Standard for the treatment of hypertension in a hospital, order 708n for arterial hypertension

Characteristics of the international protocol

The protocol data was developed by leading doctors who are excellent specialists in cardiology and neurology. Moreover, the work used research materials obtained during international scientific research. The document included the main standards for the treatment of hypertension, and we are talking exclusively about a qualified approach. In addition, it not only includes issues of standard treatment, but also considers other mandatory activities:

individual approaches based on pathological factors and risks arising from arterial hypertension;
a set of mandatory diagnostic procedures;
therapeutic processes.

The protocol focuses on pharmacological agents that can be used for treatment or emergency management of high blood pressure. These data are more of a recommendation for practicing specialists.

The standard of care for arterial hypertension, all its protocols are in full compliance with the instructions defined by the Ministry of Education.

International protocol for the treatment of hypertension and first aid

The International Protocol for the Treatment of Hypertension is a modern treatment document on which doctors from all countries rely when fighting such a common and insidious disease.

Today, the number of patients with arterial hypertension is steadily growing, and for many, high blood pressure is a permanent condition.

What are the main points of the standard protocol, what do they concern, and what help can specialists provide during a hypertensive crisis?

Characteristics of the international protocol

The document includes the basic standards for the treatment of hypertension, and we are talking exclusively about a qualified approach.

In addition, it not only includes issues of standard treatment, but also considers other mandatory activities:

individual approaches based on pathological factors and risks arising from arterial hypertension;
a set of mandatory diagnostic procedures;
therapeutic processes.

The protocol focuses on pharmacological agents that can be used for treatment or emergency management of high blood pressure. These data are more of a recommendation for practicing specialists.

Based on the protocol for the treatment of hypertension, doctors control the volume and quality of medical services provided. If we translate the definition into simple language, then this document is a hint on what to do if a patient is admitted suffering from hypertension or with similar symptoms, but without an established diagnosis.

The standard of care for arterial hypertension, all its protocols are in full compliance with the instructions defined by the Ministry of Education.

A series of general questions

A patient is diagnosed with arterial hypertension if his blood pressure (BP) has been steadily increasing over a long period, but the person is not yet taking medications that lower it.

When pressure increases, two indicators are taken into account - systolic (the upper limit of the indicator) and diastolic - the lower limit. We can talk about hypertension if the first indicator is equal to or higher than 140 mm Hg. Art., and the second is equal to or exceeds 90 mm Hg. Art.

The standard of treatment for hypertension divides the pathology into several forms:

primary (essential) hypertension;
hypertension complicated by pathologies of the heart muscle;
hypertension caused by renal dysfunction;
hypertension, accompanied by deterioration in the functionality of the heart and kidneys.

In addition, there is resistant hypertension, described by the standard as a type of arterial hypertension in which taking medications does not produce the expected reduction in levels.

If we talk about the short-term form of hypertension, then this condition develops as the body’s response to stress, the influence of any components and other unfavorable situations. But even in this case, the patient cannot be left without medical care, according to the approved protocol.

Management of patients suffering from arterial hypertension

According to the standards, all diagnostic and therapeutic measures, as well as treatment regimens, are subject to regulations:

Stage 1 hypertension, occurring without complications and hypertensive crisis;
2-3 stages of hypertension, without a hypertensive crisis, but complicated by concomitant renal, vascular, heart diseases or pathological conditions of the brain;
with elevated blood pressure, an uncomplicated hypertensive crisis develops.

First of all, the doctor determines the type and form of hypertension, and then prescribes medications for primary emergency care and further long-term treatment of arterial hypertension.

The therapy prescribed for the treatment of essential hypertension differs from the treatment of a disease complicated by heart failure or other dysfunctions of this organ.

What treatment for hypertension can be offered in a clinic?

Timely bringing the indicators back to normal reduces the risks of developing a hypertensive crisis and the occurrence of subsequent serious complications. The clinic will provide first aid for high blood pressure, and the patient’s condition will improve in a short time.

You can contact either your local doctor or a cardiologist.

For doctors, a rapid decrease in blood pressure during hypertension and stabilization of its indicators means eliminating the threat of damage to target organs: the heart, kidneys, and brain.

In the international standard for indicators of arterial hypertension, they are assessed as follows:

120/80 mmHg - norm;
130/85 mm Hg. Art. - allowed;
from 130/85 to 139/89 - prehypertensive state.

Such therapy makes it possible to exclude further progression of the disease and its transition to the next, more dangerous stage.

In the clinic, in addition to providing first aid and prescribing treatment, the doctor prescribes a number of important recommendations.

The following measures can normalize the condition of a patient suffering from hypertension:

balanced diet with limited salt intake;
regular physical activity;
body weight control;
compliance with a rational regime of rest and physical activity.

Competent treatment and adherence to medical advice can have a good effect on the body in order to get rid of arterial hypertension.

Treatment in a hospital setting

The issue of hospitalization of the patient is decided after emergency care for high blood pressure has been provided. In fact, there are many indications for admitting a patient to a hospital:

the history indicates that the patient has already suffered one or more hypertensive crises, which led to cerebrovascular accident;
at pressure above 150/100 mmHg. Art., found in a woman carrying a child;
if even after professional help the pressure does not decrease to a safe level;
in the case when medical care to lower blood pressure does not give a positive result and the patient only gets worse;
if there is a strong drop in indicators against the background of the assistance provided;
when there are symptoms not only of hypertension, but also of poor circulation - stroke, ischemia;
if there is a need to determine the patient’s ability to work and exclude or confirm the diagnosis of hypertension.

Diagnostic measures

If a hypertensive attack occurs, then, according to the protocol, doctors carry out a set of diagnostic and therapeutic measures. This approach makes it possible to determine the causes of the pathology, as well as to find out how much it affected the condition of the target organs.

Even before the patient is hospitalized, a specialist from the ambulance team carries out primary diagnostics: measures pressure using a tonometer and, in some cases, performs electrocardiography.

In addition, the patient is questioned about existing symptoms and concomitant diseases.

A more thorough diagnostic examination is performed when the patient is admitted to the hospital.

Before prescribing treatment, the doctor performs the following standard procedures:

assesses medical history;
interviews the patient;
carries out an initial inspection.

