Hypertension (arterial hypertension) is a syndrome of systolic arterial hypertension ≥ 140 mm Hg. Art. and/or diastolic ≥ 90 mm Hg. Art. A common disease of the cardiovascular system requires timely action. Treatment of hypertension is prescribed after a complete examination. Therapy includes symptomatic correction and the fight against diseases, the symptoms of which are high blood pressure.
some statistics
Hypertension occurs in 90-95% of patients with high blood pressure. In other cases, we are talking about secondary symptomatic manifestations: renal (3-4%), endocrine (0, 1-0, 3%). Less common is hypertension in the context of neurological, hemodynamic and stressful situations.
The social importance and danger of hypertension in the increased risk of stroke, myocardial infarction and coronary heart 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 to treat hypertension
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. |
|---|---|
| a | 140-159 to 90-99 |
| two | 160-179 by 100-109 |
| 3 | 180 to 110 and more |
The most common signs of hypertension that require treatment are:
- throbbing or pressing headaches in the back of the head;
- dizziness and flickering of dark circles and "flies";
- heart palpitations, nausea and tinnitus.
The described clinical picture is typical for the time of increased blood pressure. In practice, cases of asymptomatic course of the disease are described. If high blood pressure is not controlled, this condition negatively affects the functionality of the internal organs. The first to suffer are the "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 of the heart.
- Violation of the diastolic function of the myocardium.
- Chronic heart failure.
- progressive atherosclerosis.
- Myocardial infarction.
- encephalopathy
- Race.
- Glomerulosclerosis of the kidneys.
- Angiopathy of the fundus vessels.
The stages of hypertension are determined by the nature of the involvement of the internal organs. At the first stage of the defeat of "target organs" is not observed. The second stage is characterized by single or multiple lesions in the absence of AMI (myocardial infarction), chronic diseases of the urinary system, and cerebrovascular accidents. The third stage is characterized by manifestations of chronic kidney disease, stroke and heart attack.
The higher the blood pressure and the more symptoms present, the greater the risk of developing vascular accidents. With grade 3 hypertension, the probability of complications is high, regardless of the presence 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 levels. The optimal value for most is 140-90 mm Hg. Art. ;for elderly patients: 140-150 to 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 treating arterial hypertension are developed not only by the degree of increased blood pressure, but also by the probability of developing cardiovascular pathologies. According to this, with 1 degree of hypertension, it is enough to exclude negative factors by adjusting the lifestyle. Drug therapy in this case is necessary if the pressure does not stabilize for 2-3 months.
List of corrective measures that are necessary for hypertension of 1 degree:
- Give up bad habits (alcohol, smoking).
- Balance 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 levels (25 kg/m2).
Treatment of hypertension at 2 and 3 degrees
Treatment of hypertension in high blood pressure includes drug therapy, which is prescribed immediately, regardless of the risk of complications. It is mandatory to take medication in the presence of 3 or more risk factors for the development of cardiovascular complications.
Basic drugs for the treatment of arterial hypertension:
- Calcium antagonistsContribute to the expansion of peripheral vessels, reducing the risk of strokes, hypertrophy and blood clots. Contraindicated in severe heart failure and in violation of intracardiac conduction.
- Angiotensin II receptor blockers, angiotensin converting enzyme inhibitors. Effective agents that improve prognosis in patients with heart failure. Medications prevent kidney pathologies and left ventricular hypertrophy.
Beta blockers are prescribed for hypertension, which is combined with arrhythmia and coronary heart disease. Therapy with these drugs is indicated for patients with bronchial asthma, diabetes mellitus and intracardiac conduction disorders. Less popular drugs are alpha blockers, imidazoline receptor agonists, and renin inhibitors.
Tactics for the treatment of hypertension.
If you follow the federal guidelines for treating hypertension, a medication should only be used if there is a slight risk of complications. If single-component drug therapy does not work, only funds belonging to other groups are added.
Patients with blood pressure values from 180 to 100 mm Hg. Art. Initially it is recommended to prescribe a two-component drug therapy:
- adrenoblocker, calcium channel blocker (dihydropyridine), and ACE inhibitor;
- ACE blocker, diuretic and inhibitor;
- adrenoblocker, diuretic and antagonist of aldosterone receptors.
Many patients, due to the need to take a large number of tablets per day, discontinue drug treatment of hypertension, which leads to serious consequences. To address this not uncommon problem, drug companies have started producing combination drugs that combine two antihypertensive drugs.
To increase the effectiveness of drug treatment of hypertension, additional drugs are prescribed - antiplatelet agents and statins. Tablets that keep the cholesterol value within acceptable limits - from 4 to 5 mmol / l - are also needed. This approach eliminates the possibility of complications from the cardiovascular system.
Additional therapeutic measures
Drug therapy is often not enough. The treatment of arterial hypertension must be approached in a comprehensive manner. Only in this case, you can count on achieving a quick result that will be stable.
Physiotherapy for the treatment of hypertension
This approach to the treatment of high blood pressure deserves special attention, since it is quite effective, especially in combination with drug therapy.
