Chronic hypertension

Definition

Arterial hypertension is the most popular pathology of the cardiovascular system, in which a person has an increase in blood pressure. It is diagnosed in people of different ages, although the elderly are most susceptible to it. Chronic hypertension is a medical condition that requires medical treatment for the rest of your life. In addition, the insidiousness of this pathology lies in the fact that it provokes many new diseases.

Normal blood pressure values ​​are no more than 120 mm Hg. Art. (upper) and 80-90 mm Hg. Art. (bottom). If the readings are above 140/90 mm Hg. Art., then you need to see a doctor, as this may be the onset of chronic hypertension. With a blood pressure value of more than 140/90 mm Hg. the person is already beginning to feel the characteristic symptoms.

Hypertension is considered chronic if a person has consistently high readings on the tonometer, regardless of the time of day and psychological state. This disease is characterized by obstruction of blood flow due to vasospasm. It is the cause of internal organ dysfunction.

The task of the arteries and arterioles branching from them is to supply the tissues of the body with blood, nutrients and oxygen, and the venous vessels return the blood back. For this circulation to be carried out normally, energy is expended. The force that acts on the walls of the vessels for blood flow is blood pressure. It depends on how the heart works. Dysfunction of this whole process is a manifestation of arterial hypertension. And if it is persistent and permanent, then the disease is called chronic.

Chronic hypertension can be malignant. At the same time, blood pressure shows rather high rates, and rapid progression is characteristic of such a syndrome. This is reflected in the target organs. Also, the malignancy of such hypertension is explained by resistance to drug therapy. This condition often occurs in men 40-50 years old. Malignant hypertension develops in a small percentage of patients - 0.5-1%. The prognosis of such a pathology is unfavorable if adequate treatment has not been prescribed. In this case, mortality occurs during the first year in 70% of patients. Most cases were reported from hemorrhagic stroke, renal and heart failure, aortic aneurysm of the dissecting type.

There are 2 indicators of blood pressure:

• Systolic pressure, it is also called upper. This is an indicator during systole, that is, when the heart contracts, at the time of cardiac output.
• Diastolic pressure, or lower. The numbers indicate the strength of the pressure at the moment of cardiac relaxation. At this moment, the heart fills up before the next discharge.

Development mechanisms

The exact reason why a chronic disease has developed is often not possible to determine. But doctors usually associate it with factors such as hormonal imbalance, excessive amounts of salts in the kidneys, and if substances have collected in the blood that provoke vasoconstriction. These reasons cause essential hypertension, or primary. An important role in the development of this form of the disease is played by a hereditary predisposition.

The main cause of chronic hypertension is atherosclerotic vascular disease. Plaques arise from excess cholesterol in the blood, they are deposited in the vessels, thereby reducing its lumen. Accordingly, the blood flow is impeded, and the pressure rises.

Chronic arterial hypertension is often provoked by kidney disease. Such a mechanism for increasing blood pressure is that an excess amount of salt is retained. As a result, the fluid is retained in the body, and this is fraught with an increase in blood volume, which means an increase in blood pressure. The kidneys also secrete the enzyme renin, which directly affects blood pressure.

Pheochromycytoma is an adrenal gland disorder in which blood pressure rises through the production of large amounts of the hormone adrenaline.

There are also such factors that provoke an increase in blood pressure and the development of chronic hypertension:

• Obesity. Fatty deposits provoke the development of atherosclerosis. It is noted that each extra kilogram adds 2 mm to the main indicator of blood pressure. rt st.
• Sedentary way of life. In this case, the body undergoes changes. For example, the heart weaned from exertion, it works much worse. As a result, metabolic processes in the body slow down.
• Smoking. This bad habit negatively affects the state of blood vessels, provoking their spasm, and damaging their walls. At the sites of these lesions, atherosclerotic plaques begin to form.
• Alcohol abuse. Alcohol affects the rheological properties of the blood. As a result, blood thickens and it is harder for the heart to pump it.

