Arterial hypotension

Arterial hypotension

"A hungry man faints, a saturated man falls to bed ..." (Visob)

What is it?

This phenomenon is already a physiological explanation. After eating, a number of people have a decrease in blood pressure, why they feel drowsiness (the so-called postprandial hypotension).

If the "fall" of blood pressure becomes a system, and it begins to cause inconvenience, then one can already talk about arterial hypotension and, in some cases, hypotonic disease.

Arterial hypotension (AH) is acute and chronic.

Acute AH (collapse [toxic vascular injury], shock [paralytic vasodilation] is usually accompanied by a decrease in oxygen intake (hypoxia) in the brain and a decrease in the functions of vital organs.The severity of the condition is determined here not so much by the height of arterial pressure as by the speed and degree of its decrease.

Acute hypertension may occur with acute circulatory insufficiency, severe acute intoxication (alcohol, drugs, drugs, especially fast - and short-acting, for example, clonidine, corinfar, hood, etc.)), acute infection and sepsis, blood loss, dehydration. Thus, acute hypertension is, as a rule, a complication of the disease, has an obvious cause, which should, first of all, be taken into account in emergency treatment.

Persons prone to chronic arterial hypotension (CAG), as a rule, are not exposed in the long term to such a high risk of cardiovascular complications as "hypertensive persons" and they, unduly, receive much less attention. Criteria for the XAG and its distribution.

Blood pressure (BP) is usually considered low if it is: SBP / DBP = 100/60 mm Hg. Art. And less in men and 95/60 mm Hg, respectively. Art. And less in women. Pay attention to the high (up to 6.7%) frequency of it in young men and young people (Gridnev RI et al., 2004). In recent decades, the emphasis has shifted towards older age groups, in which XAG can cause ischemic stroke.

Causes and classification of CAG

CAG in general is due to violations of the regulation of blood pressure. These violations can have different nature, for the recognition of which is important, above all, carefully collected history and disease, a comprehensive examination of a therapist's doctor.

In a simplified version, the classification of AH is as follows

Physiological hypertension

  • Individual variant of the norm (so-called normal low blood pressure);

  • AH of high fitness (sports AH);

  • AG adaptive (compensatory, characteristic for highlanders, tropics, the Arctic).

Pathological hypertension

  • Acute (collapse, shock, etc.);

  • Orthostatic hypertension (with a change in body position);

  • AH neurocirculatory (with unstable reversible course and pronounced persistent form [hypotonic disease]);

  • Chronic secondary (symptomatic) hypertension with orthostatic syndrome, without orthostatic syndrome (as a manifestation of the underlying disease).

Manifestations of the CAG

The peculiar and sometimes basic manifestation of CAG of any nature can be orthostatic (postural) hypotension - an additional decrease in systolic blood pressure by 20 mm Hg. Art. And more and diastolic by 10 mm Hg. Art. And more directly after a transition from a horizontal position to a vertical position, which is usually maintained for 1-3 min. They often appear in the morning, accompanied by a deterioration in the blood supply to the brain - dizziness, darkening in the eyes, noise in the ears, sometimes fainting (with the danger of ischemic stroke), falling (with the possibility of injuries and fractures), especially in the elderly. Orthostatic hypotension is facilitated by prolonged bed rest, severe illnesses, operations, many medicines.

Common manifestations of CAG, in addition to the above, are weakness, fatigue, nervousness, fatigue in the morning, poor performance, headaches, a tendency to fainting, and sometimes pain in the heart. Characteristic is also poor tolerance of cold, heat, stuffiness, physical exertion, chilliness.

Neurocirculatory dystonia (NDC) is the most common cause of CAG, especially in young adults. In addition, CAG is sometimes combined with other disorders of the autonomic nervous system: bradycardia (a rare pulse), sweating, increased gastric secretion (manifested by heartburn), digestive disorders, a tendency to hypoglycemia (lowering blood glucose). CAG in NCDs, even with severe symptoms and poorly treatable, usually does not pose a threat to life, but significantly impairs the quality of life.

Somatic pathology as the cause of CAG includes diseases that can be accompanied by a decrease in cardiac output, excessive expansion of peripheral vessels, a decrease in the volume of circulating blood. These are chronic heart failure, valvular stenosis, arrhythmias; Kidney, adrenal, thyroid, anemia (anemia), varicose veins; starvation; Insufficiency of the pituitary gland (iron in the brain) of a different nature. Therefore, a patient with hypotension should undergo a comprehensive examination with the therapist.

CAG treatment is a problem of normalizing a lifestyle style. General measures - regular exercise in the air in the training regime, sufficient sleep and rest, refusal of alcohol - can eventually improve vegetative regulation.

Food

It is advisable to exclude from the diet sharp, salty and smoked dishes. You can not overeat. It is very important to eat at least 4 times a day, and at the same time.

In the morning it is recommended to drink a cup (100 g) of the decoction of the following composition: pharmacist officinalis, basil, birch leaf, yarrow flowers, verbena herbal grass, clary sage flowers and St. John's wort. Take 50 grams of dry raw materials of each kind, add 100 g of dry grass gravel of urban, then 2 tbsp. Spoons of this mixture are combined with 1 teaspoon of juniper berries, pour 0.5 liters of boiling water, grind on low heat for 5-10 minutes, filter.