The specialist must find out whether the patient has previously had blood pressure surges to critical levels - hypertensive crises. If yes, then find out what caused such phenomena and what pills the patient took to lower blood pressure. It is important for the doctor to find out which drugs had the maximum effect without negative side effects.

During diagnosis, the patient's blood pressure is often measured, taking into account the time of day and the conditions under which this is done. Cardiography and consultation with an ophthalmologist are prescribed to examine the fundus.

Most often, patients over 40 years of age with frequent surges in blood pressure are diagnosed with arterial hypertension. But in order to accurately determine the disease, an additional examination is prescribed:

a urine test is taken to detect protein, glucose, nitrogen, creatinine;
blood test to detect hematocrit and hemoglobin.

Therapeutic therapy for hypertension

Arterial hypertension requires mandatory medical intervention. If emergency assistance is not provided and adequate treatment is not carried out, the patient’s condition will steadily deteriorate.

Effective relief of a hypertensive crisis, standards confirm this, necessarily includes taking antihypertensive medications, otherwise it is almost impossible to stabilize the patient’s condition.

What pills can be taken in this case are clearly indicated in the standard treatment protocol.

To normalize high levels, it is necessary to take the drug in a small dose, which will gradually reduce the pressure, preventing it from falling critically.

Help with a hypertensive crisis additionally includes taking diuretics. The drug Indap or Hydrochlorothiazide may be prescribed, which will prevent the development of stroke or ischemia.

If the patient has previously suffered a heart attack or suffers from heart rhythm disturbances, then treatment includes the use of beta blockers, for example Atenolol, Betaxolol, Metaprolol. But patients are warned that if they increase the dosage on their own, negative reactions are possible.

Almost all therapeutic regimens for hypertension include calcium antagonists. There are tablets with short and long action. Taking the former ensures a rapid reduction in blood pressure, while the latter maintains normal levels for a long time.

When providing assistance during a hypertensive crisis or prescribing therapy, it should be borne in mind that calcium antagonists should not be taken by patients whose concomitant diseases include bronchial asthma, diabetes mellitus, or vegetative-vascular dystonia.

In most cases, specialists prescribe tablets such as Diltiazem, Amlodipine, Verapamil.

Hypertensive patients are recommended to take drugs that are ACE inhibitors. They are able to reduce blood pressure in a short time; in addition, they have a positive effect on brain cells, the nervous system, and protect the body from pathological changes in the kidney structures. This group includes medications such as Enalapril, Ramipril, Captopril, etc.

Why does hypertension occur?

Hypertension is a pathology characterized by a chronic, that is, long-term increase in blood pressure (BP). The disease usually occurs between the ages of 40 and 50, but there are increasingly cases where the diagnosis is made at a young age - this is due to an abundance of bad habits, disruption of sleep and wakefulness intervals, poor diet, and unfavorable environment.

There are two main types of this disease - primary and secondary hypertension. Primary hypertension is the most interesting in terms of causes and clinical cases; it accounts for more than 90% of all visits to doctors regarding high blood pressure. This is an increase in blood pressure that occurred on its own, without previous diseases.

It has no specific organic cause, and the pathogenesis is complex and forms a vicious circle. The main role is played by the formation of renin, which is converted to angiotensin under the action of ACE (angiotensin-converting enzyme). This leads to the release of a powerful vasoconstrictor, angiotensin II, which sets off a cascade of consequences. Treatment is symptomatic or pathogenetic (aimed at breaking the vicious circle).

Secondary hypertension has a clear cause - it has an underlying disease that has affected one of the systems that regulate blood pressure levels. This may be a pathology of the cardiovascular system, kidneys, endocrine system (pituitary or adrenal glands, sometimes thyroid gland). Treatment of secondary hypertension takes into account its etiology, the true cause.

Risk factors contribute to the occurrence of primary hypertension:

stress and emotional stress;
smoking;
disturbance of sleep and wakefulness;
poor nutrition;
obesity;
inactive lifestyle;
age over 40 years;
male gender;
genetic predisposition (the presence in the family of people with a similar pathology);
diabetes;
disturbances of water-salt metabolism (for example, excessive consumption of sodium in the form of table salt).

They statistically significantly increase the risk of developing the disease, and if several risk factors are present, then the likelihood of developing hypertension increases significantly.

Analyzes and laboratory tests

Examination of the patient and collection of anamnesis for hypertension is a mandatory part of the examination, and based on its results, the doctor prescribes a number of tests. The patient needs to undergo several additional procedures to determine the condition of the cardiovascular system, brain, kidneys, liver, and visual organs.

The patient needs to undergo urine and blood tests, both general and for the level of sugar, creatinine, and uric acid. They are necessary to determine the degree of damage to internal organs and identify additional risk factors.

The examination standard includes examination of target organs and determination of their clinical condition, which affects the risk of cardiovascular complications.

The general plan for diagnosing hypertension includes:

electrocardiogram to detect cardiac dysfunction and pathologies;
X-rays of light;
Ultrasound of internal organs.

At the second stage of the examination, the following is prescribed:

additional blood tests for cholesterol;
blood lipid profile study;
analysis of the condition of the kidneys, thyroid gland, adrenal glands (they are necessary to determine the presence and degree of pathologies);
ultrasound examination of the heart to detect enlargement of the walls of the left ventricle, characteristic of hypertension;
arteriography to determine the condition of arterial walls, lumens and the presence of plaques;
ultrasound examination of blood flow in vessels.

Based on the data obtained, the doctor confirms the diagnosis and determines the degree and stage of hypertension. Additionally, consultations and examinations with a psychologist, neurologist and ophthalmologist can be prescribed.

A series of general questions

A patient is diagnosed with arterial hypertension if his blood pressure (BP) has been steadily increasing over a long period, but the person is not yet taking medications that lower it.

primary (essential) hypertension;
hypertension complicated by pathologies of the heart muscle;
hypertension caused by renal dysfunction;
hypertension, accompanied by deterioration in the functionality of the heart and kidneys.

In addition, there is resistant hypertension, described by the standard as a type of arterial hypertension in which taking medications does not produce the expected reduction in levels.

Diagnosis of hypertensive heart disease

To identify hypertension, several methods are used to examine the patient: monitoring blood pressure throughout the day, taking a history of the disease, standard physical examination and collecting tests.

