Author:
Amelicheva Alena Aleksandrovna medical editor
High blood pressure (arterial hypertension, hypertension) is a persistent increase in systolic blood pressure above 130 mmHg and/or diastolic blood pressure above 90 mmHg.
Blood pressure is the force of blood pressure on the walls of the arteries. High blood pressure is more than normal pressure from the blood against the walls of the arteries.
Causes of high blood pressure
High blood pressure is divided into 2 types:
- primary (essential) hypertension (or hypertension) is the most common type of high blood pressure, often has no cause, develops over many years, the risk increases with age;
- secondary hypertension occurs against the background of the development of any disease (kidneys, endocrine system organs, sleep apnea) or taking certain medications.
Causes of high blood pressure include:
- old age (the older a person is, the higher the likelihood of developing hypertension);
- family history of the disease (high blood pressure in parents or other close relatives);
- unhealthy diet - diet high in salt and fat;
- lack of physical activity;
- overweight, obesity;
- sleep disorders;
- chronic diseases (chronic kidney disease, endocrine disorders, diabetes, high cholesterol);
- race (eg, African Americans have a higher risk);
- gender (in middle age, high blood pressure develops more often in men, in old age - in women; women who had high blood pressure during pregnancy are more prone to arterial hypertension in old age);
- certain medications (contraceptives, decongestants, NSAIDs, antidepressants);
- stress;
- smoking;
- alcohol abuse;
- non-compliance with sleep schedule, night shift work.
High blood pressure is often called the “silent killer” due to its lack of noticeable symptoms. In some cases (especially when blood pressure levels reach dangerously high levels), a person may complain of headache, nosebleeds, and shortness of breath. Many people do not associate these symptoms with abnormal blood pressure readings because they are not in the habit of periodically monitoring their blood pressure with a doctor or at home.
Why can pressure “jump”?
There are actually many reasons for high blood pressure, but here is a list of the most common:
- The heart does not work as before, its strength is reduced.
- The quality of the blood has changed. The older a person is, the thicker his blood is, which makes it difficult for it to pass through the vessels. Blood thickening can be caused, for example, by diabetes or autoimmune diseases.
- The vessels have become less elastic. Possible causes are poor diet, excessive exercise, and taking certain medications.
- Atherosclerotic plaques due to increased levels of “bad” cholesterol.
- A sharp narrowing of blood vessels due to hormonal imbalance.
- Malfunctions of the endocrine system.
- Hereditary factor.
In most cases, high blood pressure can be stabilized on your own by starting to eat right, eliminating bad habits and stress, and starting to move more. This will allow you to stay healthy for as long as possible and avoid the dangerous complications of hypertension (stroke, heart attack).
If lifestyle changes do not affect the situation, the doctor prescribes antihypertensive drugs that must be taken on an ongoing basis so that the blood pressure remains normal.
Blood pressure readings
- Normal pressure is from 90/60 mm Hg. Art. up to <120/80 mmHg Art.
- Prehypertension (risk factor for the development of arterial hypertension) - 120–129 mm Hg. Art. / <80 mmHg Art.
- Arterial hypertension 1st degree - 130–139 mm Hg. Art. or 80–89 mm Hg. Art.
- Arterial hypertension 2 degrees - ≥140 mm Hg. Art. or ≥90 mm Hg. Art.*
*American Heart Association classification.
Online blood pressure calculator on the NHS website.
American College of Cardiology online cardiovascular risk (stroke, heart attack and other diseases) calculator (risk of complications for patients with high blood pressure over the next 10 years and beyond).
Symptoms of high blood pressure
Very often, the increase in pressure does not manifest itself for a long time. This is the insidiousness of hypertension. It is not for nothing that the disease is called the “silent killer” - for many years the pathological process progresses in the body: the heart, blood vessels, kidneys are destroyed, but the person feels well, so he does not go to the doctor.
Over time, the patient develops fatigue, headaches of varying degrees of intensity, decreased performance, and sleep disturbances. Damage to target organs causes pain in the heart, blurred vision, irritability, and decreased performance.
Signs of high blood pressure:
- Hypertensive crisis is a dangerous condition caused by a sharp increase in blood pressure to high numbers (190/120 mm Hg).
- Symptoms of a hypertensive crisis:
- A sharp headache, mainly in the occipital region.
