Blood pressureThere are two blood pressure indicators:Systolic blood pressure (garden) - reflects pressure in the arteries, which is created when the heart is reduced and the blood is released in the arterial part of the vascular system;Diastolic blood pressure (DDAD) - Pressure in the arteries at the time of relaxation of the heart, during which it is filled before the next reduction. High blood pressure symptomsThe clinic, that is to say the manifestations of hypertension has no specific symptoms. For many years, patients may not know their illness, do not complain, have a high activity of life, although sometimes attacks of "wickedness", serious weakness and dizziness can occur. But even then, everyone believes that it comes from overwork. Although this is when you have to think about blood pressure and measure it. Complaints for hypertension occur if the so-called target organs are affected by the most sensitive to the increase in blood pressure. The occurrence of dizziness, headache, noise in the head, a decrease in memory and performance indicate the initial changes in brain traffic. This is then joined in the eyes, sparkling the flies, the weakness, the numbness of the limbs, the speaking difficulties, but at the initial stage, the changes in blood circulation arrive. The large -scale stage of high blood pressure can be complicated by brain or brain hemorrhage infarction. The oldest and constant sign of constantly increased blood pressure is an increase, or an enlarged left ventricle of the heart, with the growth of its mass due to the thickening of cardiac cells, cardiomyocytes.First, the thickness of the wall of the left ventricle increases and, in the future, the expansion of this heart chamber also occurs. It is necessary to pay particular attention to the fact that the hypertrophy of the left ventricle is an unfavorable prognostic sign. In a certain number of epidemiological studies, the appearance of hypertrophy of the left ventricle has considerably increased the risk of sudden death, coronary disease, heart failure and ventricular rhythm disorders. The progressive dysfunction of the left ventricle leads to the appearance of symptoms such as: lesing shortness of charge, paroxysmal nocturnal breath (cardiac asthma), pulmonary edema (often with crises), chronic heart failure (congestive). In this context, myocardial infarction, ventricular fibrillation is more common.
With raw morphological changes in the aorta (atherosclerosis), it develops, its stratification, a rupture can occur. Refine lesions are expressed by the presence of proteins in the urine, microhemature and cylinder. However, renal failure by hypertension, if there is no malignant lessons, rarely develops. Eye lesions can be manifested by an alteration of vision, a decrease in the sensitivity of light and the development of blindness. Thus, it is quite obvious that hypertension must be treated more carefully.Risk factors for high blood pressureRisk factors not linked to registration include:Hérétité - People who have patients with hypertension in loved ones are the most predisposed to the development of this pathology in them.The male soil - It has been established that the incidence of high blood pressure of men is significantly higher than the incidence of women. But the fact is that female sex hormones, estrogens hinder the development of hypertension. But such protection, unfortunately, is short. The menopausic period occurs, the savings effect for estrogen purposes and women are aligned in incidence with men and often exceed them.Modified risk factors include:Increase in body weight - In people with excess body weight, the risk of developing high blood pressure is higher;A sedentary lifestyle - in another hypodynamia, a sedentary lifestyle and low physical activity lead to obesity, which in turn contributes to the development of hypertension;In alcohol consumption, excessive alcohol consumption promotes high blood pressure. Eating a large amount of salt in food - a very salt diet helps increase the pressure. Here, the question arises of the amount of salt that can be consumed per day? The answer is short: 4, 5 grams or a high teaspoon. An unbalanced diet with an excess of atherogenic lipids, an excessive calorie content, leading to obesity and promoting the progression of type II diabetes. Atherogenic lipids, that is to say, "creating atherosclerosis", are contained in large quantities in all animal fats, meat, in particular pork and lamb;Smoking is another variable and formidable factor in the development of high blood pressure and its complications. The fact is that tobacco substances, including nicotine, create a constant spasm of the arteries, which is fixed, leads to the rigidity of the arteries, which implies an increase in the pressure of the vessels;Stress - leads to the activation of a sympathetic nervous system which fulfills the function of an instant activator of all body systems, including cardiovascular. In addition, the presser, that is to say causing a spasm of the arteries, hormones, is thrown into the blood. All this, as for smoking, leads to the rigidity of the arteries and high blood pressure develops;Roaring sleep disorders by the type of nighttime apnea syndrome or snoring. Roding is a real scourge of almost all men and many women. Why is snoring dangerous? The fact is that it causes an increase in pressure in the chest and the abdominal cavity. All this is reflected on ships, leading to their spasm. High blood pressure is developing.Causes of high blood pressureThe cause of the disease remains unknown in 90 to 95% of patients, which is essential (that is to say primary blood pressure). In 5 to 10% of cases, an increase in blood pressure has an established cause - this is symptomatic (or secondary) hypertension.Causes of symptomatic high blood pressure (secondary):Primary renal lesions (glomerulonephritis) are the most common cause of secondary high blood pressure;Distribution (stenosis) or bilateral (stenosis) of the renal arteries; Coarcation (congenital narrowing) of the aorta;Feochromocytoma (adrenal tumor producing adrenaline and noradrenaline);hyperaldosteronism (tumor of the adrenal glands which produces aldosterone);thyrotoxicosis (increase in thyroid function);Ethanol consumption (wine alcohol) more than 60 ml per day;Medicines: Hormonal drugs (including oral contraceptives), antidepressants and others;Risk factors for cardiovascular complications with high blood pressureBasic:Men over 55;women over 65;Totalxz blood cholesterol level>6, 5 mmol / L, an increase in the level of Lipoprotein cholesterol with low density (>4, 0 mmol / L) and lipoprotein cholesterol with high low density;Family history of early cardiovascular diseases (in women under the age of 65, in men<55 years);Abdominal obesity (size volume ≥ 102 cm for men or ≥ 88 cm for women);Level C - Reactive protein in blood ≥ 1 mg / dl;Diabetes mellitus (blood sugar blood sugar Vide>7 mmol / l).Additional:violation of glucose tolerance;low physical activity;Improvement of the fibrinogen level.Note. The accuracy of the determination of the general cardiovascular risk directly depends on the completeness of the patient's clinical and instrumental examination.High blood pressure complicationsAmong the most important complications of high blood pressure are:hypertensive crises;cerebrovascular disorders (hemorrhagic or ischemic stroke);myocardial infarction;nephrosclerosis (wrinkled primary kidney);heart failure;Relatives the aorta aneurysm.Studies for high blood pressureIn all patients with high blood pressure, the following studies should be carried out:Test of blood and general urine;the level of creatinine in the blood (to exclude renal lesions);The level of potassium in the blood outside the use of diuretics (a sharp decrease in potassium levels is suspicious of the presence of a adrenal tumor or a stenosis of the renal artery);Electrocardiogram (signs of left ventricular hypertrophy - proof of a long course of high blood pressure);Determination of the level of glucose in the blood (empty stomach);The blood content of total cholesterol, triglycerides cholesterol with high and low density, uric acid;Echocardiography (determine the degree of hypertrophy of the left ventricular myocardium and a state of contractile capacity)Study of the bottom of the eyes.Recommended search:thoracic radiography;Ultrasound of kidneys and adrenal glands;Ultrasound of the brachiocephalic and renal arteries;C-reactive protein in blood serum;Urine analysis for the presence of bacteria (bacteriuria), quantitative estimate of protein in urine (proteinuria);Determination of microalbumin in urine (compulsory in the presence of diabetes).In the depth study:Evaluation of the functional state of the brain blood, myocardial, kidneys;Examination in the blood of the concentration of aldosterone, corticosteroids, radio activity; determination of catecholamines and their metabolites in daily urine; abdominal aortography; CT scan or magnetic resonance tomography of the adrenal glands and the brain.High blood pressure treatment The main objective of treating patients with high blood pressure is the maximum decrease in the risk of developing cardiovascular complications and death on their part. This is carried out by long -term therapy for life intended for:Decrease in blood pressure to a normal level (less than 140/90 mm HG). With a combination of high blood pressure with diabetes or kidney damage, it is recommended to reduce blood pressure<130/80 mm Hg. (but not less than 110/70 mm HG);The "protection" of the target organs (brain, heart, kidneys), preventing their other damage;Active impact on unfavorable risk factors (obesity, hyperlipidemia, carbohydrate disorders, excessive salt consumption, hypodynamia), contributing to the progression of blood pressure and the development of its complications.Non -medication of high blood pressureRefusal to smoke;body weight normalization (body mass index<25 kg / m2);Decrease in alcoholic beverages<30 g of alcohol per day in men and 20 g / day in women;Increase in physical-physical activity of 30 to 40 minutes. at least 4 times a week;Reduction of table salt consumption at 5 g / day;A change in the diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in potassium, calcium of vegetables, fruits, cereals and magnesium contained in dairy products.The basic principles of blood pressure medication:The treatment of drugs must start with minimum doses of any class of antihypertensive drugs (taking into account the appropriate contraindications), gradually increasing the dose to a good therapeutic effect.The choice of medication should be justified, the antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.With the low efficiency of monotherapy (therapy with a drug), it is advisable to use optimal combinations of drugs to obtain maximum hypotensive effects and minimum side effects.It is necessary to carry out a long (practically permanent) administration of drugs to maintain the optimal level of blood pressure and prevent complications of high blood pressure.The choice of the necessary drugs:Currently, seven drug classes are recommended for the treatment of high blood pressure:Diuretics;Blockers B;calcium antagonists;inhibitors of the reproductive enzymes of angiotensin;angiotensin receptor blockers;Higanist receptor agonistsAdvertising blockers.Indications for hospitalizationPatients with high blood pressure are used:Unclear diagnosis and the need for special research methods, more often invasive, to clarify the form of high blood pressure;The difficulties in the selection of drugs are frequent hypertensive crises, refractory high blood pressure.Indications for emergency hospitalization:Hypertensive crisis, not stopping at the prehospital stage;Hypertensive crisis with pronounced manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);Complications of hypertension, requiring intensive care and constant medical observation: brainstem, subarachnoid hemorrhage, acute visual disturbances, pulmonary edema, etc.
