Diastolic arterial hypertension

Blood pressure is defined as the force with which the blood flow acts on the walls of the arteries. Its unit of measurement is millimeters of mercury, abbreviated mmHg. It is measured with a special device - a tonometer, which records two numbers: the larger one determines the systolic blood pressure, and the smaller one - diastolic blood pressure. The indicators of a person with normal pressure are 120/80 mmHg. At values above 140/90 mmHg, a diagnosis of arterial hypertension is established. Systolic pressure (SBP) is the force with which blood is ejected into the bloodstream at the moment of cardiac contraction, diastolic (DBP) - in a state of relaxation and its entry into the heart. A persistent increase in the lower indicator is called diastolic arterial hypertension.

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Epidemiology

According to statistics, arterial hypertension is the most common cardiovascular disease. According to WHO, 10% to 20% of people on the planet are susceptible to this disease, if you take into account people with blood pressure of 160/90 and below. If you add patients with higher rates, and there are many of them, the percentage will increase significantly. This figure is rapidly growing among people over 60 years old, especially women.

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Causes diastolic arterial hypertension

Diastolic hypertension is caused by two main reasons: spasm of arterial vessels and an increase in blood volume. Factors leading to such conditions include:

• kidney pathologies (atherosclerosis, glomerulonephritis), in which enzymes are produced in the kidneys that increase vascular tone and narrow their lumen;
• thyroid diseases, leading to excessive concentration of hormones, which also have an impact on the condition of blood vessels;
• fluid retention in the body caused by poor kidney function, hormonal imbalances, or a love of over-salted foods.

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Risk factors

Risk factors for the development of diastolic arterial hypertension are divided into two types: uncontrollable – hereditary, age (for women over 65 years old, for men over 55) and controllable.

The latter include:

• excess weight (considered the main factor);
• smoking;
• alcohol consumption;
• insufficient physical activity;
• high salt content in food;
• high intellectual load;
• diabetes mellitus;
• high blood cholesterol;
• frequent and prolonged stress.

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Pathogenesis

To understand the pathogenesis of diastolic arterial hypertension, it is necessary to understand what organs and mechanisms are involved in the circulatory system. This entire system functions thanks to the heart, blood vessels and the central neuroregulatory apparatus. Blood pressure depends on the heart rate, vascular resistance, which, in turn, depends on the tone of the arterioles. Diastolic pressure is formed at the moment of relaxation of the heart after a heart contraction (systole): at the same time, the atria and ventricles of the heart are filled with blood, at this time the valves between them are open. The process of blood supply to the organ is called the filling phase and it depends on the elasticity of the arteries and the volume of blood. High diastolic pressure indicates disturbances in this system, most often kidney pathology.

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Symptoms diastolic arterial hypertension

Symptoms of diastolic arterial hypertension depend on the stage of the disease. The first signs at the initial stages are manifested in the form of infrequent episodes of headache, nausea, lethargy, fatigue, tinnitus, pulsation in the temples, tingling in the limbs, and sometimes numbness, dizziness.

In case of persistent increase in pressure to 90-105 mm Hg, pain behind the breastbone, chills, veil and "flies" before the eyes, nausea, vomiting, possible nosebleeds, swelling of the face, arms and legs appear.

Higher diastolic values together with high systolic pressure result in hypertensive crises, which are characterized, in addition to the above symptoms, by severe headache, rapid heartbeat, vomiting, numbness of the tongue and lips, speech impairment, and cold sweat.

Isolated diastolic hypertension

Isolated diastolic arterial hypertension is when the upper systolic pressure is less than 140 mm Hg, and the lower diastolic pressure exceeds 90. This type of hypertension most often indicates that something is wrong with either the kidneys or the endocrine system, a heart defect or a tumor is possible. It is dangerous because the heart is in constant tension and does not relax, while the walls of the vessels become rigid and lose elasticity. Over time, isolated diastolic arterial hypertension can lead to irreversible changes in the vascular bed and heart muscle.

