Hypertension (arterial hypertension) is a syndrome of systolic high blood pressure ≥ 140 mmHg. 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 comprehensive examination. Therapy includes symptomatic correction and the fight against diseases, the symptoms of which are increased blood pressure.
Some statistics
Hypertension occurs in 90-95% of patients with high blood pressure. In other cases they are 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 social significance and danger of hypertension in increasing the risk of stroke, heart attack 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.
| Level | The value of blood pressure, mm Hg. Art. |
|---|---|
| one | 140-159 to 90-99 |
| 2 | 160-179 for 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 flickering of dark circles and "flies";
- heart palpitations, nausea and tinnitus.
The described clinical picture is typical for the moment 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 function of internal organs. The first to suffer from it 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.
- Heart attack.
- encephalopathy.
- Stroke.
- Glomerulosclerosis of the kidneys.
- Angiopathy of the fundus vessels.
The stages of hypertension are determined by the nature of the involvement of internal organs. At the first stage of defeat of "target organs" it is not observed. The second stage is characterized by single or multiple lesions in the absence of MI (myocardial infarction), chronic urinary tract diseases and stroke. The third stage is characterized by manifestations of chronic kidney disease, stroke and heart attack.
The higher the blood pressure and the more symptoms there are, the greater the risk of developing vascular accidents. 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, negative factors need to be minimized and blood pressure stabilized 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
The tactics of treating arterial hypertension is developed not only by the degree of increase in blood pressure, but also by the likelihood of developing cardiovascular pathologies. Based on 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 needed for 1st degree hypertension:
- 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.
- Don't forget 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 drugs in the presence of 3 or more risk factors for the development of cardiovascular complications.
Basic drugs for the treatment of arterial hypertension:
- calcium channel blockers. They contribute to the expansion of peripheral vessels, reducing the risk of stroke, 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. Drugs prevent kidney disease 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. The less popular drugs are alpha blockers, imidazoline receptor agonists, and renin inhibitors.
Tactics for the treatment of hypertension
If federal guidelines for treating hypertension are followed, only one drug should be used if there is a slight risk of complications. If one-component drug therapy does not work, only then funds belonging to other groups are added.
Patients with blood pressure values of 180 to 100 mm Hg. Art. Initially it is recommended to prescribe two-component drug therapy:
- adrenoblocker, calcium channel blocker (dihydropyridine) and ACE inhibitor;
- blocker, diuretic and ACE inhibitor;
- adrenoblocker, diuretic and aldosterone receptor antagonist.
Many patients, due to the need to take a large number of tablets per day, stop drug treatment of hypertension, which leads to serious consequences. To solve this problem, which is not uncommon, drug companies have started producing combination drugs that combine two hypertensive drugs.
To increase the effectiveness of drug treatment of hypertension, additional drugs are prescribed - antiplatelet agents and statins. Tablets are also needed that keep the cholesterol value within acceptable limits - from 4 to 5 mmol / l. This approach eliminates the possibility of complications from the cardiovascular system.
Further therapeutic measures
Drug therapy is often not enough. Treatment of hypertension needs to be addressed comprehensively. Only in this case can you count on achieving a quick and stable result.
Physiotherapy for the treatment of hypertension
This approach to treating hypertension deserves special attention, because it is quite effective, especially in combination with drug therapy.
The most successful procedures for the physiotherapy of hypertension are:
- Electrosleep. A set of methods of influencing the patient's body with the help of electricity. 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 currents (up to 60-80 V) to stimulate physicochemical 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 collar area.
- Balneotherapy. The program includes Charcot's shower, baths with perozone, iodine, bromine, etc. The procedures have a gentle effect and are indicated only in the early stages of the disease. Indicated for preventing the development of strokes and heart attacks.
- Magnetotherapy. The physiotherapy procedure involves exposure to an alternating magnetic field. Widely used for 1 and 2 degree arterial hypertension. Current is sent to the brain through the back of the head, which helps stimulate blood flow and reduce heart rate.
- Diadynamic therapy. The vegetative-corrective method has a therapeutic effect on the genitourinary system and kidneys to reduce the synthesis of angiotensin (a hormonal substance that constricts blood vessels).
Physiotherapy reduces the dosage of drugs, normalizing blood pressure and strengthening blood vessels. The procedures improve the work of the heart, preventing sudden changes in blood pressure. Sections of the central nervous system are stabilized, which contributes to the normalization of blood pressure. Excitability and nervousness are disrupted, damaged nerve cells are regenerated, and hypertension stops progressing. Cardiac and kidney complications are minimized.
Surgical method
To eliminate the cause of arterial hypertension, radiofrequency destruction of the renal nerves is prescribed. The procedure aims to eliminate 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 is achieved through electrical stimulation of the carotid artery. Despite the effectiveness of surgical treatment, there is no safety information. The use of this method of treating hypertension is only recommended for patients with resistance to the 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 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 function of the spine. Regular exercise helps:
- elimination of muscle clamps;
- better 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, burn 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 class, it should be comfortable and convenient so that no one gets distracted and you can concentrate.
Elements of gymnastics for the treatment of hypertension:
- "Metronome". Alternating neck fixation for 10 seconds on the right and left sides.
- "Heron". The chin is extended to the maximum upward, 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 on one shoulder, then on the other.
- "Chassis". The left hand is on the right shoulder, the head is turned to the left. Then repeat for the right hand.
- "Fakir". The palms of the hands are closed above the head so that the fingers are pointing upwards. The head should be turned to the side 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 normalizes quickly, which helps improve well-being. With hypertension, only metered 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 up on tiptoe. Slowly lowering your hands. Shake the brushes, exhale.
- Hands on the belt, rotate the pelvis in both directions.
- Light that works in place for 1-2 minutes. To restore breathing, let's move on to walking.
- Hands on the belt, in the inhalation we bend forward, bringing the head back, in the exhalation we straighten.
- Feet shoulder-width apart, hands on the belt. On the inspiration, we make elastic tilts forward, on the exhale - 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 the ventilation of the lungs is improved.
Physical activity is contraindicated in patients with blood pressure above 180/120 mmHg. Art. , And also after a hypertensive crisis. It is unacceptable to exercise at 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 the heart rhythm is disturbed, 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 long and responsible process that only yields results if the doctor's recommendations are followed. Self-medication can cause the development of serious complications that pose a danger not only to health, but also to life. Any measure must be agreed in advance and approved by a specialist.
Sanatoriums have everything necessary to carry out diagnostic measures in the line of equipment for hypertension: electrocardiography, ultrasound. The treatment process is carried out with the use of: physiotherapy, balneotherapy, halotherapy.