Hypertension (arterial hypertension) is a syndrome of high blood pressure systolic ≥ 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 comprehensive examination. Therapy includes symptomatic correction and combating the disease whose symptom is elevated 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 background of neurological, hemodynamic and stressful situations.
The social importance and danger of hypertension in increasing the risk of stroke, heart attack and coronary heart disease, which are the main causes of death. If high blood pressure is not controlled, chronic kidney disease develops, leading to kidney failure and disability.
When to treat hypertension
In order to prescribe effective therapy, it is necessary to determine the degree of arterial hypertension. To do this, you need to measure your 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 with 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 the dark circles and "flies";
- palpitations, nausea and tinnitus.
The described clinical picture is typical for the moment of blood pressure increase. Cases of asymptomatic course of the disease have been described in practice. If high blood pressure is not controlled, then 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 internal organ damage 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.
- Stroke.
- Kidney glomerulosclerosis.
- Angiopathy of fundus vessels.
The stages of hypertension are determined by the nature of involvement of internal organs. In the first stage, 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 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 present, the higher the risk of developing vascular accidents. With hypertension of the 3rd degree, the probability of complications is high, regardless of the presence of accompanying symptoms.
Basic rules for the treatment of hypertension
The main task is to reduce the risk of complications. In order 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 at 90-95 mm Hg. Art. You have to be careful here, because low blood pressure (hypotension) only increases the risk of developing vascular accidents.
Treatment of hypertension of the 1st degree
The tactics of treating arterial hypertension are developed not only according to the degree of increase in blood pressure, but also according to the probability of developing cardiovascular pathologies. Accordingly, 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 the 1st degree:
- Give up bad habits (alcohol, smoking).
- Balance your diet - include foods rich in magnesium and potassium in your menu, limit salt (no more than 5 g per day), discard marinades and fried foods.
- Do not forget about daily physical activity (running, swimming, walking 30 minutes a day).
- Normalize body mass index to optimal levels (25 kg/m2).
Treatment of hypertension at 2 and 3 degrees
Hypertension treatment for 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 antagonists. They contribute to the expansion of peripheral vessels, reducing the risk of stroke, hypertrophy and blood clots. Contraindicated in severe heart failure and intracardiac conduction disorders.
- Angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors. Agents that improve prognosis in patients with heart failure. Medicines 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 federal guidelines for the treatment of hypertension, then only one drug should be used if there is a low risk of complications. If single-component drug therapy fails, only then are agents belonging to other groups 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;
- blocker, diuretic and ACE inhibitor;
- adrenoblocker, diuretic and aldosterone receptor antagonist.
Many patients, due to the need to take a larger number of pills a day, stop taking medication for hypertension, which leads to serious consequences. To solve this problem, which is not uncommon, pharmaceutical companies have begun to produce combination drugs that combine two hypertension drugs.
In order to increase the effectiveness of the treatment of hypertension with drugs, additional drugs are prescribed - antiplatelet agents and statins. Tablets that maintain the cholesterol value within acceptable limits - from 4 to 5 mmol / l are also needed. This approach eliminates the possibility of complications on the cardiovascular system.
Additional therapeutic measures
Often drug therapy is not enough. Treatment of high blood pressure should be approached comprehensively. 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, because it is quite effective, especially in combination with drug therapy.
The most successful procedures for physiotherapy of hypertension are:
- Electrosleep. A set of methods for influencing the patient's body with the help of electricity. The advantages of this method are the beneficial effect on the central nervous system (central nervous system), functioning of the endocrine glands and metabolism. Intense currents not only improve 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 and chemical processes in tissues and cells. With the introduction of drugs, the procedure is called drug electrophoresis. For the treatment of hypertension, the influence is carried out on the calf muscles, the interscapular region and the neck zone.
- Balneotherapy. The program includes a Charcot shower, baths with perozone, iodine, bromine, etc. The procedures have a mild effect and are indicated only in the early stages of the disease. Shown to prevent the development of stroke and heart attack.
