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Tablets for high blood pressure () in the modern classification are represented by 4 main groups: diuretics (diuretics), antiadrenergics (alpha- and beta-blockers, drugs that are called “central acting drugs”), peripheral vasodilators, calcium antagonists And ACE inhibitors(angiotensin converting enzyme).

This list does not include antispasmodics, such as papaverine, since they give a weak hypotensive effect, slightly reducing it due to relaxation of smooth muscles, and their purpose is somewhat different.

Many people also include folk remedies as blood pressure medications, but this is, in general, everyone’s business, but we will consider them, since in many cases they are really effective as an auxiliary treatment, and in some (at the initial stage) they completely replace the main one .

Diuretics lower blood pressure

This statement is absolutely true. A set of blood pressure pills prescribed at a clinic usually includes diuretics:

Diuretics are not prescribed for arterial hypertension (AH) accompanying severe renal failure. The only exception in this case is furosemide. Meanwhile, for hypertensive patients with symptoms of hypovolemia or signs of severe anemia, diuretics such as furosemide and ethacrynic acid (uregitis) are strictly contraindicated.

• Captopril (capoten) - can specifically block ACE. Beginners with hypertension and people with experience in this area know captopril as first aid for high blood pressure: a tablet under the tongue - after 20 minutes the pressure decreases;
• Enalapril (Renitec) is very similar to captopril, but it cannot change blood pressure so quickly, although it manifests itself an hour after administration. Its effect is longer (up to a day), while captopril after 4 hours there is no trace;
• Benazepril;
• Ramipril;
• Quinapril (Accupro);
• Lisinopril - acts quickly (in an hour) and for a long time (days);
• Lozap (losartan) is considered a specific antagonist of angiotensin II receptors, reduces systolic and diastolic blood pressure, is used for a long time, since the maximum therapeutic effect is achieved after 3-4 weeks.

The mechanism of action of ACE in CHF

Contraindications to the use of angiotensin II receptor antagonists

ACE inhibitors are not prescribed in the following cases:

1. History of angioedema (a kind of intolerance to these medications, which is manifested by impaired swallowing, difficulty breathing, swelling of the face, upper limbs, hoarseness of the voice). If such a condition occurs for the first time (at the initial dose), the drug is discontinued immediately;
2. Pregnancy (ACE inhibitors negatively affect the development of the fetus, leading to various anomalies or death, therefore they are canceled immediately after this fact is established).

In addition, for ACE inhibitors there is list of special instructions, warning against undesirable consequences:

• In case of SLE and scleroderma, the advisability of using drugs in this group is very questionable, since there is a considerable risk of changes in the blood (neutropenia, agranulocytosis);
• Stenosis of the kidney or both, as well as a transplanted kidney, can lead to the development of renal failure;
• CRF requires a reduction in the dose of the drug;
• In severe heart failure, renal dysfunction may occur, even leading to death.
• Liver lesions with impaired function due to decreased metabolism of certain ACE inhibitors (captopril, enalapril, quinapril, ramipril), which can lead to the development of cholestasis and hepatonecrosis, require a reduction in the dose of these drugs.

There are also side effects that everyone knows about, but nothing can be done about them.. For example, in people with functional kidney disorders (especially, but sometimes without them), when using ACE inhibitors, biochemical blood parameters may change (the content of potassium and potassium increases, but the level decreases). Patients often complain of a cough, which is especially active at night. Some go to the clinic to find another medicine for hypertension, while others try to endure... True, they postpone taking ACE inhibitors to the morning and this helps themselves somewhat.

When can you not do without a doctor?

In the treatment of arterial hypertension, other drugs are traditionally used, which, in general, do not have pronounced features inherent in any specific group of antihypertensives. For example, the same dibazol or, say, magnesium sulfate(magnesia), which is successfully used by emergency doctors to relieve a hypertensive crisis. Magnesium sulfate injected into a vein has an antispasmodic, sedative, anticonvulsant and slightly hypnotic effect. A very good drug, however, it is not easy to administer: it must be done very slowly, so the work lasts for about 10 minutes (the patient becomes unbearably hot - the doctor stops and waits).

For the treatment of hypertension, in particular, in severe hypertensive crises sometimes Pentamine-N is prescribed (an anticholinergic blocker of the sympathetic and parasympathetic ganglia, which reduces the tone of arterial and venous vessels), benzohexonium, similar to pentamin, arfonade(ganglionic blocker), aminazine(phenothiazine derivatives). These drugs are intended for emergency assistance or intensive care, therefore can only be used by a doctor who is well aware of their characteristics!

