High blood pressure, also known as hypertension, is the most common cardiovascular disease.

Blood pressure refers to the force of blood pushing against artery walls as it courses through the body. Like air in a tire or water in a hose, blood fills arteries to a certain capacity. Just as too much air pressure can damage a tire or too much water pushing through a garden hose can damage the hose, high blood pressure can threaten healthy arteries and lead to life-threatening conditions such as heart disease and stroke.

Hypertension is the leading cause of stroke and a major cause of heart attack. In the U.S. alone, more than 30% of American adults have high blood pressure.

If you have high blood pressure, you'll probably find out about it during a routine checkup. Or, you may have noticed a problem while taking your own blood pressure. Be sure to see your doctor for a definite diagnosis, and take the opportunity to learn what you can do to bring your blood pressure under control.

A blood pressure reading appears as two numbers. The first and higher of the two is a measure of systolic pressure, or the pressure in the arteries when the heart beats and fills them with blood. The second number measures diastolic pressure, or the pressure in the arteries when the heart rests between beats.

Normal blood pressure rises steadily from about 90/60 at birth to about 120/80 in a healthy adult. If someone were to take your blood pressure immediately after you'd delivered a speech or jogged five miles, the reading would undoubtedly seem high. This is not necessarily cause for alarm: It's natural for blood pressure to rise and fall with changes in activity or emotional state.

It's also normal for blood pressure to vary from person to person, even from one area of your body to another. But when blood pressure remains consistently high, talk with your doctor about treatment. Consistently high blood pressure forces the heart to work far beyond its capacity. Along with injuring blood vessels, hypertension can damage the brain, eyes, and kidneys.

People with blood pressure readings of 140/90 or higher, taken on at least two occasions, are said to have high blood pressure. If the pressure remains high, your doctor will probably begin treatment. People with blood pressure readings of 200/130 or higher need treatment immediately. People with diabetes are treated if their blood pressure rises above 130/80, because they already have a high risk of heart disease.

Researchers identified people with blood pressures slightly higher than 120/80 as a category at high risk for developing hypertension. This condition is called prehypertension and affects an estimated 50 million American men and women. Prehypertension is now known to increase the likelihood of damage to arteries and the heart, brain, and kidneys, so many doctors are now recommending early treatment, though there is no evidence that this helps in the long run.

Even so, many people with high blood pressure don't realize they have the condition. Indeed, hypertension is often called “the silent killer” because it rarely causes symptoms, even as it inflicts serious damage to the body. Left untreated, high blood pressure can lead to vision problems, as well as to heart attack, stroke, and other potentially fatal conditions, including kidney failure.

Hypertension may also lead to heart failure, a common but disabling condition that can cause breathing problems. Patients who have very high blood pressure are said to have malignant hypertension, with a diastolic pressure usually exceeding 130 or a systolic pressure above 200. Malignant hypertension is a dangerous condition that may develop rapidly and cause organ damage quickly. It requires immediate medical attention.

Fortunately, high blood pressure can be controlled effectively. The first step is to have your blood pressure checked regularly.

High blood pressure is more likely in people who:

●Have a family history of high blood pressure, heart disease, or diabetes

●Are African-American

●Are over age 55

●Are overweight

●Are not physically active

●Drink excessively

●Smoke

●Eat foods high in saturated fats or salt

●Use certain medications such as NSAIDs (ibuprofen, aspirin, e.g.), decongestants, and illicit drugs such as cocaine

In as many as 95% of reported high blood pressure cases in the U.S., the underlying cause cannot be determined. This type of high blood pressure is called essential hypertension.

Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the U.S., blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.

Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.

Many people with high blood pressure are “salt sensitive”, meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other factors that have been associated with essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.

When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills — specifically those containing estrogen — and pregnancy can boost blood pressure, as can medications that constrict blood vessels.

Are there hypertension symptoms? What are the complications of high blood pressure? Learn about hypertension, its symptoms, complications, and types.

