Hypertension (arterial hypertension) is a syndrome of high systolic blood pressure ≥ 140 mm Hg. Art. and/or diastolic ≥ 90 mm Hg. Art. Common diseases of the cardiovascular system require timely action. Treatment of hypertension is prescribed after a comprehensive examination. Therapy includes correction of symptoms and combating the disease, the symptom of which is high blood pressure.
Some statistics
Hypertension occurs in 90-95% of patients with high blood pressure. In other cases, we are talking about the manifestation of secondary symptoms: kidney (3-4%), endocrine (0. 1-0. 3%). Less common is hypertension against the background of neurological, hemodynamic and stress conditions.
The social importance and danger of hypertension in increasing the risk of stroke, heart attack and coronary heart disease, which is the leading cause of death. If high blood pressure is not controlled, chronic kidney disease develops, leading to kidney failure and disability.
When Treating Hypertension
To prescribe effective therapy, it is necessary to determine the level of arterial hypertension. To do this, you need to measure blood pressure and compare the indicators in the table.
| Degree | Blood pressure value, mm Hg. Art. |
|---|---|
| one | 140-159 to 90-99 |
| 2 | 160-179 times 100-109 |
| 3 | 180 to 110 and above |
The most common signs of hypertension that require treatment are:
- throbbing or pressing headache in the back of the head;
- dizziness and flashes of dark circles and "flies";
- heart palpitations, nausea and tinnitus.
The clinical picture described is typical for the moment when blood pressure rises. In practice, cases of the asymptomatic course of the disease are described. If high blood pressure is not controlled, then this condition has a negative effect on the function 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:
- Left ventricular hypertrophy of the heart.
- Violation of myocardial diastolic function.
- Chronic heart failure.
- progressive atherosclerosis.
- Myocardial infarction.
- encephalopathy.
- Stroke.
- Renal glomerulosclerosis.
- Fundus angiopathy.
The degree of hypertension is determined by the nature of internal organ involvement. At the first stage the defeat of the "target organ" is not observed. The second stage is characterized by single or multiple lesions without the presence of AMI (myocardial infarction), chronic diseases of the urinary system and stroke. The third stage is characterized by the manifestation of chronic kidney disease, stroke and heart attack.
The higher the blood pressure and the more symptoms present, the higher the risk of having a vascular accident. With grade 3 hypertension, the likelihood 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 to the lowest level. The optimal value for most is 140-90 mm Hg. 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 having a vascular accident.
Treatment of hypertension 1 degree
The tactics of treating arterial hypertension are developed not only by the level of increased blood pressure, but also by the possibility of developing cardiovascular pathology. In accordance with 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 is not stable for 2-3 months.
List of necessary corrective measures for hypertension 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), avoid 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 the optimal level (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 the drug in the presence of 3 or more risk factors for the development of cardiovascular complications.
Basic drugs for the treatment of arterial hypertension:
- calcium antagonists. Contributes to the expansion of peripheral vessels, reducing the risk of stroke, hypertrophy and blood clotting. Contraindicated in severe heart failure and violation of intracardiac conduction.
- Angiotensin II receptor blocker, angiotensin converting enzyme inhibitor. An effective agent that improves prognosis in patients with heart failure. Medicines prevent kidney pathology 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 federal guidelines for the treatment of hypertension, then only one drug should be used if there is little risk of complications. If single-component drug therapy does not work, then 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:
- 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 the treatment of hypertension drugs, which leads to serious consequences. To solve this problem, which is not common, pharmaceutical companies have begun to produce combination drugs that combine two hypertension drugs.
To improve the effectiveness of hypertension drug treatment, additional drugs are prescribed - antiplatelet agents and statins. Tablets are also needed that maintain cholesterol values within acceptable limits - from 4 to 5 mmol/l. This approach eliminates possible complications from the cardiovascular system.
Additional therapeutic measures
Often, drug therapy is not enough. Treatment of high blood pressure must be approached holistically. Only in this case, you can expect to achieve quick results that will be stable.
Physiotherapy for the treatment of hypertension
This approach to the treatment of high blood pressure deserves special attention, because it is quite effective, especially in combination with drug therapy.
The most successful procedures for hypertension physiotherapy are:
- Electrosleep. A set of methods to influence the patient's body with the help of electricity. The advantage of this method is the good effect on the central nervous system (central nervous system), endocrine gland function and metabolism. The rapid current not only improves blood circulation, but also reduces the level of bad cholesterol in the blood.
- Galvanization. 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. For the treatment of hypertension, the effect is done on the calf muscles, interscapular area and collar zone.
