High blood pressure or hypertension means that blood pressure in the arteries is elevated.
Arteries are blood vessels that carry blood from the heart to the rest of the body.
In the case of high blood pressure, this means work overload for the heart and blood vessels.
Over time, the risk of
- Heart attack
When to worry?
Table with blood pressure values
|Normal||< 80||< 120|
|Grade I hypertension||90/99||140/159|
|Grade II hypertension||> 100||> 160|
Diagnosis of arterial hypertension
It is absolutely necessary to confirm the presence of hypertension, a single measurement is not sufficient for this, this test must be repeated at least three times.
The measurement must be made:
- At least 10 minutes in the patient’s supine position,
- In the greatest possible quiet situation.
The doctor takes the anamnesis, especially with regard to essential and genetic forms.
Secondary hypertension is the most likely form:
- If the patient is young, before the age of 30
- In the case when the pressure values are greatly increased, diastolic >120 mmHg;
- In the case of organ damage, if hypertension has occurred recently;
- If the patient also has typical signs and symptoms of endocrine hypertension: hypokalemia, palpitations and profuse sweating.
The pulse measurement (on the arm and in the groin) makes it possible to detect coarctation of the aorta: for this it is always necessary to compare between the upper and lower limbs:
The test result is positive if there is a difference in pressure between the limbs:
- Above (hypertension),
- Below (missing pulse in the groin due to lack of blood circulation).
Renal hypertension: lack of symptoms or previous urinary tract infections. In auscultation (where the doctor listens to sounds coming from the abdomen and uses a stethoscope) you can hear an abdominal noise caused by a narrowing of a renal artery.
It is important to ask the patient which medications he takes, because these can cause high blood pressure.
Then the doctor proceeds with the diagnostic examinations.
They are carried out:
- To rule out secondary hypertension,
- To assess organ damage.
Examinations of the first hour (routine) are:
Electrocardiogram (may show typical damage of left ventricular hypertrophy or damage caused by an infarction) and echocardiogram;
Examinations of kidney function:
- urine test,
- Blood test to determine creatinine levels and azotemia
Examination of the fundus
This examination is essential to identify the stage of the disease.
In the case of an initial diagnosis of high blood pressure, this is always indicated.
It is the only part of the body where:
- You can see the arterioles,
- One can determine the degree of atherosclerosis.
Depending on the aspect of the arterioles, different degrees of hypertension can be distinguished, from a mild form (with normal fundus) to severe forms with:
- arteriovenous crossovers,
- exudation (inflammatory fluid),
- flame bleeding,
- In the most severe form of hypertensive retinopathy, papilledema is seen.
Examinations of the second stage (if there are not yet sufficient data for diagnosis):
- cardiac CT and stress echo (stress echocardiography);
- CT or MRI of the brain;
- echo-doublers of the kidneys and supraaortic vessels (TSAs), which are the blood vessels that supply the head;
Therapy for arterial hypertension
Above all, the risk factors must be eliminated:
- Quit smoking;
- Light physical training – doctors recommend 30-60 minutes a day, 4 days a week, but often this is not enough. A one-hour walk is recommended, half in the morning and half in the evening.
- Weight loss;
- diet rich in fruits and vegetables;
- reduce salt, less than 6 g of table salt daily;
- Avoid alcohol;
Drug therapy – guideline
The therapy is tailored to the patient according to the characteristic features and other diseases from which he suffers.
- Diuretika: (gewöhnlich der bevorzugten Wahl). Sie wirken auf die Ausscheidung (Sekretion nach außen) von Natrium. Zu Beginn vermindern sie das Volumen des zirkulierenden Blutes und das Herzminutenvolumen, in der Folge setzen sie die Empfindlichkeit der Arteriolen auf die vasokonstriktorischen Reize herab. Der Arzt kann Thiazide und Furosemid empfehlen.
- Angiotensin-Inhibitoren: ACE (Angiotensin Converting Enzym);
- β-Blocker haben verschiedene Funktionen:
- On the heart, they decrease the heartbeat,
- On sympathetic nerve endings, they block the release of vasoconstricting norepinephrine,
- On the juxtaglomerular apparatus (a structure in the kidney), they reduce the production of renin (an enzyme with vasoconstrictive action),
- They are contraindicated in bronchial asthma and obstructive bronchial disease, they block, for example, the β-2 receptors in bronchial smooth muscles. In this way, they block bronchodilation, but there are some types of drugs with mainly cardiac function, that is, acting on the β-1 receptors.
- vasodilators: drugs that block the “calcium channels” (calcium antagonists) and counteract vasoconstriction, but they also inhibit the aggregation of platelets, which has a positive effect on atherosclerosis and the progression of chronic renal failure;
- Drugs that affect the central nervous system: they work by reducing the tone of the sympathetic system (α-methyldopa) or by strengthening baroreceptors (clonidine).
