Prevention of hypertension is extremely important for every person, even completely healthy. Most people do not attach serious importance to the increased pressure figures, considering that the most dangerous thing to which it will lead is a short headache. Is it really? Of course no.
What is hypertension and how dangerous it is, should know not only doctors, but also the general public. This is a serious illness that is terrible for its complications. Over time, high pressure begins to stretch the heart, interfere with its normal operation and injure blood vessels throughout the body. The result is severe impairment on the part of all organs, especially the kidneys, brain and heart muscle.
Hypertension is recommended to be prevented as early as possible, especially if there are a number of predisposing factors described below. This will help avoid complications and reduce the quality of life.
Who is at risk?
As already mentioned, prevention of arterial hypertension is an actual activity for any person. With age, mechanisms inevitably arise that lead to an increase in pressure in the vessels. Their logical consequence is the appearance of the disease.
Unfortunately, in some individuals, pathological changes in the body occur much earlier and appear more intense. In many cases, it is these patients who have a severe disease course, with high rates on the tonometer and a large number of complications.
To prevent this allows timely prevention of hypertension. First of all, it is recommended to those who belong to the risk group - these are people who are affected by various harmful factors. They are not the direct cause of pathology, but they "push" the body to its occurrence. The most common and dangerous ones are listed below:
- Genetic addiction. To determine it, it is enough to analyze the presence in the family of cases of the disease. Particular attention should be paid to relatives, whose pressure increased in young and middle age (up to 35 years),
- "Passive lifestyle. In scientific literature, this condition is called "hypodynamia." Numerous studies have shown that lack of motor activity is the most common risk factor to which patients often do not pay attention,
- Regular overvoltage. Both physical and emotional stress depletes the body’s resources. If they become familiar satellites of a person, his defense systems weaken, and the regulation of the work of various systems (circulatory, lymphatic, nervous, and others) is broken,
- Bad habits. Smoking and alcohol doctors call chronic toxicity for a reason. Toxic substances entering during the use of these “legal drugs” negatively affect not only the function of respiration and digestion. They are also absorbed into human blood, act on the walls of blood vessels and spread throughout the body. In the end, it will always lead to the formation of various pathologies,
- Kidney disease. Very often, damage or improper operation of this body provokes an increase in pressure. Why? There may be a delay of active sodium ions and water, which "overwhelm" the bloodstream. In addition, the kidneys produce a special hormone (renin), which causes arterial hypertension. Its amount also increases with damage / malnutrition of the kidney tissue,
- Overweight. Currently, everyone knows about the dangers of increased body weight. In this condition, human blood contains a large amount of various fats (cholesterol, triglycerides and complex protein complexes). They can easily be deposited on the wall of an artery or vein, which leads to disruption of their work,
- Postmenopause. “A woman is protected by her hormones” is a well-known statement by the Soviet gynecologist A.N. Rakhmanov also applies to hypertension. Estrogens have a significant effect on the vascular wall, which prevents the onset of high blood pressure, in most cases. Unfortunately, after the end of menstruation, a woman loses her natural defense and becomes vulnerable to this disease.
The presence of even one of these factors is a reason to begin the prevention of hypertension in the near future. Neglect of these activities with a high degree of probability will lead to the formation of pathology for several years.
Prevention and treatment of hypertension
Modern methods of treatment of hypertension, as a rule, involve the simultaneous use of several drugs:
- Beta blockers: Atenolol, Bisoprolol, Carvedilol, Propranolol, etc.,
- ACE Inhibitors: Enalapril, Fosinopril, Captopril,
- Calcium antagonists: Amlodipine, Nifedipine,
- Diuretic drugs: spironolactone, diacarb and others.
- Read more in the article all about drugs to reduce pressure.
Their effectiveness is not questioned, however, the use of significant doses of medication is always the risk of side effects. That is why the task of any doctor is to reduce the dosage of the drug, without prejudice to health. How to treat hypertension correctly so that this principle is respected? The answer is lifestyle correction. This will help not only to adequately cope with the disease, but also to prevent its occurrence. The proven and most effective measures for the prevention and treatment of hypertension are presented below.
Nutrition and healthy foods
A diet for arterial hypertension has only two strict rules that patients must follow:
- Salt restriction. In the monograph of Professor Storozhakov, the daily rate of this product for the prevention or treatment of the disease is clearly indicated - no more than 6 grams. However, in real life it is almost impossible to measure its quantity in the diet. In order not to burden themselves with complicated calculations, the doctors gave a clear recommendation - do not add food, do not eat smoked meat and "salinity". This is quite enough to maintain an optimal concentration of trace elements and water in the patient’s body,
- Rejection of high-calorie meals. Eating at elevated pressure (hypertension) should prevent the action of one very harmful factor - excess cholesterol and blood fat. The amount of these substances increases in the blood by eating fatty foods and easily digestible carbohydrates. Their most typical representatives are flour and butter dishes, mayonnaise, sour cream, fast food.
Other nutritional changes are advisory in nature, but they are also important for the patient's health. First of all, you should regularly use healthy foods for hypertension, which contain a sufficient concentration of trace elements (potassium, calcium, magnesium) and protein. Plant food, lean meat (chicken or beef) and low-fat dairy products will optimally complement the usual diet.
Exercise and physiotherapy
Almost all loads increase the pressure - this fact is widely known and it is absolutely correct. So why do doctors recommend to be sure to perform various exercises for hypertension? Numerous studies of domestic and foreign clinicians have proven that training the body affects not only the muscular system, but also the following elements of the body:
- Cardiac muscle - with regular exercise in gymnastics with hypertension or its analogies, the heart is more likely to tolerate daily loads and stressful situations. This is reflected in the preservation of the normal frequency of contractions (no more than 90 beats / min) and adequate release of blood in one stroke. Over time, the number of episodes of pressure increase, palpitations and other unpleasant symptoms of hypertension decreases.
- Vessels - muscles in the wall of this organ, as well as cardiac tissue, adapts to various physical activities, which allows to improve the patient's well-being,
- Adipose tissue - the combination of proper nutrition and regular exercise is an excellent addition to the prevention and treatment of hypertension. These activities will allow to bring to the norm the amount of "blood fats" and reduce the weight of the patient (if necessary).
