Every year the number of people who are diagnosed with hypertension is rapidly increasing. And that's just the official statistics. And a third of them already had a hypertensive crisis. What it is, you need to know not only patients, but also people who do not suffer from hypertension in order to help their loved ones and friends overcome this difficult period.
Everyone knows that the clinical picture of this disease is characterized by high blood pressure due to a violation of the mechanisms of regulation of this process. And the crisis itself is a severe manifestation of the disease, which can lead to irreversible consequences.
Causes of hypertension
In most cases, neuropsychic stress and stressful situations that continue for a long period of time become a prerequisite for the development of hypertension. Therefore, if a person's work activity is carried out inconstant emotional stress, the risk of disease is very high.
Hypertension is often the result of a concussion. Moreover, the disease may not appear immediately after the injury, but after a few weeks or even months. Therefore, many patients do not even associate a concussion with the occurrence of hypertension.
Hereditary predisposition is also one of the first places in the list of causes of this disease. So, if someone in the family had hypertension, the disease can manifest itself in the heirs, regardless of age and lifestyle. Therefore, people in this risk group should think about preventing the disease even before the onset of the first symptoms.
Another cause of hypertension is age-related physical inactivity, in which in the human body, due to the aging process, there is a violation of the vital functions of the body, one of which is blood circulation. Against the background of this natural process, atherosclerosis can occur, which can be aggravated by hypertension. The danger of the disease lies in the fact that the blood flow to the vital organs is significantly reduced. And if atherosclerotic deposits, the so-called plaques, are present in the vessels, then a stroke and even myocardial infarction are possible.
For the fair sex, a dangerous period when hypertension can occur is the time of restructuring the female body during menopause. In addition, the risk increases several times with excessive s alt intake andsmoking.
Hypertension symptoms
One of the first symptoms by which you can recognize the disease is, of course, high blood pressure. In a he althy person, these indicators should not exceed the boundary norm at rest 130/85. With emotional stress or physical exertion, these values \u200b\u200bcan increase by 10-15 units, but after a few minutes of rest they should return to normal. In patients with hypertension, blood pressure exceeds the permissible figures even in a calm state, and in stressful situations, the indicators increase significantly.
In addition to high blood pressure, the disease is characterized by headache. This is due to spasm and narrowing of the vessels of the brain. Often patients also complain of tinnitus, general weakness, blurred vision, frequent dizziness and a feeling of heaviness in the head. And all these signs appear already at the initial stage of hypertension. Feeling even one of these symptoms in combination with high blood pressure, you should immediately seek qualified medical help in order to prevent further development of the disease. Neglect of treatment at the initial stage of the development of hypertension can lead to the fact that a hypertensive crisis will occur. What it is and what the consequences may be, it is necessary to understand in more detail.
So what is it?
Under this frightening concept of “hypertensive crisis”, the causes of which we examined, doctors mean a sudden deterioration in the condition of a patient with hypertension, in which blood pressure indicators are at the level220/120 and above. If a person in such a state is not provided with the first necessary medical aid, the disease can lead to irreversible consequences, such as a stroke, heart attack, etc. However, given the level of modern medical equipment, such complications are very rare today.
Even if the crisis was managed to stop at home, it is necessary to consult a doctor on the same or the next day. The specialist will take all the necessary measures to examine the condition and prescribe systematic therapy, which will avoid the occurrence of such situations.
Mechanism of occurrence of hypertensive crisis
Just like hypertension, a hypertensive crisis occurs because the balance between vascular tone and minute volume of blood, which is pushed into the vascular bed by the heart, is disturbed. In a state of crisis in a patient with sufficiently powerful heart contractions, a spasm of small arterioles (vessels) occurs. The consequence is an increase in blood pressure to very high levels and a violation of the delivery of the required amount of oxygen to tissues and organs. It is the latter factor that explains the frequent development of ischemic complications, such as strokes and heart attacks.
Exogenous causes of hypertensive crises
Even a slight increase in blood pressure may indicate that hypertension is beginning to develop. The risk in this disease is mainly associated not even with the occurrence of crises, but with their consequences. Therefore, in order toto prevent deterioration of the patient's condition, it is worth, if possible, to exclude its main exogenous causes.