Natural remedies for arterial hypertension
With high blood pressure, natural treatment is most effective. This consists of:
- healthy nutrition,
- Daily physical exercise.
Recommended diet for high blood pressure
Prunes: A quarter cup of prunes contains 316.6mg of potassium and only 1.7mg of sodium.
Melons: Melons are rich in potassium and magnesium. These minerals contribute to the reduction of arterial pressure.
The carotenoids present in melons and watermelons help prevent atherosclerosis (hardening and narrowing of the walls of arteries and veins).
Avocados: The avocado is rich in potassium and helps maintain the balance between potassium and sodium in the body.
Usually, our diet is rich in sodium, so it is important to increase potassium intake.
The avocado has a high proportion of monounsaturated fatty acids, which contribute to:
- lower LDL or “bad cholesterol”,
- Increase HDL or “good cholesterol” in the body.
Nevertheless, the avocado has a lot of calories, so you should only eat a smaller amount of it.
Berries: Berry fruits such as blueberries, strawberries and raspberries are rich in vitamin C, potassium, fiber and antioxidants.
Blueberries contain a substance called pterostilbene, which prevents plaque build-up in the arteries.
Bananas: Bananas are rich in potassium and contain little sodium.
Two bananas a day can lower arterial hypertension.
A medium-sized banana contains 1 mg of sodium and 385 mg of potassium, so this is one of the most useful fruits against high blood pressure.
Apricots: Apricots are rich in potassium and fiber.
Celery: A vegetable helpful for lowering blood pressure is celery.
Celery contains a phytochemical substance that relaxes the muscle layer in the artery walls.
The result is an increase in blood flow, which reduces blood pressure.
Chili: Chili contains capsaicin, which dilates the vessels.
Carrots: Carrots have a high proportion of beta-carotene and potassium, serve to maintain normal blood pressure and prevent cardiopathies.
One should eat carrots raw to preserve its nutritional properties.
You can drink a glass of carrot juice with a few herbs such as mint or parsley.
Asparagus: Asparagus is rich in vitamins A, C, E and K and also contains glutathione, an antioxidant.
The anti-inflammatory properties of asparagus help prevent heart disease. It also contains fiber and vitamins of group B, which reduce the risk of high blood pressure.
Peas: Peas are high in fiber and low in calories.
The proteins of the peas help in lowering arterial hypertension. In addition, folic acid and vitamin B6 promote heart health.
Chickpeas: The iron in chickpeas increases the level of hemoglobin and improves blood flow to the heart.
Fenugreek: The leaves of fenugreek are a rich source of fiber and potassium.
Both nutrients help keep the nasty cholesterol in the blood low.
Cruciferous vegetables: The following vegetables contain glutamic acid:
- Brussels sprouts.
These amino acids help lower blood pressure and the risk of stroke.
Green leafy vegetables: Green leafy vegetables such as spinach, lettuce, cabbage, mustard seeds, beetroot, Chinese cabbage, etc. contain many minerals, vitamins and fiber, but have few calories.
These vegetables contain various phytochemical substances and antioxidants that stop plaque formation in the blood vessels.
Eggs: A study by Clemson University and Jilin University shows that protein can lower blood pressure.
Foods to avoid
Some foods and drinks raise blood pressure, especially table salt.
Processed foods, such as those available in supermarkets, contain sodium, including desserts. You should therefore check all the products you want to buy.
Stimulating and stimulating drinks should be avoided, such as:
According to a scientific study (Effects of a 6-Month Walking Study on Blood Pressure and Cardiorespiratory Fitness in U.S. and Swedish Adults: ASUKI Step Study. Soroush A, Der Ananian C, Ainsworth BE, Belyea M, Poortvliet E, Swan PD, Walker J, Yngve A – Asian J Sports Med. 2013 Jun; 4(2):114-24), blood pressure is significantly lowered if you walk 10,000 steps daily.
When should surgery be performed for arterial hypertension?
With hypertension resistant to treatment, surgical intervention to denervate the renal artery may be performed.
With hypertension, there is hyperexcitability of the sympathetic nervous system.
Denervation is a procedure in which the connection between the nerve and the renal artery is interrupted to block the hyperexcitability of the sympathetic nervous system.
- The surgeon gains percutaneous access (via a small hole) into the inguinal artery, so there is no abdominal incision.
- From here, a catheter is advanced and an ablation (removal) of the nerve is carried out by means of radio frequency.
The results can be seen after a few months up to 2 years.
The hospital stay lasts only a few days, within a week you can resume your daily activities.
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