The latest blood pressure medications

Meanwhile, patients try to keep abreast of the latest advances in pharmacology and often look for the latest blood pressure medications, but new does not mean better, and it is also unknown how the body will react to it. You definitely can’t prescribe these kinds of drugs yourself. Nevertheless, I would like to introduce the reader somewhat to these modern developments, on which great hopes are pinned.

Perhaps the most successful in adding to the list of innovations are angiotensin II receptor antagonists (ACEIs). This list includes medications such as: cardosal(olmesartan), termisartan, which they say is now not inferior to the most popular ramipril.

If you carefully read about antihypertensive drugs, you will notice that blood pressure is increased by a mysterious substance - renin, which none of the listed drugs can cope with. However, to the delight of patients suffering from high blood pressure, a cure has recently appeared - rasilez (aliskiren), which is a renin inhibitor and may be able to solve many problems.

The newest blood pressure drugs include the recently developed endothelial receptor antagonists: bosentan, enrasentan, darusentan, which block the production of the vasoconstrictor peptide – endothelin.

Folk remedies for blood pressure

Considering all kinds of remedies that can cope with high blood pressure, it is hardly possible to ignore the recipes for tinctures, decoctions, and drops that have come from the people. Some of them have been adopted by official medicine and are successfully used to treat initial (borderline and “mild”) arterial hypertension. Patients place great trust in medicines that are made from herbs growing in Russian meadows or organs of trees that make up the flora of our vast Motherland:

Monastic tea for hypertension

The application should be mentioned separately; this “newest folk remedy” raises too many questions, which has really proven itself as an auxiliary or preventive measure. It’s not surprising - the monastery collection for hypertension contains a list of medicinal herbs that improve cardiac activity, brain function, have a positive effect on the functional abilities of the vascular wall and are quite helpful in the initial stages of hypertension.

Unfortunately, this medicine will not be able to completely replace high blood pressure pills taken for years in advanced cases of arterial hypertension, although it is quite possible to reduce their number and dose. If you take tea constantly...

So that the patient himself can understand the benefits of the drink, we consider it correct to recall the composition of the monastery tea:

• Rose hip;
• St. John's wort;
• Elecampane;
• Oregano;
• Motherwort;
• Chokeberry;
• Hawthorn;
• Black tea.

In principle, there may be some variations in the recipe, which should not alarm the patient, because there are so many medicinal plants in nature.

Video: folk remedies for blood pressure

Treatment of patients with arterial hypertension requires a lot of time. Using the “trial and error” method, the doctor searches for each patient with his own medicine, taking into account the condition of the whole organism, age, gender and even profession, since some drugs have side effects that make professional work difficult. Of course, it will be difficult for the patient himself to solve such a problem, unless, of course, he is a doctor.

Hypertension is one of the most common problems among the elderly population. High blood pressure is a disorder of the cardiovascular system that can lead to serious complications and cause premature death.. Against the background of hypertension, heart failure, stroke, heart attack and other pathological serious conditions can develop. Pressure in blood vessels often provokes the formation of aneurysms and other abnormal phenomena that pose a threat not only to people’s health, but also to their lives. Frequent attacks of hypertension force patients to systematically take hypertensive drugs in order to maintain their performance and their condition normal.

In the treatment of pathology, various drugs are used, differing in their action, composition and basic properties. Diuretics occupy an important place in the complex treatment of high blood pressure.. Let's try to figure out what these pharmacological agents are and what their role is in the treatment of hypertension.

Diuretics for hypertension

Drugs in this group are diuretics and are widely used for diseases of the heart and blood vessels, which are accompanied by increased blood pressure. These medicines are one of the main treatments for the disease. Diuretics for hypertension help cleanse the body of excess salt and water, which are excreted from the body along with urine.

After a certain time after starting to take the drugs, the body becomes accustomed to it, and the process of removing excess fluid occurs naturally. The effect of reducing blood pressure also persists, which subsequently normalizes not under the influence of diuretics, but against the background of weakening resistance to blood flow.

There are different types of diuretics and each of them affects the body differently and causes certain side effects. However, their inclusion in therapy is more appropriate than treatment with modern drugs that lower blood pressure, such as ACE inhibitors and calcium antagonists. The use of the latter is accompanied by numerous side effects.

The great advantage of diuretics is their relatively low cost combined with high efficiency.