Daily monitoring

To establish the amount and frequency of increases in blood pressure (blood pressure), it is necessary to measure its level daily and record the data. Another method is to conduct daily monitoring. Its essence is to measure blood pressure during the day every 15 minutes and every 35-45 minutes during sleep.

The blood pressure level is elevated - from 140 to 90 mmHg.

History of the disease

Another important part of diagnosing hypertensive heart disease is taking a medical history. This includes: medical history, symptoms and complaints of the patient, data on damage to internal organs. Doctors also pay attention to the presence of a hereditary predisposition to cardiovascular diseases, hyperlipidemia, and diabetes mellitus. An assessment is made of the person’s diet, physical activity, bad habits, psychological characteristics and character.

This examination is necessary to identify additional risk factors:

increased body hair in women;
obesity, accompanied by the appearance of stretch marks and pathological changes in the skin;
kidney pathology;
swelling in the arms, legs, face;
bleeding.

If hypertension is suspected, it is advisable to carry out the examination in the first half of the day, and during the appointment, pressure readings are taken twice with an interval of 20 minutes. If the data diverge by more than 5 mmHg, then take the average value. Listening to the heart and lungs, as well as palpating the thyroid gland to determine the size and identify nodes are mandatory.

Signs of primary hypertension

Arterial hypertension requires mandatory medical intervention. If emergency assistance is not provided and adequate treatment is not carried out, the patient’s condition will steadily deteriorate.

The duty of the attending physician is to provide mandatory consultation to the patient; he must explain what to do to avoid complications, what consequences can be expected if the recommendations are not followed. Effective relief of a hypertensive crisis, standards confirm this, necessarily includes taking antihypertensive medications, otherwise stabilize the patient’s condition almost impossible. What pills can be taken in this case are clearly indicated in the standard treatment protocol.

To normalize high levels, it is necessary to take the drug in a small dose, which will gradually reduce the pressure, preventing it from falling critically.

Help with a hypertensive crisis additionally includes taking diuretics. The drug Indap or Hydrochlorothiazide may be prescribed, which will prevent the development of stroke or ischemia.

When providing assistance during a hypertensive crisis or prescribing therapy, it should be borne in mind that calcium antagonists should not be taken by patients whose concomitant diseases include bronchial asthma, diabetes mellitus, or vegetative-vascular dystonia.

A sign of arterial hypertension is blood pressure levels exceeding 130 mmHg. Art. for systolic and 90 mm Hg. Art. for diastolic.

Hypertension can be hidden for a long time; a person often does not notice that his blood pressure is higher than normal. This is possible with a mild form of the disease. Patients are only occasionally bothered by unpleasant symptoms such as general malaise and headache attacks; as a rule, they do not pay much attention to this.

The patient may not suspect for a long time that he has high blood pressure.
In later stages, the disease manifests itself in a bright clinical picture, which varies from mild malaise to vivid symptoms associated with damage to target organs and systems:

cardiovascular (a feeling of squeezing or a painful jolt behind the sternum, tachycardia, arrhythmia, uneven force of heart beats or a feeling of cardiac arrest, tingling);
brain (dizziness, drowsiness, headaches, clouding of consciousness, memory and thought process disorders);
kidneys (oliguria - decreased diuresis, pain when urinating, development of kidney dystrophy);
retina (floaters before the eyes, darkening of the eyes, blurred vision).

If such symptoms appear, you should consult a specialist rather than resort to self-treatment. First of all, it is necessary to determine the exact degree of the disease - in the first degree, treatment with drugs is not used, or they are used symptomatically, and the manifestations of the disease are eliminated by normalizing the daily routine, revising the diet and increasing physical activity.

Arterial hypertension and bad habits

If we ask an ordinary person who smokes and drinks alcohol frequently

, why does he do this, most will answer that smoking calms the nerves and alcohol dilates blood vessels! Whatever we are willing to believe to justify our sins.

But in life everything is quite the opposite - regular intake

medium (and even more so large) doses
of alcohol
contribute to
vasospasm and increased blood pressure, smoking
several times accelerates
the process of deposition of cholesterol into the walls of blood vessels
(the so-called atherosclerotic plaques -
the cause of heart attacks, strokes, thrombosis in blood vessels
) and disrupts the regulation of vascular tone,
leading to hypertensive crises.
Emergency care for hypertensive crisis

Modern recommendations

limit alcohol intake to small doses (only 50 ml per day in terms of ethanol for men, and 30 ml for women).
However, alcoholic drinks contain many calories and contribute to weight gain. Do you remember how we snack on them? Not to mention beer, regular consumption of which reduces the level of male sex hormones in men. Limit your alcohol intake!
Stop smoking! After all, by maintaining these bad habits, you begin to fight the disease on one side, leaving the doctor alone!
What kind of victory or control over hypertension can there be?

Management of patients suffering from arterial hypertension

There is no single therapeutic protocol that is 100% suitable for treating any form of this disease. Treatment of hypertension depends on the form of arterial hypertension, associated complications, the patient’s age and other factors. According to the standards, all diagnostic and therapeutic measures, as well as treatment regimens, are subject to regulation:

Stage 1 hypertension, occurring without complications and hypertensive crisis;
2-3 stages of hypertension, without a hypertensive crisis, but complicated by concomitant renal, vascular, heart diseases or pathological conditions of the brain;
with elevated blood pressure, an uncomplicated hypertensive crisis develops.

The therapy prescribed for the treatment of essential hypertension differs from the treatment of a disease complicated by heart failure or other dysfunctions of this organ.

Protocol arterial hypertension 2016

The chief cardiac surgeon of the Ministry of Health of the Russian Federation states: “Hypertension is not a death sentence. The disease is truly dangerous, but it is possible and necessary to fight it. Science has stepped forward and medications have appeared that eliminate the causes of hypertension, and not just its consequences. Just enough... Read the article >>

Hypertension is an increase in blood pressure above established limits, which decreases after taking antihypertensive drugs.

Our readers successfully use Normaten to treat HYPERTENSION. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

Classification of hypertension (very briefly):

Hypertension is also divided into:

A division is also made according to the degree of risk of cardiovascular complications (heredity and anamnesis are taken into account).

