What is H-type hypertension?Many people may not be entirely clear about this concept. In February 2016, the Chinese Society of Cardiology, the Hypertension Group of the Chinese Society of Cardiology, the Precision Cardiovascular Medicine Group of the Chinese Society of Cardiology, and the Hypertension Professional Committee of the Chinese Medical Doctor Association—these three authoritative hypertension organizations—jointly released the "Diagnosis and Expert Consensus on H-type Hypertension." Judging by its release date, it’s no wonder that most people are not very familiar with it.Nor has there been widespread promotion of what H-type hypertension is.Therefore, it’s not surprising that awareness of it remains low.
The consensus is divided into the following three parts:
Consensus One:The concept of H-type hypertension: What exactly is H-type hypertension? Hypertension accompanied by...Hcyan elevated level is called H-type hypertension, while hypertension accompanied by elevated blood lipids is called C-type hypertension, which is more common among Westerners.
So what is Hcy? Perhaps you’re hearing this term for the first time today and don’t yet know what it is. It’s an important health indicator. Now that you know about it, we hope you’ll consider adding this test to your future medical checkups. On our lab reports, it is labeled in English as Hcy.HcyIt is marked as Hcy on our lab reports.
Consensus Two:It concerns theepidemiological status of H-type hypertension:A survey conducted in six Chinese cities showed that H-type hypertension accounts for 75% of hypertension cases in China, meaning that three out of every four hypertensive patients have H-type hypertension. Meanwhile, baseline data from the China Stroke Primary Prevention Trial (CSPPT)
also indicatedthat the proportion of H-type hypertension in China is approximately 80.3%. In other words, the vast majority of hypertensive patients in China actually have H-type hypertension.That is to say, the vast majority of hypertensive patients in China actually have H-type hypertension.
Consensus Three states:All hypertensive patients should undergo Hcy testing. The diagnostic standard for high Hcy is Hcy ≥ 10. If you have a piece of paper nearby, we suggest you write down this number—that is, make a note that Hcy greater than or equal to 10 micromoles per liter is the threshold—and remember, whenever you go for a medical checkup in the future, no matter what standards or detection methods the lab report uses, just remember that if your Hcy is greater than or equal to 10 micromoles/liter, it is considered “hyperhomocysteinemia,” and your body has entered an unhealthy state.
As previously mentioned, C-type hypertension, which involves elevated blood lipids, is more common among Westerners, whereas H-type hypertension is over 50% more prevalent among Chinese people. Why is that? The consensus also provides an answer. For H-type hypertension,the MTHFR C677T genotypecan further increase the risk of stroke.
From the above chart, we can see that China’s “Guidelines for Primary Prevention of Stroke” also point out that the MTHFR gene, particularly at the C677T locus,with a high genetic mutation rate of over 70%,is an important reason for the high incidence of stroke among the Chinese population. The MTHFR gene, especially the C677T locus, is a gene site related to folate metabolism in our bodies. A high mutation rate in a vitamin (folate) metabolism gene site can lead to a high incidence of stroke within an ethnic group. It’s clear that mutations in certain gene sites can have a significant impact on human health.strokehigh incidence
Professor Hu Dayi from Peking University First Hospital, Professor Liu Lisheng from the former Peking Union Medical College Hospital, and other experts conducted a 10-year prospective follow-up study involving 100,000 people. The research concluded that 75% of hypertensive patients have H-type hypertension with elevated homocysteine levels—that is, three out of every four current hypertensive patients have H-type hypertension. The risk of heart disease events in H-type hypertension is five times that of simple hypertension, and 25–30 times higher than that of healthy individuals. Moreover, the risk of stroke in H-type hypertension is 12 times that of healthy individuals. The hidden dangers and risks of H-type hypertension deserve high attention.
The consensus also emphasizes that H-type hypertension is significantly positively correlated with the incidence of stroke. In other words, if you have high blood pressure along with elevated homocysteine levels, your risk of stroke increases substantially. We know that complications of hypertension can lead to myocardial infarction, stroke, kidney disease, diabetes, heart failure, and more. Among these, stroke is the disease with the highest mortality, disability, and poverty rates in China. In traditional Chinese medicine, stroke is also referred to as "zhongfeng" (stroke).If a blood clot forms in the blood vessels and then travels to block a cerebral artery, it is called cerebral infarction. If bleeding in the brain occurs due to a ruptured blood vessel, it is referred to as cerebral hemorrhage. Both of these conditions fall under the category of "stroke."
Every year in China, 3 million people die from cardiovascular and cerebrovascular events, and 7 million people become paralyzed due to stroke. Among these individuals, 75% will be left with permanent disabilities. If you have a calculator handy, try dividing 7 million by 365 days—you’ll find out how many people in China become paralyzed due to stroke every day. I believe you’ll quickly come to the conclusion that around 19,000 people become paralyzed daily due to just one disease—stroke. Most of these individuals will suffer lifelong disabilities and lose their ability to care for themselves. I’m sure this number is quite shocking to you. So many people paralyzed every day due to a single disease, leading to a complete life turnaround for individuals and an unexpected crisis for families.
We know that the pathogenesis of hypertension is relatively complex. In addition to traditional risk factors such as unhealthy lifestyles, imbalanced diets, and chronic diseases like obesity, diabetes, and coronary heart disease, there are also other contributors. These conventional risk factors are relatively well-known to us. For those caused by traditional factors, we typically recommend reducing oil and salt intake, quitting smoking, limiting alcohol, maintaining a balanced diet, controlling emotions, and increasing physical activity.
Beyond these traditional factors, we understand that H-type hypertension not only accounts for a large proportion among the Chinese population but also poses significant risks. According to expert consensus, the culprit behind H-type hypertension is actuallyexcessively high levels of homocysteinein the blood. Therefore, monitoring and reducing homocysteine levels are crucial steps in improving H-type hypertension and lowering the incidence of heart attacks and strokes. Future articles will delve into specific methods for reducing homocysteine levels.
Source: Chinese Journal of Hypertension, February 2016, Volume 24
Author Information:
Wang Jingmin
National Level 1 Health Management Specialist
Nutrition Lecturer at Beijing Nutritionist Club
Nutrition Guest on Beijing TV’s “Life Face to Face” and “Life 2016”
Contributing Writer for multiple media outlets including “Health Times,” “Health Times Weekly,” “Health in a Nutshell,” “Modern Commercial Bank,”
and China’s leading weight-loss platform “Shoushou” (Shoushou, meaning "Slim Slim")
Email: [email protected]