Diuretics significantly reduce the risk of complications that often occur with hypertension. The risk of myocardial infarction is reduced by 15%, and stroke by 40%.

Types of diuretics

1. Thiazide - weakly remove salt and fluid from the body, but are highly effective in lowering blood pressure. This type includes: Hydrochlorothiazide, Chlorthiazide, Benzthiazide.
2. Thiazide-like - are analogues of the previous type. Trade names of drugs: Indapamide, Chlorthalidone, Clopamide.
3. Loop - influence the filtration functions of the kidneys. They successfully cope with the task of activating the processes of removing moisture and salt, but at the same time they cause numerous adverse reactions from the body systems. Loop diuretics are represented by the following drugs: Torasemide, Furasemide, Ethacrynic acid.
4. Potassium-sparing - act on the renal nephrons, promoting the release of sodium and chloride substances from the body. Moreover, such drugs prevent the active excretion of potassium, which is how the drugs got their name. This type of diuretics includes: Triamterene, Amiloride, Spironolactone.
5. Aldosterone antagonists are drugs for hypertension that differ in their action from the others, since the decrease in pressure does not occur by removing fluid, but by blocking the release of aldosterone, a hormone that helps retain moisture and salt in the body.

Mainly used in the treatment of hypertension thiazide And thiazide-like types of diuretics that are combined with taking other medications for high blood pressure. In cases where therapy is ineffective and a hypertensive crisis develops with all the ensuing complications, patients are prescribed loop diuretics.

Features of treatment

Diuretics for hypertension are used in small doses, but over long courses. If patients do not experience improvement in their condition, and blood pressure surges continue as before, then therapy is adjusted. It is not recommended to increase the daily intake of diuretics, since such a measure will not help cope with hypertension, but can lead to serious consequences.

Taking diuretics in high doses leads to the development of diabetes mellitus, as well as an increase in blood cholesterol levels. Therefore, it is advisable not to increase the dosage of drugs, but to replace them with more powerful diuretics, and supplement them with other drugs for the treatment of hypertension.

Diuretics are generally not prescribed to young people who have high blood pressure. Also, medications in this group are contraindicated for hypertensive patients with diabetes and obesity. At the discretion of the doctor, patients may be prescribed the diuretics Indapamide and Torsemide. These two types of drugs have a minimum of contraindications and side effects, and therefore do not cause undesirable metabolic phenomena in the body.

What medications are used for hypertension?

Pharmacology to protect health

The development of drugs for hypertension has been going on for decades. But even today, medicine and pharmacology are still faced with the acute problem of developing new, more effective and safe means of reducing and controlling blood pressure.

Today there is a wide range of such drugs, but they all differ in the type of effect, effectiveness, indications and contraindications. Their cost also plays an important role.

Therefore, for each patient, the doctor selects an individual drug treatment regimen for hypertension, based primarily on the reasons that caused it.

People have been struggling with high blood pressure for many years.

Main groups of drugs for hypertension

Hypertension is an extremely complex and multifaceted disease, the cause of which can be a variety of factors. Therefore, in each individual case, the doctor selects drugs from the appropriate group. The most frequently used categories are:

Diuretics

An extensive group of diuretic drugs that allow you to remove excess fluid from the body, reducing the load on the heart and blood vessels. But they can only be used if there are no kidney diseases, diabetes, or obesity. They are often prescribed to older people suffering from hypertension. This group includes Arifon, Triamtaren, Indap, Indapamide.

Calcium antagonists

These drugs partially block calcium channels, producing a vasodilator effect. They are recommended if there are vascular diseases along with hypertension, but are contraindicated for people who have had a myocardial infarction. They are quite safe and can be used during pregnancy and lactation. This group is extremely extensive, primarily including Kalchek, Blockaltsin, Cordipin, Cordaflex, Lomir, Lacipin, Felodip and so on.

ACE inhibitors

These drugs reduce the production of angiotensin-converting enzyme, which stimulates vasoconstriction. They are very effective, well tolerated by patients with hypertension, and have a beneficial effect on the cardiovascular system. They are often recommended after a myocardial infarction, as well as for high blood pressure due to diabetes mellitus. The most popular drugs of the group: Aceten, Capoten, Monopril, Enap, Ednit, Dapril, Accupro, Hopten.

Medicines that lower blood pressure should be prescribed by a doctor.