It is desirable for hypotenics to include in their diet mainly dairy and vegetable food with an abundance of fruits and vegetables, as well as foods containing high-grade proteins (lean meat, fish, cheese, cottage cheese, soy products).

For lunch it is recommended to salad from equal parts of sweet onions, parsley and black radish (grate 30 minutes before eating), seasoned with a small amount of olive oil with grape or apple cider vinegar. At lunch, you can eat 100-150 grams of low-fat meat (veal, poultry, boiled fish).

For dinner - dishes without meat: vegetables, pasta, fresh fruit compotes, kefir or yogurt with the addition of 1-2 st. Spoons of raw grated celery root or dried apricots, dried bread. After eating at lunch and in the evening, you can consume 100 grams of dry wine, then - a cup of natural coffee.

2 hours after eating, drink a cup of broth from a mixture of leaves of black currant, melissa herb, sweet potato, basil, camomile, camellia flowers. Take 50 g of each type, then 2 tbsp. Spoons of this mixture are poured into 0.5 liters of boiling water, cooked under the lid for 10 minutes, cooled, filtered.

Inhabitants of southern regions suffering from hypotension, we can recommend regular intake of mulberry (mulberry) fruits: in summer - fresh, in winter - in the form of jam, jam, juice and wine. The most useful is the blackberry mulberry.

It is very useful to hypotonic patients to include in the diet dishes from oatmeal (porridge, oatmeal, whole-grain decoction).

If possible, it is necessary to eliminate the factors contributing to the maintenance of the CAG.

If the patient has orthostatic hypotension, he should be taught to rise from bed not immediately, to sit for 1-2 minutes before getting up. The reaction softens if you sleep with the raised head of the bed. Postprandial hypotension can be gradually eliminated if eat more often and in small portions. Medications that promote hypotension should be partially or completely abolished.

Some activities - work on transport, at a height, near moving machinery, work in conditions of heat, in stuffiness, in contact with vibration, electromagnetic radiation, mercury - for various reasons are not suitable for patients prone to dizziness and fainting.

In cases when, against the background of general measures, the patient retains the associated clinical symptomatology associated with XAG, it is necessary to prescribe medications.

Toning preparations - usually 2 r / day - in the morning and at lunch (but not in the evening)

  • Pantocrinum 30 drops per dose or 1 ml and / to 1 p / day

  • Tincture of Schisandra 20-30 drops before meals

  • Ginseng tincture of 15-25 drops

  • Saparal for 0,05 g 2-3 r / day for 15-30 days

  • Eleutherococcus fluid extract, leuzea liquid extract, tincture tincture, aralia tincture - 15-30 drops per reception.

  • Caffeine 0,05 g inside 2-3 r / day.

  • Securinin 0.002 g or 10-20 drops of 0.4% solution.

  • Vitamins B1 and C.

  • With vagotonia (predominance of bradycardia) - preparations of belladonna (belloid, bell-taminal).

  • With severe AG-deoxycorticosterone, acetate 0.5% r-1 ml IM in a day (usually for a course of 10-12 injections). Side effects - edema, impaired kidney function.

  • The use of a-adrenostimulating agents (midodrine hydrochloride - Gutron, Nycomed). The drug is usually prescribed an average of 7 drops of 2 r / day (morning and evening) or 1 tab. 2 p / day.

Obligatory recommended resort treatment and physiotherapy: oxygen or white turpentine baths.

One should not forget about phytotherapy, this is the case when you cannot do without it.

In hypotonic disease, it is advisable to use plants that do not stimulate as much as regulate the tone of the vasomotor center and metabolic processes in the heart and wall of the vessels. They can be used both individually and as part of complex fees.

Here are simple and effective prescriptions for some phytospores:

  • dandelion roots - 2 parts, nettle grass - 1 part, veronica medicinal grass - 2 parts, roots of elecampane - 1 part, fruits of hibernation - 2 parts, horsetail grass - 1 part, prickly leaves of prickly thorn - 5 parts, herb hyssop - 1 part, birch leaves - 2 parts, strawberry forest grass - 2 parts;

  • leaves of raspberry forest - 1 part, leaf of plantain - 1 part, fruits of wild strawberry - 3 parts, cumin fruits - 1 part, hibernating herb grass - 1 part, black mauve grass - 2 parts, hips - 2 parts.

The courses of treatment with these fees are 3-4 weeks with breaks of 7-10 days.

The total duration of treatment is 3-4 months. Normalization of blood pressure and improvement of patients' well-being usually begins after 2-3 weeks.

In order to avoid recurrences of the disease, it is recommended to take these charges in spring and autumn (even at normal pressure) for 1.5-2 months.

Remember the food in Cambridge, than not the phytobar, only not for $ 20, but much cheaper, if not free. By the way, our grandmothers and great-grandmothers used phyto-tea, figuratively speaking, even when Cambridge was not "born".

With reduced blood pressure in the elderly and general weakness, it is recommended to use royal jelly: 1 g of fresh natural milk is mixed with 100 g of honey and taken 0.5-1 teaspoonful 3 times a day during or after a meal (stored in a refrigerator ).

In the treatment of hypotension, successful procedures are used such as hot chest wraps, white turpentine baths according to A. Zalmanov, cool and cold baths, wipes, douches and showers, aromatic body massage.

Vladimir Baksheev

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