An excerpt from the air RIA news about exercises for hypertensive
These positive effects can be achieved in various ways. In addition to classical gymnastics, patients can practice yoga for hypertension. Contrary to popular belief, this is not just a set of exercises, but also a special state of the whole body. Due to the training of the body, the formation of proper breathing and mental attitude, this method is an excellent prevention and treatment procedure. However, it is important that the entire practice be conducted under the guidance of an experienced specialist - this will reduce the likelihood of errors and negative phenomena.
What other options for physical education?
A great combination is swimming and hypertension. Very often, this disease affects people with pathologies of bones or joints, which are difficult to make active movements. This situation can occur in the presence of osteoarthritis, various arthritis (rheumatoid, psoriatic, ankylosing, etc.) and osteochondrosis. It is difficult for this group of patients to perform even a simple set of exercises on land, as they experience pain and discomfort in damaged tissues. According to associate professor N.S. Volchkova, classes in water are the best way out in this case.
In addition to these techniques, exercises on a stationary bike with hypertension, easy running, sports gait and even regular walks, at least 30-40 minutes 2-3 times a day, have a proven effect. Each of these procedures will reduce the likelihood of developing the disease and improve the effect of therapy.
How important is therapeutic breathing for hypertension? Undoubtedly, it has additional value in therapy, but with regular practice, the technique helps to achieve an improvement in the patient’s quality of life. At present, respiratory gymnastics A.N. Strelnikova.
The positive effect of this method of breathing in hypertension is realized through two main mechanisms:
- Direct effect on neural structures. The inhale technique described in Strelnikova’s gymnastics inhibits the work of particular regulatory (sympathetic) centers. Their main “sphere of activity” is the narrowing of blood vessels and the formation of increased pressure. Reducing their influence allows you to balance blood flow and reduce the likelihood of damage to the arteries,
- Improving nutritional renal tissue. As mentioned above, the kidneys are largely responsible for the occurrence of hypertension. With their ischemia (lack of oxygen supply), the production of the hormone renin increases, causing a rise in blood pressure. The oxygen saturation of the blood, which occurs during respiratory gymnastics, interrupts this mechanism and prevents the formation of the disease or its complications.
Training and practice of therapeutic breathing in hypertension does not take much time, but despite this, it is used quite rarely. The positive effect of the use of gymnastics compensates for all the effort expended, as it helps the patient to prevent the occurrence of the disease or make it more favorable.
What is impossible with hypertension?
Patients with this disease often have to change their usual daily routine to stop the progression of pathology. These changes concern not only nutrition, but also habits, nature of work, daily workloads, rest regime and some other nuances. Only if the recommendations of the doctors are observed, the therapy will be quite effective.
What can not be done with hypertension, and what restrictions are the patients forced to observe? The main points for lifestyle correction are shown in the table:
Currently, there is not one classification of hypertension. The disease is usually distinguished by the nature of the course, the presence of complications, causes of development, pressure indicators and much more.
Modern cardiologists allocate several degrees of hypertension (depending on the indicators of high blood pressure):
- Stage 1 - the pressure rises to 159-140 / 99-90 mm Hg. Art.,
- 2 degree - on the arrows of the mechanical tonometer indicator 179-160 / 109-100 mm Hg is diagnosed. Art.,
- Grade 3 - persistent or periodic increase in pressure of more than 180/110 mm Hg. Art.
According to the generally accepted classification of WHO, there are such stages of the disease:
- Stage 1 - transient increase in pressure without target organ damage,
- Stage 2 - the presence of signs of damage to internal organs, among which the main target is the heart, vessels, structures of the eye, brain and kidneys,
- Stage 3 - a steady increase in blood pressure against the background of the development of complications, from the manifestations of which a person may die.
Hypertensive illness has its own types of flow, including:
- benign type or sluggish variant of GB, when the symptoms of pathology develop very slowly, over decades, and the risk of complications is estimated as minimal,
- a malignant illness in which sudden pressure surges, target organ damage, and frequent hypertensive crises are recorded (this variant of the disease is difficult to give to drug therapy).
The disease at the initial stages of its development is almost asymptomatic, which complicates its early detection. In such patients, elevated pressure can be detected by chance during a physical examination or during a routine admission at a clinic.
A more complex type of hypertension characterizes a number of symptoms that significantly impair the quality of a person’s life and cause him to turn to specialists. The main symptom of the disease is an increase in blood pressure above 140/90 mm Hg. Art. This condition provokes the development of headaches, which are the result of a reflex narrowing of cerebral vessels. As a rule, persons prone to hypertension, complain of the appearance of pain in the neck and temples, having a pulsating character, characterized by its severity and suddenness of development. Such pains and throbbing do not go away after taking analgesic drugs.
Hypertensive patients often feel solo dizziness, which can occur after doing simple work. Symptom often accompanies nausea and vomiting, as well as general malaise due to increased intracranial pressure. Narrowing of the vessels of the hearing system causes tinnitus, when a person feels that his ears are heavily buried, and he practically loses the ability to perceive the sounds of the environment normally.
Impaired coronary blood flow leads to the development of myocardial ischemia. In such patients, shortness of breath and chest pains, which can be corrected well with nitrates, appear. The body at this time is working in an enhanced mode in order to be able to push a batch of blood into the constricted great vessels. Each attack of angina pectoris is accompanied by a rapid pulse, a pronounced heartbeat, and the risk that such a terrible complication of a pathological condition, such as myocardial infarction, will arise.
In hypertension, eye dysfunction with a sharp deterioration of vision and the development of hypertensive angiopathy of retinal vessels are determined. The fundus of the eye is also involved in the pathological process, which swells and squeezes the optic nerve. At this time, a person marks in his "goosebumps" before his eyes, darkened circles, and the like.
The complication of the symptoms of high blood pressure in women most often occurs during menopause, when menopause occurs. During this period, the body of the weaker sex occurs hormonal adjustment with impaired production of biologically active substances that control the normal level of pressure. That is why hypertension is the most common consequence of menopause among women.
