Hypertensive disease: treatment, stages, drugs

Hypertonic diseaseIs a chronic disease characterized by a constant (in the initial stages - periodically) high blood pressure. In this case, the increase in blood pressure in hypertensive disease - this is not the result of some other disease (kidneys, organs of the endocrine system, etc.). Hypertension doctors are called a "silent killer."

Increased pressure is a risk factor for many diseases. Therefore, it is very important to timely and correctly organize the treatment of essential hypertension, both simple home folk remedies, and medical preparations. It is necessary to know the extent, risk and stages of hypertension.

Causes and Symptoms

The emergence of hypertension is facilitated by many factors. This is a heredity, a lack of movement, the use of large amounts of table salt, obesity, alcohol abuse, The decisive role in the development of the disease has a prolonged emotional overstrain, leading to a breakdown of the nervous mechanisms of regulation of the heart and blood vessels. Often, the number of cardiac contractions (palpitation, or tachycardia) increases, which in turn leads to an increase in the amount of blood entering the aorta. At the same time, the tone of the small vessels of the arterial bed increases and, as a consequence, their inner diameter decreases with increasing resistance to the blood flow.

The cause of hypertension is not yet fully understood, but the main mechanisms of its occurrence are known. The first and leading among them is the nervous mechanism. The initial part of it is emotions, emotional experiences, often accompanied by healthy blood pressure.

With a strong increase in blood pressure, hypertension is manifested by increased heart rate to such an extent that pulsation is felt in the head, sweating, edema of the eyelids, face and hands in the morning. Characteristic for hypertension is also numbness in the fingers, chills, a state of heightened anxiety. But there are cases when hypertension passes asymptomatically, and then you can find out about this disease only when you are on a hospital bed.

Signs of high blood pressure

At elevated pressure, the following main signs are noted:

1. headache;
2. dizziness;
3. sensation of "hot flashes" when it seems that the blood has poured to the head and becomes hot;
4. increased irritability;
5. fast fatiguability;
6. disorders in the work of the heart - tachycardia or irregular heartbeat (arrhythmia);
7. changes in urination (increased urine volume, urge to urinate predominantly at night);
8. nasal bleeding;
9. reduction of visual acuity up to its partial or complete loss.

Complaints of shortness of breath, weakness and rapid fatigue are associated with manifestations of heart failure. Complaints about changes in urination are a consequence of developed renal failure, in which the excretory function of the kidneys is primarily disturbed. The change in visual acuity is associated with the development of the pathology of the fundus of the eye - hemorrhage, retinal detachment,

What pressure is considered elevated:

According to WHO, the upper (systolic) pressure is considered elevated, starting at 140 mm Hg. st., lower (diastolic) - with 90 mm of mercury. Art.

There are three degrees of pressure increase:

1. up to 160/100 mm Hg. Art. - hypertension I degree (mild);
2. up to 180/110 mm Hg. Art. - hypertension II degree (moderate);
3. more than 180/110 mm. gt; Art. - Hypertension III degree (severe).

All, of course, know that normal blood pressure should be 120/80 or 110/70 mm Hg. Art. However, for many people, normal, normal pressure is 90/60, and they are assured that they feel well at the same time. But even if the normal normal pressure - 110/70 - starts to rise and reaches only 125/85, you may not feel good: headache, dizziness, although you do not need to take medication at this pressure, because it is considered normal. However, for you, even such a slight increase can mean that there has been some failure in the regulation of blood pressure and that this may be the beginning of hypertensive disease.

In the vast majority of cases, hypertension is not associated with other diseases and is calledprimary essential(that is, advancing for unknown reasons)arterial hypertension,orhypertensive disease. Secondary hypertensioncalled a condition in which the increase in blood pressure is due to diseases other than the cardiovascular system, and other body systems. The difference between secondary hypertension and primary is that if the cause is eliminated, that is, the disease that causes it is curable, then the hypertension passes, so they prescribe medications to treat the underlying disease.

About 5% of cases arevasorenal hypertension,which is caused by the narrowing of the renal arteries due to atherosclerosis or other causes.

In a special, rather rare form,malignant hypertension,at which arteriolar wall damage, necrosis and sclerosis of arterioles develop very rapidly.