- Tachycardia, shortness of breath, feeling of lack of air.
- Nausea, vomiting.
- Visual impairment.
- Dizziness.
Trying to lower your blood pressure on your own can lead to myocardial infarction or stroke. If symptoms indicating high blood pressure appear, you should immediately call an ambulance and urgently take measures to reduce the pressure.
Before the medical team arrives:
- Sit the patient down and place pillows under his back.
- Check pressure every 15 minutes.
- Hot foot bath for blood flow to the lower extremities. For this purpose, mustard plasters are also applied to the calves of the legs.
- An antihypertensive tablet under the tongue - Andipal, Capoten, Captopril.
How often should you check your blood pressure readings?
Blood pressure is usually measured when visiting a doctor (for example, a therapist). There is no need to specifically visit a specialist for this; it is enough to ensure that the pressure is measured at least once every 2 to 5 years, starting from the age of 18 (with normal blood pressure and no increased risk of cardiovascular diseases).
People over 40 years of age, and people 18–40 years of age at risk of high blood pressure, should have their blood pressure checked at a healthcare facility at least once a year. If a diagnosis of arterial hypertension has been established or a person has other risk factors for developing cardiovascular diseases, it is recommended to measure blood pressure more often and not neglect monitoring at home. Your doctor will help you choose a device for measuring blood pressure (tonometer).
For children 3 years of age and older, blood pressure is measured regularly during annual routine examinations.
Caution: The American Heart Association does not recommend the use of wrist- or finger-worn blood pressure monitors, which are less accurate.
If recommended, measure blood pressure at home twice a day on the left and right arm: in the morning before breakfast (but not immediately after waking up) and before taking any medications, and in the evening, preferably at the same time. In each case, you need to measure the pressure 2-3 times (at short intervals, 1-3 minutes) for a confident, accurate result. 30 minutes before, do not smoke, do not eat, do not drink coffee (and alcohol), do not exercise, and empty your bladder. During the measurement, you must sit in a comfortable position, leaning back in a chair or armchair, do not cross your legs and ankles, and do not talk. The arm on which the cuff is worn must be freed from clothing and held at heart level; it is most convenient to place it on a table or armrest of a chair. Don't forget to write down your measurement results.
Verapamil
A drug from the group of calcium antagonists,
Sold by prescription in the form of tablets and solution for injection.
Verapamil is prescribed for hypertension, for the prevention and treatment of angina pectoris and supraventricular arrhythmias. These blood pressure pills reduce the oxygen demand of the heart muscle, reducing the number of myocardial contractions. The coronary vessels of the heart dilate - blood flow improves. Verapamil has an impressive list of contraindications,
so only a doctor can prescribe this drug. These tablets are prescribed with caution to people after a heart attack, with kidney disease, or left ventricular failure.
Verapamil
Alkaloid, Macedonia
Treatment and prevention of coronary artery disease: chronic stable angina (angina pectoris), unstable angina, vasospastic angina (Prinzmetal angina/variant angina).
Treatment and prevention of heart rhythm disturbances: paroxysmal supraventricular tachycardia, chronic form of atrial flutter and fibrillation (tachyarrhythmic variant), supraventricular extrasystole. Arterial hypertension. Hypertensive crisis. Hypertrophic cardiomyopathy. from 30
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Is it possible to normalize high blood pressure and what to do?
Yes, with the help of lifestyle modification (influencing modifiable factors), treating the underlying disease, taking medications that normalize blood pressure.
Lifestyle modifications include proper nutrition, including avoiding fatty foods and reducing salt intake (the DASH (Dietary Approaches to Stop Hypertension) eating plan recommended by the US National Heart, Lung, and Blood Institute is preferred); weight normalization; quitting smoking and alcohol; regular physical activity; stress management (for example, mastering relaxation techniques).
If you have persistently high blood pressure due to a medical condition (such as diabetes) or caused by taking certain medications, it is recommended that you consult your doctor. Control of the underlying disease, refusal of drugs (or their replacement) that increase blood pressure, make it possible to stabilize the patient’s blood pressure and condition.
Nonmodifiable risk factors associated with high blood pressure include age and family history.