Treatment of hypertension

Standards of medical care (international treatment protocol) and WHO recommendations have been developed.

Conventionally, they can be divided into:

Outpatient protocol for the treatment of hypertension

Diagnosis: “primary arterial hypertension” is established when there is a twofold or more increase in blood pressure recorded at rest at two or more appointments with a therapist.

When the diagnosis of hypertension is beyond doubt, a blood test (blood test), urine test is prescribed, an ECG is recorded, the fundus of the eye is examined, and a chest x-ray is performed. The level of cholesterol in the blood is determined.

Secondary hypertension (hydronephrosis, glomerulonephritis, renal artery stenosis, polycystic kidney disease, coarctation of the aorta) is excluded. Concomitant pathology and target damage (heart, lungs, kidneys, cerebral vessels) are excluded.

Treatment is divided into non-pharmacological and medicinal.

Non-drug treatment

Non-drug treatment is prescribed for newly diagnosed hypertension in patients with a low risk of complications.

It starts with lifestyle changes:

Drug treatment

If there is a persistent increase in blood pressure, despite primary measures, potassium-sparing diuretics (veroshpiron) are prescribed.

If ineffective, an antihypertensive drug + diuretic regimen is used. If this regimen fails, two antihypertensive drugs from different groups + a diuretic, three drugs + a diuretic.

In patients at very high risk, the non-drug stage is skipped and a regimen of one or two antihypertensive drugs + a diuretic is immediately prescribed.

Six groups of drugs are used:

Beta blockers (metoprolol, propranolol)
ACE inhibitors (enalapril, captopril, perindopril)
Calcium antagonists (nifedipine, amlodipine)
Alpha blockers (carvedilol)
Antagonists of AG-1, angiotensin-2 receptors: losartan, valsartan
Imidozoline receptor antagonists (clonidine, moxonidine)

The selection of a combination of drugs is carried out individually, taking into account sensitivity and individual intolerance and can be delayed for a long time until a stable therapeutic effect is established.

However, there are several ready-made schemes. Most likely, the therapist will start with these:

HYPERTENSION AND PRESSURE RUPS WILL BE A thing of the past!

Pressure surges each time cause colossal overloads of the heart muscle, which sooner or later end in cardiac arrest. Roughly speaking, each time increased pressure leads to a 10-20-fold overload of the heart.

If we talk about the final development of the disease, then hypertension always leads to the same result - death. However, if we single it out as the key cause of human death, then this happens in 89% of cases. That is, in 89% of situations, hypertension ends in a heart attack or stroke and the death of a person.

Moreover, if 20-30 years ago patients with this diagnosis had a good chance of living 10-20 years, now approximately 2/3 (two thirds) of patients die during the first five years of the disease. What’s especially scary is the fact that a lot of people don’t even suspect that they have hypertension.

And they miss the opportunity to fix something, simply dooming themselves to death.

In 2020, at the Scientific and Practical Center of Cardiology and Cardiac Surgery, which is part of the State Research Center for Preventive Medicine, clinical trials of a new generation drug created to combat hypertension were successfully completed. The press service of the institute released the following: Read the article >>

Diuretic + beta blocker (indapamide + metoprolol; furosemide + atenolol); When prescribing furosemide, potassium preparations (panangin) are required, because taking furosemide leads to a significant loss of potassium salts.

Beta blocker + ACE inhibitor (metoprolol + Enap).

There are other effective schemes.

The most common and widespread mistake in the outpatient treatment of arterial hypertension is that after a certain period, many patients “stop” taking antihypertensive drugs, explaining that “the pressure is already normal. Why waste money on pills that don’t help.”

The patient feels great (hypertensive drugs improve quality of life). But, as soon as the drug is completely removed from the body, the pressure rises again. Therefore, tablet treatment for hypertension should continue for life, despite normalization of blood pressure.

Standard for the provision of medical care for hypertension by emergency medical services teams

The ambulance team that arrives to the call works strictly according to standards, which include measuring blood pressure, temperature, recording an ECG, and express blood sugar diagnostics.

The standards are clear. Every action of the brigade is strictly prescribed. Any deviation from the standard situation is taken into account. The standards are presented in paper form. EMS doctors either carry them with them or know them by heart.

When blood pressure is 160/100 mmHg, 1 tablet of capoten (25 mg) or nifedipine (50 mg) is given; if treatment is unsuccessful, another one is given. In case of ineffectiveness, Enap 1 ml intravenously with simultaneous catheterization of a peripheral vein. If the pressure does not decrease - dibazole, papaverine, magnesia, furosemide, droperidol.

Intractable hypertensive crisis (BP 180 or more), associated complications (heart attack, stroke) are indications for hospitalization.

Urgent Care

The ambulance team begins to provide emergency assistance in the event of a complication at the scene of the call:

In each case, humidified oxygen (100%) is given through a mask.

When clinical death occurs, resuscitation measures are carried out for 30 minutes, with a simultaneous call to the intensive care team (ICU).

Resuscitation. How to do cardiac massage and artificial respiration? Actions after resuscitation.

Standards for the treatment of hypertension in a hospital

Hypertension is an outpatient disease. However, in some cases, as mentioned earlier, hospitalization is necessary.

Intractable hypertensive crisis, development of myocardial infarction, transient ischemic attack, stroke, pulmonary edema are indications for hospitalization.

Standards of hospital care are clear and must be strictly adhered to by doctors and nurses.

Diagnostic procedures are performed: CBC, urine, biochemistry of blood, urine, chest x-ray. Consults with an endocrinologist and other specialists. A heart monitor is connected.

Treatment is carried out in the intensive care ward.

Blood pressure is reduced by fenoldopam and sodium nitroprusside.
Vital functions are stabilized during a complicated crisis:

After stabilization of blood pressure, the patient is selected an individual regimen of antihypertensive drugs with lifelong use.

After the final stabilization of blood pressure and vital functions, the patient is discharged from the hospital under the supervision of a local therapist.

