The seven core principles: a reliable method for lowering blood pressure            

      

Chun-Song Hu, MD,¹ Da-Yi Hu, MD^{2, 3}

 

¹Outpatient Department, Medical College of Nanchang University, Nanchang, China

²Medical College of Tongji University, Shanghai, China

³Department of Cardiology, People’s Hospital, Peking University, Beijing, China

 

Address for correspondence:

Dr. Chun-Song Hu, chunsong_hu@yahoo.com.cn;

Dr. Da-Yi Hu, heart@gw-icc.org

 

Abstract

In this article, we review the seven core principles (SeCP) for the treatment of hypertension. SeCP is an important step in hypertension treatment, especially in China. We discuss the “full principles” (FP), “partial principles,” and “no principles” strategies for the treatment of hypertension. SeCP, an FP strategy, is a reliable method for lowering blood pressure in patients with hypertension.

 

Key words: hypertension, treatment, principles

 

The seven core principles (SeCP) for the treatment of hypertension are (1) early identification, early diagnosis, and early and lifelong treatment; (2) administration of long-acting and slow-release antihypertensive drugs to control blood pressure (BP); (3) use of low-dose and combined therapy; (4) individual and racial therapy; (5) integration of traditional Chinese and Western medicine; (6) lifestyle modification; (7) and enhancement of compliance.¹ We refer to these core principles (CP), which encompass overall principles for hypertension and aspects of traditional Chinese medicine, as “GAO —LIU’s principles”. SeCP will play an important role in the future treatment of hypertension.

 

In China, BP is controlled in only 6.1% of patients treated for hypertension. In a study not yet completed, we have found that most hypertensive patients and their doctors do not apply SeCP, or a “full principles” (FP) strategy. Most patients with hypertension follow a “partial principles” (PP) strategy (that is, they apply some CP) or a “no principles” (NP) strategy. In the NP strategy, patients do not receive, accept, or apply any CP in the course of treatment; for example, treatment is not instituted early enough, patients do not take antihypertensive drugs as directed, patients stop treatment on their own, BP is decreased too rapidly, short-acting antihypertensive drugs are used for a long period, BP is not monitored during the course of treatment, drugs are not individualized according to the patient’s history, traditional Chinese medicine Huoxuehuayi prescriptions are not combined with Western medicine, patients do not exercise or watch their diet, or patients are unwilling to change treatments or to stop treatment when BP has been controlled and symptoms have disappeared.

In our study, we have found that the majority of patients with hypertension follow the PP strategy. (Percentages have yet to be determined.) Which strategy is followed depends on patients’ and doctors’ application of SeCP—that is, whether doctors provide health education to their patients, whether patients modify their lifestyles, whether patients comply with treatment, and so on—as well as economic conditions and other factors.

 

Lifestyle plays a key role in the development of hypertension. SeCP focuses on early and lifelong treatment, combination therapy and individual therapy, and lifestyle modification. ² More attention should be paid to lifestyle modification because of the effect of lifestyle on cardiovascular and cerebrovascular disease.

 

SeCP is a reliable method for lowering BP (to < 140/90 mmHg). If SeCP were promoted in clinical practice, the percentage of hypertensive patients with controlled BP in would increase dramatically and the number of cardiovascular and cerebrovascular events would greatly decrease. Moreover, economic and social benefits would also accrue. Use of long-acting antihypertensive drugs and traditional Chinese medicine Huoxuehuayi prescriptions would increase, injury of target organs would decrease, and quality of life and life expectancy would improve.

 

References

1．Hu CS, Gao RL, Liu LS. Seven core principles for treatment of hypertension [in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2006;26:363–5

 

2．Hu CS, Hu DY. ‘Zhongzi’ (S-E-E-D) rules for health [in Chinese]. Pacific Review Monthly 2005;1:76–7

 

（注：作于2006年，首次发表。）

  

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