The impetus for the development of a hypertensive crisis is often psycho-emotional stress and great physical overwork. Therefore, patients with hypertension should be more attentive to the rhythm of their lives, and sometimes even give up their favorite sport or responsible work.
To reduce the risk of a hypertensive crisis, it is necessary to reconsider not only your life priorities, but also your own diet. Trusted s alt should be excluded from it or its consumption should be reduced to a minimum. After all, it is this component of all dishes that prevents the removal of fluid from the body, the amount of which also needs to be reduced. Even at the initial stage of hypertension, the volume of drinks and water should be reduced, especially coffee.
Not so often, a hypertensive crisis can also be the result of irrational therapy. Most often, patients who neglect the recommendations of doctors and independently cancel the intake of antihypertensive drugs become hostages of this situation. Also, a crisis can occur when adrenergic drugs are administered against the background of long-term use of sympatholytics. Therefore, it is important when contacting a specialist to report those drugs that were used during the previous period.
Endogenous factors in the occurrence of crises in hypertension
If we exclude the causes of hypertensive crisis, which depend on external factors, it is possible that endogenous effects cannot be prevented. So,for example, patients with coronary artery disease are at risk, especially during periods of its exacerbation. This list is supplemented by those who suffer from cerebrovascular disorders, pain syndromes of various origins, etc.
If we consider the age criterion of the risk group, then it includes people in the second half of life, from about 35 years old. Exacerbations of focal infections can also provoke a hypertensive crisis, which is understandable. Indeed, at the time of the development of the inflammatory process, all the forces of the body are aimed at stopping the focus, which makes the activity of other vital organs and systems unprotected.
This disease is especially dangerous for women. Hypertension can slowly progress for many years, and manifest itself during age-related hormonal changes.
Classification of hypertensive crises
Today, in medical practice, the division of crises in hypertension into two main types is used. The first is due to an excessive release of adrenaline and manifests itself when arterial hypertension is just beginning to develop. This type of crisis is characterized by an increase in systolic blood pressure. The duration of this state can be calculated both in minutes and hours. It is characterized by such clinical manifestations as headache, trembling in the body, hyperemia and local hyperhidrosis of the skin, rapid pulse and high systolic pressure. The crisis is stopped quickly enough and does not lead to particularly serious consequences.
The second type most often develops in people suffering from advanced stages of arterial hypertension,and it is due to a large amount of norepinephrine in the blood. The clinical picture of this condition is characterized by a sharp increase in diastolic pressure, in rare cases also systolic. Patients complain of severe headaches, blurred vision, lethargy, vomiting and nausea. This state may even last for several days. And if measures are not taken to stop the crisis, it is simply impossible to predict how difficult the consequences will be. Indeed, at this time, when arterial hypertension is in the acute phase, not only circulatory disorders of the brain with characteristic symptoms or a true stroke can develop, but also kidney damage, left ventricular failure, myocardial infarction.
Clinical picture
Characteristic symptoms for this dangerous condition is a sharp pain in the occipital region of the head. The condition is aggravated by a feeling of strong pulsation in the temple area, as well as nausea and vomiting, which does not bring relief. Most patients have an unreasonable feeling of fear and anxiety even for the slightest reason, hyperemia and swelling of the face may also appear, and vision may deteriorate. In addition, during a hypertensive crisis, various neurological disorders occur, which are accompanied by dissociation of reflexes.
Depending on the violation of the type of hemodynamics, the variant of the increase in blood pressure and the pathophysiological mechanism for the development of an acute manifestation of hypertension, the symptoms may be more extensive. That is why it is so important whenthe first of the above symptoms seek qualified help and prevent all possible consequences.
Complications
If hypertension is diagnosed, treatment should be started immediately, as this disease can cause many serious ailments. Due to a hypertensive crisis, the patient may develop acute left ventricular failure, acute ischemic stroke, myocardial infarction, hemodynamic angina, renal failure, and many other serious diseases. All these complications can not only significantly undermine human he alth, but also cause death.
