From this article you will learn about such a phenomenon as the big difference between upper and lower pressure. Such a state can cause certain complaints in the patient, and can be a completely random finding with the next measurement of pressure.
Contents of the article:
- The reasons for the big difference between the
- indices The symptoms of the
- pathology Diagnosis
- Treatment methods
- Forecast
When measuring the pressure with a tonometer, the result is two digits - the upper and lower BP, respectively. The first - a large figure in value - is the upper, or systolic, pressure. It reflects the work of the heart. The second indicator - the lower the number - is the lower or diastolic pressure. It reflects the work of blood vessels and passage of a portion of blood through large elastic vessels - the aorta, arteries and arterioles. BP is measured in millimeters of mercury.
A large difference between the two components of blood pressure is the difference between the upper and lower values by more than 50 mm Hg. Art.
In the overwhelming majority of cases, such a "runaway" is achieved precisely because of the high figures of the upper pressure, while the lower one remains within the norm. This condition is called isolated systolic hypertension, or ISH.This is a special type of hypertensive disease, which we will discuss in more detail below.
Click on the picture to enlarge Usually, isolated arterial hypertension is not subject to radical treatment, but it is necessary to monitor the blood pressure and receive corrective treatment. Isolated high upper pressure and a large difference in its indices with the lower one can provoke strokes, cerebrovascular and cardiac circulatory disturbances in the same way as conventional arterial hypertension.
Physicians and cardiologists are most often the problem of ISH.
Causes of a big difference between the pressure indicators
The culprit of a large difference in the measured blood pressure is precisely the upper or systolic pressure. It is the increase of this indicator of more than 50 mm Hg. Art.in comparison with diastolic characterizes the onset of systolic arterial hypertension. The heart works in full force, forcing blood pressure, but the blood vessels for a number of reasons do not respond to changes in blood pressure - the lower one remains stably normal or even lowered.
ISG is differently called hypertension of the elderly, because it is the age factors that determine its main causes:
- The destruction and thinning of the muscular layer in the arteries. It is the muscular layer in these vessels that determines the elasticity of the arteries and the possibility of changing their diameter for control of blood pressure.
- Artery atherosclerosis - the deposition of salts of cholesterol, calcium and thrombotic masses on the inner shell of the arteries - the formation of atherosclerotic plaques. Vessels become "glass" - dense, unyielding and unable to fully reduce, reacting to changes in pressure.
- Depletion of kidney reserves and their chronic diseases. Kidneys are powerful regulators of blood pressure, and in the old age their condition inevitably worsens.
- The destruction of specific receptors in the heart and large vessels that are responsible for the response of blood vessels to changes in upper pressure. Normally, these receptors should "catch" high blood pressure from the heart and cause the blood vessels to balance it.
- Deterioration of blood supply to the brain and brain centers of vascular tone regulation.
All these features, which are so characteristic of older people - over 60 years of age, are the main cause of this condition as the big difference between systolic and diastolic pressure.
Symptoms of pathology
The main problem of isolated systolic hypertension is its latent and lingering course. Patients high digits of upper pressure may not disturb.
In some cases, patients present fairly general complaints:
- , congestion of the ears and tinnitus;
- headache, dizziness, heaviness in the temples;
- unstable and unsteady gait, movement coordination disorders;
- memory loss, psychoemotional instability;
- pain in the heart, heart rhythm disturbances.
The main difference of this type of hypertension is a soft and stable course, but with the attendant complicating factors and it can lead to hypertensive crises and circulatory disorders. Such aggravating factors include:
- Diabetes mellitus.
- Obesity.
- A sedentary or sedentary lifestyle.
- Cardiac insufficiency and disorders of the heart structure - left ventricular hypertrophy.
- Chronic renal failure. Stroke and history of myocardial infarction.
Diagnostics
By and large the diagnostics of the IGS is simple. It is enough several times in the dynamics to measure the patient's blood pressure or make daily monitoring of blood pressure with a special tonometer - SMAD.
As a qualifying study the patient can do:
- Clinical analysis of blood and urine.
- Blood test for glucose.
- Biochemical blood test with an emphasis on the lipidogram - indicators of the exchange of cholesterol and its fractions.
- Coagulogram or blood coagulation test.
- Cardiac electrocardiogram.
- Ultrasound examination of the heart, large vessels, in particular, the BSA - brachiocephalic arteries feeding the brain.
- Ultrasound examination of kidneys and kidney vessels.
- Consultations of specialists: neurologist, endocrinologist, vascular surgeon.
Treatment methods
Treatment of IOG should be prescribed by a GP together with a cardiologist after a proper examination of the patient.
It is very important to observe several mandatory conditions for the treatment of this type of hypertension:
- The pressure should never be reduced drastically. Its upper figures should fall gradually so that the vessels "have time to get used to" their new indicators. Otherwise, the patient may experience strokes, heart attacks and other ischemic disorders.
- Drugs for the treatment of ICH should only affect systolic pressure as much as possible. To begin therapy it is necessary from as much as possible small doses of a preparation, gradually increasing a dosage.
- The action of drugs should not negatively affect the kidneys and cerebral circulation, which already affects the elderly.
The following groups of medicines are used to treat IOG and equalize the difference between upper and lower pressure:
- Antihypertensive drugs - drugs against pressure. In this case, it is preferable to use calcium antagonists, beta-adrenoblockers, ACE inhibitors and angiotensin receptor blockers. When properly used, these drugs fully satisfy the specified criteria. Diuretics Diuretics. Reducing the volume of circulating blood can significantly reduce the upper pressure and cardiac output.
- Drugs that improve cerebral, renal and cardiac blood flow, further protect these organs from the harmful effects of pressure.
- Neuro- and cerebroprotectors - drugs that improve the nutrition of nerve tissues and the brain - are used to prevent strokes and cerebral circulation disorders.
For the best effect, you can use combinations of drugs, and sometimes even dramatically change the drugs and their combinations under the close supervision of a doctor.
The lifestyle of the patient is also very important: proper nutrition with low fat and simple carbohydrates, dosed physical activity, walking outdoors, full sleep and rest, vitamin therapy, rejection of bad habits.
Forecast
The course of the ISG is not aggressive. In many patients, the disease runs for years and even decades, and periods of normal health alternate with impairments.
The problem of IGG is that against a background of marked increase in systolic pressure( 200 mm Hg and above), against the background of altered inelastic vessels, there is a high probability of hemorrhages in the brain, retina of the eye, kidneys. Such "glass vessels" can not stand the pressure of blood pressure and burst.
Timely treatment and individual approach to each patient, stable maintenance of upper blood pressure at a level of no more than 140 mm Hg. The right way of life significantly increases the life expectancy and its quality in elderly patients.