- Balneotherapy. This program includes Charcot baths, baths with perozone, iodine, bromine, etc. This procedure has a mild effect and is only indicated in the early stages of the disease. Shown to prevent the development of strokes and heart attacks.
- Magnetotherapy. Physiotherapy procedures involve exposure to alternating magnetic fields. Widely used for arterial hypertension 1 and 2 degree. Current is sent to the brain through the back of the head, which helps to stimulate blood flow and reduce heart rate.
- Diadynamic therapy. Vegetative correction methods have a therapeutic effect on the genitourinary system and kidneys to reduce the synthesis of angiotensin (hormonal substance that narrows blood vessels).
Physiotherapy reduces the dose of medication, normalizes blood pressure and strengthens blood vessels. The procedure increases the work of the heart, preventing sharp jumps in blood pressure. The part of the central nervous system is stabilized, which contributes to the normalization of blood pressure. Excitement and restlessness are stopped, damaged nerve cells are regenerated, and hypertension stops developing. Heart and kidney complications are minimized.
Surgical method
To eliminate the cause of arterial hypertension, radiofrequency destruction of the renal nerve is prescribed. This procedure aims to eliminate the autonomous stimulation of the "renal" mechanism that increases blood pressure.
An effective surgical treatment for hypertension is carotid sinus baroreceptor stimulation. This result is achieved through electrical stimulation of the carotid artery. Despite the effectiveness of surgical treatment, there is no information about safety. To use this method of hypertension treatment is only recommended for patients who have resistance to three antihypertensive drugs.
Gymnastics
With hypertension, gymnastics is most effective. Thanks to the many years of experience of doctors with hypertensive patients, it is possible to know that any drug therapy is more effective in combination with dosed physical activity.
Gymnastic training is aimed at reducing the dose of drugs to exclude the development of adverse reactions. With daily practice, it is possible to completely abandon the drug for most patients.
Gymnastics for the neck in the treatment of hypertension improves the function of the spine. Regular exercise helps:
- removal of muscle clamps;
- better nutrition of the intervertebral disc;
- normalization of blood flow in blood vessels in the neck;
- restoration of cerebral blood circulation;
- the establishment of metabolic processes that support normal blood pressure;
- increase the level of physical activity, and, thus, burn excess calories;
- activates 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 training. During the class, it should be comfortable and easy so that no one disturbs, and you can concentrate.
Elements of gymnastics for the treatment of hypertension:
- "Metronome". Neck fixation alternately for 10 seconds on the right and left side.
- "Bird". The chin is maximally extended 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 the head alternately to one shoulder, then to the other shoulder.
- "Frame". Left hand on right shoulder, head turned to left. Then repeat for the right hand.
- "Poor". The palms are closed above the head so that the fingers point upwards. The head should be turned to the side every 10 seconds.
- "Airplane". Arms extended to the sides, elbows not bent. Every 10 seconds the arm is lowered to rest.
Effective exercise for hypertension
Moderate physical activity trains the central nervous system and strengthens blood vessels. Vascular tone quickly normalizes, which helps improve well-being. With hypertension, only a dosed load is allowed.
A set of exercises for hypertensive patients (we repeat each element 5-6 times):
- Legs spread shoulder width apart, hands raised. We stood up. Slowly lower your hands. Shake the brush, blow.
- Hands on the belt, rotate the pelvis in both directions.
- The light burns in place for 1-2 minutes. To restore breathing, we turn to walking.
- Hands on the belt, on inhalation we bend forward, take the head back, on exhalation we straighten.
- Legs shoulder-width apart, hands on the belt. On inspiration, we lean forward, while exhaling - backward, throwing our head back.
Simple exercise increases the capacity of the respiratory system by increasing the elasticity of blood vessels. Harmful products accumulated in the body are excreted faster, which reduces the burden on the kidneys. The immune system is strengthened and lung ventilation improves.
Physical activity is contraindicated in patients with blood pressure above 180/120 mm Hg. Art. , and also after a hypertensive crisis. It is unacceptable to exercise with the risk of myocardial infarction and stroke. Absolute contraindications are atrial fibrillation, paroxysmal tachycardia, thrombosis, weakness and angina attacks.
If, during the exercise, pain occurs in the chest, shortness of breath appears, or the heart rhythm is disturbed, then the class should be interrupted. 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. Medicines themselves can cause the development of serious complications that pose a danger not only to health, but also to life. Any move must first be agreed upon and approved by an expert.
The sanatorium has everything necessary to carry out diagnostic measures in the line of hypertension equipment: electrocardiography, ultrasound. The treatment process is carried out using: physiotherapy, balneotherapy, halotherapy.