One of the most dangerous aspects of hypertension is that you may not know that you have it. In fact, nearly one-third of people who have high blood pressure don't know it. The only way to know if your blood pressure is high is through regular checkups. This is especially important if you have a close relative who has high blood pressure.

If your blood pressure is extremely high, there may be certain symptoms to look out for, including:

●Severe headache

●Fatigue or confusion

●Vision problems

●Chest pain

●Difficulty breathing

●Irregular heartbeat

●Blood in the urine

●Pounding in your chest, neck, or ears

If you have any of these symptoms, see a doctor immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke.

Untreated hypertension can lead to serious diseases, including stroke, heart disease, kidney failure and eye problems.

In most cases, there are no clear warning signs of high blood pressure, but blood pressure can become dangerously high and threaten your organs and your life.

Types

Malignant hypertension is extremely high blood pressure that develops suddenly and rapidly and causes some type of organ damage. “Normal” blood pressure is below 120/80. A person with malignant hypertension has a blood pressure that's typically above 180/120. It's considered a hypertensive emergency and should be treated as a medical emergency.

In many people, high blood pressure is the main cause of malignant hypertension. Missing doses of blood pressure medications can also cause it. In addition, there are certain medical conditions that can cause it. They include:

●Collagen vascular disease, such as scleroderma

●Kidney disease

●Spinal cord injuries

●Tumor of the adrenal gland

●Use of certain medications, including birth control pills and monoamine oxidase inhibitors (MAOIs)

●Use of illegal drugs, such as cocaine

Malignant hypertension is rare. About 1% of people who have a history of high blood pressure develop this life-threatening condition.

You are at greater risk of developing it if you are a man, African-American, or someone of lower economic status. Poor access to health care increases the risk.

The main symptoms of malignant hypertension are a rapidly increasing blood pressure of 180/120 or higher and signs of organ damage. Usually the damage happens to the kidneys or the eyes.

Other symptoms depend on how the rise in blood pressure affects your organs. A common symptom is bleeding and swelling in the tiny blood vessels in the retina. The retina is the layer of nerves that line the back of the eye. It senses light and sends signals to the brain through the optic nerve, which can also be affected by malignant hypertension. When the eye is involved, malignant hypertension can cause changes in vision.

Other symptoms of malignant hypertension include:

●Blurred vision

●Chest pain (angina)

●Difficulty breathing

●Dizziness

●Numbness in the arms, legs, and face

●Severe headache

●Shortness of breath

In rare cases, malignant hypertension can cause brain swelling, which leads to a dangerous condition called hypertensive encephalopathy. Symptoms include:

●Blindness

●Changes in mental status

●Coma

●Confusion

●Drowsiness

●Headache that continues to get worse

●Nausea and vomiting

●Seizures

High blood pressure, in general, makes it difficult for kidneys to filter wastes and toxins from the blood. It is a leading cause of kidney failure. Malignant hypertension can cause your kidneys to suddenly stop working properly. If this happens, the condition is called malignant nephrosclerosis.

A diagnosis of malignant hypertension is based on blood pressure readings and signs of acute organ damage.

If you have symptoms of malignant hypertension, the doctor will:

●Recheck your blood pressure and listen to your heart and lungs for abnormal sounds.

●Examine your eyes to check for damage to the blood vessels of the retina and swelling of the optic nerve.

●Order blood and urine tests that may include:

●Blood urea nitrogen (BUN) and creatinine levels, which increase if you have kidney damage.

●Blood clotting tests.

●Blood sugar (glucose) level.

●Complete blood count.

●Sodium and potassium levels.

●Urinalysis to check for blood, protein, or abnormal hormone levels related to kidney problems.

Additional blood tests may be needed, depending on the result of the tests listed above.

The doctor will also ask for imaging tests, including:

●Echocardiogram to check heart function and blood flow through the heart.

●Electrocardiogram (ECG) to check the heart's electrical function.

●Chest X-ray to look at the shape and size of the heart structures and to detect fluid in the lungs.

●Other imaging tests to evaluate the kidneys and their arteries.

