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HYPERTENSION:

BLOOD PRESSURE. ARTERIAL PRESSURE.
06.07.2020

Blood pressure is the pressure in the blood vessels (blood pressure in the arteries, capillary pressure in the capillaries and venous pressure in the veins). Pressure allows blood movement through the circulatory system, whereby metabolic processes occur in the body tissues.

Arterial pressure level is determined mainly by the cardiac contractibility, the amount of blood pumped by the heart with each contraction, the resistance provided against blood flow by blood vessel walls (especially peripheral vessel walls). The amount of circulating blood, its viscosity, pressure fluctuations in the abdominal and chest cavities due to respiratory movements and other factors also affect the blood pressure.

Maximum blood pressure is reached during the contraction (systole) of the left ventricle. With this, 60-70 ml of blood is pushed out of the heart. This amount of blood cannot pass directly through small blood vessels (especially capillaries), so the elastic aorta stretches out and the pressure in it increases (systolic pressure). Normally it reaches 100-140 mm Hg in large arteries.

During the pause between contractions of the ventricles of the heart (diastole), the walls of blood vessels (aorta and large arteries), being stretched, begin to contract and push the blood into the capillaries. Blood pressure gradually drops and by the end of the diastole reaches a minimum value (70-80 mmHg in large arteries). The difference in the size of systolic and diastolic pressure, more precisely the fluctuations in their values, we perceive as a pulse wave, which is called the pulse.

Blood pressure in the blood vessels decreases as it is removed from the heart. For example, the pressure in the aorta is 140/90 mmHg (the first digit stands for systolic or upper pressure and the second for diastolic or lower pressure). In large arteries, the pressure is on average 120/75 mm Hg. In arterioles, there is practically no difference in systolic and diastolic pressure, and blood pressure is about 40 mm Hg. In capillaries, the blood pressure drops to 10-15 mmHg. When blood passes into the venous channel, the blood pressure drops more, and in the largest veins (upper and lower hollow veins) blood pressure may be negative.

Normally, the amount of blood pressure depends on individual characteristics, lifestyle and occupation. Its magnitude changes with age, increases with physical activity, emotional stress, etc. However, in persons systematically engaged in heavy physical labor, as well as in athletes, the value of systolic pressure may decrease and be 100-90, and diastolic - 60 or even 50 mmHg.

Approximate values of blood pressure in different age periods:

The normal blood pressure of a healthy adult is 100-129 (upper) and 70-80 (lower). If the pressure is higher than these values, but lower than 140 (upper) and 90 (lower), it is called "normal high".
In children, the value of systolic pressure can be roughly calculated by the formula 80 + 2a, where a is the number of years of life of the child.

Despite significant fluctuations in blood pressure (e.g. depending on the load, emotional state, etc.), the body has complex mechanisms for regulating its level, trying to return the pressure to normal at the end of these factors. In some cases, the mechanisms of this regulation are disturbed, which leads to changes in blood pressure levels. Persistent upward change in blood pressure is called arterial hypertension (hypertension), and downward change in blood pressure is called arterial hypotension. Although a change in blood pressure often plays a protective role, it is better to consult a physician if it deviates from the norm.

Hypertensive disease

Hypertension accounts for up to 90% of all cases of chronic blood pressure rise. In economically developed countries 18-20% of adults suffer from hypertension, i.e. they have repeated blood pressure rises up to 140/90 mmHg and higher. They focus on the values of the so-called "random" pressure measured after a five-minute rest, in sitting position, three times in a row (the lowest values are taken into account). During the first examination of a patient, the doctor measures blood pressure necessarily on both arms and, if necessary, on the legs.

Symptoms and course of hypertension

Hypertension usually occurs at the age of 30-60 years, it is chronic with periods of deterioration and improvement. 

I HYPERTENSION STAGE (MILD)

  • is characterized by blood pressure rises within the range of 160-180/95-105 mm Hg. This level is unstable and gradually normalizes during rest. Pain and noise in the head, disturbed sleep, decrease in cognitive performance. Occasionally, dizziness, nosebleeds. 

II HYPERTENSION STAGE (MEDIUM)

  • higher and more stable blood pressure level (180-200/105-115 mmHg at rest). Headaches and pain in the heart area are worsening, dizziness. Possible hypertensive crises (sudden and significant increases in arterial pressure). There are indications of damage to the heart, central nervous system (transient cerebral circulation disorders, strokes), changes in the ocular floor, reduced blood flow in the kidneys. 