Beta-blockers

They lower the heart rate and reduce its strength. They have a wide range of applications and can be recommended for angina, tachycardia, after a heart attack, and against the background of heart failure. However, they should not be prescribed to patients with diseases of the respiratory system and blood vessels. The most common representatives of the group: Metacard, Nebilet, Atenolol, Betak, Serdol, Metokard, Egilok.

Selective imidazoline receptor agonists

This group of drugs not only reduces blood pressure, but also reduces appetite, which makes them especially effective in the treatment of hypertension in the setting of obesity. The group includes Tsint, Albarel, Physiotens.

Angiotensin II receptor antagonists

In their action they are similar to ACE inhibitors and can replace it in case of intolerance or in case of other contraindications. But they are used infrequently due to their high cost. Representatives of this group: Diovan, Kozaar, Atakand, Teveten, Aprovel.

These are not all groups of drugs used to treat hypertension, but they are the ones recommended most often. Of course, they are presented for informational purposes only. Buying and starting to take something on your own is strictly prohibited, since only a doctor, and only after consultation and examination, can select the most effective and safe remedy and draw up a regimen for taking it.

It is necessary to understand that most drugs have an effect only during use, without affecting the causes of hypertension. Therefore, it is necessary to treat this disease comprehensively, using both medicinal and non-medicinal means.

Medicines for emergency blood pressure reduction

All of the medications listed above are taken in long courses as part of the complex treatment of hypertension. At the same time, sometimes a situation arises when the pressure needs to be reduced urgently. Most often this occurs during a hypertensive crisis, when blood pressure within a short period of time becomes significantly higher than the working zone. In such cases, the following tactics are recommended:

1. Drink a sedative: extract of motherwort, valerian, peony root.

2. Place 1-2 nitroglycerin tablets under the tongue.

3. Take a tablet of medication for emergency blood pressure reduction: Captopril, Nifedepine, Clonidine.

In people prone to high blood pressure, these drugs should always be on hand in case of a hypertensive crisis. But after the first emergency actions, it is necessary to call an ambulance and continue treatment under the supervision of a doctor.

Use of the drug Valsacor for arterial hypertension: results of a Slovenian multicenter study

Ostroumova O.D. Guseva T.F. Shorikova E.G.

Currently for treatment arterial hypertension(HTN) five main classes of antihypertensive drugs are recommended drugs. angiotensin converting enzyme inhibitors, angiotensin 1 receptor blockers (ARBs), calcium antagonists, b-blockers, diuretics.

To choose from drug many factors influence, the most important of which are: the presence of risk factors in the patient, target organ damage, associated diseases, kidney damage, diabetes mellitus, metabolic syndrome, concomitant diseases for which prescription or restriction is necessary applications antihypertensive drugs different classes, the patient's previous individual reactions to drugs different classes (pharmacological history), the likelihood of interaction with medications that the patient is prescribed for other reasons, as well as socio-economic factors, including the cost of treatment.

When choosing an antihypertensive drug it is necessary first of all to evaluate its effectiveness, the likelihood of side effects and the benefits of the drug in a certain clinical situation. Russian recommendations for the diagnosis and treatment of hypertension specifically emphasize that the cost of the drug should not be the main deciding factor.

Based on results multicenter randomized research. it can be assumed that none of the main classes of antihypertensive drugs has a significant advantage in reducing arterial pressure (BP). At the same time, in each specific clinical situation it is necessary to take into account the peculiarities of the action of various antihypertensive drugs discovered during randomized trials. research .

ARBs have proven themselves to slow down the rate of progression of target organ damage and enable regression of their pathological changes. They have proven effective in reducing the severity of left ventricular myocardial hypertrophy, including its fibrotic component, as well as significantly reducing the severity of microalbuminuria, proteinuria and preventing a decrease in renal function.

In recent years, indications for application BRAs have expanded significantly. To the previously existing ones (nephropathy in type 2 diabetes mellitus, diabetic microalbuminuria, proteinuria, left ventricular myocardial hypertrophy, cough when taking ACE inhibitors), such items as chronic heart failure, previous myocardial infarction, atrial fibrillation, metabolic syndrome and diabetes mellitus were added.

Currently, several ARBs are used or are undergoing clinical trials in global medical practice: valsartan, irbesartan, candesartan, losartan, telmisartan, eprosartan, zolarsartan, tazosartan, olmesartan (olmesartan, zolarsartan and tazosartan are not yet registered in Russia). Different sartans differ in the set of indications for their application(Fig. 1), which is due to the degree of study of the clinical effectiveness of drugs in the relevant large research.