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Stages

Depending on the course of the disease, diastolic arterial hypertension is divided into three stages:

• I – transient, corresponds to DBP within 95-105 mm Hg, rare hypertensive crises, absence of pathological changes in organs;
• II – stable, DBP 110-115 mmHg, severe hypertensive crises, cerebral ischemia, organic organ damage;
• III – sclerotic, DBP 115-130 mm Hg, frequent hypertensive crises that threaten human life, severe complications caused by serious damage to the central nervous system and internal organs.

According to the pressure level, the pathology is divided into mild hypertension (it corresponds to diastolic arterial hypertension of the 1st degree - up to 100 mm Hg), manifests itself by abrupt changes in the lower pressure, sometimes rising, sometimes returning to normal. Other variants of diastolic arterial hypertension: moderate - there is a more prolonged increase with indicators up to 115 mm Hg; severe - constantly remains at high indicators (above 115).

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Complications and consequences

Stage I of the disease is generally not characterized by consequences and complications. But stage II is characterized by the development of atherosclerosis of the aorta and arteries, hypertrophy of the left ventricle of the heart, and renal dysfunction; stage III is characterized by cardiac and renal failure, coronary heart disease, aortic dissection, arterial occlusion, hemorrhage, strokes, myocardial infarction, and hypertensive encephalopathy.

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Diagnostics diastolic arterial hypertension

The diagnosis of the disease is based on the patient's medical history, determination of blood pressure using a tonometer, with measurements taken on both arms in the morning and evening, laboratory tests, and instrumental diagnostics. The secondary nature of the pathology is excluded, the stage is determined, and the target organs affected by fluctuations in diastolic pressure.

• Tests

If diastolic arterial hypertension is suspected, a biochemical blood test is performed to measure cholesterol, sugar, potassium, creatinine – an important indicator of kidney function, triglyceride – to diagnose atherosclerosis, corticosteroids, and renin activity. Urine analysis is performed according to Nechiporenko, Zimnitsky, and others to assess the condition of the kidneys and their concentration capabilities. Catecholamines – hormones produced by the adrenal glands – are determined.

• Instrumental diagnostics

Instrumental diagnostics includes an electrocardiogram (ECG), echocardiography, MRI of the brain, a study of its electrical activity using electroencephalography, aortography, ultrasound of the kidneys and abdominal cavity, CT of the kidneys and adrenal glands.

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Differential diagnosis

Differentiation of diastolic arterial hypertension is carried out between nephrogenic, endocrine, neurogenic, hemodynamic. It is also important to determine the primary or secondary nature of the disease, although secondary cases account for only 5% of cases.

Treatment diastolic arterial hypertension

Treatment of diastolic arterial hypertension, as well as hypertension in general, consists of reducing blood pressure to readings below 90 mm Hg, eliminating risk factors that contribute to the progression of the pathology, and treating organs affected by hypertension.

Isolated diastolic BP is more difficult to treat, since antihypertensive drugs reduce both upper and lower pressure. In this case, only a doctor can select the right combination of drugs to reduce pressure and direct treatment to the pathology causing such a manifestation. Most often, such patients are prescribed hospital treatment.

Read this article to find out how to lower your blood pressure.

Medicines

There are many drugs on the pharmaceutical market that lower blood pressure, but sometimes patients have to try more than one of them to find the one that “works”. Depending on the mechanism of action, they are divided into several groups. Here are the main ones:

• beta blockers (block the flow of adrenaline into the heart, which leads to relaxation of its muscle): timolol, concor, lokren, labetalol;
• calcium antagonists (inhibit the passage of calcium through calcium channels into the cells of blood vessels and the heart): isoptin, cordafen, diazem, gallopamil, amlodipine;
• ACE inhibitors (by blocking certain enzymes, they improve blood flow through the vessels, increasing their elasticity): alcadil, berlipril, diroton, lisinopril, enap;
• thiazide, thiazide-like, loop diuretics (remove fluid from the body, thereby reducing the volume of blood passing through the vascular bed): benzthiazide, hydrochlorothiazide, indapamide, chlorthalidone, furosemide, torasemide.