High blood pressure symptomsThe clinic, that is to say the manifestations of hypertension has no specific symptoms. For many years, patients may not know their illness, do not complain, have a high activity of life, although sometimes attacks of "wickedness", serious weakness and dizziness can occur. But even then, everyone believes that it comes from overwork. Although this is when you have to think about blood pressure and measure it. Complaints for hypertension occur if the so-called target organs are affected by the most sensitive to the increase in blood pressure. The occurrence of dizziness, headache, noise in the head, a decrease in memory and performance indicate the initial changes in brain traffic. This is then joined in the eyes, sparkling the flies, the weakness, the numbness of the limbs, the speaking difficulties, but at the initial stage, the changes in blood circulation arrive. The large -scale stage of high blood pressure can be complicated by brain or brain hemorrhage infarction. The oldest and constant sign of constantly increased blood pressure is an increase, or an enlarged left ventricle of the heart, with the growth of its mass due to the thickening of cardiac cells, cardiomyocytes.First, the thickness of the wall of the left ventricle increases and, in the future, the expansion of this heart chamber also occurs. It is necessary to pay particular attention to the fact that the hypertrophy of the left ventricle is an unfavorable prognostic sign. In a certain number of epidemiological studies, the appearance of hypertrophy of the left ventricle has considerably increased the risk of sudden death, coronary disease, heart failure and ventricular rhythm disorders. The progressive dysfunction of the left ventricle leads to the appearance of symptoms such as: lesing shortness of charge, paroxysmal nocturnal breath (cardiac asthma), pulmonary edema (often with crises), chronic heart failure (congestive). In this context, myocardial infarction, ventricular fibrillation is more common.
With raw morphological changes in the aorta (atherosclerosis), it develops, its stratification, a rupture can occur. Refine lesions are expressed by the presence of proteins in the urine, microhemature and cylinder. However, renal failure by hypertension, if there is no malignant lessons, rarely develops. Eye lesions can be manifested by an alteration of vision, a decrease in the sensitivity of light and the development of blindness. Thus, it is quite obvious that hypertension must be treated more carefully.Risk factors for high blood pressureRisk factors not linked to registration include:Hérétité - People who have patients with hypertension in loved ones are the most predisposed to the development of this pathology in them.The male soil - It has been established that the incidence of high blood pressure of men is significantly higher than the incidence of women. But the fact is that female sex hormones, estrogens hinder the development of hypertension. But such protection, unfortunately, is short. The menopausic period occurs, the savings effect for estrogen purposes and women are aligned in incidence with men and often exceed them.Modified risk factors include:Increase in body weight - In people with excess body weight, the risk of developing high blood pressure is higher;A sedentary lifestyle - in another hypodynamia, a sedentary lifestyle and low physical activity lead to obesity, which in turn contributes to the development of hypertension;In alcohol consumption, excessive alcohol consumption promotes high blood pressure. Eating a large amount of salt in food - a very salt diet helps increase the pressure. Here, the question arises of the amount of salt that can be consumed per day? The answer is short: 4, 5 grams or a high teaspoon. An unbalanced diet with an excess of atherogenic lipids, an excessive calorie content, leading to obesity and promoting the progression of type II diabetes. Atherogenic lipids, that is to say, "creating atherosclerosis", are contained in large quantities in all animal fats, meat, in particular pork and lamb;Smoking is another variable and formidable factor in the development of high blood pressure and its complications. The fact is that tobacco substances, including nicotine, create a constant spasm of the arteries, which is fixed, leads to the rigidity of the arteries, which implies an increase in the pressure of the vessels;Stress - leads to the activation of a sympathetic nervous system which fulfills the function of an instant activator of all body systems, including cardiovascular. In addition, the presser, that is to say causing a spasm of the arteries, hormones, is thrown into the blood. All this, as for smoking, leads to the rigidity of the arteries and high blood pressure develops;Roaring sleep disorders by the type of nighttime apnea syndrome or snoring. Roding is a real scourge of almost all men and many women. Why is snoring dangerous? The fact is that it causes an increase in pressure in the chest and the abdominal cavity. All this is reflected on ships, leading to their spasm. High blood pressure is developing.Causes of high blood pressureThe cause of the disease remains unknown in 90 to 95% of patients, which is essential (that is to say primary blood pressure). In 5 to 10% of cases, an increase in blood pressure has an established cause - this is symptomatic (or secondary) hypertension.Causes of symptomatic high blood pressure (secondary):Primary renal lesions (glomerulonephritis) are the most common cause of secondary high blood pressure;Distribution (stenosis) or bilateral (stenosis) of the renal arteries; Coarcation (congenital narrowing) of the aorta;Feochromocytoma (adrenal tumor producing adrenaline and noradrenaline);hyperaldosteronism (tumor of the adrenal glands which produces aldosterone);thyrotoxicosis (increase in thyroid function);Ethanol consumption (wine alcohol) more than 60 ml per day;Medicines: Hormonal drugs (including oral contraceptives), antidepressants and others;Risk factors for cardiovascular complications with high blood pressureBasic:Men over 55;women over 65;Totalxz blood cholesterol level>6, 5 mmol / L, an increase in the level of Lipoprotein cholesterol with low density (>4, 0 mmol / L) and lipoprotein cholesterol with high low density;Family history of early cardiovascular diseases (in women under the age of 65, in men<55 years);Abdominal obesity (size volume ≥ 102 cm for men or ≥ 88 cm for women);Level C - Reactive protein in blood ≥ 1 mg / dl;Diabetes mellitus (blood sugar blood sugar Vide>7 mmol / l).Additional:violation of glucose tolerance;low physical activity;Improvement of the fibrinogen level.Note. The accuracy of the determination of the general cardiovascular risk directly depends on the completeness of the patient's clinical and instrumental examination.High blood pressure complicationsAmong the most important complications of high blood pressure are:hypertensive crises;cerebrovascular disorders (hemorrhagic or ischemic stroke);myocardial infarction;nephrosclerosis (wrinkled primary kidney);heart failure;Relatives the aorta aneurysm.Studies for high blood pressureIn all patients with high blood pressure, the following studies should be carried out:Test of blood and general urine;the level of creatinine in the blood (to exclude renal lesions);The level of potassium in the blood outside the use of diuretics (a sharp decrease in potassium levels is suspicious of the presence of a adrenal tumor or a stenosis of the renal artery);Electrocardiogram (signs of left ventricular hypertrophy - proof of a long course of high blood pressure);Determination of the level of glucose in the blood (empty stomach);The blood content of total cholesterol, triglycerides cholesterol with high and low density, uric acid;Echocardiography (determine the degree of hypertrophy of the left ventricular myocardium and a state of contractile capacity)Study of the bottom of the eyes.Recommended search:thoracic radiography;Ultrasound of kidneys and adrenal glands;Ultrasound of the brachiocephalic and renal arteries;C-reactive protein in blood serum;Urine analysis for the presence of bacteria (bacteriuria), quantitative estimate of protein in urine (proteinuria);Determination of microalbumin in urine (compulsory in the presence of diabetes).In the depth study:Evaluation of the functional state of the brain blood, myocardial, kidneys;Examination in the blood of the concentration of aldosterone, corticosteroids, radio activity; determination of catecholamines and their metabolites in daily urine; abdominal aortography; CT scan or magnetic resonance tomography of the adrenal glands and the brain.High blood pressure treatment The main objective of treating patients with high blood pressure is the maximum decrease in the risk of developing cardiovascular complications and death on their part. This is carried out by long -term therapy for life intended for:Decrease in blood pressure to a normal level (less than 140/90 mm HG). With a combination of high blood pressure with diabetes or kidney damage, it is recommended to reduce blood pressure<130/80 mm Hg. (but not less than 110/70 mm HG);The "protection" of the target organs (brain, heart, kidneys), preventing their other damage;Active impact on unfavorable risk factors (obesity, hyperlipidemia, carbohydrate disorders, excessive salt consumption, hypodynamia), contributing to the progression of blood pressure and the development of its complications.Non -medication of high blood pressureRefusal to smoke;body weight normalization (body mass index<25 kg / m2);Decrease in alcoholic beverages<30 g of alcohol per day in men and 20 g / day in women;Increase in physical-physical activity of 30 to 40 minutes. at least 4 times a week;Reduction of table salt consumption at 5 g / day;A change in the diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in potassium, calcium of vegetables, fruits, cereals and magnesium contained in dairy products.The basic principles of blood pressure medication:The treatment of drugs must start with minimum doses of any class of antihypertensive drugs (taking into account the appropriate contraindications), gradually increasing the dose to a good therapeutic effect.The choice of medication should be justified, the antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.With the low efficiency of monotherapy (therapy with a drug), it is advisable to use optimal combinations of drugs to obtain maximum hypotensive effects and minimum side effects.It is necessary to carry out a long (practically permanent) administration of drugs to maintain the optimal level of blood pressure and prevent complications of high blood pressure.The choice of the necessary drugs:Currently, seven drug classes are recommended for the treatment of high blood pressure:Diuretics;Blockers B;calcium antagonists;inhibitors of the reproductive enzymes of angiotensin;angiotensin receptor blockers;Higanist receptor agonistsAdvertising blockers.Indications for hospitalizationPatients with high blood pressure are used:Unclear diagnosis and the need for special research methods, more often invasive, to clarify the form of high blood pressure;The difficulties in the selection of drugs are frequent hypertensive crises, refractory high blood pressure.Indications for emergency hospitalization:Hypertensive crisis, not stopping at the prehospital stage;Hypertensive crisis with pronounced manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);Complications of hypertension, requiring intensive care and constant medical observation: brainstem, subarachnoid hemorrhage, acute visual disturbances, pulmonary edema, etc.