GB is among the insidious diseases that are slowly progressive in nature and are very often diagnosed already at the stage of the appearance of the first complications of the pathological process. With a constant increase in blood pressure in the target organs dystrophic and sclerotic changes occur, leading to gross functional impairment. Primarily, the kidneys, the brain, the heart, the visual analyzer and the blood vessels suffer from hypertension.
There are several risk factors that affect the rate of development of complications of hypertension and their severity:
- bad habits, especially smoking
- sedentary lifestyle and increased body mass index,
- elevated blood cholesterol and hyperglycemia,
- frequent stress
- deficiency of potassium and magnesium in the body,
- age changes
- genetic predisposition.
In hypertensive illness, the heart is forced to work under conditions of increased stress, which is associated with the need to push blood into constricted vessels. Over time, the myocardial wall thickens and a person has left ventricular hypertrophy and oxygen starvation of the heart muscle.
From the heart, there are several types of complications of hypertension:
- ischemic disease
- angina pectoris
- atherosclerosis of the coronary vessels,
- acute heart failure in the form of myocardial infarction,
- chronic heart failure.
A high level of blood pressure provokes the appearance of disorders in the human brain, which in practice are manifested by severe dizziness, headache, tinnitus, memory loss, and more. There are several options for complex cerebral complications of hypertension:
- encephalopathy with vestibular disorders,
- ischemic and hemorrhagic stroke,
- cognitive impairment of brain activity.
As you know, the kidneys control the amount of water and salt in the body. But with increasing blood pressure, they can fully perform their main work. This contributes to the emergence of a number of complications, including:
- renal insufficiency
- dysfunctional filtering and release of fluid
Such disorders lead to the development of hypertension in a number of symptoms that indicate renal pathology. A sick person begins to complain of general weakness, malaise, the appearance of edema, unreasonable nausea.
Damage to the eyes is manifested by the occurrence of hemorrhages in the retina of the eye, swelling of the optic nerve head and progressive loss of vision. From the side of peripheral vessels with arterial hypertension, the most terrible complication is the separation of their walls, in particular, the known aortic aneurysm, which is formed and proceeds asymptomatically, often causing a sudden death.
Diagnosis of GB with the establishment of the stage and degree of development of the disease - an important step towards the appointment of adequate treatment of the pathological condition. That is why, when the first signs that indicate a hypertensive illness appear, you should immediately contact a medical institution to find out the causes of high blood pressure and methods for its correction.
The complex of diagnostic measures for suspected hypertension includes a number of laboratory and instrumental studies, including:
- laboratory blood test to determine the level of potassium and magnesium, creatinine, harmful cholesterol, glucose and the like,
- biochemical study of urine with the amount of protein,
- electrocardiography (ECG),
- ultrasound examination of the heart
- Doppler flowmetry,
- examination of the fundus.
The diagnostic procedure for hypertension, which allows to determine the degree of impairment, consists of two stages:
- the first stage is the determination of the clinical manifestations of the disease from the words hypertension and obtaining the results of additional studies,
- The second stage is a special study, which allows to determine the exact degree of the disease and the patient's presence of its complications using magnetic resonance therapy (MRI) or x-ray examination.
Obtain an accurate picture of the course of the disease allows daily monitoring of blood pressure. Thanks to him, it is possible to establish a range of pressure fluctuations throughout the day and determine its average index, which will characterize the degree of hypertension. The main disadvantage of this study is its high cost.
Treatment of exacerbations of hypertension should occur in the conditions of the cardiological hospital, where there is a possibility of constant control over the level of blood pressure. In addition, if necessary, the doctor may amend the patient's treatment plan and prescribe more effective drugs in each specific clinical case.
Treatment of the disease begins with the appointment of a special diet, which strictly limits the salt, fatty and fried foods, as well as by-products, smoked meats, flour products. Nutrition hypertension is aimed at improving the general condition, preventing the development of edema, normalization of weight and the like.
According to the new European recommendations, treatment of hypertension should be comprehensive and must include a number of drugs that are aimed at reducing blood pressure and eliminating the risks of transforming the disease into a malignant version of its course or the development of complications of a pathological condition. Among the most used groups of drugs for hypertension should be highlighted:
- alpha blockers (guanfacin),
- ganglioblockers (Pentamine, Benzogeksony),
- ACE inhibitors (Enap, Enalapril, Captopril),
- beta blockers (Metaprolol, Bisoprolol, Concor),
- calcium channel blockers (verapamil),
- diuretics (Lasix, Furosemide, Veroshpiron).
The doctor pays special attention to the appointment of diuretics. The fact is that not every diuretic is safe for hypertensive organism because of its properties to flush out potassium. That is why the use of such drugs should be combined with the use of potassium drugs under the control of the biochemical composition of the blood. In addition, diuretics not only reduce pressure, but also eliminate tissue swelling due to the removal of excess sodium. More details about taking diuretics are discussed in our article: Why do I take diuretics in hypertension?
Self-treatment of hypertension is strictly prohibited.
It is also not recommended to use antihypertensive drugs of traditional medicine without coordination of such use with your doctor. Prohibited action, as the main contraindication, can provoke an urgent hypertensive crisis and the need to immediately place the patient in a specialized hospital to find out the causes of the development of complications and to decide on the further tactics to eliminate them.
Types and symptoms of arterial hypertension
Hypertension can be divided into two types:
- Essential hypertension - hypertensive disease that has no specific cause, develops over the years due to aging of the body, lack of physical activity, overweight or excessive salt intake, can sometimes be hereditary.
- Secondary hypertension: renal (3-4%), endocrine (0.1–0.3%), hemodynamic, neurological, stressful, iatrogenic hypertension (caused by the intake of certain substances) and arterial hypertension of pregnant women.
Symptoms of arterial hypertension usually occur only when the pressure is above 140/90 mm Hg. Art., which can lead to such manifestations as:
- nausea and dizziness,
- Strong headache,
- labored breathing,
- blurred vision
- chest pain.