Treatment of hypertensive crises
Often, when a person has a hypertensive crisis, what it is and what measures should be taken, he simply does not know. And he perceives his condition as a natural manifestation of hypertension. And then he regrets his carelessness. In order not to end up in such a situation, the patient and his family should find out what kind of care should be provided for a hypertensive crisis and what drugs should always be in the home medicine cabinet. Such foresight can not only alleviate the condition and prevent complications, but sometimes even save a life.
Of course, a hypertensive crisis of any severity, type and genesis requires a differentiated treatment algorithm, so you should immediately seek qualified medical help. And while the ambulance team has not arrived, it is necessary to alleviate the condition as much as possiblepatient, providing him with bed rest and complete rest. If the blood pressure indicators are in the critical zone, it is necessary to try to stabilize the vascular system with the help of medications. But it is worth remembering that lowering blood pressure should be gradual in order to avoid acute vascular accidents. During the first 60 minutes, the indicators should be reduced by 15-20%, and over the next 2-6 hours, bring the value of blood pressure to 160/100 mm Hg. Art. Only such an algorithm in a hypertensive crisis will allow stabilizing the patient's condition without harm to his he alth.
In an uncomplicated crisis, the drug "Nifedipine" is used, which blocks calcium channels, relieves spasm and dilates blood vessels. Also used are vasodilators that reduce the load on the heart, such as Diazoxide and Sodium Nitroprusside. As ACE inhibitors, the drugs Captopril and Enalapril are used. Of course, other groups of drugs can be used to stop the crisis, but they, like the treatment of hypertension, should be prescribed directly by the doctor.
As for the symptomatic treatment of hypertensive crises, it includes the introduction of antiarrhythmic, analgesic, antianginal, sedative, antiemetics, as well as diuretics and cardiac glycosides. Doctors recommend using oxygen therapy and distraction treatments such as mustard plasters and hot foot baths.
Hypertension treatment
Since a hypertensive crisis is nothing more than an exacerbation of hypertension, it is worth knowing how to treat itto each. And the first thing to start with is an appeal to a cardiologist, because it is this specialist who will be able to tell at what stage of development the disease is currently at. Hypertension is treated not only with medications, this process consists of a set of measures aimed at stabilizing blood pressure and preventing crises.
After receiving the results of the examination, the doctor will prescribe a course of treatment that can maintain normal blood pressure. For this, b-blockers can be used that reduce heart rate and vascular resistance, such as Metoprodol, Visken, Atenolol and others. Another group of drugs to lower blood pressure are ACE inhibitors - inhibitors that block the production of renin. It includes Methiopril, Moex, Spirapril, Kapoten. Often, a patient with hypertension is prescribed diuretics, which remove excess fluid from the body. However, these medications should be handled with extreme caution, as many of them can leach out beneficial potassium.
It is completely impossible to get rid of hypertension, because the walls of blood vessels have been adapting to high pressure for a long time, and therefore it will not be possible to return them to their previous shape. Therefore, in addition to systematic therapy, it is necessary to constantly monitor blood pressure indicators and, at the right time, quickly respond to acute manifestations of the disease.
Prevention of hypertension and hypertensive crises
If we take into account that the hypertensive crisis is the "brainchild" of hypertension, then their preventive measuresalmost identical. And the first place in this list, of course, is occupied by a rational regime of rest and work. If possible, you should avoid exhausting physical exertion, compensate for the expended strength with a full sound sleep. This is especially important for those who already suffer from hypertension and want to prevent a possible hypertensive crisis. What it is, you can learn from your own experience if you abuse alcohol and nicotine, so these bad habits should be abandoned immediately. It is also worth reviewing the daily diet, excluding s alt, as well as fatty and spicy dishes from it.
In addition, if hypertension has already appeared, treatment should be carried out strictly in accordance with the doctor's instructions and do not stop taking antihypertensive drugs on your own. The latter action can provoke the body to respond to drug withdrawal with a hypertensive crisis.
