Hypertension (arterial hypertension) is a syndrome of high blood pressure systolic ≥ 140 mm Hg. Art. and/or diastolic ≥ 90 mm Hg. Art. General disease of the cardiovascular system requires timely measures. Treatment of hypertension is prescribed after a comprehensive examination. Therapy includes symptomatic correction and treatment of diseases whose symptoms are high blood pressure.
Some statistics
Hypertension occurs in 90-95% of patients with elevated blood pressure. In other cases, we are talking about secondary symptomatic manifestations: renal (3-4%), endocrine (0. 1-0. 3%). Hypertension is less common against the background of neurological, hemodynamic and stressful conditions.
The social importance and danger of hypertension in increasing the risk of stroke, heart attack and cardiovascular diseases, which are the main cause of death. If high blood pressure is not controlled, chronic kidney disease develops, leading to kidney failure and disability.
When should hypertension be treated?
In order to prescribe effective therapy, it is necessary to determine the degree of arterial hypertension. To do this, it is necessary to measure blood pressure and compare the indicators in the table.
| Degree | Value of blood pressure, mm Hg. Art. |
|---|---|
| one | From 140-159 to 90-99 |
| 2 | 160-179, 100-109 |
| 3 | 180 to 110 and above |
The most common symptoms of hypertension requiring treatment are:
- throbbing or pressing headaches in the back of the head;
- dizziness and trembling of dark circles and "flies";
- palpitations, nausea and tinnitus.
The described clinical picture is typical for the moment of increased blood pressure. Cases of asymptomatic course of the disease have been described in practice. If high blood pressure is not controlled, 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 indicators 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.
- Hit.
- Glomerulosclerosis of the kidneys.
- Angiopathy of fundus vessels.
The stages of hypertension are determined by the nature of involvement of internal organs. It is not observed in the first stage of the defeat of "target bodies". 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 failure, stroke and heart attack.
The higher the blood pressure and the more symptoms there are, 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. To achieve this, it is necessary to minimize negative factors and stabilize blood pressure at the lowest possible level. For many, the optimal value is 140-90 mm Hg. Art. ; for elderly patients - 140-150 at 90-95 mm Hg. Art. You need to be careful here, because low blood pressure (hypotension) only increases the risk of developing vascular accidents.
Treatment of hypertension 1 degree
The tactics of treatment of arterial hypertension are developed not only by the degree of increase in blood pressure, but also by the possibility of developing cardiovascular pathologies. Accordingly, with 1 degree hypertension, it is enough to exclude negative factors by adjusting the lifestyle. If the pressure does not stabilize within 2-3 months, in this case drug treatment is necessary.
List of corrective measures necessary for 1 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 hypertension 2 and 3 degrees
Treatment of hypertension in high blood pressure involves immediate drug treatment, regardless of the risk of complications. It is mandatory to take medication if there are 3 or more risk factors for the development of cardiovascular complications.
The main drugs for the treatment of arterial hypertension:
- calcium antagonists. Help expand peripheral vessels, reduce the risk of stroke, hypertrophy and blood clots. Contraindicated in severe heart failure and impaired intracardiac conduction.
- Angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors. Effective agents that improve prognosis in patients with heart failure. Medicines prevent kidney pathologies and left ventricular hypertrophy.
Beta-blockers are prescribed for hypertension associated 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, only one drug should be used if there is little risk of complications. If single-component drug treatment does not work, only then are added funds belonging to other groups.
Patients with blood pressure between 180 and 100 mm Hg. Art. Initially, it is recommended to prescribe a two-component drug treatment:
- adrenoblocker, calcium channel blocker (dihydropyridine) and ACE inhibitor;
- blocker, diuretic and ACE inhibitor;
- adrenoblocker, diuretic and aldosterone receptor antagonist.
Many patients stop the drug treatment of hypertension due to the need to take a large number of tablets daily, which leads to serious consequences. To solve this not uncommon problem, pharmaceutical companies have begun 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. Tablets that keep the cholesterol value at an acceptable level are also needed - between 4 and 5 mmol / l. This approach eliminates the possibility of complications from the cardiovascular system.
Additional therapeutic measures
Often drug treatment is not enough. A comprehensive approach to the treatment of high blood pressure is necessary. 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 high blood pressure deserves special attention, because it is especially effective in combination with drug therapy.
The most successful procedures for physiotherapy of hypertension:
- Electrosleep. A number of methods to affect the patient's body with the help of electricity. The advantages of this method are the beneficial effect on the central nervous system (CNS), endocrine gland activity and metabolism. In addition to improving blood circulation, strong currents also reduce the level of bad cholesterol in the blood.
- Galvanization. Use of low-frequency current (up to 60-80 V) to stimulate physico-chemical processes in tissues and cells. The procedure with the application of drugs is called drug electrophoresis. For the treatment of hypertension, the effect is carried out on the calf muscles, the interscapular region and the collar zone.
