Hypertension (high blood pressure) is a syndrome of high systolic blood pressure ≥ 140 mm Hg. Art. and/or diastolic ≥ 90 mmHg. 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 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 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 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.
| Grade | The blood pressure value, mm Hg. Art. |
|---|---|
| 1 | 140-159 to 90-99 |
| two | 160-179 by 100-109 |
| 3 | 180 to 110 and above |
The most common signs of hypertension that require treatment are:
- throbbing or pressing headaches in the back of the head;
- dizziness and flicker of dark circles and "flies";
- heart palpitations, nausea and tinnitus.
The clinical picture described is typical for the moment of increase in arterial pressure. In practice, cases of asymptomatic evolution of the disease are described. If high blood pressure is not controlled, this condition will negatively affect 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 myocardial diastolic function.
- Chronic heart failure.
- progressive atherosclerosis.
- Myocardial infarction.
- encephalopathy.
- Leakage.
- Glomerulosclerosis of the kidneys.
- Fundus vessel angiopathy.
The stages of hypertension are determined by the nature of internal organ involvement. 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 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 greater 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. For this, it is necessary to minimize the negative factors and stabilize blood pressure at the lowest possible levels. The ideal value for most is 140-90 mm Hg. Art. ;for elderly patients - 140-150 at 90-95 mm Hg. Art. Care must be taken here, as low blood pressure (hypotension) only increases the risk of developing strokes.
Treatment of 1st degree hypertension
High blood pressure treatment tactics are developed not only by the degree of increase in blood pressure, but also by the likelihood 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 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), avoid 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 2nd and 3rd degree hypertension
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 high blood pressure:
- calcium antagonists. Contribute to the expansion of peripheral vessels, reducing the risk of stroke, hypertrophy and blood clots. Contraindicated in severe heart failure and violation of intracardiac conduction.
- Angiotensin II receptor blockers, angiotensin converting enzyme inhibitors. Effective agents that improve prognosis in patients with heart failure. Medications prevent renal 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 treating hypertension, only one drug should be used if there is a small risk of complications. If single component drug therapy does not work, only funds belonging to other groups will be added.
Patients with blood pressure values of 180 to 100 mm Hg. Art. It is initially 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 large number of pills daily, interrupt the drug treatment of hypertension, which leads to serious consequences. To solve this problem, which is not uncommon, drug companies have started to produce combination drugs that combine two hypertensive drugs.
To increase the effectiveness of drug treatment of hypertension, additional drugs are prescribed - antiplatelet agents and statins. Pills that keep the cholesterol value within acceptable limits are also needed - from 4 to 5 mmol / l. 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 should be comprehensively addressed. Only in this case you can count on a fast and stable result.
Physiotherapy in the treatment of hypertension
This approach to the treatment of hypertension deserves special attention as it is quite effective, particularly in combination with drug therapy.
The most successful procedures for hypertension physiotherapy are:
- Electrosleep. 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 (central nervous system), the functioning of the endocrine glands and metabolism. The intense currents not only improve blood circulation, but also reduce the level of bad cholesterol in the blood.
- galvanizing. The use of low frequency current (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 performed on the calf muscles, in the interscapular region and in the collar area.
- 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 strokes and heart attacks.
- Magnetotherapy. The physical therapy procedure involves exposure to a magnetic field of an alternating nature. Widely used for 1st and 2nd degree high blood pressure. Current is sent to the brain through the back of the head, which helps to 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).
Physical therapy reduces the dosage of medication, normalizing blood pressure and strengthening blood vessels. The procedures improve the work of the heart, preventing sudden jumps 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 high blood pressure, radiofrequency destruction of renal nerves is prescribed. The procedure aims to eliminate the autonomic stimulation of the "renal" mechanisms that increase blood pressure.
An effective surgical treatment for hypertension is the stimulation of 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 safety. Resorting to this method of treating hypertension is recommended only for those patients who are resistant to all three antihypertensive drugs.
Fitness
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 physical activity.
Gymnastic exercises aim to reduce the dose of medication to exclude the development of adverse reactions. With daily training, it is possible to completely abandon medications for most patients.
Neck gymnastics in the treatment of hypertension improves the functionality of the spine. Regular exercise helps:
- elimination of muscle clamps;
- better nutrition of the intervertebral discs;
- normalization of blood flow from blood vessels in the neck;
- restoration of blood circulation to the brain;
- the establishment of metabolic processes that sustain normal blood pressure;
- increase the level of physical activity and, consequently, the burning of excess calories;
- activating the work of blood vessels 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 as far up as possible, the arms are lowered. Every 10 seconds we take the starting position for 1-2 seconds.
- "Spring". Chin retraction and extension with fixation for 5-10 seconds.
- "Sadness". Bending the head alternately to one shoulder and then to the other.
- "Painting". 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 over the head so that the fingers are pointing upwards. The head should be turned to the sides every 10 seconds.
- "Plane". Arms are extended to the sides, 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 improve well-being. With hypertension, only dosed loads are allowed.
A set of exercises for hypertensive patients (we repeat each element 5-6 times):
- Feet shoulder-width apart, arms raised. We climbed on tiptoe. Slowly lowering your hands. Shake the brushes, exhale.
- Hands on the belt, rotate the pelvis in both directions.
- Light on-site operation for 1-2 minutes. To restore breathing, we started walking.
- Hands on the belt, on inhalation we bend forward, bringing the head back, on exhalation we straighten.
- Feet shoulder-width apart, hands on belt. On inhalation, we make elastic bends forward, on exhalation - backwards, throwing the head back.
Simple exercises increase the capacity of the respiratory system, improving the elasticity of blood vessels. Harmful products that accumulate in the body are excreted much more quickly, which reduces the burden on the kidneys. The immune system is strengthened and 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 with risk of myocardial infarction and stroke. An absolute contraindication is atrial fibrillation, paroxysmal tachycardia, thrombosis, weakness and angina attacks.
If, during exercise, chest pain, shortness of breath or heart rhythm disturbance occurs, classes 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
The treatment of hypertension is a responsible and time-consuming process that only gives 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 previously agreed and approved by a specialist.
Sanatoriums have everything needed 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.