypertension can be cured 3. Clear the cause and target the drug treatment 4. If it is not diagnosed and treated in time, the disability and mortality rates are extremely high

The characteristics of secondary hypertension begin before the age of 30 or after the age of 50, and severe hypertension ( More than 180/110 mmHg), poor response to usually effective treatments, clinical manifestations of secondary hypertension, accompanied by unexplained hypokalemia, or hypokalemia after application of diuretics, abdominal vascular murmur, blood pressure fluctuations with headache, and tachycardia Symptoms of kidney disease such as tachycardia, sweating, tremor, edema, and anemia, snoring, daytime sleepiness, and obesity; obvious target organ damage: hypertension, fundus classification grade 2 or above (Keith-W agener fundus classification method)/increased serum creatinine Or proteinuria, cardiac enlargement or left ventricular hypertrophy, abnormal activity of endocrine hormones catecholamines, aldosterone, renin, cortisol, etc.

Common causes 1. Renal hypertension: renal parenchyma, renovascular, Renal tumors; 2. Endocrine diseases: pheochromocytoma, primary aldosteronism, hypercortisolism; 3. Macrovascular lesions: such as aortic coarctation, Takayasu arteritis, etc.; 4. Brain lesions: Such as brain tumors, trauma, encephalitis, etc.; 5. Others: pregnancy-induced hypertension, drugs (hormones), altitude sickness, sleep apnea syndrome, hyperthyroidism, aortic valve insufficiency, severe anemia.

Therefore, secondary hypertension depends on the situation, and you can go to the endocrinology department, nephrology department, neurology department and other departments for treatment.

3. The simple distinction is that primary hypertension cannot find a specific cause, and it is not known what the specific cause of hypertension is, and can only be treated in a targeted manner; while secondary hypertension can Once a clear cause is found, it is usually secondary to certain diseases. If the original underlying disease can be cured, then secondary hypertension will be treated. What are the treatment and blood pressure lowering goals for essential hypertension?

The treatment of essential hypertension includes non-drug treatment and drug treatment. Most patients need long-term or even lifelong treatment. The main goal of treating hypertension is to minimize the overall risk of cardiovascular and cerebrovascular complications and death.

1. Non-drug treatment of hypertension 1. Reduce sodium intake and increase potassium intake; 2. Control weight; 3. Do not smoke; 4. Do not drink excessive alcohol; 5. Physical exercise; 6. Reduce mental stress and maintain psychological balance.

2. Drug treatment of hypertension There are four basic principles for the application of antihypertensive drugs: 1. Small dose, 2. Try to use long-acting preparations, 3. Combined medication, 4. Individualization. Commonly used antihypertensive drugs for the treatment of hypertension include: ① Calcium channel blockers: nifedipine, nitrendipine, verapamil and diltiazem, ② Angiotensin-converting enzyme inhibitors (ACEI): captopril, Belapril, ③ angiotensin II receptor blockers (ARB): losartan, valsartan, ④ diuretics: furosemide, spironolactone, ⑤ β-blockers: propranolol, valsartan Thorol.

3. The blood pressure reduction target for essential hypertension The blood pressure reduction target for general hypertensive patients is below 140/90mmHg. The blood pressure of elderly patients with hypertension should be lowered to below 150/90mmHg, and can be lowered to below 140/90mmHg if tolerated.

The target blood pressure lowering value for the elderly over 80 years old is