Hypertension. Hypertensive crisis - protocol for providing assistance at the EMS stage

I10 Essential (primary) hypertension

I11 Hypertensive heart disease (hypertension primarily affecting the heart)

I11.9 Hypertensive disease without congestive heart failure

I12 Hypertensive (hypertensive) disease with predominant kidney damage

I13.9 Hypertensive (hypertensive) disease with predominant damage to the heart and kidneys, unspecified

I15 Secondary hypertension

Diagnostics

https://www.youtube.com/watch?v=xvC33TGh96M

Then a comprehensive examination is prescribed. It begins with a doctor’s examination and blood pressure measurement, followed by several instrumental methods - an ECG (electroencephalogram), an ultrasound examination of the heart muscle and heart chambers for hypertrophy, a portable tonometer is installed to measure blood pressure throughout the day - this provides comprehensive information on which can accurately determine the presence of hypertension and its type (daytime or nighttime). The fundus of the eye is examined for the presence of modified vessels, which are often found during prolonged exposure to high pressure.

Laboratory diagnostic methods include general blood and urine tests, biochemical blood tests.

How is screening done for hypertension? Standards, forms and diagnostic methods

Hypertension is a chronic condition in which the main symptom of the disease is persistent high blood pressure. It occurs all over the world more often than other pathologies. Hypertension is diagnosed in every third elderly person.

When prescribing treatment, it is important to know the cause of arterial hypertension, so appropriate diagnosis must be carried out. The standards, forms and methods of examining a patient in a clinic will be discussed in this article.

Outpatient treatment plan for hypertension

If a person shows signs of hypertension, he or she should first consult a physician. He prescribes the necessary examinations and tests. First of all, the doctor should find out:

Does the patient have chronic diseases?
Close relatives of the patient have a similar problem.
Have there been any history of heart problems in the past?

The main additional examinations are:

general clinical blood and urine tests;
Ultrasound of the kidneys;
blood test for thyroid hormones;
Dopplerography of the vessels of the lower extremities.

It is imperative to check the functioning of the heart muscle. For this purpose, echocardiography, ECG and arteriography are performed. The patient's fundus is checked to exclude retinal pathologies.

After all these diagnostic measures, the patient is referred to specialists:

nephrologist;
neurologist;
cardiologist;
ophthalmologist;
endocrinologist;
nutritionist and others.

Preparing the patient for procedures

Since examining a person with hypertension involves several procedures , the preparation for them may differ. Even just to measure your blood pressure, you need to know how to prepare for it.

In order for the tonometer to show a reliable result, you need to calm down 10-15 minutes before the procedure and overcome your anxiety. Before most examinations, a categorical refusal of caffeine and a heavy dinner is required. It is advisable not to have breakfast in the morning. You should calm down, since a person’s condition also affects the test results.

Main stages

Examination for hypertension includes several main stages.

Primary

The primary examination is a history taking and examination of the patient.

The doctor’s algorithm of actions is as follows:

Studying the patient's medical record.
Determining the location of the patient's pain.
Find out what medications the patient is taking, since some medications provoke an increase in blood pressure.
Measuring a person's height and weight. Sometimes extra pounds provoke an increase in blood pressure.
Listening to the patient's heart and lungs. Often, a person suffering from hypertension exhibits tachycardia, bradycardia or other cardiac abnormalities.
Examination of the thyroid gland and peripheral vessels.
Daily blood pressure monitoring.

Lab tests

The following laboratory tests are required:

Urine - for the presence of protein, glucose and red blood cells.
Blood - the number of red blood cells, hemoglobin, glucose, leukocytes and other formed elements is determined.
Biochemical blood test - based on the amount of liver transaminases, urea, creatinine, calcium, sodium, potassium, cholesterol, uric acid, glucose, etc. evaluate the functioning of internal organs.

ECG

Electrocardiography is performed to evaluate the functioning of the heart muscle and the presence of abnormalities. But for a thorough study of this organ, an ECG will not be enough. The most informative will be an ultrasound examination.

Doppler ultrasound allows you to view the major vessels that run from the heart system to the brain. In the presence of hypertension, this examination is the most important , since it determines the presence of cholesterol plaques, can identify a pre-stroke condition and makes it possible to prevent it in a timely manner.

Ultrasound of internal organs

In case of secondary hypertension, an ultrasound scan of the kidneys, liver, and spleen is performed, assessing their visual condition.

MRI

Magnetic resonance imaging for hypertension is necessary to detect stroke , since it is the very first complication of high blood pressure.

X-ray

This diagnostic method allows you to determine the size of the heart muscle, its pathological increase or decrease, since this condition often occurs with hypertension.

Pulse oximetry

Thanks to pulse oximetry, doctors learn not only the heart rate, but also the degree of oxygen saturation of the heart. This diagnosis is no less important than the others, but it is usually used only in intensive care conditions.

Sphygmomanometry

This is the well-known indirect measurement of blood pressure with a tonometer, also known as a sphygmomanometer. inflated cuff with an attached sensor allows you to determine the filling of blood vessels with blood .

Fundus examination

Over time, chronic hypertension leads to retinopathy, i.e. retinal pathologies. To prevent this condition, it is necessary to undergo regular fundus examinations by an ophthalmologist.

This reveals tortuosity and narrowing of the arteries, dilated veins, and minor hemorrhages. Stages 3 and 4 retinopathy can lead to vision loss.

Differential diagnosis

Hypertension can be primary or secondary . Primary hypertension appears without cause. Secondary – develops against the background of underlying pathologies, the identification of which is aimed at differential diagnosis:

kidney diseases;
endocrine disorders;
hemodynamic problems;
brain lesions and injuries;
congenital anomalies and others.

To get rid of secondary hypertension, treatment of the underlying disease is necessary.

Diagnosis of hypertension is extremely important, since a variety of reasons can provoke an increase in blood pressure. Thanks to diagnostic procedures, the doctor will prescribe adequate treatment and help you cope with the problem.

Treatment in a hospital setting

At the clinic, a specialist offers complex, step-by-step therapy. The primary task that the doctor sets for himself is to reduce blood pressure. That is, first aid for hypertension is taking an antihypertensive drug, correctly prescribed and strictly dosed. Timely bringing the indicators back to normal reduces the risks of developing a hypertensive crisis and the occurrence of subsequent serious complications.

For doctors, a rapid decrease in blood pressure during hypertension and stabilization of its indicators means eliminating the threat of damage to target organs: the heart, kidneys, and brain.