Symptoms of hypertension during pregnancy, in addition to the symptoms mentioned above, may also include leg swelling, as well as severe abdominal pain.
In alleged cases of hypertension during pregnancy, it is important to consult with your obstetrician-gynecologist to prevent the occurrence of complications, such as eclampsia, which can endanger the life of the pregnant woman and the baby.
Foods Undesirable for Hypertension
- salted butter,
- canned food
- sausages, smoked meats, etc.
- salty fish,
- sauces, mayonnaise, bouillon cubes,
- sweet soda,
- fast food,
- Black tea.
Uncontrolled arterial hypertension in the elderly is the most important risk factor for developing heart disorders at this age, such as a heart attack, for example.
Drug treatment of hypertension
Currently, there are several types of antihypertensive drugs that should be prescribed depending on each case: captopril, losartan, enalapril, amlodipine, ramipril, diuretics, for example. In addition, people with hypertension should be consulted regularly by a cardiologist for blood pressure assessment and treatment.
Treatment of hypertension in the elderly can be carried out with the help of drugs, and some changes in lifestyle, depending on the severity of the disease. Therefore, it is recommended:
- Medical visits to evaluate the effectiveness of treatment
- Take medication prescribed by a doctor
- Weight loss,
- Rejection of bad habits,
- Avoid foods that are high in fat and salt, as well as fast food and give preference to homemade food,
- Exercise at least 3 times a week
- Eat more foods rich in potassium, magnesium, calcium, and fiber,
Drug treatment is medication for reducing pressure: diuretics, calcium channel antagonists, angiotensin inhibitors, and beta-blockers, for example.
In addition, it is important to note that the treatment of arterial hypertension in the elderly should be very thorough and individual, especially for those who have other health problems, such as heart disease, urinary incontinence and a tendency to dizziness when standing up.
Medications to control hypertension
Uncontrolled hypertension increases the risk of developing heart disease, kidney disease, stroke, and heart attack. In most cases, the cardiologist recommends the use of drugs when the pressure remains above 140/90, with a low-salt diet and regular exercise.
Major antihypertensive drugs.
To control pressure, the doctor may recommend various medications, such as:
- Diuretics are medicines that act on the kidneys and increase the elimination of water and salt in the urine, such as furosemide, hydrochlorothiazide, spironolactone, or indapamide, for example.
- Vasodilator drugs that relax the arteries, and can be used along with other antihypertensive drugs. Examples of vasodilators are hydralazine and minoxidil.
- Calcium channel blockers are a class of antihypertensive drugs that dilate blood vessels, such as nifedipine, amlodipine, nicardipine, and verapamil, for example.
- ACE inhibitors - are widely used in the treatment of hypertension, as they prevent the production of a hormone that increases pressure, for example, captopril, enalapril, lisinopril or ramipril. Some people may develop a dry cough with regular use of these drugs. Another class of drugs with similar effects, but without the effect of cough, are angiotensin receptor antagonists, which reduce blood pressure, preventing the effects of angiotensin hormones. Some drugs for hypertension in this class are losartan, valsartan, candesartan, telmisartan.
- Beta-blockers - are part of a group of drugs that help to keep pressure under control, reduce the frequency of heart rhythms. These include: propranolol, atenolol, carvedilol, metoprolol, and nebivolol.
Side Effects of Drug Treatment for Hypertension
Side effects of drugs for treating hypertension include dizziness, fluid retention, a change in heart rate, headache, vomiting, nausea, sweating, or impotence. If you notice any of these symptoms, you should talk to your doctor to assess the possibility of reducing the dose of the drug or even exchange it for another.
Hypertension medications do not gain weight, but some of them may cause swelling, and in these cases, a cardiologist may also prescribe diuretic use.
However, the use of these drugs should always be recommended by a doctor. In the simplest cases, treatment is carried out using only one drug, especially when the values do not exceed 160/90 mm Hg. Art. However, in some cases, the doctor recommends using 2 or 3 drugs together.
The use of drugs for the treatment of hypertension in most cases persists for a lifetime, because hypertension is a chronic disease. However, in some special cases, for example, for the operation, the cardiologist advises to stop using drugs for several days.
A hypertensive crisis is a situation that can occur at any age and is characterized by a rapid increase in blood pressure, usually around 200/100 mm Hg. Art., and, if not treated, it can lead to serious complications.
In most cases, hypertensive crisis is the result of insufficient control of this disease, but can also occur in people who have never had problems with pressure.
How to diagnose hypertensive crisis?
Hypertension is often accompanied by symptoms such as dizziness, blurred vision, headache and pain in the neck, and in some cases it can be associated with a serious illness, heart attack or stroke, for example.
In an emergency, there is a sharp rise in blood pressure associated with serious diseases, such as acute myocardial infarction, hypertensive encephalopathy, acute pulmonary edema, hemorrhagic stroke, or aortic dissection, for example. In such cases, the patient should be hospitalized to stabilize health and pressure in order to avoid more serious complications.
To treat a hypertensive crisis, you need to go to the emergency room, measure the pressure and perform an electrocardiogram. Treatment varies depending on the test results, and in most cases it is necessary to take medications for the heart and diuretics.
Danger of hypertension
A person does not always suspect that he has this pathology, since many clinical manifestations of hypertension have an obvious similarity with the symptoms of ordinary fatigue. The disease often leads to the development of serious complications, including life-threatening conditions. In particular, if previously it was thought that atherosclerotic changes in blood vessels lead to myocardial infarction and hemorrhagic strokes, it is now established that the presence of hypertension is sufficient for the development of these conditions.
Arterial hypertension, like a number of other chronic diseases, cannot be completely cured, but its development can be prevented. Even with an already established diagnosis, adequate therapeutic measures can minimize the manifestations of hypertension, greatly improving the quality of life of the patient.
note: the risk of complications almost directly depends on the age of the patient. If hypertension is diagnosed in a young person, then the prognosis is less favorable than in patients of the middle age group.
To “catch” the disease at the initial stage, when the changes are reversible, you need to regularly measure blood pressure. If in the course of periodic measurements often figures are detected that exceed normal values, correction of blood pressure is necessary.