One of the reasons for the increase in blood pressure is an increase in cardiac output, when the heart contracts more than usual, and the blood must pass through narrowed large arteries that have lost normal elasticity. This is a common situation in the elderly.

Measurement of pressure

A simple instrument is used to measure pressure -tonometer. The arm above the elbow is tightly wrapped with a special cuff, which is pumped either manually (with the aid of a rubber pear connected to it) or "automatically" after pressing a certain button (if an electronic manometer is used). At the same time, the cuff compresses the arteries of the hand, and then air is slowly released from the cuff.

The manometer "catches" the moment when the pressure of the systolic ("upper") in the brachial artery becomes slightly higher than the pressure in the cuff: at this point the blood portion "breaks through" the clamping point and strikes the vessel walls below this place. The pressure in the cuff at this point is considered "systolic."

Then the air continues to leave the cuff, the pressure in it falls, and all large portions of blood pass through the artery, and at some point it becomes so weak that it does not clamp the artery and does not interfere with the blood flow even during diastole-the relaxation of the heart. The corresponding pressure in the cuff is considered diastolic ("lower").

The pressure should be measured three times in 5 minutes of rest and the result of the last measurement should be considered as the final result. The interval between measurements must be at least 3 minutes.

Stages of essential hypertension

There are three stages of hypertension.

1. The first stage -unstable, moderately elevated pressure; there are no lesions of organs. The main complaints: headaches, dizziness, noise in the ears, "flies" before the eyes; in some people - indeterminate pain in the heart, palpitation, dyspnea. However, there are often no complaints.

2. The second stage- Increased pressure persistent; there are changes in the vessels of the fundus and arteries that feed the heart muscle. Uncertain pain in the heart at this stage is often transformed into angina. When ultrasound is detected signs of thickening of the artery wall. It is possible the formation of atherosclerotic plaques in large arteries.

3. The third stage- depending on what organs are affected, the patient is threatened:

• stroke;
• myocardial infarction, angina pectoris, chronic heart failure;
• nephropathy, chronic renal failure;
• aortic aneurysm;
• retinal damage eye.

Hypertensive crisis

The hypertensive crisis is a sudden, sharp and significant rise in blood pressure. Most often, hypertensive crisis occurs in people with hypertensive disease, often after excitement, especially associated with negative emotions, as well as after physical overload or a sudden change in weather. A crisis can occur for no apparent reason. Increased pressure is accompanied by nausea, noise in the ears and head, dizziness, headache, weakness. There may be unsteadiness of gait, a feeling of heat, increased heartbeat, pain in the heart, feelings of constriction beyond the sternum and lack of air, hearing and vision impairment. The crisis can last from several hours to several days.

How to help a patient before an ambulance arrives

1. Measure the pressure. Find out from the patient what pressure is usually on him. If he does not know his "usual" pressure, and at the moment the pressure is above 150/90, then most likely the cause of poor health is the hypertensive crisis.
2. Put the patient in bed in a semi-sitting position, with a high pillow under his head.
3. Give him any sedative medicine - seduxen, elenium, Relanium: chew 1-2 tablets, drink with water.
4. Make a hot foot bath, you can with mustard.
5. Give 1-2 tablets of dibazol, papazola, drotaverina or nospy. If a person has not previously been treated for hypertension, then you should not give him strong remedies! These tablets can too sharply lower the pressure, which is fraught with complications right up to the collapse.
6. If the patient is being treated for hypertension, then the tablet is most likely needed. Give him these pills - as much as he says, but not more than the maximum single dose.

Treatment and prevention of hypertension

The increase in pressure deserves serious attention to both the patient and the doctor. People with high blood pressure should not only take medications prescribed by a doctor in a timely manner, but also follow all the doctor's recommendations that concern the increase in physical activity, diet, etc.

As a rule, a healthy lifestyle and non-medicinal means of influence, such as dosed physical exercise, physiotherapy procedures, allow achieving a stable normalization of blood pressure. Since hypertension is a chronic disease, it needs to be treated constantly, and not "from case to case."