Valsartan is one of the most studied ARBs. Conducted more than 150 clinical research with the study of more than 45 performance assessment points. Total number of patients included in clinical trials research. reaches 100 thousand, of which more than 40 thousand are included in studies studying morbidity and mortality. The effect of valsartan on patient survival and survival without cardiovascular complications was studied in a number of large randomized trials. multicenter research: VALUE, Val-HeFT, VALIANT, JIKEI Heart.

The antihypertensive effect of valsartan and other angiotensin II antagonists is due to a decrease in total peripheral vascular resistance due to the elimination of the pressor (vasoconstrictor) effect of angiotensin II, a decrease in sodium reabsorption in the renal tubules, a decrease in the activity of the renin-angiotensin-aldosterone system and mediator processes in the sympathetic nervous system. Antihypertensive effect with long-term application is stable, since it is also caused by regression of pathological remodeling of the vascular wall. The effectiveness of the original valsartan in hypertension, its good tolerability and safety in long-term application fully confirmed in a large number of clinical studies.

All of the above effects of angiotensin II are in one way or another involved in the regulation of blood pressure under normal conditions, as well as in maintaining it at a pathologically high level in hypertension. Selective blockade of AT1 receptors makes it possible to reduce the pathologically increased tone of the vascular wall, promotes regression of myocardial hypertrophy and improves diastolic function of the heart, reducing the rigidity of the myocardial wall in patients with hypertension.

There is a strong relationship between blood pressure levels and the likelihood of stroke or coronary events. Although the activity of the RAAS can be more or less successfully controlled using ACE inhibitors, blockade of the action of angiotensin II at the receptor level is believed to have a number of advantages compared to ACE inhibitors - it blocks the effect of angiotensin II regardless of its origin, the absence of "escape effect" , as well as no effect on the degradation of bradykinin and prostaglandins.

For hypertension, valsartan is prescribed once at a dose of 80-320 mg per day; the hypotensive effect is dose-dependent. The drug is rapidly absorbed from the gastrointestinal tract, peak plasma concentrations are reached approximately 2-4 hours after oral administration. The antihypertensive effect manifests itself within 2 hours in most patients after a single dose of the drug. The maximum decrease in blood pressure develops after 4-6 hours. After taking the drug, the duration of the hypotensive effect lasts more than 24 hours. With repeated use, the maximum reduction in blood pressure, regardless of the dose taken, is usually achieved within 2-4 weeks and is maintained at the achieved level during long-term therapy. The stability of the effect is due to the strength of the bond between valsartan and AT1 receptors, as well as its long half-life (about 9 hours). At the same time, the normal daily rhythm of blood pressure is maintained. Randomized studies have shown that the hypotensive effect of valsartan persists with long-term use - for 1 year, 2 years or more.

In 2008, one of the first generic drugs of valsartan was registered in Russia - Valsacor produced by KRKA (Slovenia). First of all, it was proven that Valsacor bioequivalent to the original valsartan (Fig. 2).

However, any generic drug must have studies that examined the clinical effects of this particular drug, and not just blood concentrations in healthy volunteers. For antihypertensive drugs, this is, at a minimum, an effect on blood pressure levels. Unfortunately, only a few generic medicines can boast of this.

Therefore, they deserve special attention results recently ended multicenter research conducted by our Slovenian colleagues. The purpose of this study was to evaluate the effectiveness and safety of valsartan (Valsacor) in patients with mild to moderate hypertension. The total number of patients was 1119 people (53% men, 44% women, mean age 63.5±11.7 years). Of these, 174 patients (15.5%) had not previously received antihypertensive therapy, and 944 patients (84.4%) had already received antihypertensive medications. Patients receiving therapy before enrollment most often received enalapril (20.4%), ramipril (13.5%), valsartan (11.3%), indapamide (7.9%) and perindopril (7.5%). %). Since the 24-hour effect of valsartan was proven, patients received 40, 80, 160 or 320 mg of valsartan (Valsakor®, KRKA) once daily and were examined 3 times over 3 months. At the first visit and two visits over time, blood pressure was measured, information on tolerability was collected, and at the end of the observation period the effectiveness of therapy was assessed.

Initially, before appointment Valsacora. Blood pressure averaged 155.4 mm Hg. for systolic blood pressure (SBP) and 90.9 mmHg. for diastolic blood pressure (DBP) (Fig. 3). Within a month, SBP reached 142.6 mm Hg. and DBP also decreased to 84.9 mmHg. At the third visit, a further decrease in blood pressure was noted, and the average SBP was 136.4 mmHg. Art. and DBP 81.6 mm Hg. Overall, the average reduction in SBP was 19 mmHg. Art. (12.2%), DBP - 9.3 mm Hg. (-10.2%). All these changes were statistically significant.

