Every year, the number of people diagnosed with hypertension is rapidly increasing. And these are only official statistics. And a third of them have already had a hypertensive crisis. What it is, you need to know not only the sick, but also people who do not suffer from hypertension, 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 regulation mechanisms of this process. And the crisis itself is a serious manifestation of the disease, which can lead to irreversible consequences.
Causes of Hypertension
In most cases, the prerequisite for the development of hypertension is neuropsychic stress and stressful situations that last for a long period of time. Therefore, if a person's working activity is carried out in a constant emotional stress, the risk of a disease is very high.
Often, hypertension is the result of a concussion. Moreover, the disease may not appear immediately after the injury, but after several weeks and even months. Therefore, many patients do not even associate concussion with the occurrence of hypertension.
Hereditary predisposition also occupies one of the first places in the list of causes of this disease. So, if someone had hypertension in the family, the disease can occur in the heirs, regardless of age and lifestyle. Therefore, people in this risk group should think about the prevention of the disease before the onset of the first symptoms.
Another cause of hypertension is age-related inactivity, in which a violation of the vital functions of the body occurs in the human body due to aging processes, one of which is blood circulation. Against the background of this natural process, atherosclerosis can occur, which can be exacerbated by hypertension. The danger of the disease lies in the fact that the flow of blood to 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 the restructuring of the female body with menopause. In addition, the risk increases several times with excessive salt intake and smoking.
Symptoms of hypertension
One of the first symptoms by which a disease can be recognized is, of course, high blood pressure. In a healthy person, these indicators should not exceed the boundary norm at rest 130/85. With emotional stress or physical exertion, these values can increase by 10-15 units, but after a few minutes of rest they should return to normal. In patients with hypertension, blood pressure exceeds acceptable values 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, a veil before the eyes, frequent dizziness and a feeling of heaviness in the head. And all these signs are manifested already at the initial stage of hypertension. Having felt even one of these symptoms in combination with high blood pressure, you should immediately seek qualified medical help in order to prevent the further development of the disease. Neglect of treatment at the initial stage of the development of hypertension can lead to a hypertensive crisis. What it is and what the consequences may be, it is necessary to understand in more detail.
So what is it?
By this concept that scares everyone, “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 levels are at a level of 220/120 and higher. If in this state a person does not receive the first necessary medical care, the disease can lead to irreversible consequences, such as a stroke, heart attack, etc. However, given the level of modern equipment of medicine, such complications are very rare today.
Even if the crisis was stopped at home, you need to consult a doctor the same or the next day. The specialist will carry out all the necessary measures for examining the condition and prescribe systematic therapy, which will avoid the appearance of such situations.
The mechanism of hypertensive crisis
Just like hypertension, a hypertensive crisis arises because the balance between the vascular tone and the minute volume of blood is disrupted, which is pushed into the vascular bed by the heart. 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 rates and a violation of the delivery of the required amount of oxygen to tissues and organs. It is the last 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 onset of crises, but with their consequences. Therefore, to prevent the deterioration of the patient's condition, it is 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 abandon their favorite sport or responsible work.
To reduce the risk of a hypertensive crisis, it is necessary to review not only your life priorities, but also your own diet. Attached salt should be excluded from it or its consumption should be minimized. 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 for coffee.
Not so often, a hypertensive crisis can also result from irrational therapy. Most often, patients who neglect the recommendations of doctors and independently cancel the use of antihypertensive drugs become hostages of this situation. A crisis can also occur when adrenergic drugs are administered against the background of prolonged use of sympatholytics. Therefore, it is important when contacting a specialist to report on those medicines that were used during the previous period.
Endogenous factors for the emergence 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, at-risk patients include coronary heart disease, especially during periods of 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 of the second half of life, from about 35 years old. Exacerbations of focal infections can also trigger 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 progress poorly for many years, and manifest itself during age-related hormonal changes.
Classification of hypertensive crises
To date, medical practice uses the division of crises in hypertension into two main types. The first is due to excessive adrenaline rush and manifests itself when arterial hypertension is just beginning to develop. This type of crisis is characterized by an increase in systolic blood pressure. By duration, this condition can be calculated both in minutes and in 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 stops quickly enough and does not lead to particularly serious consequences.