Drugs that lower blood pressure

A person who has been diagnosed with "essential hypertension" should clearly understand that he will have to be treated all his life. True, patients with stage I hypertension, if the right treatment has been started in time, and also those who managed to eliminate the cause of the increase in arterial pressure, with secondary arterial hypertension, can avoid this fate.

Drugs that reduce blood pressure, calledantihypertensive. The choice of medicine is made by the doctor, taking into account the stage of hypertension, the cause of the increase in pressure, sex, age of the patient, concomitant diseases. Self-medication can lead to undesirable results.

Treatment of hypertension usually begins withdiuretics. The fact is that the kidneys are involved in the regulation of blood pressure and with any form of hypertension. They delay water, produce special substances - both increasing and reducing pressure. It is recommended to use diuretics with a gradual and prolonged action. These include a group of thiazides (hypothiazide, dichlorothiazide). However, using diuretics, one should remember about the possible decrease in potassium in the body and about the increase in the level of sugar.

Good action hasbeta-blockers, which treat patients of a young age, with increased excitability, a penchant for palpitations.

Hypotensive effect possesscalcium antagonists. Preparations of this group block calcium, reducing peripheral resistance and blood pressure. These drugs includepifidipine, corinfar, cardafen. Take them should be 1-2 tablets 2-3 times a day; at high pressure it is possible to put under the tongue. Medicinal products of prolonged action from the same group -Amlodipine, Norvasc, Corinfar retard- Take 1-2 times a day.

ACE Inhibitors- excellent funds for the treatment of hypertension. These includecaptopril, capoten, enalapril, enap, renitek, ednit, as well as new generations -kazoar, losartanand etc. All of them control blood pressure, prevent complications (strokes, heart attacks, etc.), prevent the development of thickening of the walls of the heart.

Well reduces pressure drugclonidine, it is important only to comply with the dosage prescribed by the doctor (there are tablets of 0.075 mg and 0.015 mg). Possible side effects of this medication are dry mouth, drowsiness, so it is not recommended to take it to people whose work requires increased attention and quick response.

Preparationsreserpine, raunatin, raurazanhave a mild hypotensive and soothing effect, they are taken 1 tablet 1-3 times a day, after meals. However, they can cause weakness, insomnia, so they are prescribed less often than others.

There are combination drugs (adelphan), consisting of several components, including a diuretic, or added potassium (triside). They are taken after eating 1/2 tablet 2-3 times a day. Nevertheless, it is preferable to use single-component ("pure") drugs.

If the above funds are ineffective, stronger drugs are prescribed -prazozinandprtsiol.They can be takenonly by appointmentand under the supervision of a doctor to prevent a sharp drop in blood pressure, even to fainting.

The main rule of drug treatment of hypertension is a gradation, that is, first treatment with small doses of one drug followed by an increase in the dose. If it is ineffective, add drugs from another group (with a gradual increase in dose) or an ineffective drug is replaced with another. Irregular medication can create a misconception about their effectiveness. You can not abruptly refuse to take the medication, even if the blood pressure has dropped to normal values. It is necessary to continue the course of treatment, while reducing the dose to a minimum.

And, of course, dietary recommendations remain, especially salt restriction.

In hypertensive disease, diastolic ("lower") pressure is of the greatest importance, therefore one should strive to reduce it to the norm, that is, up to 90 mm Hg. Art. and below.

Nutrition for hypertension

First of all, with hypertension, it is necessary to limit the intake of table salt (at exacerbation and completely eliminate), do not eat salty foods (canned food, sausages, smoked products, cheeses) and dishes. In people with moderate hypertension, even a small restriction of table salt (up to 3-5 grams per day) often leads to a normalization of pressure even without medication, and in case of severe hypertension it leads to a restoration of sensitivity to pressure-reducing drugs. By the way, to improve the taste of unsalted food you can use garlic, spicy vegetables, herbs, spices, lemon and tomato juice.

