Diastolic arterial hypertension

Arterial pressure is defined as the force with which the blood flow affects the walls of the arteries. The unit of its measurement is millimeters of mercury, in short, mm Hg. Art. It is measured by a special device - a tonometer, on which two figures are fixed: the large one determines the systolic, and the smaller one - the diastolic blood pressure. The parameters of a person with normal pressure are 120/80 mm Hg. Art. At values above 140/90 mm Hg. Art. The diagnosis of arterial hypertension is established. Systolic pressure (SBP) - the force with which blood is released into the bloodstream at the time of cardiac contraction, diastolic (DAD) - in a state of relaxation and its entry into the heart. A persistent increase in the lower indicator is called diastolic hypertension.

[1], [2], [3], [4], [5], [6], [7], [8]

Epidemiology

According to statistics, hypertension is the most common disease of the cardiovascular system. According to WHO, this disease affects from 10% to 20% of people on the planet, if you consider people with blood pressure of 160/90 and below. If you add to them patients with higher rates, and there are many such, the percentage will increase significantly. This indicator is growing rapidly among people who have crossed 60 years, especially women.

[9], [10], [11], [12], [13]

Causes of the diastolic arterial hypertension

Diastolic arterial hypertension is due to two main causes: spasm of arterial vessels and an increase in blood volume. Factors leading to such states include:

• pathology of the kidneys (atherosclerosis, glomerulonephritis), in which they produce enzymes that increase the tone of the vessels and narrow their lumen;
• diseases of the thyroid gland, leading to an excessive concentration of hormones, which also have an effect on the state of the vessels;
• fluid retention in the body, provoked by poor kidney function, hormonal disorders, love for salted food.

[14], [15], [16], [17], [18], [19], [20], [21]

Risk factors

Risk factors for the occurrence of diastolic arterial hypertension are divided into two types: uncontrolled - hereditary, age (for women more than 65 years, for men more than 55) and manageable.

The latter include:

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

[22], [23], [24], [25]

Pathogenesis

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

[26], [27], [28], [29], [30], [31]

Symptoms of the diastolic arterial hypertension

Symptoms of diastolic arterial hypertension depend on the stage of the disease. The first signs in the initial stages appear in the form of infrequent episodes of headache, nausea, lethargy, a sense of fatigue, noise in the ears, pulsations in the temples, tingling in the limbs, and sometimes numbness, dizziness.

In the case of a persistent increase in pressure to 90-105 mm Hg. Art. There are pains behind the breastbone, chills, shroud and flies in the eyes, nausea, vomiting, there may be nosebleeds, swelling of the face, hands and feet.

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

Isolated diastolic arterial hypertension

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

[32], [33]

Stages

In the course of the disease, diastolic arterial hypertension is distinguished in three stages:

• I - transitory, it corresponds to DBP within 95-105 mm Hg. St., rare hypertensive crises, absence of pathological changes in organs;
• II - stable, DBP 110-115 mm Hg. 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 lesions of the central nervous system and internal organs.

On the level of pressure, the pathology is divided into hypertension of a mild course (it corresponds to diastolic arterial hypertension of the 1st degree - up to 100 mm Hg), manifests itself by abrupt changes in the lower pressure, then rising, then coming back to normal. Other variants of diastolic arterial hypertension: moderate course - there is a longer increase with indices up to 115 mm Hg. P. Heavy - keeps constantly at high rates (above 115).

[34], [35], [36], [37], [38], [39], [40]

Complications and consequences

For the first stage of the disease, the effects and complications are generally not characteristic. But for II, the development of atherosclerosis of the aorta and arteries, hypertrophy of the left ventricle of the heart, violations of kidneys; for stage III - cardiac and renal insufficiency, ischemic heart disease, aortic dissection, blockage of arteries, foci of hemorrhage, strokes, myocardial infarction, hypertensive encephalopathy.

[41], [42], [43], [44], [45], [46], [47], [48]

Diagnostics of the diastolic arterial hypertension

Diagnosis of the disease occurs on the basis of anamnesis of the patient, determination of blood pressure using a tonometer, and measurements should be made on both hands in the morning and in the evening, laboratory tests, instrumental diagnostics. Excludes the secondary pathology, the stage is determined, the target organs affected by the diastolic pressure fluctuations.