Irkutsk City Clinical Hospital No. 9
Facts about hypertension:
According to the results of epidemiological studies in our country, about 30 million people (25 - 30% of the population) suffer from arterial hypertension.
- People with high blood pressure are 3-4 times more likely to develop coronary heart disease and 7 times more likely to develop cerebrovascular accidents. In 68 out of 100 cases of myocardial infarction and in 75 out of 100 cases of stroke, patients had long-term elevated blood pressure.
- It has been proven that lowering blood pressure
- even by 3 mmHg. can reduce mortality from stroke by 8%, from coronary heart disease - by 3%.
Arterial hypertension to persistently elevated blood pressure (BP). This is one of the most common diseases.
The only way to know that you have arterial hypertension is to measure your blood pressure!
A level below 130/85 mmHg is accepted as normal blood pressure. Blood pressure between 130/85 and 139/89 is considered elevated and normal.
The diagnosis of arterial hypertension is made when blood pressure is detected above 140/90 mmHg. at least twice during repeated visits to the doctor.
Today there are three degrees of hypertension
| Degrees AG | Systolic blood pressure | Diastolic blood pressure |
| 1 | 140-159 | 90-99 |
| 2 | 160-179 | 100-109 |
| 3 | more than 180 | More than 110 |
There are no symptoms specific to arterial hypertension, but you may suspect this disease if you have:
| If these signs are present |
- attacks of “lightness”;
- dizziness;
- weakness;
- headaches, pain in the heart area;
| Measure blood pressure regularly 3-4 times a day and when symptoms appear and record the results in a diary. |
- noise in ears;
- deterioration of performance and memory;
- flashing “spots” before the eyes, double vision;
- difficulty speaking;
- numbness of the limbs;
- shortness of breath caused by exercise;
- swelling of the legs;
- visual impairment.
Regardless of whether your blood pressure is normal or elevated, be sure to check whether you have risk factors for hypertension and try to reduce their impact on your health:
| Risk factors | Results after risk factor adjustment |
| Excess body weight | A decrease in body weight by 10 kg leads to a decrease in blood pressure by at least 10 mmHg. |
| Physical inactivity | It has been established that regular physical training reduces systolic and diastolic blood pressure by 5-10 mmHg. |
| Chronic stress | With reduced exposure and elimination of stress factors, as well as rest, blood pressure decreases spontaneously. |
| Smoking | Quitting smoking helps reduce blood pressure, cholesterol, fibrinogen in the blood and platelet aggregation activity. |
| Alcohol | Reducing the frequency and dose of a single alcohol intake to 20-30 g of pure ethanol per day for men (200-250 ml of dry wine, 500-600 ml of beer) and 10-20 g for women will avoid the development of hypertension in 11% of men and in 1% of women and reduce the risk of stroke in patients with hypertension by 3-4 times. |
| Excess salt intake | Reducing the consumption of table salt to 4.5 g per day contributes to a significant reduction in blood pressure. |
| Poor nutrition | It has been established that a decrease in systolic and diastolic blood pressure in the population while following the DASH diet leads to a reduction in the incidence of coronary pathology by 15% and strokes by 27%. |
| Coffee | You should not overuse coffee, as drinking 2-3 cups of coffee can increase systolic blood pressure by 3-14 mmHg, and diastolic blood pressure by 4-13 mmHg. |
| You need to measure blood pressure: -at least 2 times a year, if the last time diastolic blood pressure was <85, systolic blood pressure <140 mmHg. -weekly, if the last time diastolic blood pressure was 85-89 mmHg. -daily if systolic blood pressure was >140 and diastolic blood pressure >89 mmHg, especially in the early morning hours from waking up to noon. |
| How to measure blood pressure correctly: 1) one hour before measuring blood pressure, you should not drink coffee or tea, and half an hour before you should not smoke; 2) blood pressure is measured at rest after a 5-minute rest; 3) the hand should be at the level of the heart; 4) clothing should not squeeze the hand; 5) the cuff is placed on the shoulder, its lower edge should be 2 cm above the elbow, the phonendoscope is installed on the brachial artery; 6) pump air into the cuff until the pulsation stops and add another 30 mmHg, then release the air at a speed of approximately 2-3 mmHg. in 1 second; 7) the appearance of pulsation will indicate the figures of systolic blood pressure, the cessation will indicate diastolic blood pressure.