During the entire observation period, 52 adverse reactions were observed in 42 patients (3.8%) out of a total of 1119 patients. The most frequently observed side effects were headache (15 patients, 1.3%), dizziness (8 patients, 0.7%) and fatigue (4 patients, 0.4%). Cough was reported in 3 patients (0.3%). 13 patients (1.2%) discontinued therapy due to adverse reactions.

By the end of the study, 64% of patients achieved blood pressure less than 140/90 mmHg. and had no adverse reactions (clinical assessment of treatment “excellent”) (Fig. 4); 20% of patients achieved a blood pressure level of less than 140/90 mmHg. and had mild adverse reactions (clinical assessment of treatment “very good”); In 8% of patients, SBP decreased by at least 10 mmHg. and DBP by at least 5 mmHg. Art. without the manifestation of unwanted side reactions (clinical assessment of treatment “good”) (Fig. 4). The remaining patients achieved target blood pressure levels and had moderate or severe adverse reactions (rated as “satisfactory” or “unsatisfactory”).

Received in result The data from this study allowed the authors to conclude that Valsacor®; is an effective and safe antihypertensive drug for the treatment of patients with mild and moderate hypertension.

Appearance Valsacora in Russia will make ARB treatment more accessible to a wide range of patients, which will help improve the effectiveness of hypertension treatment and reduce cardiovascular and cerebrovascular morbidity and mortality.

Literature

1. Diagnosis and treatment arterial hypertension. Russian recommendations (third revision). Cardiovascular therapy and prevention - 2008 - No. 6 (Appendix 2) - Page. 3-32.

2. Study of the effectiveness and safety of valsartan (Valsacor) in the treatment of patients with mild and moderate hypertension. Krka's own data, New Place, 2009.

Content

High blood pressure over a long period of time is called hypertension (or hypertension). In 90% of cases, arterial essential hypertension is diagnosed. In other cases, secondary arterial hypertension occurs. Treatment of hypertension requires a special regimen and a specific combination of drugs, this guarantees the effectiveness of treatment at different stages of the disease.

What is hypertension

A normal blood pressure is 120/70 (± 10 millimeters of mercury). The number 120 corresponds to systolic pressure (the pressure of blood on the walls of the arteries during heart contraction). The number 70 is diastolic pressure (blood pressure on the walls of the arteries during relaxation of the heart). With prolonged deviation from the norm, certain stages of hypertension are diagnosed:

Hypertension is a very common pathology. The reasons for its occurrence still remain unclear. Essential hypertension refers to a disease of unknown etiology. Secondary hypertension, which occurs in 10% of patients, includes:

• renal;
• endocrine;
• hemodynamic;
• neurological;
• stressful;
• hypertension in pregnant women;
• use of dietary supplements;
• taking contraceptive medications.

The human body has a system that regulates blood pressure. When blood pressure increases on the walls of large blood vessels, the receptors that are located in them are activated. They transmit nerve impulses to the brain. The control center for vascular activity is located in the medulla oblongata. The reaction is vasodilation and a decrease in pressure. When the pressure decreases, the system performs the opposite actions.

An increase in blood pressure can be due to many reasons:

• obesity, overweight;
• kidney dysfunction;
• thyroid dysfunction;
• diabetes mellitus and other chronic diseases;
• magnesium deficiency;
• oncological diseases of the adrenal glands, pituitary gland;
• psychological stress;
• heredity;
• mercury, lead poisoning and other causes.

Existing theories about the causes of the disease have no scientific basis. Patients who are faced with this problem are forced to constantly resort to medications to alleviate their physical condition. Treatment for hypertension is aimed at reducing and stabilizing blood pressure, but does not eliminate the root cause.

Symptoms differ at different stages of the disease. A person may not feel the primary manifestations of pathology for a long time. Attacks of nausea, dizziness, and weakness are associated with overwork. Further observed: noise in the head, numbness of the limbs, decreased performance, memory impairment. With a prolonged increase in pressure, a headache becomes a constant companion. At the last stage of hypertension, dangerous complications can occur: myocardial infarction, ischemic stroke, damage to blood vessels, kidneys, and blood clots.