Various factors can be the causes of a hypertensive crisis. Quite often, in people with a chronic form of the disease, a severe attack occurs after psycho-emotional stress, alcohol consumption, improper intake of medications, and also if the person has not taken the necessary medication on time. Also, the manifestation of a hypertensive crisis can be influenced by meteorological factors.

If for some reason the blood supply to the brain is reduced, then the body turns on its compensatory mechanisms. As a result, blood pressure rises and more blood (than usual) is sent to the brain. Because of this, there is an increase in heart rate, contraction of blood vessels in the lower extremities and abdominal cavity. As a result, the problems of the cardiovascular system are exacerbated, and hypertension is already becoming chronic.

Symptoms

For hypertension, the main symptom is malaise and weakness. A person who leads an active lifestyle sometimes has an attack of loss of strength and dizziness. Often people attribute this condition to overwork.

Also, this pathology is characterized by the following manifestations:

• Headache. It is localized in the back of the head or around the entire circumference of the head. Pain syndrome does not depend on the time of day.
• Noise in ears.
• Darkening in the eyes that appears intermittently and suddenly.
• Dizziness.

These symptoms occur due to the fact that, due to high blood pressure, the target organs that are most sensitive to this condition are affected. The above signs may indicate a violation of blood circulation in the brain. As the situation worsens, speech disorders, double vision and flies in the eyes, numbness of the limbs appear.

In people with chronic hypertension, the condition can worsen from time to time. In this case, blood pressure rises sharply. Seizure symptoms:

• nausea and vomiting;
• a sharp deterioration in visual function;
• headache of varying intensity;
• chest pain, tightness;
• dyspnea;
• redness of the face;
• convulsions.

A hypertensive crisis can lead to dangerous consequences - stroke, cerebral hemorrhage, internal bleeding.

In chronic hypertension, the arteries are deformed. Under the influence of various factors, the muscle walls of the vessels thicken significantly, and the lumen becomes smaller. This condition can actively progress if you do not adhere to the recommendations of doctors. This can even lead to loss of vision.

Changes in the heart muscle are diagnostic signs of chronic hypertension. The earliest and most frequent are hypertrophic changes in the left ventricle. At the same time, its wall thickens, and the mass of the heart increases. This condition is very dangerous, and if you do not start treatment on time, it can lead to sudden cardiac death, coronary heart disease, ventricular arrhythmias.

If there is a history of left ventricular hypertrophy, the following symptoms will appear:

• during physical exertion - shortness of breath;
• shortness of breath at night - cardiac asthma;
• swelling of the lungs.

In this case, congestive heart failure develops, and there is a high probability of developing myocardial infarction and ventricular fibrillation.

Treatment

Despite the prevalence of hypertension, treatment should be prescribed only by a doctor, based on the individual characteristics of the body and diagnosis. A single blood pressure measurement is not enough to make a diagnosis of hypertension. But in cases where a person has an indicator of 170/105 mm Hg. Art., the diagnosis will be justified even with a single measurement. If the indicator is lower, then the pressure should be measured several times to confirm. For this, measurements are prescribed for some time. It is also important to record the indicator after drinking coffee, during stressful situations and after smoking.

In addition to measuring blood pressure, a person must be fully examined, since hypertension, which has acquired a chronic form, has left a mark on all organs and systems. The eyes are examined first.

Sometimes a person even needs to be hospitalized. As a rule, this happens in such cases:

• If the diagnosis is not completely determined, and it is necessary to conduct a full instrumental study on an outpatient basis. It is important to determine the form of arterial hypertension.
• If it is impossible to find the right drug therapy, and because of this, hypertensive crises often appear.

A person who is diagnosed with chronic arterial hypertension must understand that treatment will continue throughout life, since this type of hypertension is incurable.

Medicines

Drug therapy for chronic hypertension requires a comprehensive one. With the help of drugs, the patient controls his condition. The main therapy includes the following groups of drugs:

• Calcium channel blockers.
• Beta and alpha blockers.
• Angiotensin blockers.
• ACE inhibitors.
• Diuretics

Calcium channel blockers help stop calcium influx. At the same time, the vascular walls relax, this helps to lower blood pressure. Adrenergic blockers act on nerve receptors located in the heart, this action helps to normalize the heart rate.