It is necessary to enrich the diet with such trace elements as potassium, magnesium and calcium.Potassiumpromotes the excretion of excess sodium and water from the body and, thus, reduces the pressure. Kaliam is rich in products such as pumpkin, watermelons, zucchini, dried apricots, raisins, apples, potatoes.Calciumallows you to lower blood pressure. Sources of calcium are many vegetables and fruits, dairy products, cereals.Magnesiumhas a vasodilating effect, so when hypertension is recommended such magnesium-rich foods as oat, buckwheat, pearl and millet cereals, wheat bran, carrots, dried fruits, broth of wild rose, apricot juice.

With a persistent increase in blood pressure and hypertensive crises, it is advisable to spend 2 consecutive days of unloading diets: rice-compote, apple, dried fruits, vegetable, lactic, curd.

Fruit and vegetable diet

First breakfast: 200 g of hot broth of wild rose, salad of fresh cabbage, carrots or apples with 10 g of vegetable oil.

Lunch: vegetable puree, 100 g of fruit juice.

Dinner: 250 g of vegetarian soup, vegetable salad with 10 g of sour cream or vegetable oil, 100 g of nuts.

Afternoon snack: grating carrots or beets, broth of wild rose.

Dinner: vinaigrette with 10 g of vegetable oil, 200 g of compote of dried fruits or juice.

Bread saltless from wholemeal flour - 100 grams, sugar - 30 grams per day or its substitutes.

Recipes of traditional medicine

1. One glass of chopped garlic to insist in 0.5 liters of vodka; Take 1 teaspoon before meals.
2. One teaspoon of flowers or hawthorn fruit brew 1 cup of boiling water; Take 1 tablespoon 2-3 times a day for 30 minutes before meals.
3. Squeeze the juice from fresh berries of viburnum and mix it thoroughly with honey (1: 2). Before use, dilute with boiled water. Drink a glass 2-3 times a day.
4. The juice of the black mountain ash reduces arterial pressure and has vasodilating properties. It is used in the initial stage of hypertension: drink 50 ml 3 times a day for half an hour before meals for 10-30 days. And you can replace the juice with the fruits of the black mountain ash: 100 g 3 times a day, also half an hour before meals.
5. One tablespoon of St. John's wort is mixed with 1/2 teaspoon of chamomile. Water infusion take 1/4 cup 2-3 times a day.
6. Mix 1 glass of beetroot juice, 1 glass of carrot juice, 1 glass of horseradish juice, 1 lemon juice and 1 glass of liquid honey. Take 1 tablespoon 2-3 times a day for 1 hour before or after eating.
7. Ten grams of dandelion flowers boil in 200 ml of water, insist 20-30 minutes, drain. Take 1 tablespoon 3-4 times a day.
8. One glass of cranberries grind with 3 tablespoons of powdered sugar and eat every day at the same time one hour before a meal. This tool is used for mild forms of hypertension.
9. Beetroot juice - 4 cups, honey - 4 cups, marshweed herb grass - 100 g, vodka - 500 g. All the components are combined, mixed thoroughly, infused for 10 days in a tightly corked container in a dark cool place, strain, wring out. Take 1-2 tablespoons 3 times a day for 30 minutes before eating. The remedy is used for hypertensive disease of I-II degree.
10. Squeeze the juice from 3 kg of onions, mix it with 500 g of honey, add 25 g of walnut films and pour 0.5 l of vodka. Infuse for 10 days. Take 1 tablespoon 2-3 times a day. It helps to lower blood pressure.

Prevention

To prevent the development of hypertensive disease, it is necessary to reduce the neuro-emotional tension, to create conditions for the "discharge" of emotions, as if accumulating in the central nervous system. The human body is designed in such a way that discharge of the nervous system occurs most naturally only in the process of increased physical activity. Therefore, it is desirable that during a period of emotional stress, a pedestrian walk or occupation with a favorite sport or work followed, requiring physical exertion.

Prevention of hypertension is the moderate use of salt, dosing loads on the nervous system and observing a reasonable diet in order not to gain excess weight. Must sleep at least eight hours a night. It is useful to sleep at least for half an hour during the day. Everyone can independently prevent the development of hypertensive disease or prevent it from becoming, without resorting to drugs - it is enough to lead a healthy lifestyle and eat less salt.

Source: "Home medical encyclopedia. Symptoms and treatment of the most common diseases »: AST, Owl; Moscow, Saint Petersburg; 2010 (fact sheet)