Hypertension (arterial hypertension) is a syndrome of systolic hypertension ≥ 140 mm Hg. Art. and/or diastolic ≥ 90 mm Hg. Art. A common disease of the cardiovascular system requires timely action. Treatment for hypertension is prescribed after a comprehensive examination. Therapy includes symptomatic correction and combating diseases, the symptoms of which are increased blood pressure.
Some stats
Hypertension occurs in 90-95% of patients with elevated blood pressure. In other cases, we are talking about secondary symptomatic manifestations: renal (3-4%), endocrine (0. 1-0. 3%). Less common is hypertension against the background of neurological, hemodynamic and stressful situations.
The societal importance and danger of hypertension in increasing the risk of stroke, heart attack and coronary artery disease, which are the leading causes of death. If high blood pressure is not controlled, chronic kidney disease develops, leading to kidney failure and disability.
When should high blood pressure be treated?
In order to prescribe effective therapy, it is necessary to determine the degree of arterial hypertension. To do this, you need to measure blood pressure and compare the indicators in the table.
| Degree | The value of blood pressure, mm Hg. Art. |
|---|---|
| one | 140-159 to 90-99 |
| 2 | 160-179 by 100-109 |
| 3 | 180 to 110 and more |
The most common signs of hypertension requiring treatment are:
- throbbing or pressing headache in the back of your head;
- dizziness and flickering of dark circles and "flies";
- Palpitations, nausea and tinnitus.
The clinical picture described is typical for the moment of rising blood pressure. In practice, cases of asymptomatic course of the disease are described. If hypertension is not controlled, this condition negatively affects the functionality of internal organs. The first to suffer are "target organs" such as the kidneys, brain, heart, and blood vessels.
The main markers of damage to internal organs in hypertension:
- Hypertrophy of the left ventricle.
- Violation of the diastolic function of the myocardium.
- Chronic heart failure.
- progressive atherosclerosis.
- Heart attack.
- encephalopathy.
- Stroke.
- Glomerulosclerosis of the kidneys.
- Angiopathy of the fundic vessels.
The stages of hypertension are determined by the nature of the involvement of internal organs. In the first phase of the defeat of "target organs" is not observed. The second stage is characterized by single or multiple lesions without AMI (myocardial infarction), chronic diseases of the urinary system and stroke. The third stage is characterized by manifestations of chronic kidney disease, stroke and myocardial infarction.
The higher the blood pressure and the more symptoms are present, the higher the risk of vascular accidents. With grade 3 hypertension, the likelihood of complications is high, regardless of concomitant symptoms.
Basic rules for the treatment of hypertension
The main task is to reduce the risk of complications. To achieve this, it is necessary to minimize negative factors and stabilize blood pressure at the lowest possible level. The optimal value for most people is 140-90 mmHg. Art. ;for elderly patients - 140-150 at 90-95 mm Hg. Art. Here you need to be careful, because low blood pressure (hypotension) only increases the risk of developing vascular accidents.
Treatment of hypertension 1 degree
Tactics for the treatment of arterial hypertension are developed not only by the degree of increase in blood pressure, but also by the likelihood of developing cardiovascular pathologies. Accordingly, with 1 degree of hypertension, it is enough to exclude negative factors by adjusting lifestyle. Drug therapy is required in this case, if the pressure does not stabilize for 2-3 months.
List of corrective measures required for hypertension 1 degree:
- Give up bad habits (alcohol, smoking).
- Balancing the diet - include foods rich in magnesium and potassium in the menu, limit salt (no more than 5 g per day), refuse marinades and fried foods.
- Do not forget about daily physical activity (running, swimming, walking for 30 minutes a day).
- Normalize the body mass index to optimal values (25 kg/m2).
Treatment of hypertension at 2 and 3 degrees
Treatment of hypertension for hypertension includes drug therapy, which is immediately prescribed, regardless of the risk of complications. Taking drugs is mandatory in the presence of 3 or more risk factors for the development of cardiovascular complications.