Lokren is a film-coated tablet containing betaxolol as an active ingredient. Take 1 tablet (20 mg) once a day, the maximum daily dose is 2 tablets. In case of renal failure, the dosage is selected individually, in severe cases it should not exceed 10 mg. There are known cases of side effects: abdominal pain, insomnia, dizziness, dry mouth, heart failure. The drug has a fairly large list of contraindications, especially cardiac pathologies, so it should be taken as prescribed by a doctor. In general, it is not prescribed: for bronchial asthma, low blood pressure, during pregnancy and lactation, for children under 14 years of age, or for peripheral circulatory disorders. Before use, you must refer to the instructions and study the drug interactions, as there is a large list of drugs that cannot be used simultaneously with Lokren.

Amlodipine - tablets, has the ability to regulate the concentration of calcium ions in the cytoplasm and intercellular fluid. It is taken once a day, if hypertension is not complicated by other diseases, in a dose of 2.5 mg orally, the effect occurs in 2-4 hours and lasts for 24 hours. In case of coronary heart disease and angina pectoris, 5 mg is prescribed, the maximum you can take is 10 mg. Possible side effects: a feeling of fatigue, hypotension, heart rhythm disturbances, flatulence, gastritis, allergies. Contraindicated in pregnant and lactating women, with low blood pressure. Patients with diabetes mellitus, liver dysfunction, chronic heart failure should take it with caution.

Berlipril - tablets (0.005 g and 0.01 g), in the body, interacting with water, forms an active substance that reduces the resistance of peripheral vessels. The required dose is determined by the doctor, since there are nuances in the use of various concomitant diagnoses. The average daily dose is 5 mg, for the elderly, the initial dose is 1.25 mg. If necessary, it can be gradually increased. There are known cases of fainting, arrhythmia, tinnitus, dry mouth, nausea, anemia, dry cough when taking the drug. Not indicated for under 18 years of age, pregnant women, breastfeeding women, with renal and hepatic insufficiency.

Enap - tablets, reduces peripheral vascular resistance, the load on the left ventricle, reduces ventricular arrhythmias. The initial dose of the drug is 5 mg, if necessary, it can be increased to 20 mg. For children, it is calculated proportionally to body weight: 2.5 mg of the drug is recommended for 20-50 kg, over 50 kg - 5 mg. Taking Enap can cause a decrease in leukocytes and platelets, accompanied by nausea and vomiting, diarrhea, muscle spasms. Contraindicated in case of hypersensitivity to the active substance, women planning pregnancy, in the 2nd, 3rd trimester of pregnancy.

Indapamide - 1.5 mg tablets, reduces blood pressure without significantly affecting the volume of urination. Take 1 tablet in the morning. May cause muscle pain, cough, pharyngitis, vertigo, fatigue, hypokalemia, decreased sodium in the blood. Not prescribed to pregnant and lactating women, children under 18, with cerebrovascular accidents, allergic reactions to the drug, in combination with drugs that increase the QT interval.

Vitamins

People suffering from arterial hypertension simply need to enrich their bodies with various vitamins:

• C - participates in oxidation-reduction processes of cells, maintains the elasticity of arteries, normalizes cholesterol metabolism;
• E - increases the amount of oxygen in the blood, thereby promoting the functioning of the heart and circulatory system;
• P – reduces the fragility and permeability of blood vessels;
• B1 – is responsible for the functioning of muscles and the nervous system;
• B2 – participates in oxidative processes; without it, vision deteriorates and increased fatigue appears;
• B3 – reduces cholesterol, promotes lipid metabolism;
• B6 – prevents the formation of atherosclerosis, acts as a diuretic, thereby reducing blood pressure;
• B12 – participates in oxygen and cholesterol metabolism.

Physiotherapy treatment

Physiotherapeutic treatment for hypertensive patients is prescribed strictly individually, taking into account the characteristics of each patient and the aggravation of other diagnoses. It may include:

• therapeutic exercise;
• water and mud therapy;
• galvanization (weak electric currents are passed through electrodes attached to the head);
• electrophoresis (a cloth soaked in an antihypertensive drug is applied to the body, and under the influence of current it penetrates the skin);
• low-frequency magnetic therapy (electromagnetic inductors on the back of the head improve blood supply to the brain);
• ultra-high frequency therapy (alternating electric fields directed to the solar plexus area improve metabolism and reduce the risk of blood clots);
• infrared physiotherapy (the left side of the sternum is affected, the result is dilation of blood vessels, improvement of the functions of the heart muscle).