Normal numbers are:
- for people in the age of 16-20 years - 100/70 - 120/80 mm. Hg Art.,
- in 20-40 years - 120/70 - 130/80,
- 40-60 - not higher than 135/85,
- 60 years and more - no higher than 140/90.
Symptoms of hypertension
The latent course of hypertension or the initial stage of the disease can be suspected if periodically noted:
- unmotivated feeling of anxiety,
- hyperhidrosis (increased sweating),
- hyperemia (redness) of the skin of the facial area,
- small spots before eyes,
- memory impairment
- low performance
- irritability for no reason,
- puffiness of the eyelids and faces in the morning,
- heart palpitations at rest,
- numbness of fingers.
These symptoms may occur regularly or occur rarely enough. It is impossible not to attach importance to them, because the disease is very insidious. These clinical manifestations require an urgent lifestyle change, since a correction not carried out in time leads to a sufficiently rapid progression of the disease. As pathology develops, the list of persistent symptoms of hypertension expands. A lack of coordination of movements, a decrease in visual acuity is added.
Note:even the presence of only a few characteristic symptoms from the list above is grounds for an immediate visit to the doctor. Especially carefully you need to listen to your body if there are certain risk factors for hypertension. Self-medication is dangerous, uncontrolled medication can only worsen the situation.
Etiology and pathogenesis of hypertension
The onset of hypertension is caused by certain disorders in the central nervous system and the autonomic nervous system, which are responsible for vascular tone.
Important:in men from 35 to 50 years and in women in menopause, the likelihood of developing hypertension increases.
One of the most important risk factors for hypertension is a burdened family history. In patients with a genetic predisposition, increased permeability of cell membranes is detected.
External factors provoking the development of the disease include strong and frequent psycho-emotional stresses (nervous shocks, hard feelings). Они являются причиной выброса адреналина, который увеличивает объем сердечного выброса и повышает частоту сокращений миокарда.In combination with the burdened heredity, this often provides the appearance of hypertension.
The immediate causes leading to hypertension include:
- disorders of the nervous system,
- ion exchange disorders at the cellular and tissue levels (increased levels of sodium and potassium ions),
- metabolic disorders,
- atherosclerotic vascular lesions.
Important:in overweight people, the risk of hypertension is 3–4 times higher than in others.
The risk of hypertension increases significantly with alcohol abuse, nicotine addiction, with the consumption of large amounts of salt and physical inactivity.
Periodic increase in blood pressure causes the heart to function with increased load, which leads to myocardial hypertrophy, and subsequently - to the wear of the heart muscle. As a result, chronic heart failure (CHF) develops, and inadequate nutrition of organs and tissues leads to serious consequences and the development of a number of associated diseases. High pressure causes thickening of the vascular walls and narrowing of the vessel lumen itself. Gradually, the walls become brittle, which greatly increases the risk of hemorrhage (including the development of hemorrhagic strokes). Permanent blood vessel spasm maintains high blood pressure, closing this circle of disorders.
note: Normally, blood pressure fluctuations during the day do not exceed 10 units. Hypertensive numbers may vary by 50 mm. Hg Art. and more.
Hypertension may be the result of taking certain pharmacological agents (FS).
With extreme caution you need to take the FS of the following groups:
- hormonal contraceptive drugs,
- Supplements to suppress appetite
- some anti-inflammatory drugs (in particular - Indomethacin).
Hypertension or hypertension: what is the difference?
Hypertension means rising blood pressure above 140/90. We can say that hypertension and hypertension are almost identical concepts. But hypertension is a disease, and hypertension is one of its symptoms. Approximately one in ten patients abnormally high blood pressure is a manifestation of another pathology.
There are the following types of symptomatic hypertension:
Medications indicated for hypertension
Drugs are prescribed if non-pharmacological therapy of the 1 st degree of the disease does not give a positive effect for 3–4 months or 2 stage of the disease is diagnosed. Monotherapy is indicated (i.e., the use of a single FS). The “first row” drug does not affect the metabolism of lipids and carbohydrates, does not lead to fluid retention, does not disturb the electrolyte balance, does not inhibit the central nervous system and does not provoke a sharp increase in blood pressure after withdrawal.
At stages 2-3, combinations of β-adrenergic blockers with calcium antagonists, diuretic drugs, or angiotensin-converting enzyme inhibitors can be shown. It is also possible to combine ACE inhibitors with diuretics or calcium antagonists.
In severe hypertension, combinations of 3-4 drugs belonging to the groups mentioned above, as well as α-blockers, are sometimes prescribed.
Non-drug methods of treatment are shown at 1 degree. With hypertension, it is important to give up bad habits, to follow a diet with a limited content of sodium chloride (salt) and animal fats. An alternative to pharmacological drugs can be acupuncture therapy, acupuncture, auto-training and massage. Patients are advised to strictly adhere to the regimen, take funds with antioxidant activity and fortifying herbal remedies.
Helps with hypertension gymnastics. Regular dosed physical activity contributes to the development of a pronounced antihypertensive effect. Exercises should be performed daily for 30 minutes, increasing the load gradually.
Remember that if you have diagnosed hypertension, then with a sharp deterioration in the general condition, you should immediately call the doctor at home! Before his visit, it is better to take a half-sitting position, make a hot foot bath or put mustard plasters on the calves, take Valocordin (30-35 drops) and your “usual” medicine to reduce blood pressure. For pain in the chest, a Nitroglycerin capsule should be placed under the tongue, and in case of severe headache, take a diuretic.
Prevention of hypertension requires a healthy lifestyle, nutrition, adherence to work and rest, as well as monitoring blood pressure.
To get more information about the treatment of arterial hypertension, you can read this video review:
Konev Alexander, therapist
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The leading manifestation of hypertension is persistently high arterial pressure, i.e. blood pressure, which does not return to normal levels after a situational rise as a result of psycho-emotional or physical exertion, but decreases only after taking antihypertensive drugs. According to WHO recommendations, blood pressure is normal, not exceeding 140/90 mm Hg. Art. Excess systolic index over 140-160 mm Hg. Art. and diastolic - over 90-95 mm Hg. Art., fixed in a state of rest with a double measurement during two medical examinations, is considered hypertension.