Malignant hypertension is a medical emergency and needs to be treated in a hospital, often in an intensive care unit. The doctor will consider your symptoms and overall health when deciding what treatment plan is best for you. The goal of treatment is to carefully lower your blood pressure within a matter of minutes.

You will receive blood pressure medicines through an IV, which is the quickest way to treat extremely high blood pressure. Once blood pressure is at a safe level, the medications may be switched to oral forms. If you develop kidney failure, you may need kidney dialysis.

Other treatments depend on your specific symptoms and possible causes of the malignant hypertension.

Untreated, malignant hypertension causes death. Complications of malignant hypertension include:

●Aortic dissection, which is a sudden rupture of the main blood vessel leaving the heart.

●Coma.

●Fluid in the lungs, called pulmonary edema.

●Heart attack.

●Heart failure.

●Stroke.

●Sudden kidney failure.

Immediate medical treatment decreases your chances for life-threatening complications.

In about 10% of people, high blood pressure is caused by another disease (this is called secondary hypertension). In such cases, when the root cause is treated, blood pressure usually returns to normal or is significantly lowered. These causes include the following conditions:

●Chronic kidney disease

●Sleep apnea

●Tumors or other diseases of the adrenal gland

●Coarctation of the aorta — A narrowing of the aorta that you are born with that can cause high blood pressure in the arms

●Pregnancy

●Use of birth control pills

●Alcohol addiction

●Thyroid dysfunction

In the other 90% of cases, the cause of high blood pressure is not known (primary hypertension). Although the specific cause is unknown, certain factors are recognized as contributing to high blood pressure.

Factors That Can't Be Changed

●Age: The older you get, the greater the likelihood that you will develop high blood pressure, especially systolic, as your arteries get stiffer. This is largely due to arteriosclerosis, or “hardening of the arteries.”

●Race: African Americans have high blood pressure more often than whites. They develop high blood pressure at a younger age and develop more severe complications sooner.

●Family history (heredity): The tendency to have high blood pressure appears to run in families.

●Sex: Generally men have a greater likelihood of developing high blood pressure than women. This likelihood varies according to age and among various ethnic groups.

Renal hypertension, also called renovascular hypertension, is elevated blood pressure caused by kidney disease. It can usually be controlled by blood pressure drugs. Some people with renal hypertension can be helped by angioplasty, stenting, or surgery.

Renal hypertension is caused by a narrowing in the artery that delivers blood to the kidney. One or both kidneys' arteries may be narrowed. This is a condition called renal artery stenosis.

When the kidneys receive a low blood flow, they act as if the low flow is due to dehydration. So they respond by releasing hormones that stimulate the body to retain sodium and water. Blood vessels fill with additional fluid, and blood pressure goes up.

The narrowing in one or both renal arteries is most often caused by atherosclerosis, or hardening of the arteries. This is the same process that leads to many heart attacks and strokes. A less common cause of the narrowing is fibromuscular dysplasia. This is a condition in which the structure of the renal arteries develops abnormally for unclear reasons.

Renal hypertension usually causes no symptoms. The narrowing in the arteries can't be felt. Unless it's dangerously high, high blood pressure causes no symptoms either. Symptoms of severely elevated blood pressure include:

●Headache

●Confusion

●Blurry or double vision

●Bloody (pink-colored) urine

●Nosebleed

The vast majority of people with renal hypertension never experience these (or any) symptoms. High blood pressure is dangerous partly because there are no symptoms, so organ damage can occur slowly without being recognized.

Renal hypertension can cause chronic kidney disease. This is a slow decline in kidney function. Until the condition is well advanced, chronic kidney disease also causes no symptoms.

Because there are usually no symptoms, a doctor may suspect renal hypertension when someone has uncontrolled high blood pressure despite multiple medications or has unexplained chronic kidney disease.

Medications are used first to try to control high blood pressure in renal hypertension. The most important blood pressure medications to treat renal hypertension include:

●ACE inhibitors (angiotensin converting enzyme inhibitors). These include lisinopril, captopril, benazepril, ramipril, and others.

●ARBs (angiotensin II receptor blockers). Examples include valsartan, losartan, candesartan, and olmesartan.