In the international standard for indicators of arterial hypertension, they are assessed as follows:

120/80 mmHg - norm;
130/85 mm Hg. Art. - allowed;
from 130/85 to 139/89 - prehypertensive state.

Treatment of the initial stage of the disease, which occurs in a mild form, is carried out on an outpatient basis. In most cases, therapy is limited to taking several medications - tablets are prescribed that can correct blood pressure. Such therapy makes it possible to exclude further progression of the disease and its transition to the next, more dangerous stage.

balanced diet with limited salt intake;
regular physical activity;
body weight control;
compliance with a rational regime of rest and physical activity.

Competent treatment and adherence to medical advice can have a good effect on the body in order to get rid of arterial hypertension.

The issue of hospitalization of the patient is decided after emergency care for high blood pressure has been provided. In fact, there are many indications for admitting a patient to a hospital:

the history indicates that the patient has already suffered one or more hypertensive crises, which led to cerebrovascular accident;
at pressure above 150/100 mmHg. Art., found in a woman carrying a child;
if even after professional help the pressure does not decrease to a safe level;
in the case when medical care to lower blood pressure does not give a positive result and the patient only gets worse;
if there is a strong drop in indicators against the background of the assistance provided;
when there are symptoms not only of hypertension, but also of poor circulation - stroke, ischemia;
if there is a need to determine the patient’s ability to work and exclude or confirm the diagnosis of hypertension.

What pills to take for high blood pressure?

It is possible to stabilize arterial or intracranial pressure at home. The question arises, what should you drink if you have high blood pressure?

Typically, to stabilize blood pressure and ICP, synthetic medications are used, produced in the form of tablets for oral use. The most widely used drugs are ACE inhibitors, diuretics, sartans, calcium channel blockers, and beta-blockers.

ICP is reduced by drugs with neurometabolic effects, venotonics and vasoactive therapy. Also, herbal tinctures and folk remedies can be used to stabilize blood pressure and ICP.

Tablets for stabilizing blood pressure

Arterial hypertension is a pathology in which blood pressure indicators exceed 140-150 by 90-100 mmHg. The disease is treated symptomatically with antihypertensive medications.

If therapy is not carried out in a timely manner, complications such as stroke, myocardial infarction, coronary heart disease, and hypertensive crisis may develop (BP levels during a crisis exceed 170-200/120-130 mmHg).

What to drink for high blood pressure? The following drugs can be used to stabilize blood pressure:

Thiazide diuretics. Medicines block the absorption of sodium and chlorine ions in the kidney tubules, due to which excess fluid leaves the body, the blood vessels dilate and blood pressure stabilizes. Hypotiziad is considered the best thiazide. Cyclomethiazide and Hydrochlorothiazide have also worked well.
Sulfonamides. Their use is justified in the treatment of resistant forms of hypertension, when blood pressure exceeds 168-170/120-130 mmHg. The best sulfonamides are Oxodoline, Acripamide and Indap.
Beta blockers. The drugs reduce blood pressure by blocking vascular beta receptors and inhibiting the secretion of renin with angiotensin 2. Beta blockers significantly reduce the likelihood of progression of heart failure, stroke and myocardial infarction. In addition, you can take these medications to lower blood pressure if you have angina. The best representatives of this group are Concor, Bisoprolol, Anaprilin, Nebivolol.
ACE inhibitors. Medicines prevent the conversion of angiotensin to renin. They also help strengthen the heart muscle, stop tachycardia and stabilize blood circulation. The best drugs in this group are Captopril, Lisinopril, Ramipril, Quinopril. ACE inhibitors are not recommended for use in old age if hypertension is accompanied by atherosclerosis.
Sartans. The drugs lower blood pressure by blocking angiotensin II receptors. Medicines stop palpitations and significantly reduce the likelihood of progression of a hypertensive crisis. The list of the most effective sartans includes Losartan, Mikardis, Kozar, Valsartan.
Calcium channel blockers. The drugs help to gently lower blood pressure and increase physical endurance. If pressure readings exceed 160/100 mmHg, co-prescription of calcium channel blockers and ACE inhibitors is justified. The best drugs are under the trade names Amlodipine, Verapamil, Cardil.

What pills to take for high blood pressure when a crisis begins? In this case, it is best to take centrally acting antihypertensive drugs. They help lower blood pressure quickly. But the disadvantage of such drugs is the fact that they can cause hypotension (BP < 90/60 mmHg).

The best centrally acting antihypertensives are Moxonidine, Physiotens, Clonidine and Tenzotran.
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Folk remedies for lowering blood pressure

What should you drink for blood pressure, besides antihypertensive pills? To stabilize blood pressure, you can use traditional medicine. Their use is justified even during pregnancy or breastfeeding.

People who have a tendency to allergic reactions should take decoctions and tinctures with caution. Traditional medicine should also be used carefully by people who have acute pathologies of the digestive system.

To reduce blood pressure it is advisable to use:

Beetroot juice with honey (ratio 1:1). It is enough to take 50-100 ml of this drug per day. Doctors say that beetroot juice with honey will even help lower cholesterol levels and normalize heart rate.
Tincture of red cones. It is immediately worth noting that this drug cannot be taken on an ongoing basis. The duration of the course is limited to 2-3 weeks. How to prepare the infusion? You need to wash the cones and fill a liter jar with them. Next, you need to add 400-500 ml of vodka to the container. Then you need to cover the jar with a lid and leave the drug in a dark place for 4-5 weeks. Before use, the infusion is filtered. Take 20-30 drops 2 times a day.
Plant collection. Take 10 grams of chamomile, immortelle, birch buds and St. John's wort (all components in dried form). Pour the ingredients into 300 ml of water and boil over low heat for 20-30 minutes. Next, the collection must be judged and strained through several layers of gauze. It is enough to take 100 ml of the drug 2-3 times a day.
A decoction of valerian and yarrow. Dried herbs should be taken in equal quantities (optimally 20 grams), mixed, and pour 500 ml of water. Next, the drug is simmered over low heat for 40 minutes. Before use, strain through cheesecloth. Take 200 ml 2 times a day.

The above drugs will be most effective for mild hypertension (140/90 mmHg).