The prevalence of hypertension in women and men is approximately the same 10-20%, most often the disease develops after the age of 40, although hypertension is often found even in adolescents. Hypertension promotes more rapid development and severe atherosclerosis and the emergence of life-threatening complications. Along with atherosclerosis, hypertension is one of the most frequent causes of premature mortality in the young working-age population.
There are primary (essential) arterial hypertension (or hypertension) and secondary (symptomatic) arterial hypertension. Symptomatic hypertension is from 5 to 10% of cases of hypertension. Secondary hypertension is a manifestation of the underlying disease: renal diseases (glomerulonephritis, pyelonephritis, tuberculosis, hydronephrosis, tumors, renal artery stenosis), thyroid (hyperthyroidism), adrenal gland (pheochromocytoma, Syndrome Cushing's, primary hyperaldosteronism), coarctation or aortic atherosclerosis, etc. .
Primary arterial hypertension develops as an independent chronic disease and accounts for up to 90% of cases of arterial hypertension. In hypertension, increased pressure is a consequence of an imbalance in the regulatory system of the body.
The mechanism of the development of hypertension
The basis of the pathogenesis of hypertension is an increase in the volume of cardiac output and resistance of the peripheral vascular bed. In response to the impact of the stress factor, there are dysregulations in the regulation of peripheral vascular tone by the higher centers of the brain (hypothalamus and medulla). There is a spasm of arterioles in the periphery, including kidney, which causes the formation of dyskinetic and dyscirculatory syndromes. The secretion of the neurohormones of the renin-angiotensin-aldosterone system increases. Aldosterone, which is involved in mineral metabolism, causes water and sodium retention in the bloodstream, which further increases the volume of blood circulating in the vessels and increases blood pressure.
When hypertension increases blood viscosity, which causes a decrease in blood flow velocity and metabolic processes in the tissues. Inert walls of blood vessels thicken, their lumen narrows, which fixes a high level of general peripheral resistance of blood vessels and makes arterial hypertension irreversible. In the future, as a result of increased permeability and plasma impregnation of the vascular walls, the development of elastotic fibrosis and arteriolosclerosis occurs, which ultimately leads to secondary changes in the tissues of organs: myocardial sclerosis, hypertensive encephalopathy, and primary nephroangiosclerosis.
The degree of damage to various organs in hypertension can be unequal, so several clinical and anatomical variants of hypertension are distinguished with a primary lesion of the vessels of the kidneys, heart and brain.
Risk factors for the development of hypertension
A leading role in the development of hypertension plays a violation of the regulatory activities of the higher parts of the central nervous system, controlling the work of the internal organs, including the cardiovascular system. Therefore, the development of hypertension can be caused by frequently repeated nervous overstrain, prolonged and violent disturbances, and frequent nervous shocks. The emergence of hypertension contributes to excessive stress associated with intellectual activity, work at night, the influence of vibration and noise.
A risk factor in the development of hypertension is increased salt intake, which causes arterial spasm and fluid retention. It has been proven that daily consumption of> 5 g of salt significantly increases the risk of developing hypertension, especially if there is a genetic predisposition.
Heredity, burdened by hypertension, plays a significant role in its development in the immediate family (parents, sisters, brothers). The likelihood of developing hypertension significantly increases in the presence of hypertension in 2 or more close relatives.
Contribute to the development of hypertension and mutually support each other arterial hypertension in combination with diseases of the adrenal glands, thyroid, kidney, diabetes, atherosclerosis, obesity, chronic infections (tonsillitis).
In women, the risk of developing hypertension increases in menopause due to hormonal imbalances and exacerbation of emotional and nervous reactions. 60% of women develop hypertension in the period of menopause.
The age factor and gender determine the increased risk of developing hypertensive disease in men. At the age of 20-30 years, hypertension develops in 9.4% of men, after 40 years - in 35%, and after 60-65 years - already in 50%. In the age group up to 40 years, hypertension is more common in men, in the field of older age the ratio changes in favor of women. This is due to a higher rate of male premature mortality in middle age from complications of hypertension, as well as menopausal changes in the female body. At present, hypertensive disease is increasingly detected in people at a young and mature age.
Extremely favorable for the development of hypertensive disease, alcoholism and smoking, irrational diet, excess weight, physical inactivity, poor ecology.
Symptoms of hypertension
Variants of the course of hypertension are varied and depend on the level of increased blood pressure and on the involvement of target organs. In the early stages, hypertension is characterized by neurotic disorders: dizziness, transient headaches (most often in the nape of the neck) and heaviness in the head, tinnitus, pulsation in the head, sleep disturbances, fatigue, lethargy, a feeling of weakness, palpitations, nausea.
In the future, shortness of breath comes along with fast walking, running, exercise, climbing the stairs. Blood pressure stays above 140-160 / 90-95 mm Hg Art. (or 19-21 / 12 hPa). There is sweating, reddening of the face, chill-like tremor, numbness of the toes and hands, and dull long-lasting pains in the region of the heart are typical. With fluid retention, swelling of the hands is observed (“ring symptom” - it is difficult to remove the ring from the finger), faces, eyelid puffiness, stiffness.
In patients with hypertension, there is a veil, flashing of flies and lightning before the eyes, which is associated with vasospasm in the retina, there is a progressive decrease in vision, retinal hemorrhages can cause complete loss of vision.
Treatment of hypertension
In the treatment of hypertension, it is important not only to reduce blood pressure, but also to correct and minimize the risk of complications. It is impossible to completely cure hypertension, but it is quite realistic to stop its development and reduce the incidence of crises.
Hypertension requires the combined efforts of the patient and the doctor to achieve a common goal. At any stage of hypertension, it is necessary:
- Follow a diet with increased intake of potassium and magnesium, limiting the consumption of salt,
- Stop or severely restrict alcohol intake and smoking,
- Get rid of excess weight,
- Increase physical activity: it is useful to engage in swimming, physical therapy, make walking,
- Systematically and for a long time to take prescribed drugs under the control of blood pressure and dynamic observation of a cardiologist.
