Before prescribing treatment for patients with arterial hypertension , 24-hour blood pressure monitoring is performed. This is necessary in order to establish a hypertension profile. In determining the diurnal changes in blood pressure, adequate medication is selected.
Treatment of hypertension includes non-pharmacological agents and pharmaceuticals. Non-drug therapy of this disease consists, first of all, in maintaining a healthy lifestyle. Of great importance is the normalization of night sleep, the restriction of the use of salt, the complete cessation of smoking and drinking alcohol, weight loss and regular physical activity.
Drug treatment of hypertension is the appointment of pharmaceutical preparations of the following groups:
- diuretics
- beta-blockers
- angiotensin converting enzyme inhibitors
- calcium antagonists
Diuretics are one of the most popular drugs for lowering blood pressure. Pressure reduction occurs as a result of a decrease in fluid volume. An undesirable effect of their use is a decrease in sexual activity, photosensitivity, pancreatitis, an increase in total cholesterol, muscle weakness, dizziness, decreased appetite, and hypokalemia. For potassium-sparing diuretics, on the contrary, the development of hyperkalemia is characteristic, which can lead to the development of endocrine disorders, intrahepatic cholestasis, and a violation of the rheological properties of the blood.
Beta-blockers lower blood pressure by reducing cardiac output and inhibiting renin synthesis. They combine well with diuretics and calcium antagonists. When treating with beta-blockers, it is necessary to strictly adhere to the prescribed dose of the drug. An overdose is manifested by the development of severe bradycardia, hypotension, impaired cardiac conduction. In patients with concomitant bronchial obstruction, progressive bronchospasm may develop. These drugs should not be prescribed to patients with bronchial asthma, insulin-dependent diabetes mellitus, and peripheral vascular disease. Treatment of hypertension with beta-blockers begins with small doses, controlling heart rate and blood pressure, in the absence of complications, the dose of the drug is increased.
ACE inhibitors are powerful vasodilators, with which for a long time it is possible to block the influence of the main pressor factor - angiotensin. These drugs prevent the breakdown of bradykinin, help increase blood levels of vasodilator prostaglandins, and help with heart failure. Undesirable effects of these drugs are cough, angioedema, hyperkalemia, skin rash, dizziness, loss of appetite and taste disturbance. The main contraindication for the use of ACE inhibitors is bilateral narrowing of the renal arteries, as in this case, blood pressure increases due to an increase in blood renin, which these drugs do not act on.
Calcium antagonists reduce heart rate, lower blood pressure, but have some negative qualities, including severe headache, facial redness. Currently, these drugs are mainly used to treat hypertensive crises.
The treatment of hypertension depends on the degree of the disease. At 1 degree, non-drug treatment is mainly used. Hypertension of the 2nd degree requires the appointment of a course of treatment with medications. With a disease of the 3rd degree, drug treatment should be constant.
Preventing the development of any disease is not as difficult as treating it. Prevention of hypertension is the elimination of the etiological factors of the disease, adherence to a healthy lifestyle.