Basic drugs used to treat arterial hypertension:
- calcium channel blockers. Contribute to the dilation of peripheral vessels and reduce the risk of stroke, hypertrophy and blood clots. Contraindicated in severe heart failure and violation of intracardiac conduction.
- Angiotensin II receptor blockers, angiotensin converting enzyme inhibitors. Effective agents that improve prognosis in patients with heart failure. The drugs prevent kidney disease and left ventricular hypertrophy.
Beta-blockers are prescribed for hypertension associated with arrhythmia and coronary artery disease. Therapy with these drugs is indicated in patients with bronchial asthma, diabetes mellitus and intracardiac conduction disorders. Less popular drugs include alpha-blockers, imidazoline receptor agonists, and renin inhibitors.
Tactics for treating high blood pressure
If you follow the federal guidelines for the treatment of high blood pressure, only one drug should be used if the risk of complications is low. If single-component drug therapy does not work, then only then funds are added that belong to other groups.
Patients with blood pressure readings from 180 to 100 mm Hg. Art. First of all, it is recommended to prescribe a two-component drug therapy:
- adrenoblockers, calcium channel blockers (dihydropyridine) and ACE inhibitors;
- blockers, diuretics and ACE inhibitors;
- Adrenoblocker, diuretic and aldosterone receptor antagonist.
Many patients, due to the need to take a large number of tablets every day, stop drug treatment for hypertension, which leads to serious consequences. To solve this not uncommon problem, pharmacological companies have started to produce combination drugs that combine two hypertensive drugs.
To increase the effectiveness of drug treatment for hypertension, additional drugs are prescribed - antiplatelet drugs and statins. Tablets are also needed that keep the cholesterol level within acceptable limits - from 4 to 5 mmol / l. This approach eliminates the possibility of complications from the cardiovascular system.
Additional therapeutic measures
Drug therapy is often not enough. The treatment of hypertension must be approached comprehensively. Only in this case can you be sure of a quick and stable result.
Physiotherapy to treat high blood pressure
This approach to treating hypertension deserves special attention, since it is very effective, especially in combination with drug therapy.
The most successful methods of physiotherapy for high blood pressure are:
- electro sleep. A set of methods of influencing the patient's body with the help of electrical energy. The advantages of this method lie in a beneficial effect on the central nervous system (central nervous system), the functioning of the endocrine glands and metabolism. Intense currents not only improve blood circulation, but also reduce the level of bad cholesterol in the blood.
- electroplating. The use of low-frequency current (up to 60-80 V) to stimulate physico-chemical processes in tissues and cells. With the introduction of drugs, the procedure is called drug electrophoresis. In the treatment of hypertension, the impact on the calf muscles, the interscapular region and the collar zone occurs.
- balneotherapy. The program includes Charcot shower, baths with perozone, iodine, bromine, etc. The procedures have a gentle effect and are indicated only in the early stages of the disease. Proven to prevent the development of strokes and heart attacks.
- magnetotherapy. The physiotherapeutic procedure involves exposure to an alternating magnetic field. Widely used for arterial hypertension 1 and 2 degrees. The current is sent through the back of the head to the brain, which helps stimulate blood flow and reduce heart rate.
- diadynamic therapy. The vegetative-corrective method has a therapeutic effect on the urogenital system and kidneys to reduce the synthesis of angiotensin (a hormonal substance that narrows blood vessels).
Physiotherapy reduces the dosage of drugs, normalizes blood pressure and strengthens blood vessels. The procedures improve the work of the heart and prevent sharp jumps in blood pressure. Sections of the central nervous system are stabilized, which helps normalize blood pressure. Excitability and nervousness are stopped, damaged nerve cells are regenerated and the high blood pressure does not progress any further. Heart and kidney complications are minimized.
surgical method
To eliminate the cause of arterial hypertension, high-frequency destruction of the renal nerves is prescribed. The procedure is aimed at eliminating the autonomic stimulation of the "kidney" mechanisms that increase blood pressure.
