Hypertension (arterial hypertension) is a syndrome of high systolic blood pressure ≥ 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 diseases whose symptoms are increased 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 often, hypertension is observed 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 ischemic 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 blood pressure and compare the indicators in the table.
| Degree | The blood pressure value, mm Hg. Art. |
|---|---|
| one | 140-159 to 90-99 |
| 2 | 160-179 at 100-109 |
| 3 | 180 to 110 and above |
The most common signs of hypertension requiring treatment are:
- throbbing or pressing headache in back of head;
- dizziness and flickering of dark circles and "flies";
- palpitations, nausea and tinnitus.
The described clinical picture is characteristic of the moment of increase in arterial pressure. 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 the internal organs. The first to suffer are the "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.
- Hit.
- Glomerulosclerosis of the kidneys.
- Angiopathy of the vessels of the fundus.
The stages of hypertension are determined by the nature of the involvement of 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 excretory 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 the symptoms, the greater the risk of developing vascular accidents. With hypertension of degree 3, the probability of complications is high, regardless of the presence of accompanying symptoms.
Basic rules for treating 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 to 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 need to be careful here, as low blood pressure (hypotension) only increases the risk of developing vascular accidents.
Treatment of hypertension 1 degree
The tactics of treating arterial hypertension are developed not only by the degree of increase in blood pressure, but also by 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 1 degree:
- Give up bad habits (smoking, alcohol).
- Balance the diet - include foods rich in magnesium and potassium in the menu, 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).
- Normalization of body mass index to optimal levels (25 kg/m2).
Treatment of hypertension 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.
Main drugs for the treatment of arterial hypertension:
- calcium antagonists. Contribute to the expansion of peripheral vessels, reducing the risk of strokes, hypertrophy and blood clots. Contraindicated in severe heart failure and intracardiac conduction disorders.
- 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, which is combined with arrhythmia and coronary heart disease. Therapy with these drugs is indicated in 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 little risk of complications. If single-component drug therapy does not work, 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 large number of tablets daily, stop the drug treatment of 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 drug treatment of hypertension, additional drugs are prescribed - antiplatelet agents and statins. Tablets are also needed that 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 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, as it is quite effective, especially in combination with drug therapy.
The most successful physiotherapy procedures for hypertension are:
- Electrosleep. A set of methods of influencing the patient's body using electrical energy. The advantages of this method are a beneficial effect on the central nervous system (CNS), the functioning of endocrine glands and metabolism. 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 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 area and the collar area.
- Balneotherapy. The program includes a Charcot shower, baths with perozone, iodine, bromine, etc. The procedures have a sparing effect and are indicated only in the initial stage of the disease. Shown to prevent the development of strokes and heart attacks.
- Magnetotherapy. Physiotherapy procedure involves exposure to a variable magnetic field. Widely used in arterial hypertension 1 and 2 degrees. The 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).
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 stop, damaged nerve cells regenerate and hypertension stops progressing. Cardiac and renal 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 the autonomic stimulation of the "renal" mechanisms that increase blood pressure.
An effective surgical treatment of hypertension is stimulation of the baroreceptors 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 the three antihypertensive drugs.
Gymnastics
Gymnastics is the most effective for hypertension. Thanks to the long-term experience of doctors with patients with hypertension, it was possible to establish 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 adverse reactions. With daily training, it is possible to completely abandon medication for most patients.
Gymnastics for the neck in the treatment of hypertension improves the functionality of the spine. Regular exercise helps:
- removal of muscle clamps;
- improving the nutrition of the intervertebral discs;
- normalization of blood flow in the blood vessels of the neck;
- restoration of blood circulation of the brain;
- establishment of metabolic processes that maintain 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 classes, it should be comfortable and convenient so that no one distracts 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 side.
- "Heron". The chin is maximally extended upwards, the hands 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". Bending the head alternately to one shoulder, then to the other.
- "Shot". The left hand is on the right shoulder, the head is turned to the left. Then repeat for the right arm.
- "Fakir". The palms are closed above the head so that the fingers point 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 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. In case of hypertension, only dosed loads are permissible.
A set of exercises for patients with hypertension (we repeat each element 5-6 times):
- Feet shoulder width apart, hands up. We rise on our toes. Slowly lower the arms. 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, when inhaling we lean forward, return the head back, when exhaling we stand up.
- Feet shoulder width apart, hands on the belt. When inhaling, we make springy forward bends, when exhaling - backward, throwing our heads 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 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 with the risk of myocardial infarction and stroke. An absolute contraindication is atrial fibrillation, paroxysmal tachycardia, thrombosis, weakness and angina pectoris.
If during training chest pain appears, shortness of breath appears or the heart rhythm is disturbed, then the 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
Treatment of hypertension is a responsible and long-term process that gives 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 upon and approved by a specialist.
Sanatoriums have everything necessary to carry out diagnostic measures in the line of hypertensive equipment: electrocardiography, ultrasound. The treatment process is carried out with the help of: physiotherapy, balneotherapy, halotherapy.