Folk remedies

Relying solely on folk remedies is dangerous if we are not talking about the initial stage of the disease, but it is worth combining with medication. Beetroot juice, honey, and lemon have proven themselves to be effective in lowering blood pressure. Here are some recipes from these ingredients:

• all three components (equal portions of juices with double honey) are mixed, a third of a glass is drunk an hour after meals 3 times a day;
• put a tablespoon of honey and the juice of half a lemon in a glass of mineral water, stir, drink immediately on an empty stomach;
• Mix beetroot juice with honey in equal proportions and take one spoon 4-5 times a day.

Effective in the fight against high diastolic pressure are hawthorn, nuts, freshly squeezed carrot, cucumber, potato juice, chokeberry juice. A decoction of garlic in milk is effective: boil a couple of heads in a glass of milk until softened, take a tablespoon after meals three times a day. Hot foot baths will help quickly relieve pressure, you can add mustard or a hot water bottle on the calves.

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Herbal treatment

The list of herbs that reduce blood pressure includes plantain, celery, parsley, spinach, valerian root, motherwort, peppermint, and lemon balm. If high blood pressure is associated with stress, herbs with a calming effect (blue cyanosis, motherwort, valerian) will help. Diuretic herbs (birch leaves, knotweed, kidney tea sold in pharmacies) and vasodilators (arnica, immortelle, shepherd's purse) have the best effect on reducing diastolic pressure.

Homeopathy

Among homeopathic medicines there are many that affect the cardiovascular system, cardiological:

Alvisan neo is a combined herbal mixture used as part of a combined treatment for hypertension. It can be in disposable bags or in bulk. The method of preparation is as follows: pour a glass of boiling water over a bag or a tablespoon, but do not boil it, let it brew for 15 minutes, then take it freshly prepared twice a day, in the morning and in the evening. The course of treatment is one to one and a half months. It is contraindicated for pregnant and lactating women, since its effect on this group has not been studied, as well as in case of hypersensitivity to the components of the mixture. Side effects in the form of allergic reactions are possible.

Cardio-gran - sweet-tasting granules, used for hypertension stage 1. Once or twice a day, put 5 pieces under the tongue and dissolve them, can be taken for chest pain. It has no contraindications or side effects.

Cordalone-ARN ^® - granules consisting of 5 monodrugs. The dose for children under 6 years is calculated based on the formula: one granule per year of life. Dissolved for small children in a small amount of water, or under the tongue until dissolved. After this age and for adults - 6 pieces twice a day half an hour before meals or 1.5 hours after. Duration of treatment is 1.5-2 months. Not prescribed for children under one year, pregnant women and during lactation. Side effects - possible allergic reactions.

Pumpan - tablets, used in complex therapy of heart and vascular pathologies, helps normalize blood pressure. Children aged 5-12 are recommended to take half a tablet, over 12 years and adults - a tablet twice a day for 2-3 months, for prevention purposes, you can switch to a single dose. The effect on children under 5 years of age, on pregnant women has not been studied. In case of hypersensitivity to the drug, skin rashes may appear.

Prevention

Prevention of diastolic hypertension can be primary and secondary. Primary prevention concerns healthy people who have a predisposition to developing hypertension. It consists of giving up bad habits: smoking, excessive alcohol consumption, fatty, fried and spicy foods, including more vegetables and dairy products in the diet, limiting the consumption of salt and easily digestible carbohydrates. It is also necessary to get rid of excess weight, lead an active lifestyle, play sports, walk a lot, avoid stress, conflict situations, excessive physical and intellectual stress. Secondary prevention is intended for people diagnosed with arterial hypertension. For this group of patients, the most important preventive measure is daily (morning and evening) monitoring of blood pressure, taking medications (for life), as well as all the measures provided for in primary prevention.

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Forecast

Timely diagnostics, constant monitoring of diastolic blood pressure, therapeutic and preventive measures improve the prognosis of the disease. In the absence of treatment, arterial hypertension, including diastolic, can provoke ischemic heart disease, strokes, kidney damage, and increases the risk of death.

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