Causes, symptoms and treatment of hypertensive crisis

From this article you will learn about the hypertensive crisis: what it is, the causes of its occurrence, the symptoms and principles of care - both pre-medical and first medical.

Contents of the article:

• Causes of pathology
• Complications and consequences of crises
• Symptoms of crisis
• Diagnosis of condition
• Treatment of
• Forecast for

What is hypertensive crisis? A hypertensive crisis is a sudden, sudden increase in blood pressure, characterized by a certain set of complaints and clinical symptoms. To this state it is actually extremely difficult to give any clear definition, since the figures of the so-called "crisis" pressure for each individual patient are individual. For a person with normal blood pressure, and even more so with a slightly lowered blood pressure, the blood pressure level may be higher than 140/90 mm Hg. Art. And here for a hypertensive patient "with the experience", at which pressure does not fall below 150/100 mm Hg. Art.even at rest, the crisis will be the pressure above 180/110 mm Hg. Art. It is important to understand that when making a diagnosis, doctors in this case rely more on the patient's symptoms and symptoms rather than on the indicators of the tonometer.

"Creeping" pressure levels are very dangerous. This sudden jump in pressure is a shock to blood vessels and the heart. The vessels of the heart muscle and brain are most vulnerable. Against the backdrop of a sharp increase in pressure, there is a sharp spasm of the blood vessels, blood does not flow to cells and tissues, due to which the cells deprived of nutrition begin to die - there is a heart attack or a so-called ischemic stroke. Such phenomena occur most often in the heart muscle and the brain.

The second variant of the development of the crisis is the rupture of the vessel under the influence of excessive blood pressure - hemorrhagic stroke. The vessels most affected by such ruptures are those affected by atherosclerosis or diabetes mellitus. It is the presence of such complications - heart attacks, strokes, hemorrhages in the internal organs, the brain, the retina of the eye - that defines the concept as a complicated hypertensive crisis with the defeat of target organs( brain, heart, liver, kidneys, eyes).

Such sharp and uncontrolled "jumps" of blood pressure can occur both in patients suffering from a constant form of hypertension, and in completely healthy people against the background of stress, alcohol intake and other factors, which we will discuss below. An interesting fact is that in healthy and young patients the consequences of stroke are often more severe than in patients with hypertensive disease, because their vessels are not prepared for such pressure surges.

Depending on the presence of complications, the patient's age and state of health, the speed and quality of providing first-aid and medical care, the crisis can both be suppressed completely and leave a number of unpleasant consequences after it.

Typically, the first doctor who encounters such a condition is a district therapist or an ambulance. In the complicated course of the crisis, neurologists, cardiologists, and ophthalmologists are necessarily included in the help.

Causes of hypertensive crises

Now that we have determined what it is - hypertensive crisis, it is important to understand the causes of its occurrence.

Pheochromocytoma - hormone-active adrenal tumor - one of the possible causes of hypertensive crisis

Complications and consequences of

crises It is important to understand that it is dangerous not the peak pressure rise, but those complications from internal organs that can arise as a response to high blood pressure:

• Acuteheart condition - heart attack, rhythm disturbances, acute heart failure.
• Acute disorders of cerebral circulation - stroke, cerebral hemorrhage.
• Acute renal failure with possible irreversible impairment of kidney function.
• Acute respiratory failure, pulmonary edema.
• Hemorrhages and heart attacks of other vital organs - liver, intestines, retina.
• The dissecting aortic aneurysm.
• Comatose states, loss of consciousness, falls with head injuries.

Brain stroke

Symptoms of the crisis

It is important to understand that the crisis is an acute condition, so it can not go unnoticed. This is an urgent condition that requires immediate reaction from surrounding people and medical professionals.

We list the leading signs of hypertensive crisis:

Diagnostics of the

state It is relatively easy to recognize the crisis state - it is enough to measure the pressure on both hands and assess its condition and complaints. These measures are sufficient for the initial diagnosis.

Within the walls of the medical institution, the most important goal will be to determine if the so-called target organs - brain, heart, eyes, internal organs have suffered. For this purpose, the following examinations and tests are carried out:

Holter monitoring is a method that allows recording the ECG within 24 hours.

Treatment of

Hypertensive crisis treatment, especially begun on time, is able to completely stabilize the pressure - that is, to stop the crisis. High pressure somehow stabilizes, the question is whether the crisis will succeed in provoking one or other complications.

In this section, we will highlight two main points: the principles of providing first-aid first aid and directly specialized medical care.

First aid

High blood pressure refers to those conditions, the first aid for which you need to be able to provide before the arrival of doctors. It is important to understand that the principles of rendering assistance to non-workers should be reduced to the necessary minimum:

• The first principle of providing first aid is to enlist the support of doctors. To do this, immediately call an ambulance, and only then start any action.
• The patient should be seated or given a semi-reclining position. The legs should be lowered down - this reduces the return of venous blood to the heart and reduces the load on it.
• If there is such a possibility, you need to measure blood pressure on both hands and count the pulse.
• With a high pulse - above 90 beats per minute - you can perform a so-called carotid sine massage - a technique based on receptor and reflex interactions. To do this, you need to gently, but noticeably massage the side surfaces of the neck in those places where the pulsation of the vessels is felt.
• Maximum supply of fresh air, unfasten tight collars, remove tie.
• It is important to clarify the patient, whether he suffers from hypertension, whether he takes any medications and whether they have it with him.
• If a patient has his usual medication against pressure - it makes sense to take the next dose prescribed to him by the doctor. It is strictly forbidden to offer someone else's medicines for pressure from the pressure - the effect can be unpredictable.
• The second permitted and even recommended to take medication, which can be offered to the patient before the arrival of a doctor, is nitroglycerin. This remedy has a very important effect - the expansion of the coronary vessels of the heart and the improvement of the flow of blood to the heart muscle. This medicine is recognized by the World Health Organization and all associations of cardiologists as an excellent tool for the prevention of myocardial infarction in hypertensive crisis, especially accompanied by pain in the heart. Nitroglycerin is in the form of tablets, capsules and a spray. It is necessary to take one standard dose by placing it under the tongue or cheek for more effective absorption.
• You can independently take calming agents - corvalol, validol, valokordina, valerian or motherwort. It is also important to create a quiet and calm environment for the patient, to save him from unnecessary noise and prevent panic.
• Do not take any other medications, double doses of drugs, drinking alcohol, hot baths.

These are all actions that can be performed at the stage of waiting for the arrival of doctors or on the way to a medical institution.

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Medical assistance

Within the hospital, doctors will not only start lowering blood pressure, but also assess possible complications and prevent them.

The golden rule for managing hypertensive crises is a gradual and extremely gentle pressure reduction - no more than 20% of the baseline in 2 hours. For this, the patient will be very slowly and fractionally administered antihypertensive drugs - titrate the dose.

Drugs for pressure reduction will be selected by a cardiologist depending on the situation, age and condition of the patient. Often the patient needs the appointment of several drugs at once, as well as their periodic replacement. As necessary, doctors add the following groups of drugs:

Crisis recovery usually takes from several hours to 2-3 days. After this, it is very important to choose a quality supportive patient to avoid repeated crises, to explain to him the need for constant medication and the consequences of repeated crises.

Drugs for the treatment of uncomplicated hypertensive crisis

Forecast for

The prognosis of hypertensive crisis is rather difficult. Its outcome is very dependent on the age of the patient, the condition of his heart and blood vessels, the speed and quality of first aid and many other factors.