With raw morphological changes in the aorta (atherosclerosis), it develops, its stratification, a rupture can occur. Refine lesions are expressed by the presence of proteins in the urine, microhemature and cylinder. However, renal failure by hypertension, if there is no malignant lessons, rarely develops. Eye lesions can be manifested by an alteration of vision, a decrease in the sensitivity of light and the development of blindness. Thus, it is quite obvious that hypertension must be treated more carefully.
Risk factors for high blood pressureRisk factors not linked to registration include:Hérétité - People who have patients with hypertension in loved ones are the most predisposed to the development of this pathology in them.The male soil - It has been established that the incidence of high blood pressure of men is significantly higher than the incidence of women. But the fact is that female sex hormones, estrogens hinder the development of hypertension. But such protection, unfortunately, is short. The menopausic period occurs, the savings effect for estrogen purposes and women are aligned in incidence with men and often exceed them.Modified risk factors include:Increase in body weight - In people with excess body weight, the risk of developing high blood pressure is higher;A sedentary lifestyle - in another hypodynamia, a sedentary lifestyle and low physical activity lead to obesity, which in turn contributes to the development of hypertension;In alcohol consumption, excessive alcohol consumption promotes high blood pressure. Eating a large amount of salt in food - a very salt diet helps increase the pressure. Here, the question arises of the amount of salt that can be consumed per day? The answer is short: 4, 5 grams or a high teaspoon. An unbalanced diet with an excess of atherogenic lipids, an excessive calorie content, leading to obesity and promoting the progression of type II diabetes. Atherogenic lipids, that is to say, "creating atherosclerosis", are contained in large quantities in all animal fats, meat, in particular pork and lamb;Smoking is another variable and formidable factor in the development of high blood pressure and its complications. The fact is that tobacco substances, including nicotine, create a constant spasm of the arteries, which is fixed, leads to the rigidity of the arteries, which implies an increase in the pressure of the vessels;Stress - leads to the activation of a sympathetic nervous system which fulfills the function of an instant activator of all body systems, including cardiovascular. In addition, the presser, that is to say causing a spasm of the arteries, hormones, is thrown into the blood. All this, as for smoking, leads to the rigidity of the arteries and high blood pressure develops;Roaring sleep disorders by the type of nighttime apnea syndrome or snoring. Roding is a real scourge of almost all men and many women. Why is snoring dangerous? The fact is that it causes an increase in pressure in the chest and the abdominal cavity. All this is reflected on ships, leading to their spasm. High blood pressure is developing.Causes of high blood pressureThe cause of the disease remains unknown in 90 to 95% of patients, which is essential (that is to say primary blood pressure). In 5 to 10% of cases, an increase in blood pressure has an established cause - this is symptomatic (or secondary) hypertension.Causes of symptomatic high blood pressure (secondary):Primary renal lesions (glomerulonephritis) are the most common cause of secondary high blood pressure;Distribution (stenosis) or bilateral (stenosis) of the renal arteries; Coarcation (congenital narrowing) of the aorta;Feochromocytoma (adrenal tumor producing adrenaline and noradrenaline);hyperaldosteronism (tumor of the adrenal glands which produces aldosterone);thyrotoxicosis (increase in thyroid function);Ethanol consumption (wine alcohol) more than 60 ml per day;Medicines: Hormonal drugs (including oral contraceptives), antidepressants and others;Risk factors for cardiovascular complications with high blood pressureBasic:Men over 55;women over 65;Totalxz blood cholesterol level>6, 5 mmol / L, an increase in the level of Lipoprotein cholesterol with low density (>4, 0 mmol / L) and lipoprotein cholesterol with high low density;Family history of early cardiovascular diseases (in women under the age of 65, in men<55 years);Abdominal obesity (size volume ≥ 102 cm for men or ≥ 88 cm for women);Level C - Reactive protein in blood ≥ 1 mg / dl;Diabetes mellitus (blood sugar blood sugar Vide>7 mmol / l).Additional:violation of glucose tolerance;low physical activity;Improvement of the fibrinogen level.Note. The accuracy of the determination of the general cardiovascular risk directly depends on the completeness of the patient's clinical and instrumental examination.High blood pressure complicationsAmong the most important complications of high blood pressure are:hypertensive crises;cerebrovascular disorders (hemorrhagic or ischemic stroke);myocardial infarction;nephrosclerosis (wrinkled primary kidney);heart failure;Relatives the aorta aneurysm.Studies for high blood pressureIn all patients with high blood pressure, the following studies should be carried out:Test of blood and general urine;the level of creatinine in the blood (to exclude renal lesions);The level of potassium in the blood outside the use of diuretics (a sharp decrease in potassium levels is suspicious of the presence of a adrenal tumor or a stenosis of the renal artery);Electrocardiogram (signs of left ventricular hypertrophy - proof of a long course of high blood pressure);Determination of the level of glucose in the blood (empty stomach);The blood content of total cholesterol, triglycerides cholesterol with high and low density, uric acid;Echocardiography (determine the degree of hypertrophy of