In hypertension, antihypertensive drugs are prescribed, which inhibit vasomotor activity and inhibit norepinephrine synthesis, diuretics, β-blockers, disaggregants, hypolipidemic and hypoglycemic, and sedatives. Selection of drug therapy is carried out strictly individually, taking into account the whole range of risk factors, the level of blood pressure, the presence of concomitant diseases and target organ damage.
The criteria for the effectiveness of treatment of hypertension is the achievement of:
- short-term goals: maximum reduction of blood pressure to the level of good tolerability,
- medium-term goals: preventing the development or progression of changes on the part of target organs,
- long-term goals: prevention of cardiovascular and other complications and prolongation of the patient’s life.
Prognosis for hypertension
The long-term effects of hypertension are determined by the stage and nature (benign or malignant) of the course of the disease. Severe, rapid progression of hypertension, stage III hypertension with severe vascular lesion significantly increases the frequency of vascular complications and worsens the prognosis.
In hypertension, the risk of myocardial infarction, stroke, heart failure and premature death is extremely high. Unfavorable hypertension occurs in people who become ill at a young age. Early, systematic treatment and control of blood pressure can slow the progression of hypertension.
Prevention of hypertension
For the primary prevention of hypertension, it is necessary to exclude existing risk factors. Useful moderate exercise, low-salt and hypocholesterol diet, psychological relief, the rejection of bad habits. It is important to early detection of hypertensive disease by monitoring and self-monitoring of blood pressure, dispensary registration of patients, adherence to individual antihypertensive therapy and maintaining optimal blood pressure indicators.
What is hypertension?
Hypertension is a disease characterized by high blood pressure. In a person not suffering from hypertension, the normal pressure is approximately 120/80 mm Hg, taking into account minor deviations.
Arterial hypertension has a negative effect on the patient’s vessels, which in a short time are narrowed and damaged. If the blood flow is too powerful, the walls of the vessels do not stand up and burst, as a result of which hemorrhages occur in patients.
To “catch” the disease at the initial stage, when the changes are reversible, you need to regularly measure blood pressure. If in the course of periodic measurements often figures are detected that exceed normal values, correction of blood pressure is necessary.
Normal numbers are:
- for people in the age of 16-20 years - 100/70 - 120/80 mm. Hg Art.,
- in 20-40 years - 120/70 - 130/80,
- 40-60 - no higher than 135/85,
- 60 years and more - no higher than 140/90.
Who is hypertensive?
Hypertension is a person with chronically high blood pressure. This is a dangerous condition, as with high blood pressure significantly increases the risk of serious cardiovascular diseases.
Hypertension can be called a person with a pressure above 140/90 mm Hg. Art.
According to statistics in recent years, 25% of all adults suffer from high blood pressure. And among the elderly, the percentage of hypertensive patients is even higher - 57%.
So how do you reveal true hypertension? The pressure should be measured in the supine position and during exercise. In a healthy person, the difference will not be too noticeable, and the hypertensive patient will experience difficulties and his pressure may jump to 220/120 millimeters of mercury. Simply put: in this hypertonic reaction to the load is very acute.
If a person has a pressure surge only once, this does not mean that you need to forget about it. Even a single case must force the one with whom it occurred.
To ensure a long remission period, it is important to study the etiology of the pathological process. The main causes of hypertension are impaired blood circulation through the vessels, limited admission to the left ventricle of the heart. В современной медицине этому имеется вполне логическое объяснение – структурные изменения сосудов с возрастом, формирование тромбов и атеросклеротических бляшек в их полостях.
Суть развития гипертонии – отсутствие нормальных реакций (расширения сосудов) после устранения стрессовых ситуаций. Such conditions are characteristic of the following persons:
- Salt Abusers - Excess salt intake (15 g per day) leads to fluid retention, increased stress on the heart, which can cause arterial spasm,
- Alcohol lovers and smokers,
- Persons whose work is connected with constant night shifts, emergency situations, intense physical and intellectual activity, severe stressful situations, frequent negative emotions,
- Patients with chronic kidney disease, thyroid disease, diabetes,
- People whose relatives suffered from hypertension, suffered a stroke or myocardial infarction.
Important: in men from 35 to 50 years and in women in menopause, the likelihood of developing hypertension increases.
- Sedentary lifestyle,
- excessive salt intake.
- hormonal imbalance
- associated with puberty (this cause is temporary, then the pressure returns to normal),
- smoking, drinking alcohol.
- alcoholism (including frequent consumption of beer and other low-alcohol drinks - do not think that they are safe),
- sedentary lifestyle, frequent stress, lack of sleep.
- Excess weight,
- acquired heart defects,
- kidney disease
The predisposition to hypertension is genetically determined. Symptoms occurring in the nearest blood relatives - a fairly clear signal of the need to carefully consider their health.
Stages and degrees
For the correct diagnosis of hypertension, doctors first need to determine the degree or stage of hypertension in a patient and make, so to speak, an appropriate entry in his medical record. If the diagnosis of the disease occurred in the later stages, second or third, then the consequences for the organism may be more serious than for the first stage of the disease.
- Stage 1 hypertension is a blood pressure of 140–159 / 90–99 mm Hg. Art. The pressure may return to normal values from time to time, after which it will rise again,
- Stage 2 is arterial pressure, which ranges from 160–179 / 100–109 mm Hg. Art. Pressure is often understood and very rarely returns to normal values.
- Stage 3 - when the pressure rises to 180 and above / 110 mm Hg. Art. The pressure is almost always high, and its decrease can be a sign of heart failure.
The first degree of hypertension - primary. The pressure here does not exceed 140/158 on 90/97, and it rises abruptly and periodically, for no apparent reason. After, the pressure can suddenly return to normal. Present:
- feeling of "fly" before the eyes,
- sometimes tinnitus occurs.