- Magnetotherapy. The physiotherapeutic procedure includes exposure to an alternating magnetic field. It is widely used for arterial hypertension of the 1st and 2nd degree. 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 in order to reduce the synthesis of angiotensin (a hormonal substance that constricts blood vessels).
Physiotherapy reduces the dose of drugs, normalizes blood pressure and strengthens blood vessels. The procedures improve the work of the heart, preventing sudden jumps in blood pressure. Parts of the central nervous system are stabilized, which contributes to the normalization of blood pressure. Irritability and nervousness stop, damaged nerve cells are restored, and hypertension stops progressing. Heart and kidney 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 removing the autonomic stimulation of "renal" mechanisms that increase blood pressure.
An effective surgical treatment for hypertension is baroreceptor stimulation of the carotid sinus. This result is achieved by 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 those patients who have resistance to three antihypertensive drugs.
gymnastics
In hypertension, gymnastics is the most effective. Thanks to the long-term experience of doctors with patients with hypertension, it was possible to determine that any drug therapy is much more effective in combination with dosed physical activity.
Gymnastic exercises are aimed at reducing the dose of drugs in order to exclude the development of side effects. With daily training, it is possible for most patients to get off medication completely.
Gymnastics for the neck in the treatment of hypertension improves the functionality of the spinal column. Regular exercise helps:
- elimination of muscle clamps;
- improved nutrition of intervertebral discs;
- normalization of blood flow in blood vessels in the neck;
- restoration of blood circulation in the brain;
- establishment of metabolic processes that support normal blood pressure;
- increase the level of physical activity, and thus the burning of excess calories;
- activating blood vessels by saturating the myocardium with oxygen.
Remember that only regular gymnastics makes sense. It is necessary to determine 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 fixing the door for 10 seconds on the right and left side.
- "Heron". The chin is maximally stretched upwards, the hands are down. Every 10 seconds we take the initial position for 1-2 seconds.
- "Spring". Pulling and extending the chin with fixation for 5-10 seconds.
- "Sadness". Bending the head alternately on one shoulder, then on the other.
- "Framework". 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 folded above the head so that the fingers are facing upwards. The head should be turned to the side every 10 seconds.
- "Airplane". The arms are stretched out to the sides, the elbows are not bent. Every 10 seconds, the hands come down to rest.
Effective exercises for hypertension
Moderate physical activity trains the central nervous system and strengthens blood vessels. Vascular tone quickly normalizes, which helps improve well-being. In case of hypertension, only dosed loads are allowed.
A set of exercises for hypertensive patients (we repeat each element 5-6 times):
- Feet shoulder width apart, hands raised. We stand on our toes. Lower your hands slowly. Shake the brushes, exhale.
- Hands on the belt, rotate the pelvis in both directions.
- Light jogging in place for 1-2 minutes. To restore breathing, we switch to walking.
- Hands on the belt, on inhalation we bend forward, head back, on exhalation we straighten.
- Feet shoulder width apart, hands on the belt. On inhalation we make spring bends forward, on exhalation - back, throwing the head back.
Simple exercises increase the capacity of the respiratory system by improving the elasticity of blood vessels. Harmful products that accumulate in the body are excreted much faster, which reduces the burden on the kidneys. The immune system is strengthened and lung ventilation is improved.
Physical activity is contraindicated in patients with blood pressure above 180/120 mm Hg. Art. , as well as after a hypertensive crisis. It is unacceptable to exercise at the risk of myocardial infarction and stroke. Absolute contraindication is atrial fibrillation, paroxysmal tachycardia, thrombosis, weakness and angina attacks.
If chest pain occurs during exercise, breathing becomes difficult or the heart rhythm is disturbed, classes should be stopped. In that case, it is necessary to visit a general practitioner who will make a diagnosis and, if necessary, prescribe treatment.
Treatment of hypertension in a sanatorium
Treatment of hypertension is a responsible and long-term process that gives results only by following the doctor's recommendations. 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 previously agreed upon and approved by an expert.
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.