• Analyzes

If a diastolic arterial hypertension is suspected, a biochemical blood test is performed for cholesterol, sugar, potassium, creatinine, an important indicator of kidney function, triglyceride for the diagnosis of atherosclerosis, corticosteroids, and renin activity. Urinalysis is performed by Nechiporenko, Zimnitsky, and others to assess the condition of the kidneys, their concentration capabilities. Catecholamines are defined as hormones produced by the adrenal glands.

• Instrumental diagnostics

Instrumental diagnostics includes electrocardiogram (ECG), Echo KG, MRI of the brain, the study of its electrical activity by means of electroencephalography, aortography, ultrasound of the kidneys and abdomen, CT of kidneys and adrenals.

[49], [50], [51]

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 only 5% of cases fall on the secondary.

Treatment of the diastolic arterial hypertension

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

Isolated diastolic blood pressure is more difficult to treat. Hypotensive drugs reduce both upper and lower pressure. In this case, only the doctor can choose the right combination of drugs to reduce the pressure and direct the treatment to the pathology that causes such a manifestation. Most often, such patients are shown treatment in a hospital.

How to reduce blood pressure, read this article.

Medications

In the pharmaceutical market, a lot of drugs that reduce blood pressure, but sometimes patients have to try not one of them to pick up the one that "works." Depending on the mechanism of action, they are divided into several groups. Here are the main:

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

Lokren - coated tablets, active ingredient - betaxolol. It is taken once a day 1 tablet (20 mg), the maximum daily dose of 2 pcs. In the presence of renal failure, the dosage is selected individually, with its severe form should not exceed 10 mg. There are cases of side effects: abdominal pain, insomnia, dizziness, dry mouth, heart failure. The drug has a fairly large list of contraindications, especially cardiac pathologies, therefore should be taken as prescribed by the doctor. If generalized, it is not prescribed: with bronchial asthma, low blood pressure, during pregnancy and lactation, children under 14 years old, peripheral circulation disorders. Before use, it is necessary to refer to the instructions and study the drug interactions. There is a large list of medicines that can not be consumed 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 comes in 2-4 hours and lasts a day. In the case of ischemic heart disease and angina pectoris, 5 mg is prescribed, the maximum can be taken as 10 mg. Possible side effects: a feeling of fatigue, hypotension, heart rhythm disturbance, flatulence, gastritis, allergy. Contraindicated in pregnant and lactating women, with low blood pressure. Caution should be taken patients with diabetes mellitus, impaired liver function, chronic heart failure.

Berlipril - tablets (0.005g and 0.01g), 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, tk. There are nuances in the application for various concomitant diagnoses. The average daily intake is 5 mg, for the elderly the initial dose is 1.25 mg. If necessary, it can be gradually increased. There are cases of fainting, arrhythmia, noise in the ears, dry mouth, nausea, anemia, dry cough when taking the drug. It is not indicated before the age of 18, for women in a position breast-feeding, with renal and hepatic insufficiency.

Enap - tablets, reduces peripheral resistance of blood vessels, load on the left ventricle, reduces ventricular arrhythmias. The primary dose of the drug is 5 mg, if necessary, can be increased to 20 mg. For children is calculated in proportion to the body weight: 20-50 kg recommended 2.5 mg of the drug, more than 50 kg - 5 mg. Enap can cause a decrease in white blood cells and platelets, accompanied by nausea and vomiting, diarrhea, muscle spasms. Contraindicated in hypersensitivity to the active substance, women planning pregnancy, in the 2nd and 3rd trimester of pregnancy.

Indapamide - tablets of 1.5 mg, reduces pressure, without significantly affecting the volume of urination. Drink 1 tablet in the morning. Can cause muscle pain, cough, pharyngitis, vertigo, fatigue, hypokalemia, decreased sodium in the blood. It is not prescribed for pregnant and lactating children, children under 18 years of age, with violations of cerebral circulation, allergic reaction to the drug, in combination with drugs that increase the interval of qt.