Angiotensin blockers are drugs that interfere with the synthesis of the hormone angiotensin, decreasing it. Since it is this hormone that provokes vasoconstriction and slows down the removal of salts from the body.

ACE inhibitors act on smooth muscles, they relax these muscles, which helps to normalize heart function and lower blood pressure.

Diuretics are diuretics that remove excess fluid from the body, thereby lowering blood pressure. Chronic hypertension occurs due to an increase in blood density. Reduces blood pressure with diuretics by excreting salts. But they cannot be taken on their own, the dosage must be prescribed by a doctor. Taking these drugs uncontrollably can cause dehydration. Thiazide-type diuretics have a contraindication - the presence of gout. Loop diuretics have no absolute contraindications.

Aldosterone receptor blockers are prescribed if the patient has a history of chronic heart failure, or after he has had a myocardial infarction. Contraindications to the use of these drugs are chronic renal failure, hyperkalemia.

Ethnoscience

There are many traditional medicines that are used for hypertension. Of course, it is impossible to cure a disease only with these means. It is noted that you can lower the pressure by applying:

• Beets. This vegetable is quite effective and can be taken in the form of juice, infusion, raw grated beets with honey are useful.
• Black mountain ash - juice, grated berries with sugar, decoction and infusion are used.
• Garlic. It should be consumed raw daily, in the form of a tincture (alcohol or water), in the form of a gruel of garlic and sugar.
• Cranberries. In the season when this berry grows, you need to eat it raw, you can make a mixture of cranberries with the addition of lemon zest, honey, brandy.
• Honey. This product is very effective for hypertension, it should be consumed both in pure form and added to other products.

Herbs that are effective for hypertension:

• hawthorn;
• motherwort;
• mint;
• St. John's wort;
• calendula;
• birch leaves;
• valerian root;
• horsetail.

On the Internet, you can find many methods by which treatment for this disease is carried out. Such methods are nevertheless intended for people who have been examined by doctors and know exactly their diagnosis, as well as the type of pathology.

One of the most popular methods is herbal sedation and relaxation.

These herbs include:

• valerian;
• chamomile;
• peppermint;
• hawthorn;
• melissa.

Recipes:

1. Infusion of motherwort, dill seeds and valerian root has diuretic and hypotensive effects. These plants need to be crushed, and take 1 teaspoon each, pour 500 ml of hot water. All this is infused for 1 hour. The finished infusion should be divided into 3 times and consumed throughout the day. The course of treatment is 1 month.
2. Garlic with honey. For cooking, you will need to finely chop the garlic (4 cloves) and pour all this with a glass of liquid honey. This mixture is infused for 2 days, and after that you need to drink 1 teaspoon of it on an empty stomach. The course is 1 month. This remedy is effective for atherosclerotic vascular lesions.
3. Beetroot with honey. You will need beet juice, which has previously stood in the refrigerator for 3 hours. Then you need to add 1 tablespoon of honey to 1 glass of juice. The finished product should be taken 1 tablespoon 3 times a day. The tool has a hypotensive effect, and also strengthens the cardiovascular system. A mixture of cranberry juice and honey has the same effect; it is prepared according to the same principle.

Drug therapy folk remedies must be combined with a diet. It is necessary to reduce or completely eliminate the use of animal fats, and a person should not eat more than 5 g of salt per day.

Smoked, fried, spicy foods are also prohibited. Smoking, alcohol, coffee must also be given up. The diet should contain more vegetables, fruits, herbs, fermented milk products, dried fruits. It is advisable to drink more compotes and decoctions. It is very difficult to give up your food preferences, but by starting to eat right, a person's well-being will improve over time. This is a good incentive to continue to adhere to this lifestyle. If a person smoked for a long time, then it is very difficult for him to give up this habit. But this must be done.Today there are many methods for this and even tools that can be purchased at the pharmacy.

People who are overweight are advised to start losing weight. Diet food and moderate physical activity are obligatory. It is recommended for hypertensive patients to engage in swimming, since water procedures are excellent soothing and at the same time it is a load that is needed for the normal functioning of the cardiovascular system.