Treatment of arterial hypertension

All treatment methods that are aimed at treating arterial hypertension can be divided into groups: medicinal, non-medicinal, folk, complex. Any of the chosen treatment methods is aimed not only at normalizing pressure levels in the arteries. These are therapeutic measures that prevent irreversible changes in the muscle tissue of the heart and arteries, are designed to protect target organs, and include the elimination of risk factors that contribute to the development of the pathological condition.

Principles of treatment of hypertension

With the initial manifestations of the disease and in order to prevent it, you need to adhere to the general principles of treatment, which will help correct the condition and avoid exacerbation:

• reducing the consumption of table salt, it should not exceed 5 g per day (in severe conditions, complete desalting);
• correction of body weight in the presence of extra pounds, obesity;
• feasible physical activity;
• quitting smoking, drinking alcoholic and tonic drinks;
• the use of soothing herbal preparations and herbal preparations for excessive emotional excitability;
• limiting the influence of stress factors;
• night sleep 7, and preferably 8 hours;
• eating foods rich in potassium.

Standard of treatment

If arterial hypertension is diagnosed, the key to successful stabilization of the patient’s condition is constant medical supervision. Self-administration of tablets to lower blood pressure is unacceptable. It is necessary to know the strength and mechanism of action of the drug. When mild or borderline hypertension occurs, standard treatment is limited to reducing the amount of salt in the diet.

For severe forms of hypertension, drug therapy is prescribed. Strong drugs are Atenolol and Furosemide. Atenolol is a drug from the group of b-selective adrenergic blockers, the effectiveness of which has been tested by time. This remedy is relatively safe for patients with bronchial asthma, chronic bronchitis and other lung diseases. The drug is effective provided that salt is completely excluded from the diet. Furosemide is a proven diuretic. The dose of medication is determined by the doctor.

Drug treatment of hypertension

Therapeutic measures for the treatment of hypertension are prescribed taking into account laboratory test data, the individual characteristics of the patient’s condition, and the stage of development of the disease. The use of antihypertensive medications is justified in cases of prolonged disturbances in blood pressure and non-drug therapy methods have not yielded results.

Treatment regimens

To avoid complications with the functioning of the heart and other organs, medications are prescribed to reduce blood pressure, taking into account pulse indicators:

Form of hypertension	Clinical picture	Medicines
With a high pulse	Pulse – 80 beats per minute, sweating, extrasystole, white dermographism	b-blockers (or Reserpine), Hypothiazide (or Triampur)
With a low pulse	Swelling of the face, hands, manifestations of bradycardia	Thiazide diuretics in three applications: single, intermittent, continuous.
No change in heart rate	Without pronounced edema, tachycardia, cardialgia	Angiotensin-converting enzyme blockers, thiazide diuretics, b-blockers
Severe course	Diastolic pressure above 115 mmHg	Optimal combination of 3-4 drugs

Modern drugs for the treatment of hypertension

Many patients are prescribed medications to treat hypertension that must be used continuously. The choice and use of medications must be taken very seriously. With improper therapy, complications develop: there is a high risk of heart attack and heart failure. All drugs that are used in treatment regimens can be divided into groups:

	Mechanism of action	Drug names
Angiotensin converting enzyme inhibitors (ACEIs)	Blocking the enzyme that converts angiotensin I to angiotensin II	Enap, Prerstarium, Lisinopril
Angiotensin II receptor inhibitors (sartans)	Indirect reduction of vasospasm due to effects on the renin-angiotensin-aldosterone system	Losartan, Telmisartan, Eprosartan
B-blockers	Have a vasodilating effect	Atenolol, Concor, Obzidan
Calcium channel blockers	Block the transfer of calcium into the cell, reduce energy reserves to the cell	Nifedipine, Amlodipine, Cinnarizine
Thiazide diuretics (diuretics)	Removes excess fluid and salt, prevents swelling	Hydrochlorothiazide, Indapamide
Imidazoline receptor agonists (AIRs)	Due to the connection of these substances with receptors in the brain and kidney vessels, the reabsorption of water and salt and the activity of the renin-angitensive system are reduced	Albarel, Moxonidine,

Combinations of antihypertensive drugs

The mechanism of action of antihypertensive drugs to lower blood pressure is different, so drug treatment of hypertension involves the use of combinations of medications. This is effective for complications of hypertension, damage to other organs, and renal failure. About 80% of patients require complex therapy. Effective combinations are:

• ACE inhibitor and calcium channel blocker;
• ACE inhibitor and diuretic;
• calcium antagonist and diuretic;
• alpha blocker and beta blocker;
• dihydropyridine calcium antagonist and beta blocker.

