Arterial hypertension (high blood pressure) is a syndrome of systolic high blood pressure ≥ 140 mm Hg. Art. and/or diastolic ≥ 90 mm Hg. Art. A common disease of the cardiovascular system requires prompt action. Treatment of hypertension is prescribed after a comprehensive 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 speak of secondary symptomatic manifestations: renal (3-4%), endocrine (0. 1-0. 3%). Hypertension is less common against 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 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 an effective treatment, 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.
The most common signs of high blood pressure requiring 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 the increase in 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 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.
- Stroke.
- Kidney glomerulosclerosis.
- Angiopathy of the fundus vessels.
The stages of hypertension are determined by the nature of the damage to the internal organs. At the first stage of the defeat of the "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, the higher the risk of developing strokes. 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 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 strokes.
Treatment of hypertension 1 degree
Tactics for the treatment of arterial hypertension is developed not only by the degree of increase in blood pressure, but also by the likelihood of developing cardiovascular pathologies. In accordance with this, with 1 degree of hypertension, it is enough to exclude negative factors by adjusting the lifestyle. Drug treatment in this case is necessary if the pressure does not stabilize for 2-3 months.
List of necessary corrective measures for hypertension 1 degree:
- Give up bad habits (alcohol, tobacco).
- Balance the diet - include in the menu foods rich in magnesium and potassium, limit salt (no more than 5 g per day), refuse pickles 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 2 and 3 degree hypertension
Treatment of hypertension in arterial hypertension 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 high blood pressure:
- calcium antagonists. Contributes to the expansion of peripheral vessels, reducing the risk of stroke, enlargement and blood clots. Contraindicated in severe heart failure and in case of 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 associated with arrhythmia and coronary heart disease. Treatment 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 blockers.
Tactics for the treatment of hypertension
If you are following federal guidelines for the treatment of hypertension, only one drug should be used if there is a slight risk of complications. If single-component drug therapy does not work, then only funds from 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 treatment:
- adrenoblocker, calcium channel blocker (dihydropyridine), and ACE inhibitor;
- ACE blocker, diuretic and inhibitor;
- adrenoblocker, diuretic and aldosterone receptor antagonist.
Many patients, due to the need to take a large number of tablets per day, stop drug therapy for hypertension, which leads to serious consequences. To solve this problem, which is not uncommon, pharmaceutical companies have started to produce combination drugs that combine two blood pressure medications.
To increase the effectiveness of drug treatment of hypertension, additional drugs are prescribed - antiplatelet agents and statins. Tablets are also needed to maintain the cholesterol value within acceptable limits - from 4 to 5 mmol / l. This approach eliminates the possibility of complications from the cardiovascular system.
Additional therapeutic measures
Often, drug therapy is not enough. The treatment of high blood pressure should be approached holistically. Only in this case you can count on getting a quick result that will be stable.
Physiotherapy for the treatment of hypertension
This approach to the treatment of arterial hypertension deserves special attention, since it is quite effective, especially in combination with drug therapy.
The most successful procedures for physiotherapy of hypertension are:
- Electro-sleep. A set of methods for 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 (CNS), 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 physico-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 carried out on the calf muscles, the interscapular region and the collar area.
- Balneotherapy. The program includes the Charcot shower, baths with perozone, iodine, bromine, etc. Procedures have a mild effect and are indicated only in the early stages of the disease. 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 high blood pressure 1 and 2 degrees. Current is sent to the brain through the back of the head, which helps stimulate blood circulation 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 dose of drugs, normalizes blood pressure and strengthens blood vessels. The procedures improve the work of the heart, preventing sharp jumps in blood pressure. Sections of the central nervous system are stabilized, which contributes to the normalization of blood pressure. Excitability and nervousness are stopped, damaged nerve cells are regenerated, and hypertension stops progressing. Heart and kidney complications are minimized.
Surgical method
To eliminate the cause of high blood pressure, radiofrequency destruction of the renal nerves is prescribed. The procedure aims to eliminate the autonomic stimulation of "kidney" mechanisms that increase blood pressure.
An effective surgical treatment for hypertension is stimulation of the carotid sinus baroreceptors. This result is obtained by electrical stimulation of the carotid artery. Despite the effectiveness of surgical treatment, there is no information on safety. The use of this method of treating hypertension is recommended only for patients who are resistant to all three antihypertensives.
Gymnastic
With hypertension, gymnastics is most effective. Thanks to the many years of experience of doctors with patients suffering from hypertension, it was possible to find out that any drug treatment 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 adverse effects. With daily training, it is possible to completely ditch the drugs for most patients.
Gymnastics for the neck in the treatment of hypertension improves the functionality of the spine. Regular exercise helps:
- elimination of muscle clamps;
- improved nutrition of intervertebral discs;
- normalization of blood flow from 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;
- activate the work of blood vessels, saturating the myocardium with oxygen.
Remember that only regular gymnastics makes sense. It is necessary to determine the time and place of exercises in advance. During class, it should be comfortable and practical 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 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 to 10 seconds.
- "Sadness". Bend your head alternately on one shoulder, then on 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 upwards. The head should be turned to the sides every 10 seconds.
- "Plane". 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 quickly normalizes, which helps to 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 on tiptoe. Slowly lower your hands. Shake the brushes, exhale.
- Hands on the belt, rotate the pelvis back and forth.
- Light running in place for 1-2 minutes. To restore breathing, we switch to walking.
- Hands on the belt, on inspiration we lean forward, bringing the head back, on expiration we straighten up.
- Feet shoulder-width apart, hands on belt. On the inhale we make elastic inclinations forward, on the exhale - 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 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 mm Hg. 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 pain in the chest appears, shortness of breath appears or the heartbeat is disturbed, classes should be discontinued. In this case, it is necessary to consult 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 process that brings results only if the doctor's recommendations are followed. Self-medication can lead to the development of serious complications that pose a danger not only to health, but also to life. Any measure must first be agreed and approved by a specialist.
Sanatoriums have everything necessary for carrying out diagnostic measures in the field of hypertension equipment: electrocardiography, ultrasound. The treatment process is carried out with the use of: physiotherapy, balneotherapy, halotherapy.