Pharmacy tinctures to lower blood pressure

For the treatment and prevention of hypertension, plant-based tinctures can be used. They will help stabilize the pressure at 120-130/90-80 mmHg.

The best drug in this segment is hawthorn tincture. The medicine helps eliminate high blood pressure, reduce the likelihood of progression of atherosclerosis, and relieve the unpleasant symptoms of arterial hypertension.

How to take the medicine? The tincture should be mixed with warm purified water. Dosage – 16-20 drops 2-3 times a day. The course of treatment is 2-3 weeks. If necessary, you can repeat therapy after a month.

To stabilize the operation of the SSS, you can also use:

Motherwort tincture. Dosage – 30-50 drops 3-4 times a day.
Valerian tincture. Dosage – 20-30 drops 3-4 times a day.
Peppermint tincture. Dosage 10-15 drops 3-4 times a day.

Alcohol tinctures should not be used by people who have liver dysfunction or ulcerative lesions of the digestive system.

How to stabilize ICP?

Intracranial pressure is an indicator that characterizes the force of influence of cerebrospinal fluid on brain tissue. Increased ICP can be caused by many pathologies.

The pathology can be caused by hydrocephalus, strokes, malignant neoplasms, intoxication, and swelling of the brain. To stabilize ICP, it is necessary to eliminate the root cause of the increase in this quantitative indicator.

For drug treatment the following are used:

Diuretic medications - Furosemide, Spironolactone, Hydrochlorothiazide.
Potassium preparations – Asparkam, Panangin.
Means for eliminating vascular disorders - Vinpocetine, Aminophylline, Nifedipine. Venotonics are also used, for example Diosmin or horse chestnut extract.
Medicines with neurometabolic effects - Glycine, Piracetam. Pig brain hydrolyzate is also very effective.

When dislocation syndrome develops, decompression craniotomy is performed.

What drinks can and cannot be given to hypertensive patients?

For arterial hypertension, you can drink green tea, herbal teas, and rosehip decoction. Such products perfectly tone, do not cause vasoconstriction, improve blood circulation, and increase performance.

Hypertensive patients can also drink rosehip decoction, freshly squeezed vegetable juices, and fruit juices. If you want to sweeten your drinks, it is best to use sugar substitutes (stevia, cyclamate) or honey.

If you have high blood pressure, it is recommended to consume in limited quantities or not at all:

Coffee. If you have grade 1 hypertension, you can afford no more than 1 cup of brewed coffee with milk.
Black tea.
Energetic drinks.
Cocoa.

Also, if you have arterial hypertension, it is prohibited to drink alcoholic beverages. Firstly, alcohol constricts blood vessels. This is very dangerous, since when blood vessels narrow, a sharp jump in blood pressure occurs. Secondly, alcohol neutralizes the therapeutic effect of antihypertensive medications.

Doctors say that only drinking wine or cognac is allowed, but in strictly limited quantities - no more than 50-100 ml. You should drink alcohol no more than 1-2 times a week.

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Treatment regimens for hypertension

There is a certain standard of treatment for hypertension. This is an algorithm of actions with a list of recommended drugs, which is agreed upon by international commissions and in accordance with which therapy is carried out. The doctor can deviate from it only when the patient has a special, non-trivial case. The unified protocol is used both in the clinic and in the hospital.

From the very beginning, all patients with hypertension are divided into those with primary hypertension and those with secondary hypertension. Then the stage of hypertension is determined by the presence of target organ damage in accordance with the scale:

Stage I hypertension (HD) – damage to organs and systems is absent or insufficient for diagnosis, and hypertensive crises do not manifest themselves or are not complicated by organ failure.
Stage II hypertension – single injuries in organs, hemorrhages into the parenchyma, which are accompanied by corresponding symptoms. A complicated hypertensive crisis and its consequences may occur.
Stage III HD – multiple damage to target organs, failure associated with their dysfunction, development of fibrosis and other changes in their structure. There is a high risk of a complicated crisis; maintenance therapy and constant correction of blood pressure are required.

Modern treatment of hypertension

The basis of the treatment of hypertension is the impact on pathogenetic mechanisms using combination therapy, which allows the pathology to be treated comprehensively. For this purpose, several groups of drugs that differ in their effects are used. The main group of drugs includes:

Diuretics are drugs that significantly increase daily diuresis (urine output) by influencing the nephrons of the kidneys and the ion balance in them. Diuretics can involve various mechanisms, this can be the antagonism of aldosterone (which retains sodium in the body, and with it water - this is how Spironolactone and Veroshpiron act), the exchange of sodium for potassium (in this case, sodium leaves the body and pulls fluid with it - most diuretics act exactly like this, for example Furosemide). This group also includes Hydrochlorothiazide, Hypothiazide, Indapamide (and its combination drug Arifon).
Beta-blockers are substances that block beta-adrenergic receptors, which are found in a huge number of tissues, especially in the heart and blood vessels. The doctor’s tactics in this case are to dilate the blood vessels (this effect is observed systemically after taking the correct dose of the blocker), as well as normalize the functioning of the heart muscle (eliminate ectopic foci of excitation, extrasystole and arrhythmia). These drugs include Anaprilin (it is used less and less because it is not selective and can cause bronchospasm), Metoprolol, Atenolol, Bisoprolol, Talinolol.
ACE inhibitors - angiotensin-converting enzyme triggers a cascade of reactions that end in the production of angiotensin II, a powerful vasoconstrictor. If you block it, one of the most dangerous pathogenesis of hypertension will be interrupted. Drugs in this group are highly effective, reduce blood pressure regardless of the cause, and are well suited for the treatment of hypertension in elderly people for whom diuretics are not indicated. These are Captopril (Capoten), Enalapril (Enap), Lisinopril.
Angiotensin receptor blockers - the point of action of the drugs is the same as that of the previous group, but this time the effect of angiotensin is interrupted due to blocking of its receptors. This is a new group of drugs, very effective and with virtually no side effects. These include Losartan. This drug is prescribed to children to relieve symptoms of high blood pressure due to secondary hypertension.
Calcium antagonists (calcium channel blockers) – due to calcium ions, smooth muscles in the walls of blood vessels contract, which narrows their lumen and increases blood pressure. This group of drugs blocks the binding of specific proteins to ions, so contraction of smooth muscle elements does not occur. These include Nifedipine (Corinfar), Amlodipine.