9) if the shoulder circumference is more than 33 cm, it is necessary to use a wider cuff, otherwise the blood pressure numbers will be overestimated. |
to obtain accurate data on blood pressure levels, at least two measurements should be performed;Dietary recommendations for prevention and control
Diet for hypertension (DASH)
| Product groups | Number of servings per day | Portion volume | Product names | Practical significance |
| Grain and grain products | 7-8 | 1 slice of bread, 80g dry ground grain, 120ml boiled rice, oatmeal, corn flakes, etc. | Wheat bread, pita, oatmeal, rolled oats | Main source of energy and fiber |
| Vegetables | 4-5 | 160g raw leafy vegetables, 160g cooked vegetables, 180ml vegetable juice | Tomatoes, potatoes, carrots, peas, pumpkin, broccoli, turnips, cabbage, spinach, Jerusalem artichoke, beans | Foods fortified with potassium, magnesium and fiber |
| Fruits | 4-5 | 180ml fruit juice 40g dried fruit 80g fresh, frozen or canned fruit 1 medium sized fruit | Apricots, bananas, dates, grapes, oranges, orange juice, mangoes, melons, watermelons, peaches, pineapples, plums, raisins, strawberries, tangerines | Important sources of potassium, magnesium and fiber |
| Dairy | 2-3 | 240ml milk, 120ml yogurt, 45g cheese | Skim or 1% milk, skim or reduced fat butter, yogurt, cheese | Greatest sources of calcium and proteins |
| Meat, poultry, fish | no more than 2 | 84g cooked meat, poultry or fish | Choose only lean meats, remove visible fat, bake and poach meats instead of frying; remove the skin from the bird | Foods fortified with protein and magnesium |
| Nuts, seeds, beans | 4-5 per week | 42g nuts, 14g seeds, 80g cooked beans | Almonds, hazelnuts, peanuts, walnuts, beans, lentils | Rich sources of energy, magnesium, potassium and fiber |
The diet is based on eating approximately 2,000 calories per day.
Diet . It is advisable to eat food at least 4-5 times a day, distributing it according to the calorie content of the daily diet approximately as follows: breakfast before work - 30%, second breakfast - 20%, lunch - 40%. dinner - 10%. The last meal should be at least 2-3 hours before bedtime.
| YOUR ENEMIES | YOUR FRIENDS |
| Refined foods such as white bread, rice, pasta. | Cereal derivatives - bran bread, black rice, bran, oat flakes, wheat germ, muesli, barley, buckwheat. |
| Snack food - potato and cheese chips, buttered popcorn. | Nuts, almonds, fruits: apricots, bananas, oranges, grapefruit, pears, puffed popcorn. |
| Roasted vegetables, seafood, poultry. | Baked, steamed vegetables, seafood, poultry. |
| Vegetables in rich sauce, oil. | Vegetables with low-fat sauce, seafood with herbs and low-fat or low-fat cheese. |
| Milk, cheese and whole milk ice cream | Reduced fat milk, yogurt. |
| Large portions of fatty meat, sausages, sausages. | Medium portions of lean meat, meat with vegetables. |
| Pasta with cream and cheese sauce. | Pasta with tomato sauce, olive oil. |
| Pizza with fatty cheese, meat, sausage. | Pizza with vegetables, mushrooms, spinach. |
| Hamburgers, cheeseburgers, fried chicken. | Grilled chicken, baked potatoes. |
| Salads with cream sauce. | Salads with olive and corn oil. |
| Coffee, tea, lemonade, Pepsi-Cola, Coca-Cola. | Vegetable and fruit juices, nectars. |
Physical activity for the prevention of arterial hypertension
Aerobic exercise is indicated because:
- large muscle groups take part in them;
- can be carried out for a long time;
- walking, jogging, swimming, tennis, cycling, rhythmic gymnastics contribute to more intense absorption of oxygen by the body and are beneficial for the heart and blood vessels.