The second type most often develops in people suffering from late stages of arterial hypertension, and it is caused by 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, visual impairment, lethargy, vomiting and nausea. This condition can continue even for several days. And if you do not take measures 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 an exacerbation phase, not only blood circulation disorders of the brain with characteristic symptoms or true stroke may develop, but also kidney damage, left ventricular failure, myocardial infarction.
Clinical picture
The characteristic symptoms for this dangerous condition is a sharp pain in the occipital region of the head. The condition is aggravated by a sensation of severe pulsation in the temples, 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 occur, and vision may deteriorate. In addition, during a hypertensive crisis, various neurological disorders occur, which are accompanied by dissociation of reflexes.
Depending on the type of hemodynamics impaired, the option for increasing blood pressure and the pathophysiological mechanism for the development of the acute manifestation of hypertension, the symptoms may be more extensive. Therefore, it is so important even at the first of the above symptoms to seek qualified help and prevent all possible consequences.
Complications
If hypertension is diagnosed, treatment should begin immediately, as this disease can cause many serious ailments. Due to the hypertensive crisis, the patient may manifest acute left ventricular failure, acute ischemic stroke, myocardial infarction, hemodynamic angina pectoris, renal failure and many other serious diseases. All these complications can not only significantly undermine human health, but also cause death.
Hypertensive crisis treatment
Often, when a person experiences a hypertensive crisis, what is it and what measures should be taken, he simply does not know. And perceives his condition as a natural manifestation of hypertension. And then he regrets his carelessness. In order not to be in such a situation, the patient and his family members should find out what assistance should be given for a hypertensive crisis and what drugs should be constantly in the home medicine cabinet. Such prudence will not only be able to 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, the patient’s condition should be as light as possible by providing him with
bed rest and complete rest. If blood pressure indicators are in the critical zone, you must try to stabilize the vascular system yourself with the help of medications. But it is worth remembering that blood pressure should be reduced gradually to avoid acute vascular catastrophes. Over the first 60 minutes, indicators should be reduced by 15-20%, and within the next 2-6 hours, bring the blood pressure to 160/100 mm RT. Art. Only such an algorithm for hypertensive crisis will stabilize the patient's condition without harm to his health.
In uncomplicated crises use the drug "Nifedipine", which blocks calcium channels, relieves spasm and dilates blood vessels. Also used are vasodilators that reduce the burden on the heart, such as Diazoxide and Sodium Nitroprusside. As an ACE inhibitor, 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, antiemetic agents, as well as diuretics and cardiac glycosides. Doctors recommend using oxygen therapy and distracting procedures such as mustard plasters and hot foot baths.
Hypertension treatment
Since a hypertensive crisis is nothing more than an exacerbation of hypertension, everyone should know how to treat it. And the first thing to start with is to contact a cardiologist, because it is this specialist who will be able to say at what stage of development the disease is currently at. Hypertension is not only treated 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 will be able to maintain normal blood pressure. For this, b-blockers can be used to reduce the heart rate and vascular resistance, such as Metoprodol, Visken, Atenolol and others. Another group of drugs to reduce blood pressure are ACE inhibitors - inhibitors of renin production. It includes the means "Metiopril", "Moex", "Spirapril", "Kapoten." Often, a patient with hypertension is prescribed diuretics, which remove excess fluid from the body. However, these medicines should be treated with extreme caution, as many of them may wash up beneficial potassium.
It is completely impossible to get rid of hypertension, because the walls of the vessels for a long time have adapted to high pressure, and therefore they will not be able to return to their previous shape. Therefore, in addition to systematic therapy, it is necessary to constantly monitor blood pressure and at the right time to quickly respond to acute manifestations of the disease.
Prevention of hypertension and hypertensive crises
Considering that a hypertensive crisis is the “brainchild” of hypertension, their preventive measures are almost identical. And the first place in this list, of course, is the rational mode of rest and work. If possible, you should avoid exhausting physical exertion, compensate for the expended energy 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 is it, you can learn from experience if you abuse alcohol and nicotine, so you need to immediately abandon these bad habits. It is worth revising the daily diet, excluding salt from it, as well as fatty and spicy dishes.
In addition, if hypertension has already appeared, treatment should be carried out strictly in accordance with the doctor’s instructions and do not cancel taking antihypertensive drugs on your own. The last action can provoke the body to respond to drug withdrawal by hypertensive crisis.