III HYPERTENSION STAGE (SEVERE)

  • blood pressure reaches 200-230/115-130 mm Hg, it does not normalize independently. Such a load on the vessels causes irreversible changes in the heart (angina, myocardial infarction, heart failure, arrhythmias), brain (strokes, encephalopathy), eye (retinopathy), kidneys (reduced blood flow, filtration, chronic renal failure).


This stage of hypertension is determined based on the data of systematic measurement of arterial pressure, detection of specific fundus changes, and specific changes displayed in electrocardiogram.

Hypertension must be distinguished from secondary arterial hypertension (symptomatic) arising from diseases of the kidneys, renal vessels, endocrine organs (Icepko Cushing's disease, acromegaly, primary aldosteronism, thyrotoxicosis), circulatory disorders (atherosclerosis of the aorta, aortic valve failure, complete atrial-ventricular blockade, aortic coarctation).

Treatment

Non-drug: weight loss, restriction of table salt consumption, spa treatment, physiotherapeutic procedures.

The doctor prescribes medical treatment, which may include all kinds of drugs reducing blood pressure (enalapril, metoprolol, etc.), diuretic (hypothiazid, brinaldix, triampur, etc.), etc. At the same time, the selection of therapy should be carried out purely on an individual basis.

Hypertensive patients are therefore not allowed to: 

  • Eat salty, spicy, fatty foods.
  • Gain extra weight.
  • Drink too much alcohol, especially to combine alcohol with medication intake.
  • Work nights, sleep less than 7 hours.
  • Be nervous for nothing.
  • Live a sedentary lifestyle.
  • Skip or stop taking medication prescribed by their doctor.
  • Take medications that “have helped” your neighbor (brother, friend, etc.).


It is necessary to do the following:

  • Quit smoking.
  • Restrict salt consumption. Herbs can be used to make dishes savory.
  • Eat more greens, fruits, foods rich in potassium, and not be addicted to protein foods.
  • Eat regularly, especially if food is occasioned with medication intake.
  • Try to work off excess weight.
  • Try to stay calm and not let things upset you too much.
  • Move more. Walking, swimming, therapeutic gymnastics are especially useful.
  • Use a blood pressure monitor and measure arterial pressure on a regular basis.
  • Follow all of the doctor's recommendations. Particular care should be taken when taking medication.


Hypotension

Hypotension
(primary chronic hypotension, essential hypotension) is a disease associated with an impairment of the nervous system function and neurohormonal regulation of vascular tone, which is accompanied by a decrease in arterial pressure. The original background of such a condition is fatigue associated with psycho-traumatic situations, chronic infections, intoxication (occupational hazards, alcohol abuse), and neuroses.

Symptoms and course

Patients are sluggish, apathetic, they feel weak and exhausted in the morning, do not feel vivacity even after a long sleep; memory deteriorates, scattered brain, volatile attention, reduced working capacity, the patient constantly worries about feeling short of breath, violation of potency and sexual attraction in men and menstruation in women.

Emotional instability, irritability, hypersensitivity to bright light, loud speech prevails. Usually headache is often associated with fluctuations in atmospheric pressure, abundant food intake, prolonged stay in an upright position. Headache occurs as a migraine with nausea and vomiting, and decreases after a walk in the fresh air or physical exercise, rubbing of temporal areas with vinegar, applying of ice or a cold towel onto the head. Dizziness, swaying when walking and fainting also occur. Arterial pressure is usually slightly or moderately decreased to 90/60-50 mm Hg.

This stage of hypotension is determined based on clinical signs and after exclusion of diseases accompanied by secondary arterial hypotension (Addison’s disease, pituitary failure, Simmonds’ disease, acute and chronic infections, tuberculosis, peptic ulcer, etc.).

Treatment

Correct work and rest routine. The attending physician may prescribe sedatives and tranquilizers (Mesaton, Ephedrine), as well as medicines that stimulate the central nervous system (ginseng tincture, Chinese lemongrass, devil’s-club, pantocrine, etc.). Possible physiotherapeutic (baths, massage), spa treatment, therapeutic exercise.

Something interesting

Does a person’s character have any impact on the development of arterial hypertension? Not directly, but indirectly. If a person is nervous and quick-tempered, this does not mean that they will necessarily suffer from hypertension. However, if there is genetic predisposition, the occurrence of hypertension is quite possible. It is important to cultivate the correct psychological attitudes and not to worry constantly for any reason.

A person who knows how to relax, find a source of positive emotions, whether it is a hobby, communication with a pleasant interlocutor or pets  will be obviously less prone to stress, hence, to drops in arterial pressure.

We recommend using Dr. Chekhov's "prescription": "Life is a most unpleasant thing, but it's very easy to make it beautiful... you need: a) to be able to content yourself with the present and b) to enjoy the consciousness, which could be worse".