An effective surgical treatment for hypertension is stimulation of the carotid sinus baroreceptors. This result is achieved through electrical stimulation of the carotid artery. Despite the effectiveness of surgical treatment, there is no information on safety. Resorting to this method of treating hypertension is recommended only for patients who have resistance to the three antihypertensive drugs.
gymnastics
With hypertension, gymnastics is most effective. Thanks to many years of experience of doctors with patients with hypertension, it was found that any drug therapy in combination with dosed physical activity is much more effective.
Gymnastic exercises are aimed at reducing the dose of drugs in order to exclude the development of side effects. With daily exercise, it is possible for most patients to avoid medication altogether.
Neck gymnastics for high blood pressure improves the functionality of the spine. Regular exercise helps:
- elimination of muscle cramps;
- improved nutrition of the intervertebral discs;
- normalization of blood flow from blood vessels in the neck;
- restoring blood flow to the brain;
- the establishment of metabolic processes that support normal blood pressure;
- increase the level of physical activity and, accordingly, the burning of excess calories;
- Activation of the work of blood vessels by saturating the myocardium with oxygen.
Remember that only regular gymnastics makes sense. It is necessary to set the time and place of the exercises in advance. During class, it should be comfortable and practical so that no one distracts and you can concentrate.
Elements of gymnastics for the treatment of hypertension:
- "Metronome". Alternate fixation of the neck for 10 seconds on the right and left side.
- "Heron". The chin is stretched up as much as possible, the arms are lowered. Every 10 seconds we take the starting position for 1-2 seconds.
- "Spring". Retraction and extension of the chin with fixation for 5-10 seconds.
- "Sadness". Alternately bend your head to one shoulder, then to the other.
- "Frame". The left hand rests on the right shoulder, the head is turned to the left. Then repeat for the right hand.
- "Fakir". The palms are closed over the head so that the fingers point upwards. The head should be turned to the side every 10 seconds.
- "Airplane". The arms are stretched to the sides, the elbows are not bent. Every 10 seconds the arms are lowered to rest.
Effective exercises for high blood pressure
Moderate physical activity trains the central nervous system and strengthens blood vessels. Vascular tone quickly normalizes, which helps improve well-being. With high blood pressure, only dosed loads are allowed.
A set of exercises for hypertensive patients (we repeat each element 5-6 times):
- Feet shoulder width apart, arms raised. We stand on tiptoe. Slowly lower your hands. Shake the brushes, exhale.
- Hands on belt, rotate pelvis in both directions.
- Walk lightly in place for 1-2 minutes. To restore breathing, we switch to walking.
- Hands on the belt, on the inhale we bend forward, pull the head back, on the exhale we straighten up.
- Feet shoulder width apart, hands on belt. On inspiration we make springy inclinations forward, on exhalation - back and throw our heads back.
Simple exercises increase the capacity of the respiratory system by improving blood vessel elasticity. Harmful substances that accumulate in the body are excreted much faster, which relieves the kidneys. The immune system is strengthened and ventilation of the lungs is improved.
Physical activity is contraindicated in patients with blood pressure over 180/120 mm Hg. Art. , and also after a hypertensive crisis. It is unacceptable to play sports with the risk of myocardial infarction and stroke. An absolute contraindication is atrial fibrillation, paroxysmal tachycardia, thrombosis, weakness and quinsy attacks.
If during training there is pain in the chest, shortness of breath, or the heart rhythm is disturbed, classes should be interrupted. In this case, it is necessary to visit a family doctor who will make a diagnosis and, if necessary, prescribe treatment.
Treatment of hypertension in a sanatorium
Treating hypertension is a responsible and lengthy process that will give results only if the doctor's recommendations are followed. Self-medication can lead to serious complications that threaten not only health, but also life. Each measure must first be coordinated and approved by a specialist.
The sanatoriums have everything necessary to carry out diagnostic measures in the field of high blood pressure equipment: electrocardiography, ultrasound. The treatment process is carried out using: physiotherapy, balneotherapy, halotherapy.