For most people with renal hypertension due to renal artery narrowing, medications can effectively control blood pressure. More than one blood pressure drug is often needed, however.

In some people with renal hypertension due to narrowing of the renal artery, even taking three or more medications every day cannot adequately control blood pressure. In these situations, a procedure to improve blood flow to the kidneys can often help.

Possible procedures include the following.

Angioplasty. A doctor threads a catheter through a large artery in the groin and advances it into the renal artery. A balloon is then inflated for a few moments. This widens the artery and improves blood flow.

Stenting. During angioplasty, a wire-mesh stent can be expanded inside the renal artery. The stent stays in place. This keeps the artery open after the balloon is removed. In general, stenting is more effective than angioplasty at improving blood flow to the kidney.

Surgery. A surgeon can bypass the narrowed renal artery by sewing a healthy blood vessel next to it. Surgery is generally considered only when angioplasty and stenting are not possible.

These procedures are similar to those used to improve blood flow in the heart in people with coronary artery disease.

One of the most serious health problems related to untreated high blood pressure, atherosclerosis contributes to coronary artery disease. Learn about symptoms, diagnoses, and treatment of atherosclerosis.

A stroke occurs when blood flow to an area in the brain is cut off and people who have hypertension are four to six times more likely to have a stroke. Stay safe: Learn your risk factors and the warning signs of stroke and what to do in a stroke emergency.

Heart disease is the No. 1 cause of death associated with hypertension. Learn more about related heart conditions, their diagnoses, and treatment.

Hypertension is a major cause of kidney disease and kidney failure. There are symptoms to watch for — and treatment options. Learn more.

Untreated hypertension can affect your eyesight, causing damage to the blood vessels in the retina. Known as hypertensive retinopathy, learn more about this condition and its prevention.

Hypertension is a risk factor for the development and worsening of many diabetes complications, and likewise having diabetes increases your risk of developing high blood pressure. Learn more about how these two conditions affect one another.

High blood pressure can be a sign of preeclampsia, a pregnancy-related problem that can become life-threatening. Learn what you need to know.

Metabolic syndrome is a group of health problems which include too much fat around the waist, elevated blood pressure, elevated blood sugar, and more — all increasing your risk of heart attack, stroke, and diabetes. Find out more about metabolic syndrome here.

High blood pressure by itself can lead to erectile dysfunction. But some drugs for treating high blood pressure can actually be the cause as well. Find out more about why high blood pressure is a major cause of erection problems.

This article lists the side effects that may be caused by each type of high blood pressure drug.

Diagnosing hypertension is important. Learn how doctors test for high blood pressure and even see a photo of how the test is done.

Hypertension, or high blood pressure, is often called a “silent disease” because you usually don't know that you have it. There may be no symptoms or signs. Nonetheless, it damages the body and eventually may cause problems like heart disease.

Therefore, it's important to regularly monitor your blood pressure, especially if it has ever been high or above the “normal” range, or if you have a family history of hypertension. Because hypertension can cause heart disease, you may also need to be tested for heart disease.

You can get your blood pressure measured by a health care provider, at a pharmacy, or you can purchase a blood pressure monitor for your home.

Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve.

Blood pressure is measured in two ways: systolic and diastolic.

●Systolic blood pressure is the maximum pressure during a heartbeat.

●Diastolic blood pressure is the lowest pressure between heartbeats.

Blood pressure is measured in millimeters of mercury (mm Hg) and is written systolic over diastolic (for example, 120/80 mm Hg, or “120 over 80”). According to the most recent guidelines, a normal blood pressure is less than 120/80 mm Hg. Hypertension is blood pressure that is greater than 140/90, while prehypertension consists of blood pressure that is 120 to 139/80 to 89.

Blood pressure may increase or decrease, depending on your age, heart condition, emotions, activity, and the medications you take. One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times, while you are resting comfortably for at least five minutes. To make the diagnosis of hypertension, at least three readings that are elevated are usually required.