the left ventricular myocardium and a state of contractile capacity)Study of the bottom of the eyes.Recommended search:thoracic radiography;Ultrasound of kidneys and adrenal glands;Ultrasound of the brachiocephalic and renal arteries;C-reactive protein in blood serum;Urine analysis for the presence of bacteria (bacteriuria), quantitative estimate of protein in urine (proteinuria);Determination of microalbumin in urine (compulsory in the presence of diabetes).In the depth study:Evaluation of the functional state of the brain blood, myocardial, kidneys;Examination in the blood of the concentration of aldosterone, corticosteroids, radio activity; determination of catecholamines and their metabolites in daily urine; abdominal aortography; CT scan or magnetic resonance tomography of the adrenal glands and the brain.High blood pressure treatment The main objective of treating patients with high blood pressure is the maximum decrease in the risk of developing cardiovascular complications and death on their part. This is carried out by long -term therapy for life intended for:Decrease in blood pressure to a normal level (less than 140/90 mm HG). With a combination of high blood pressure with diabetes or kidney damage, it is recommended to reduce blood pressure<130/80 mm Hg. (but not less than 110/70 mm HG);The "protection" of the target organs (brain, heart, kidneys), preventing their other damage;Active impact on unfavorable risk factors (obesity, hyperlipidemia, carbohydrate disorders, excessive salt consumption, hypodynamia), contributing to the progression of blood pressure and the development of its complications.Non -medication of high blood pressureRefusal to smoke;body weight normalization (body mass index<25 kg / m2);Decrease in alcoholic beverages<30 g of alcohol per day in men and 20 g / day in women;Increase in physical-physical activity of 30 to 40 minutes. at least 4 times a week;Reduction of table salt consumption at 5 g / day;A change in the diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in potassium, calcium of vegetables, fruits, cereals and magnesium contained in dairy products.The basic principles of blood pressure medication:The treatment of drugs must start with minimum doses of any class of antihypertensive drugs (taking into account the appropriate contraindications), gradually increasing the dose to a good therapeutic effect.The choice of medication should be justified, the antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.With the low efficiency of monotherapy (therapy with a drug), it is advisable to use optimal combinations of drugs to obtain maximum hypotensive effects and minimum side effects.It is necessary to carry out a long (practically permanent) administration of drugs to maintain the optimal level of blood pressure and prevent complications of high blood pressure.The choice of the necessary drugs:Currently, seven drug classes are recommended for the treatment of high blood pressure:Diuretics;Blockers B;calcium antagonists;inhibitors of the reproductive enzymes of angiotensin;angiotensin receptor blockers;Higanist receptor agonistsAdvertising blockers.Indications for hospitalizationPatients with high blood pressure are used:Unclear diagnosis and the need for special research methods, more often invasive, to clarify the form of high blood pressure;The difficulties in the selection of drugs are frequent hypertensive crises, refractory high blood pressure.Indications for emergency hospitalization:Hypertensive crisis, not stopping at the prehospital stage;Hypertensive crisis with pronounced manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);Complications of hypertension, requiring intensive care and constant medical observation: brainstem, subarachnoid hemorrhage, acute visual disturbances, pulmonary edema, etc.
Risk factors for cardiovascular complications with high blood pressureBasic:Men over 55;women over 65;Totalxz blood cholesterol level>6, 5 mmol / L, an increase in the level of Lipoprotein cholesterol with low density (>4, 0 mmol / L) and lipoprotein cholesterol with high low density;Family history of early cardiovascular diseases (in women under the age of 65, in men<55 years);Abdominal obesity (size volume ≥ 102 cm for men or ≥ 88 cm for women);Level C - Reactive protein in blood ≥ 1 mg / dl;Diabetes mellitus (blood sugar blood sugar Vide>7 mmol / l).Additional:violation of glucose tolerance;low physical activity;Improvement of the fibrinogen level.Note. The accuracy of the determination of the general cardiovascular risk directly depends on the completeness of the patient's clinical and instrumental examination.High blood pressure complicationsAmong the most important complications of high blood pressure are:hypertensive crises;cerebrovascular disorders (hemorrhagic or ischemic stroke);myocardial infarction;nephrosclerosis (wrinkled primary kidney);heart failure;Relatives the aorta aneurysm.Studies for high blood pressureIn all patients with high blood pressure, the following studies should be carried out:Test of blood and general urine;the level of creatinine in the blood (to exclude renal lesions);The level of potassium in the blood outside the use of diuretics (a sharp decrease in potassium levels is suspicious of the presence of a adrenal tumor or a stenosis of the renal artery);Electrocardiogram (signs of left ventricular hypertrophy - proof of a long course of high blood pressure);Determination of the level of glucose in the blood (empty stomach);The blood content of total cholesterol, triglycerides cholesterol with high and low density, uric acid;Echocardiography (determine the degree of hypertrophy of the left ventricular myocardium and a state of contractile capacity)Study of the bottom of the eyes.Recommended search:thoracic radiography;Ultrasound of kidneys and adrenal