Second degree hypertension
In the second stage of hypertension, the pressure rises to 180/100 mm. Even if the patient takes a rest, it does not go down to a normal level. In addition to increasing blood pressure may be noted:
- retinal artery narrowing,
- left ventricular hypertrophy of the heart,
- protein appears in the urine during the analysis and a slight increase in creatine in the blood plasma.
- sleep disturbance
- angina pectoris
With this stage such misfortunes as heart attacks and strokes can come.
3 degree of hypertension
The clinical picture with 3 degrees of hypertension is aggravated by the following symptoms:
- Gait change,
- Persistent blurred vision
- Permanent arrhythmia
- Impaired motor coordination
- Hypertensive seizure of significant duration with impaired vision and speech, sharp pain in the heart, clouded consciousness,
- Limiting the ability to move independently and do without help.
How to treat hypertension?
Treatment of hypertension depends on the stage of the disease. The main goal of the treatment is to minimize the risk of developing cardiovascular complications and prevent the threat of death.
The purpose of drug therapy is to reduce blood pressure, namely the elimination of the causes of this vascular condition. At the beginning of treatment is appropriate mono and combination therapy. With its ineffectiveness, I use low doses of combinations of antihypertensive drugs.
During treatment, patients should maintain a calm lifestyle, in which neither stress nor emotional overload is present. Patients need to spend more time outdoors, it is best to take long walks in the woods, in the park, by the pond. It is imperative to follow a diet, since proper nutrition is the key to successful treatment of hypertension.
The main groups of drugs for hypertension:
- Diuretics (diuretics) help unload the blood circulation, removing excess fluid. But along with the liquid, such a heart-beneficial element as potassium is derived, therefore the use of these agents is strictly metered, it requires correction with potassium preparations (asparkam, panangin). Examples of diuretic drugs: hypothiazide, indapamide.
- Drugs that can affect the power of cardiac output, muscle contractions of the heart (beta-blockers and calcium channel blockers). These include bisoprolol, carvedilol, metoprolol, amlodipine.
- Medicines acting in different ways on vascular tone. Examples of drugs: lisinopril, monopril, losartan, valsartan.
A sharp increase in blood pressure, not accompanied by the appearance of symptoms from other organs, can be stopped by oral or sublingual (under the tongue) intake of drugs with relatively fast action. These include
- Anaprilin (a group of β-blockers, usually if the rise in blood pressure is accompanied by tachycardia),
- Nifedipine (its analogues are Corinfar, Cordaflex, Cordipin) (a group of calcium antagonists),
- Captopril (a group of angiotensin-converting enzyme inhibitors),
- Clonidine (its analogue is Clofellin) and others.
Drugs for treating hypertensive crisis:
- Captopril on 10-50 mg inside. The duration of the action lasts up to 5 hours,
- Nifedipine - taken under the tongue. Duration of action means about 5 hours.
- Beta-blockers (atenolol, esmolol) are used in hypertension to normalize the tone of the sympathetic nervous system. They are used when the rise in blood pressure is combined with a decrease in the frequency of heart contractions,
- Vasodilators (sodium nitroprusside, hydralazine),
- Diuretics (furosemide).
Non-pharmacological treatment includes:
- decrease in body weight due to a decrease in the diet of fats and carbohydrates,
- limiting the consumption of salt (4-5 g per day, and with a tendency to delay sodium and water 3 g per day,
- total fluid intake - 1.2–1.5 liters per day), spa treatment, methods of physiotherapy and physical therapy,
- psychotherapeutic effects.
Dieting is one of the important moments in hypertension. Below, we have compiled a list of recommendations to follow during the meal:
- There should be as little animal fat as possible: fatty meats, especially pork, butter, fatty dairy products. The only exception is fish, because its fat lowers the level of bad cholesterol in the blood.
- The amount of salt in the diet should be as low as possible because it retains fluid in the body, which is highly undesirable.
- It is very important that fresh fruits, vegetables, greens, and juices are present in the diet.
- It is desirable to establish a fractional diet with small portions, but frequent meals.
- Strong tea and coffee should be excluded from the diet. They should be replaced with compote, herbal drinks, mors.
Recommendations for hypertensive patients
Doctors give such advice to hypertensive patients:
- balance the diet, eat at a certain time at least 4 times a day, give preference to healthy and fresh products,
- avoid stress
- get enough sleep
- improve your emotional attitude
- use the norm of fluid daily,
- exercise - every morning is important to charge, after a working day, you can visit the pool or gym,
- it is forbidden to sit for a long time in a sitting or lying position behind a computer - you need to warm up constantly and not forget about nutrition,
- monitor changes in atmospheric pressure every day and analyze your blood pressure. At the slightest indisposition, it is necessary to consult a doctor and undergo a course of therapy,
- to refuse from bad habits,
- control weight.
Contrary to common misconception, not all physical exercises are useful for this disease. You should not do strength exercises.
- The most effective gymnastics for you will be stretching, that is, a set of stretching exercises, as well as muscle relaxation as in the yoga system.
- To better treat hypertension, pay enough attention to fresh air and water treatments.
Before you use folk remedies for hypertension, be sure to consult with your doctor. Because There may be contraindications for use.
- Black currants and strawberries in combination with honey and beets can be taken a tablespoon 4 times daily,
- A teaspoon of lingonberry leaves is diluted with 2 cups of water, and cooked for 15 minutes. The solution should be drunk during the day,
- People with hypertension need to chop the head of garlic, mix with two cups of fresh cranberries and a glass of honey. It is better to use a blender or grinder to get a homogeneous mass. The tool must be taken on 3 large spoons daily immediately after breakfast.
- Grind in a blender three lemons with skins and a quarter cup of hazelnut kernels. Add half a cup of honey to the mixture. Take a monthly course of 2 spoons daily.
- Instead of tea, when hypertension is treated without medication, hypertensive patients are advised to use broths of hips, hawthorn.
- We take a honeycomb spoon of cranberries, half a tablespoon of fresh and chopped rosehip, and mix with a tablespoon of grated lemon. To this mixture add one cup of honey. To use this composition you need one tablespoon every morning and evening.