In addition to measuring your blood pressure, your doctor will ask about your medical history (whether you've had heart problems before), assess your risk factors (whether you smoke, have high cholesterol, diabetes, etc.), and talk about your family history (whether any members of your family have had high blood pressure or heart disease).

Your doctor will also conduct a physical exam. As part of this exam, he or she may use a stethoscope to listen to your heart for any abnormal sounds and your arteries for a whooshing or swishing sound that may indicate that the artery may be partially blocked. Your doctor may also check the pulses in your arm and ankle to determine if they are weak or even absent.

If you're diagnosed with high blood pressure, your doctor may recommend other tests, such as:

●Electrocardiogram (EKG or ECG): A test that measures the electrical activity, rate, and rhythm of your heartbeat via electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.

●Echocardiogram: This is a test that uses ultrasound waves to provide pictures of the heart's valves and chambers so the pumping action of the heart can be studied and measurement of the chambers and wall thickness of the heart can be made.

High blood pressure, is dangerous because it can lead to strokes, heart attacks, heart failure, or kidney disease. The goal of hypertension treatment is to lower high blood pressure and protect important organs, like the brain, heart, and kidneys from damage. Treatment for hypertension has been associated with reductions in stroke (reduced an average of 35%-40%), heart attack (20%-25%), and heart failure (more than 50%), according to research.

High blood pressure is classified as:

●Normal blood pressure: less than 120/80

●Prehypertension: 120-139/80-89

●Hypertension: greater than 140/90

●Stage 1 Hypertension:140-159/90-99

●Stage 2 Hypertension: 160 or greater/100 or greater

All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications, such as eating a healthier diet, quitting smoking, and getting more exercise. Treatment with medication is recommended to lower blood pressure to less than 140/90. For patients who have diabetes or chronic kidney disease the recommended blood pressure is less than 130/80.

Treating high blood pressure involves lifestyle changes and possibly drug therapy.

A critical step in preventing and treating high blood pressure is a healthy lifestyle. You can lower your blood pressure with the following lifestyle changes:

●Losing weight if you are overweight or obese.

●Quitting smoking.

●Eating a healthy diet, including the DASH diet (eating more fruits, vegetables, and low fat dairy products, less saturated and total fat).

●Reducing the amount of sodium in your diet to less than 1,500 milligrams a day if you have high blood pressure. Healthy adults need to limit their sodium intake to no more 2,300 milligrams a day (about 1 teaspoon of salt).

●Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week).

●Limiting alcohol to two drinks a day for men, one drink a day for women.

●In addition to lowering blood pressure, these measures enhance the effectiveness of high blood pressure drugs.

●Drugs to Treat High Blood Pressure

●There are several types of drugs used to treat high blood pressure, including:

●Angiotensin-converting enzyme (ACE) inhibitors

●Angiotensin II receptor blockers (ARBs)

●Diuretics

●Beta-blockers

●Calcium channel blockers

●Alpha-blockers

●Alpha-agonists

●Renin inhibitors

●Combination medications

Diuretics are often recommended as the first line of therapy for most people who have high blood pressure.

However, your doctor may start a medicine other than a diuretic as the first line of therapy if you have certain medical problems. For example, ACE inhibitors are often a choice for a people with diabetes. If one drug doesn't work or is disagreeable, other types of drugs are available.

If your blood pressure is more than 20/10 points higher than it should be, your doctor may consider starting you on two drugs or placing you on a combination drug.

After starting high blood pressure drug therapy, you should see your doctor at least once a month until the blood pressure goal is reached. Once or twice a year, your doctor will check the level of potassium in your blood (diuretics can lower this, and ACE inhibitors and ARBs may increase this) and other electrolytes and BUN/creatinine levels (to check the health of the kidneys).

After the blood pressure goal is reached, you should continue to see your doctor every three to six months, depending on whether you have other diseases such as heart failure.

Did you know that smoking and heart disease are related? Or that smoking increases blood pressure? Most people associate cigarette smoking with breathing problems and lung cancer. But people who smoke are more also likely to develop hypertension and heart disease.

About 30% of all deaths from heart disease in the U.S. are directly related to cigarette smoking. That's because smoking is a major cause of coronary artery disease, especially in younger people.