glands;Ultrasound of the brachiocephalic and renal arteries;C-reactive protein in blood serum;Urine analysis for the presence of bacteria (bacteriuria), quantitative estimate of protein in urine (proteinuria);Determination of microalbumin in urine (compulsory in the presence of diabetes).In the depth study:Evaluation of the functional state of the brain blood, myocardial, kidneys;Examination in the blood of the concentration of aldosterone, corticosteroids, radio activity; determination of catecholamines and their metabolites in daily urine; abdominal aortography; CT scan or magnetic resonance tomography of the adrenal glands and the brain.High blood pressure treatment The main objective of treating patients with high blood pressure is the maximum decrease in the risk of developing cardiovascular complications and death on their part. This is carried out by long -term therapy for life intended for:Decrease in blood pressure to a normal level (less than 140/90 mm HG). With a combination of high blood pressure with diabetes or kidney damage, it is recommended to reduce blood pressure<130/80 mm Hg. (but not less than 110/70 mm HG);The "protection" of the target organs (brain, heart, kidneys), preventing their other damage;Active impact on unfavorable risk factors (obesity, hyperlipidemia, carbohydrate disorders, excessive salt consumption, hypodynamia), contributing to the progression of blood pressure and the development of its complications.Non -medication of high blood pressureRefusal to smoke;body weight normalization (body mass index<25 kg / m2);Decrease in alcoholic beverages<30 g of alcohol per day in men and 20 g / day in women;Increase in physical-physical activity of 30 to 40 minutes. at least 4 times a week;Reduction of table salt consumption at 5 g / day;A change in the diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in potassium, calcium of vegetables, fruits, cereals and magnesium contained in dairy products.The basic principles of blood pressure medication:The treatment of drugs must start with minimum doses of any class of antihypertensive drugs (taking into account the appropriate contraindications), gradually increasing the dose to a good therapeutic effect.The choice of medication should be justified, the antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.With the low efficiency of monotherapy (therapy with a drug), it is advisable to use optimal combinations of drugs to obtain maximum hypotensive effects and minimum side effects.It is necessary to carry out a long (practically permanent) administration of drugs to maintain the optimal level of blood pressure and prevent complications of high blood pressure.The choice of the necessary drugs:Currently, seven drug classes are recommended for the treatment of high blood pressure:Diuretics;Blockers B;calcium antagonists;inhibitors of the reproductive enzymes of angiotensin;angiotensin receptor blockers;Higanist receptor agonistsAdvertising blockers.Indications for hospitalizationPatients with high blood pressure are used:Unclear diagnosis and the need for special research methods, more often invasive, to clarify the form of high blood pressure;The difficulties in the selection of drugs are frequent hypertensive crises, refractory high blood pressure.Indications for emergency hospitalization:Hypertensive crisis, not stopping at the prehospital stage;Hypertensive crisis with pronounced manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);Complications of hypertension, requiring intensive care and constant medical observation: brainstem, subarachnoid hemorrhage, acute visual disturbances, pulmonary edema, etc.
High blood pressure complicationsAmong the most important complications of high blood pressure are:hypertensive crises;cerebrovascular disorders (hemorrhagic or ischemic stroke);myocardial infarction;nephrosclerosis (wrinkled primary kidney);heart failure;Relatives the aorta aneurysm.Studies for high blood pressureIn all patients with high blood pressure, the following studies should be carried out:Test of blood and general urine;the level of creatinine in the blood (to exclude renal lesions);The level of potassium in the blood outside the use of diuretics (a sharp decrease in potassium levels is suspicious of the presence of a adrenal tumor or a stenosis of the renal artery);Electrocardiogram (signs of left ventricular hypertrophy - proof of a long course of high blood pressure);Determination of the level of glucose in the blood (empty stomach);The blood content of total cholesterol, triglycerides cholesterol with high and low density, uric acid;Echocardiography (determine the degree of hypertrophy of the left ventricular myocardium and a state of contractile capacity)Study of the bottom of the eyes.Recommended search:thoracic radiography;Ultrasound of kidneys and adrenal glands;Ultrasound of the brachiocephalic and renal arteries;C-reactive protein in blood serum;Urine analysis for the presence of bacteria (bacteriuria), quantitative estimate of protein in urine (proteinuria);Determination of microalbumin in urine (compulsory in the presence of diabetes).In the depth study:Evaluation of the functional state of the brain blood, myocardial, kidneys;Examination in the blood of the concentration of aldosterone, corticosteroids, radio activity; determination of catecholamines and their metabolites in daily urine; abdominal aortography; CT scan or magnetic resonance tomography of the adrenal glands and the brain.High blood pressure treatment The main objective of treating patients with high blood pressure is the maximum decrease in the risk of developing cardiovascular complications and death on their part. This is carried out by long -term therapy for life intended for:Decrease in blood pressure to a normal level (less than 140/90 mm HG). With a combination of high blood