Vitamins

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

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

Physiotherapeutic treatment

Physiotherapy treatment applied to hypertensive patients is appointed exclusively individually, taking into account the characteristics of each, burdening other diagnoses. It may include:

• exercise therapy;
• water and mud therapy;
• galvanization (with the help of electrodes attached to the head, weak discharges of electric current are passed);
• electrophoresis (tissue impregnated with an antihypertensive drug, applied to the body, under the influence of current it penetrates into the skin);
• low-frequency magnetotherapy (electromagnetic inductors on the occiput improve the blood supply to the brain);
• ultrahigh-frequency therapy (variable electric fields directed to the solar plexus area, improve metabolism, reduce the risk of blood clots);
• physiotherapy with infra-red rays (the left side of the sternum is exposed, the result is vasodilation, improvement of the functions of the heart muscle).

Alternative treatment

To rely only on alternative treatment is dangerous, if it is not a question of the initial stage of the disease, but it is worth combining with the medicamentous. Well-proven in reducing the pressure of beet juice, honey, lemon. Here are some recipes from these ingredients:

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

Effective in controlling high diastolic pressure are hawthorn, nuts, fresh carrots, cucumber, potato juices, and chokeberry juice. Effective is a decoction of garlic in milk: a couple of heads boil in a glass of milk until softening, take after eating a tablespoon three times a day. Quickly remove the pressure will help hot foot baths, you can with the addition of mustard or hot water bottle on the calves of the feet.

[52], [53], [54], [55], [56], [57], [58], [59], [60], [61]

Herbal Treatment

Among the list of herbs that reduce pressure, plantain, celery, parsley, spinach, valerian root, motherwort, peppermint, lemon balm. If the pressure increase is associated with stress, the herbs with a soothing effect (blue cyanosis, motherwort, valerian) will help. The diuretic pressure is best affected by diuretic herbs (birch leaves, spores, renal collection, sold in pharmacies) and vasodilators (arnica, cucumbers, shepherd's bag).

Homeopathy

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

Alvisan neo - combined vegetative collection, is used as part of the combined treatment of hypertension. Can be in disposable bags or in bulk. The method of preparation is as follows: pour a bag or a tablespoon with a glass of boiling water, but do not boil, allow to stand for 15 minutes, then take freshly prepared twice a day, in the morning and in the evening. The course of treatment is a month and a half. Contraindicated in pregnant and lactating women, t. Its effect on this group was not investigated, as well as with increased sensitivity to compound collection. Possible side effects in the form of allergic reactions.

Cardio-gran is a sweet taste of granules, used for hypertension of the 1st degree. Once or twice a day put under the tongue for 5 pieces and dissolve them, you can take with pain in the chest. There are no contraindications and side effects.

Cordalon-ARN ^®  - granules, consisting of 5 monopreparations. The dose for children under 6 years is calculated based on the formula: one pellet per year of life. It dissolves for small children in a small amount of water, it is possible under the tongue before it dissolves. After this age and adults - 6 pieces twice a day for half an hour before meals or 1.5 hours after. The duration of treatment is 1,5-2 months. It is not prescribed for children under one year old, pregnant and during lactation. Of adverse reactions - allergy is possible.

Pumpan - tablets, is used in the complex therapy of cardiac pathologies, blood vessels, contributes to the normalization of blood pressure. Children 5-12 years are recommended for sex tablets, over 12 years and adults - a tablet twice a day for 2-3 months, with the goal of prevention, you can go to a one-time appointment. The effect on children under 5 years of age on pregnant women has not been studied. If hypersensitivity to the drug can appear skin rashes.

Prevention

Prevention of diastolic hypertension is primary and secondary. Primary concerns healthy people who have a predisposition for the development of hypertension. It consists in the rejection of bad habits: smoking, excessive entrainment of alcoholic beverages, fatty, fried and spicy food, more in the diet include vegetables, dairy products, limit the intake of salt, easily digestible carbohydrates. It is also necessary to get rid of excess weight, lead an active lifestyle, play sports, walk a lot, avoid stresses, conflict situations, excessive physical and intellectual stress. Secondary prophylaxis is intended for people who are diagnosed with hypertension. For this group of patients, the most important preventive measure is the daily (morning and evening) monitoring of the level of pressure, the intake of medications (for life), as well as all those measures that are provided for primary prevention.

[62], [63], [64], [65], [66], [67], [68], [69]

Forecast

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

[70], [71], [72], [73], [74], [75], [76], [77], [78]