There is also an Indian method of treatment that uses only iodine. It is smeared with certain areas on the body. But it is only dangerous to be treated with this approach on its own. It is better to consult a doctor about new techniques and therapies. It should be understood that if you do not support the body with drugs, then the condition may become more complicated.

Pathology in pregnant women

Statistics show that 10% of pregnant women have high blood pressure, while diagnostics determines chronic hypertension. In pregnant women, changes occur in the body, as a result of which blood pressure rises. And this makes it difficult to diagnose chronic hypertension.

Chronic hypertension in pregnant women is an increased value of blood pressure, which has already been manifested in a woman even before pregnancy, or if it occurs before 20 weeks.

This condition is diagnosed according to individual indicators before pregnancy - if there is an indicator above 140/90 mm Hg. and also, if at the same time there was an increase at rest 2 or more times, and between these episodes there was a time interval of 4 hours. Also, chronic hypertension during pregnancy is considered to be an increase in pressure if it is registered before the 20th week of waiting for the baby, and the indicator is greater than 160/110 mm. rt. Art.

Women with a history of hypertension are at risk. This pathology can provoke such dangerous consequences:

• preeclampsia;
• premature placental abruption;
• retardation of fetal development.

These are the main pathologies, but other maternal and perinatal complications can develop.

Doctors with hypertension in a pregnant woman pay attention only to the diastolic indicator. In this case, there are no exact causes of this disease, therefore, doctors treat such women more carefully. They are observed more often, at the very first manifestations of the disease they are hospitalized, before giving birth for some time (1-2 weeks), the woman should also be observed by doctors.

In the presence of chronic hypertension, there may be contraindications for gestation. Namely:

• If the pressure gauge is 180/110 mm Hg. and higher - with grade 3 hypertension.
• For various complications caused by hypertension. This can be myocardial infarction, heart failure, stroke, encephalopathy, aortic aneurysms, as well as pathologies of the retina of the eye and kidneys.
• If chronic hypertension has acquired a malignant form - that is, the diastolic rate is more than 130 mm Hg.

Sometimes doctors have to terminate a pregnancy late in order to save a woman. These indications include the progression of malignant hypertension, aneurysm, in which aortic dissection occurs. Also, an indication is an acute type of circulatory disorder, but in this case, the termination of pregnancy is carried out only after the patient's condition has stabilized. Termination of pregnancy in late stages is carried out by performing an abdominal cesarean section.

Women with chronic hypertension who have been taking appropriate medications for some time before pregnancy are consulted by a cardiologist, and these medications are discontinued. And if these are drugs that cannot be canceled abruptly, then the dosage is gradually reduced until complete cancellation. These drugs include beta-blockers.

The cardiologist makes recommendations for such a pregnant woman. She needs to carry out daily monitoring of blood pressure indicators on her own, at home. But this is only with positive forecasts. Quite often, drug therapy is not excluded, but only corrected. Diuretics and ACE inhibitors are not prescribed during pregnancy.

An important aspect in the drug treatment of chronic hypertension in pregnant women is the control and maintenance of the diastolic index at the level of 80-90 mm. If a woman's systolic rate predominantly rises, then the goal of drug treatment is to keep it at 120-140 mm. For women in position, it is very important not to bring down the pressure lower than 110 mm. Art.

Also, important factors in the treatment of a special patient are rational nutrition, a decrease in psychoemotional stress, every day a woman should rest for 2 hours in a lying position, physiotherapy exercises for pregnant women with moderate stress are indicated.

Chronic hypertension affects people of all ages today. Therefore, it is very important to diagnose the pathology in time and take drugs according to the scheme prescribed by the doctor. Treatment for hypertension has the main task of improving the patient's quality of life and preventing complications.

It is important for people who have already been diagnosed to understand that it will no longer be possible to recover from this disease, and they will need to take medications throughout their lives. Therefore, it is better to prevent complications than to admit them. Preventive measures should be applied to people with a genetic predisposition and belonging to the risk group.