A person's risk of heart attack greatly increases with the number of cigarettes he or she smokes and the longer a person smokes, the greater their risk of heart attack. People who smoke a pack of cigarettes a day have more than twice the risk of heart attack than non-smokers. Women who smoke and also take birth control pills increase several times their risk of heart attack, stroke, and peripheral vascular disease.

Stress is a normal part of life. But too much stress can lead to emotional, psychological, and even physical problems — including heart disease, high blood pressure, chest pains, or irregular heart beats.

Reducing stress can help lower high blood pressure.

Your doctor has hundreds of different high blood pressure drugs to choose from. These medications work in a variety of ways to lower blood pressure.

Calcium channel blockers are drugs used to lower blood pressure. They work by slowing the movement of calcium into the cells of the heart and blood vessel walls, which makes it easier for the heart to pump and widens blood vessels.

Angiotensin converting enzyme (ACE) inhibitors are high blood pressure drugs that widen or dilate your blood vessels to improve the amount of blood your heart pumps and lower blood pressure.

Angiotensin II receptor blockers (ARBs) have the same effects as ACE inhibitors, another type of blood pressure drug, but work by a different mechanism.

For high blood pressure, diuretics, commonly known as “water pills,” help your body get rid of unneeded water and salt through the urine. Getting rid of excess salt and fluid helps lower blood pressure and can make it easier for your heart to pump.

Beta-blockers are drugs used to treat high blood pressure. They block the effects of the sympathetic nervous system on the heart.

In the past 10 years, many Americans have turned to omega-3 fish oil supplements. Dietary fish and fish oil supplements have benefits for healthy people and also those with heart disease.

angioplasty [,ændʒio'plæsti] n.血管成形术

arteriosclerosis [ɑː,tiəriəʊskliə'rəʊsis] n.动脉硬化

cardiovascular [,kɑːdiəʊ'væskjʊlə] adj.心血管的

creatinine [kri'ætiniːn] n.肌酐

diabetes [,daiə'biːtiːz] n.糖尿病；多尿症

dehydration [,diːhai'dreiʃən] n.脱水

diuretic [,daijʊ(ə)'retik] n.利尿剂

edema [i'diːmə] n.水肿

hypertension [haipə'tenʃ(ə)n] n.高血压；过度紧张

nephrosclerosis ['nefrəu,skliə'rəusis] n.肾硬化，肾硬变

preeclampsia [,prii'klæmpsiə] n.子痫前期；惊厥前期

retina ['retinə] n.视网膜

scleroderma [,skliərə'dɜːmə] n.硬皮病

sphygmomanometer [,sfgməʊmə'nɒmitə] n.血压计

stethoscope ['steθəskəʊp] vt.用听诊器诊断 n. 听诊器

stroke [strəʊk] n.中风；脑卒中

Adrenalglands 肾上腺

aerobic exercise 有氧运动

aortic dissection 主动脉夹层

artery walls 动脉壁

birthcontrolpills 避孕药

bloodureanitrogen (BUN) 血尿素氮

brainswelling 脑水肿

collagenvasculardisease 胶原血管病

diastolicpressure 舒张压

erectile dysfunction (ED) 勃起功能障碍

essentialhypertension 原发性高血压；特发性高血压

fibromuscular dysplasia 肌纤维发育不良；纤维肌性发育不良

hypertensivecrisis 高血压危象

hypertensiveencephalopathy 高血压性脑病；高血压脑病

hypertensive retinopathy 高血压性视网膜病变

intensive care unit (ICU) 特护病房；重症监护病房

kidney dialysis 肾透析

malignanthypertension 恶性高血压

metabolic syndrome 代谢综合征

opticnerve 视神经

pre-hypertension 高血压前期

renovascular hypertension 肾血管性高血压

saturatedfats 饱和脂肪酸

secondaryhypertension 继发性高血压

sleep apnea 睡眠呼吸暂停；睡眠呼吸暂停症

systolicpressure 收缩压

thyroid dysfunction 甲状腺功能不全