The most successful procedures for physiotherapy of hypertension are:
- electrosleep. A set of methods of influencing the patient's body with the help of electrical energy. The advantages of this method are 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.
- Galvanization. The use of low-frequency current (up to 60-80 V) to stimulate physical-chemical processes in tissues and cells. With the introduction of drugs, the procedure is called drug electrophoresis. For the treatment of hypertension, the impact is made on the calf muscles, the interscapular region and the neck area.
- Balneotherapy. The program includes a 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. It is shown to prevent the development of strokes and heart attacks.
- Magnetotherapy. The physiotherapeutic procedure involves exposure to a magnetic field of an alternating nature. Widely used for arterial hypertension of 1 and 2 degrees. The current is sent to the brain through the back of the head, which helps stimulate blood flow and slows the heart rate.
- diadynamic therapy. The vegetative-corrective method has a therapeutic effect on the genitourinary system and kidneys by reducing the synthesis of angiotensin (a hormonal substance that constricts blood vessels).
Physiotherapy reduces the dose of medications, normalizes blood pressure and strengthens blood vessels. Procedures improve the work of the heart, avoiding sharp jumps in blood pressure. Sections of the central nervous system are stabilized, which contributes to the normalization of blood pressure. Excitability and nervousness stop, damaged nerve cells regenerate, and hypertension stops progressing. Cardiac and renal complications are minimized.
surgical method
To eliminate the cause of arterial hypertension, radiofrequency destruction of the renal nerves is prescribed. The procedure is aimed at eliminating autonomic stimulation of the "renal" 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 its safety. It is recommended to resort to this method of treating hypertension only for those patients who have resistance to all three antihypertensive drugs.
Gym
With hypertension, gymnastics is more effective. Thanks to many years of experience of doctors with patients with hypertension, it was possible to find out that any drug therapy is much more effective in combination with dosed physical activity.
Gymnastic exercises are aimed at reducing the dose of drugs to exclude the development of adverse reactions. With daily training, it is possible to completely abandon medications for most patients.
Gymnastics for the neck in the treatment of hypertension improves the functionality of the spine. Regular exercise helps:
- removal of muscle clamps;
- improved nutrition of the intervertebral discs;
- normalization of blood flow of blood vessels in the neck;
- restoration of blood circulation of the brain;
- the establishment of metabolic processes that support normal blood pressure;
- increase the level of physical activity and, consequently, the burning of excess calories;
- activating the work of blood vessels by saturating the myocardium with oxygen.
Remember that only regular gymnastics makes sense. It is necessary to determine in advance the time and place of the exercises. During classes, it should be comfortable and convenient so that no one distracts you 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 sides.
- "Heron". The chin is extended to the maximum upwards, 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". Bend your head alternately towards one shoulder and then towards the other.
- "Frame". The left hand is 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 up. The head should be turned sideways every 10 seconds.
- "Airplane". The arms are extended to the sides, the elbows are not bent. Every 10 seconds the arms are lowered to rest.
Effective exercises for hypertension.
Moderate physical activity trains the central nervous system and strengthens blood vessels. Vascular tone is quickly normalized, which helps improve well-being. With hypertension, only dosed loads are allowed.
A set of exercises for hypertensive patients (we repeat each item 5-6 times):
- Feet shoulder-width apart, arms raised. We stand up on tiptoe. Slowly lowering the hands. Shake the brushes, exhale.
- With your hands on the belt, rotate your pelvis in both directions.
- Light operation in place for 1-2 minutes. To restore breathing, we switch to walking.
- Hands on the belt, on inhalation we lean forward, throwing our heads back, on exhalation we straighten.
- Feet shoulder-width apart, hands on the belt. On inspiration, we make elastic tilts forward, on exhalation - back, throwing the head back.
Simple exercises increase the capacity of the respiratory system by improving the elasticity of the blood vessels. Harmful products that accumulate in the body are excreted much faster, which reduces the load on the kidneys. The immune system is strengthened and ventilation of the lungs is improved.
Physical activity is contraindicated in patients with blood pressure greater than 180/120 mm Hg. Art. , and also after a hypertensive crisis. It is unacceptable to exercise with the risk of myocardial infarction and stroke. An absolute contraindication is atrial fibrillation, paroxysmal tachycardia, thrombosis, weakness and angina attacks.
If, during exercise, chest pain occurs, shortness of breath appears or heart rhythm is disturbed, then classes should be stopped. In this case, it is necessary to visit a general practitioner who will diagnose and, if necessary, prescribe treatment.
Treatment of hypertension in a sanatorium.
Treatment of hypertension is a responsible and long process that gives results only if the doctor's recommendations are followed. Self-medication can provoke the development of serious complications that pose a danger not only to health, but also to life. Any measure must be previously agreed upon and approved by a specialist.
The sanatoriums have everything necessary to carry out diagnostic measures in the line of hypertension equipment: electrocardiography, ultrasound. The treatment process is carried out with the use of: physiotherapy, balneotherapy, halotherapy.