- Balneotherapy. The program includes Charcot shower, perozone, iodine, bromine, etc. with bathtubs included. Procedures have a mild effect and are indicated only in the initial stages of the disease. It is shown to prevent the development of strokes and heart attacks.
- Magnetotherapy. The physiotherapeutic procedure involves exposure to a magnetic field of alternating nature. It is widely used for arterial hypertension of the 1st and 2nd degree. The current is sent to the brain through the back of the head, which helps stimulate blood flow and lower heart rate.
- Diadynamic therapy. The vegetative-corrective method has a therapeutic effect on the genitourinary system and kidneys to reduce the synthesis of angiotensin (hormonal substance that constricts blood vessels).
Physiotherapy reduces the dosage of drugs, normalizes blood pressure and strengthens blood vessels. Procedures improve heart function, prevent sharp jumps in blood pressure. The divisions of the central nervous system are stabilized, which contributes to the normalization of blood pressure. Excitement and nervousness are stopped, damaged nerve cells are restored and the development of hypertension is stopped. 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 eliminating autonomic stimulation of "renal" mechanisms that increase blood pressure.
An effective surgical treatment for hypertension is carotid sinus baroreceptor stimulation. This result is achieved by electrical stimulation of the carotid artery. Despite the effectiveness of surgical treatment, there is no information about its safety. This method of treatment of hypertension is recommended only for patients with resistance to three antihypertensive drugs.
Gymnastics
Gymnastics is most effective with hypertension. Thanks to many years of experience of doctors with hypertensive patients, it was possible to learn that any drug treatment is more effective in combination with dosed physical activity.
Gymnastics exercises are aimed at reducing the dosage of drugs to exclude the development of negative reactions. With daily exercise, it is possible for most patients to completely avoid medication.
In the treatment of hypertension, gymnastics for the neck improves the functionality of the spine. Regular exercise helps:
- elimination of muscle cramps;
- improved nutrition of intervertebral discs;
- normalization of blood flow in blood vessels in the neck;
- restoration of blood circulation of the brain;
- establishment of metabolic processes that support normal blood pressure;
- increasing the level of physical activity and, accordingly, burning 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 the time and place of the exercises in advance. During the lessons, it should be comfortable and relaxed so that no one is distracted and you can concentrate.
Elements of gymnastics for the treatment of hypertension:
- "Metronome". Alternate fixation of the height for 10 seconds on the right and left sides.
- "Heron". The chin is maximally stretched upwards, the arms are lowered. We take the starting position for 1-2 seconds every 10 seconds.
- "Spring". Retraction and extension of the chin with fixation for 5-10 seconds.
- "Sadness". Tilt the head alternately to one shoulder, then to the other.
- "Frame". The left hand is on the right shoulder, the head is turned to the left. Then repeat for the right hand.
- "Poor". The palm is closed above the head so that the fingers face upwards. The head should be turned to the sides every 10 seconds.
- "Airplane". The arms are extended to the sides, the elbows are not bent. Every 10 seconds the arms are lowered for rest.
Effective exercises for hypertension
Moderate physical activity exercises the central nervous system and strengthens blood vessels. Vascular tone quickly normalizes, which helps to improve well-being. Only dose loads are allowed with hypertension.
A set of exercises for hypertensive patients (we repeat each element 5-6 times):
- Feet are shoulder width apart, arms are raised. We rise on our toes. Lower your hands slowly. Shake the brushes, breathe.
- Hands on the belt, rotate the pelvis in both directions.
- The light works in place for 1-2 minutes. We move to walking to restore breathing.
- Hands on the belt, while breathing we bend forward, head back, straighten while breathing.
- Feet shoulder width apart, hands on the belt. With inspiration, forward, on exhalation - back, throwing our heads back, we make spring bends.
Simple exercises increase the capacity of the respiratory system by improving the elasticity of blood vessels. Harmful products accumulated in the body are removed much faster, which reduces the burden on the kidneys. The immune system is strengthened and the ventilation of the lungs improves.
Physical activity is contraindicated in patients with blood pressure above 180/120 mm Hg. Art. , but 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 chest pain, shortness of breath, or heart rhythm disturbances occur during exercise, classes should be interrupted. In this case, it is necessary to visit a general practitioner who will make a diagnosis and, if necessary, prescribe treatment.
Treatment of arterial hypertension in a sanatorium
Treatment of hypertension is a responsible and long process that gives results only if the doctor's recommendations are followed. Self-medication can lead not only to health, but also to the development of serious complications that threaten life. Any measure must first be agreed upon and approved by a specialist.
Sanatoriums have everything necessary for conducting diagnostic measures in the line of hypertension equipment: electrocardiography, ultrasound. The treatment process is carried out using the following: physiotherapy, balneotherapy, halotherapy.