Aerobic physical activity ensures maximum oxygen delivery to organs and tissues, so they must be performed at a certain heart rate, which is calculated individually for each person.
| The easiest way to calculate your training heart rate: Maximum heart rate (HR) = 220 - age (years). The training heart rate should be 50% (lower limit) - 75% (upper limit) of the individual maximum heart rate. This formula is valid for relatively “healthy” people. |
- physical activity should be performed at least 4 days a week;
- The duration of physical activity should be 30-45 minutes per day.
| Anaerobic exercises (weightlifting, bodybuilding, which provide high physical activity for a short time) — for high blood pressure CONTRAINDICATED! |
In case of a sharp increase in blood pressure (hypertensive crisis), it is necessary:
- calm down and ensure a comfortable position;
- unfasten the buttons of your outerwear and open the window;
- restore breathing: take a deep breath, hold your breath and exhale slowly, repeat this several times;
- put mustard plasters on calves;
| A drug | Initial dose | Repeat dose | Tactics |
| CLOPHELINE | 0.15 mg (1 tablet) | 0.075 mg | If after 20-30 minutes the pressure does not decrease by 25% of the initial figures, then you need to take the medicine again. If 20-30 minutes after taking the pills again, the pressure has not decreased, CALL A DOCTOR. |
| CAPOTEN | 25 mg (1 tablet) | 25 mg | |
| ATENOLOL | 50 mg (1 tablet) | 50 mg | |
| NIFEDIPINE | 20 mg (1 tablet) | 20 mg | |
| NITROGLYCERINE | 0.5 mg (1 tablet) | — | |
| FUROSEMIDE | 40 mg (1 tablet) | — |
- take the tablet under the tongue (chew or dissolve), taking one of the following medicines from the first aid kit:
| Shiatsu massage techniques are also used to reduce blood pressure. In this case, a soothing method of influencing massage points is used, i.e. continuous, smooth pressure with a gradual increase in pressure over 3-5 minutes. The massage points are shown in the figure. |
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Treatment of high blood pressure
Treatment of arterial hypertension is based on lifestyle modification, constant monitoring of blood pressure, and the use of antihypertensive drugs (medicines that lower blood pressure) - one or more, based on the patient's individual situation.
Medicines prescribed for high blood pressure include: ACE inhibitors, angiotensin II receptor inhibitors, calcium channel blockers, diuretics, beta blockers, alpha blockers, alpha beta blockers. In most cases, these medications do not cause side effects. However, you should not self-medicate; you should consult a doctor who will select an effective drug and prescribe a regimen for its administration. It is important to follow all recommendations, observe the dosage and not skip taking the drug(s).
When diagnosing arterial hypertension, 24-hour blood pressure monitoring (ABPM) provides an accurate idea of the patient’s blood pressure levels. ABPM also excludes the factor of chance, distortion of real blood pressure readings (the so-called “white coat” syndrome or “white coat” hypertension), and registers imperceptible changes in blood pressure (for example, during sleep). This test is recommended by the American Heart Association to confirm the diagnosis of hypertension.
Bisoprolol
A drug from the group of beta blockers,
which is sold by prescription and comes in tablet form.
Bisoprolol reduces the number of heart contractions and the need for oxygen in the heart muscle. These blood pressure pills reduce the likelihood of developing arrhythmias and angina. Bisoprolol is prescribed for hypertension, for the treatment of coronary heart disease, the drug reduces the risk of heart disease. Contraindications:
chronic and acute heart failure, heart block, bronchial asthma, bradycardia (pulse below 55-60 beats per minute), Bisoprolol is prescribed with caution if the patient is taking diuretics (diuretics).
Bisoprolol
Biocom, Russia
Arterial hypertension.
Coronary heart disease: prevention of attacks of stable angina. from 20
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Prevention of hypertension
Prevention of hypertension is not specific. To reduce the risk of developing the disease, it is recommended to adhere to the rules of a healthy lifestyle:
- Stop smoking and do not abuse alcohol. Alcohol and nicotine destroy blood vessels.
- Normalize weight. Obesity itself can cause hypertension. In some patients, weight loss restores normotension without medication.
- Do physical education. Cardio exercise of at least 150 minutes per week and walking are especially effective for strengthening the cardiovascular system.
- Balance your diet in terms of calories and composition. It is necessary to consume fiber daily and reduce animal fats and salt in food.
- Monitor your drinking regime. Insufficient water leads to blood thickening and retention of toxins. The norm for an adult is 2 liters per day.
If possible, it is better to avoid stress and overexertion, get enough sleep and spend time outdoors.