Irrational combinations of antihypertensive drugs

Combinations of medications must be made correctly. Drugs for hypertension in the following combination do not have the desired therapeutic effect:

• dihydropyridine antagonist and non-dihydropyridine calcium blocker;
• beta blocker and ACE inhibitor;
• an alpha blocker in combination with other antihypertensive drugs (except beta blockers).

Non-drug treatment

It is better to prevent any disease than to treat it. At the first appearance of surges in blood pressure, it is worth reconsidering your lifestyle in order to prevent the development of malignant hypertension. Non-drug treatment, despite its simplicity, is aimed at preventing the development of cardiovascular diseases. This set of measures is central to stabilizing the condition of those patients who are on long-term drug treatment.

Lifestyle change

Half of the patients diagnosed with the initial stages of hypertension manage to stabilize their condition at its first manifestations after adjusting their lifestyle. Strict adherence to a daily routine, sufficient time for rest and night sleep, balanced nutrition, physical activity, and getting rid of bad habits help reduce blood pressure.

Medical nutrition

The calorie content of a hypertensive menu should not exceed 2500 kcal. The daily diet includes 5 meals. Last dose 2 hours before going to bed. Food is steamed, boiled, baked and cooked without adding salt. The daily amount of liquid is about 1.5 liters. The ratio of proteins, carbohydrates, fats is 1:4:1. The diet should include foods rich in potassium, magnesium, and vitamins B, C, and P.

The permitted products include:

• rye and bran bread, crackers;
• lean soups;
• meat soups no more than 3 times a week;
• lean meat, fish;
• vegetable stews;
• porridge;
• fermented milk products;
• fruit casseroles;
• seafood;
• natural juices, weak tea with milk.

Physical activity

Strong physical activity is required for hypertension. It is worth giving preference to isotonic exercises. They accelerate blood circulation, activate lung function, and lower blood pressure. This is gymnastics aimed at the large muscles of the limbs. Walking, cycling, swimming, and light jogging are helpful. The ideal option is to exercise on a home gym. The optimal training regimen is 3-5 times a week.

Traditional medicine

Among the recipes of traditional medicine there are the simplest remedies aimed at stabilizing blood pressure. The most effective of them are:

• Flax seeds. Three tablespoons of seeds per day (can be crushed in a food processor) as an additive to salads and main courses normalizes fat metabolism, prevents vascular atherosclerosis, and stabilizes blood pressure.
• Red pine cones. An alcohol tincture is made from this plant material. Pine cones (collected in June-July) are poured into a liter jar, filled with vodka or alcohol and left for 2-3 weeks. Take 3 times a day before meals, 1 teaspoon.
• Garlic. Finely chop two cloves of garlic, add a glass of boiled water, and let it brew for 12 hours. The infusion is drunk and a new one is prepared. The course of treatment is 1 month, the infusion is consumed morning and evening.

Indications for hospitalization

Hypertension in severe forms is dangerous due to complications, so in some cases hospitalization is necessary:

1. A hypertensive crisis was diagnosed. This leads to a sharp deterioration in the patient’s general condition, poses a threat to his life, and there is a high risk of developing a heart attack or stroke. Urgent hospitalization is recommended.
2. Frequent surges in blood pressure occur, the cause of which is unclear and requires a comprehensive examination of the patient and identification of the diagnosis. The protocol for hospitalization does not provide for such cases, but there is a high risk of exacerbation of concomitant diseases.
3. In addition to high blood pressure, the patient is suspected of having heart disease, for example, angina pectoris.

High blood pressure is a reason to call an ambulance. Emergency doctors take effective therapeutic measures, as a result of which blood pressure and heart function indicators return to normal. In this case, there are no indications for hospitalization of the patient; then he can be treated on an outpatient basis to stabilize his condition. In other cases, if improvement cannot be achieved, he is hospitalized.

Treatment of hypertension with modern medications according to schemes and folk remedies

Anonymous 192

I was diagnosed with stage 2 arterial hypertension last year. At first, the treatment regimen changed, the main drug was the same - blood pressure lowering pills, but the dosage was changed. 5 mg is optimal, so I take it every morning, one tablet is enough to keep my blood pressure normal. Well, I buy herbs at the pharmacy, make mint tea, add it to tea... If you take care of your health, then stabilizing your blood pressure is quite possible.

3 days Answer