pressure with diabetes or kidney damage, it is recommended to reduce blood pressure<130/80 mm Hg. (but not less than 110/70 mm HG);The "protection" of the target organs (brain, heart, kidneys), preventing their other damage;Active impact on unfavorable risk factors (obesity, hyperlipidemia, carbohydrate disorders, excessive salt consumption, hypodynamia), contributing to the progression of blood pressure and the development of its complications.Non -medication of high blood pressureRefusal to smoke;body weight normalization (body mass index<25 kg / m2);Decrease in alcoholic beverages<30 g of alcohol per day in men and 20 g / day in women;Increase in physical-physical activity of 30 to 40 minutes. at least 4 times a week;Reduction of table salt consumption at 5 g / day;A change in the diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in potassium, calcium of vegetables, fruits, cereals and magnesium contained in dairy products.The basic principles of blood pressure medication:The treatment of drugs must start with minimum doses of any class of antihypertensive drugs (taking into account the appropriate contraindications), gradually increasing the dose to a good therapeutic effect.The choice of medication should be justified, the antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.With the low efficiency of monotherapy (therapy with a drug), it is advisable to use optimal combinations of drugs to obtain maximum hypotensive effects and minimum side effects.It is necessary to carry out a long (practically permanent) administration of drugs to maintain the optimal level of blood pressure and prevent complications of high blood pressure.The choice of the necessary drugs:Currently, seven drug classes are recommended for the treatment of high blood pressure:Diuretics;Blockers B;calcium antagonists;inhibitors of the reproductive enzymes of angiotensin;angiotensin receptor blockers;Higanist receptor agonistsAdvertising blockers.Indications for hospitalizationPatients with high blood pressure are used:Unclear diagnosis and the need for special research methods, more often invasive, to clarify the form of high blood pressure;The difficulties in the selection of drugs are frequent hypertensive crises, refractory high blood pressure.Indications for emergency hospitalization:Hypertensive crisis, not stopping at the prehospital stage;Hypertensive crisis with pronounced manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);Complications of hypertension, requiring intensive care and constant medical observation: brainstem, subarachnoid hemorrhage, acute visual disturbances, pulmonary edema, etc.
High blood pressure treatment The main objective of treating patients with high blood pressure is the maximum decrease in the risk of developing cardiovascular complications and death on their part. This is carried out by long -term therapy for life intended for:Decrease in blood pressure to a normal level (less than 140/90 mm HG). With a combination of high blood pressure with diabetes or kidney damage, it is recommended to reduce blood pressure<130/80 mm Hg. (but not less than 110/70 mm HG);The "protection" of the target organs (brain, heart, kidneys), preventing their other damage;Active impact on unfavorable risk factors (obesity, hyperlipidemia, carbohydrate disorders, excessive salt consumption, hypodynamia), contributing to the progression of blood pressure and the development of its complications.Non -medication of high blood pressureRefusal to smoke;body weight normalization (body mass index<25 kg / m2);Decrease in alcoholic beverages<30 g of alcohol per day in men and 20 g / day in women;Increase in physical-physical activity of 30 to 40 minutes. at least 4 times a week;Reduction of table salt consumption at 5 g / day;A change in the diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in potassium, calcium of vegetables, fruits, cereals and magnesium contained in dairy products.The basic principles of blood pressure medication:The treatment of drugs must start with minimum doses of any class of antihypertensive drugs (taking into account the appropriate contraindications), gradually increasing the dose to a good therapeutic effect.The choice of medication should be justified, the antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.With the low efficiency of monotherapy (therapy with a drug), it is advisable to use optimal combinations of drugs to obtain maximum hypotensive effects and minimum side effects.It is necessary to carry out a long (practically permanent) administration of drugs to maintain the optimal level of blood pressure and prevent complications of high blood pressure.The choice of the necessary drugs:Currently, seven drug classes are recommended for the treatment of high blood pressure:Diuretics;Blockers B;calcium antagonists;inhibitors of the reproductive enzymes of angiotensin;angiotensin receptor blockers;Higanist receptor agonistsAdvertising blockers.Indications for hospitalizationPatients with high blood pressure are used:Unclear diagnosis and the need for special research methods, more often invasive, to clarify the form of high blood pressure;The difficulties in the selection of drugs are frequent hypertensive crises, refractory high blood pressure.Indications for emergency hospitalization:Hypertensive crisis, not stopping at the prehospital stage;Hypertensive crisis with pronounced manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);Complications of hypertension, requiring intensive care and constant medical observation: brainstem, subarachnoid hemorrhage, acute visual disturbances, pulmonary edema, etc.
It is especially advisable to use prolonged action drugs to obtain a 24 -hour effect with a single use. The use of these drugs provides a milder hypotensive effect with more intense protection of the target organs.