Additional drugs include those that are used less frequently due to their high activity and the need to strictly adhere to the dosage, as well as side effects. They can lower blood pressure even more effectively than the drugs of the main group, but they are not used for outpatient treatment of hypertension, only for inpatient treatment under the supervision of a doctor and clinical pharmacist. These are the following groups:

alpha-adrenergic receptor agonists, which include Clonidine and Methyldopa (cause a short-term increase in blood pressure, after which they greatly dilate blood vessels by acting on receptors in the central nervous system);
sympatholytics (interrupt the passage of nerve impulses);
alpha blockers Prazosin and Doxazosin;
renin inhibitor Aliskiren (which has a fairly large list of side effects);
vasodilators with an injection type of administration such as magnesium sulfate (the drug is quite widely used in emergency medicine because it acts quickly, but is not selective);
antispasmodics (No-shpa and Drotaverine).

In addition, sedatives are prescribed, i.e. drugs that have a calming effect on the nervous system.

Beginning the diagnosis of hypertension

Once the diagnosis is confirmed, comprehensive treatment of the underlying and concomitant diseases is prescribed. Hypertension is treated with drugs of plant and synthetic origin that have a sedative and psychotropic effect, diuretics and medications that lower blood pressure.

If there are concomitant diseases, medications corresponding to them are prescribed. In each specific case, the dosage and composition of medications is prescribed by the doctor. This depends on factors such as disruptions in the functioning of important organs, the emotional state of the patient, gender, age, weight, and blood pressure readings.

During a hospital visit, people experience negative emotions: this may include anxiety or worry, overexcitement, uncontrollable muscle tension and spasms. Each of these conditions can provoke a sharp increase in blood pressure, which is diagnosed by a doctor. At home, the person calms down and the indicators return to normal.

People at risk include:

emotional;
indecisive, complex, with a weak psyche;
living or working in an uncomfortable psychological environment;
leading a sedentary lifestyle;
having mental illnesses of various types;
abusing smoking, alcohol, drugs, steroids or antidepressants.

When visiting a doctor, such people’s arms and legs begin to tremble from confusion and anxiety, their skin turns pale, and their heartbeat quickens. The body remembers sensations and repeats them in a similar emotional situation. Another symptom is a persistent increase in the level of bad cholesterol and sugar in the blood.

Periodic disturbances of consciousness indicate the presence and rapid development of hypertension, especially if it is accompanied by memory loss, problems with speech and coordination of movement.

The consequences of a sharp drop in blood pressure are:

stretching of the left cardiac ventricle;
kidney diseases;
disruption of the normal functioning of the blood system: stroke, subarachnoid hemorrhage or hemorrhage in the cerebellum;
cardiac hemodynamics depending on residual systolic blood volumes and the degree of damage to the heart.

The progression of the syndrome increases the risk of developing complications of diseases of the cardiovascular system, stroke, vascular and kidney damage. The syndrome is especially dangerous in adolescence, in people with diabetes, after surgery on the heart and blood vessels. In this case, the chance of developing hypertensive heart disease increases.

In pregnant women, hypertensive white coat syndrome can cause miscarriage.

The adaptation phenomenon passes without serious consequences for human health if the visit to the doctor was a single visit and will not be repeated in the near future. With frequent visits to the doctor, an increase in blood pressure can lead to the development of a hypertensive crisis. Another danger is the difficulty of making a correct diagnosis.

To determine the connection between visiting a doctor and raising blood pressure, daily blood pressure measurements are necessary and identify factors that provoke its increase. Normal blood pressure readings are no higher than 139/89 mmHg.

Patients are examined in a certain sequence:

determining the cause and magnitude of the pressure increase;
assessment of the state of the cardiovascular system and major target organs, identification of other diseases that may affect the diagnosis;
identification of medical history;
performing a physical examination;
application of laboratory research.

Complex therapy is effective in combating the syndrome. The use of non-drug treatment methods includes prescribing a diet, adjusting and introducing physical activity, and giving up alcohol and smoking. If there are no contraindications, the patient is prescribed a course of massage or physiotherapy. When treating white coat hypertension, doctors may refer patients to a psychologist.

Standards of examination and treatment of hypertension, carried out in full, will help reduce the risk of increased pain.

The examination of the patient begins with confirmation of the diagnosis.

It is necessary to establish what caused secondary arterial hypertension and assess the risk of exacerbation for the cardiovascular system and other organs.

The doctor is obliged to measure blood pressure and prescribe examinations, including laboratory tests. Additional diagnostics may be required. The doctor will determine which methods are required - they are not universal.

It is better to measure pressure on the shoulder, and on both arms. The doctor will focus on indicators with a higher value. In addition, the patient's heart rate will be measured.

The standard of care for hypertension includes obtaining a detailed medical history.

It will help you understand when the first symptoms appeared and what caused them. It is also important to identify secondary causative factors. For example, women are asked about changes in blood pressure during pregnancy.

The doctor will also ask about diet and smoking, and whether there is a history of hypertension or heart disease in the family.

The outpatient stage includes a doctor conducting diagnostics, determining negative factors and clinical conditions, for example, cerebrovascular diseases and heart diseases.

If a hypertensive crisis occurs, this is an indication for hospitalization. But before it is carried out, it is necessary to carry out several examinations, in addition to blood and urine tests, including fluorography and stool examination for worms.

When diagnosing, the doctor should ask the patient about whether there are relatives with kidney disease, whether there have been strokes, diabetes and hypertension.

Special attention to the patient’s lifestyle: what he eats, what physical exercises he does, how much salt he consumes. The doctor must weigh the patient and measure his height, determine his body mass index, and examine the fundus.

Laboratory data should include examinations for hemoglobin, red blood cells, cholesterol, potassium, sodium, as well as the results of ultrasound of the arteries and kidneys and other studies.

The standard of care for hypertension contains a “maneuver” for non-drug therapy.

To begin with, the doctor will suggest giving up salt and cigarettes, changing your diet by adding vegetables and fruits.

The doctor will prescribe medications to patients with a high and very high risk of developing cardiovascular diseases. The choice of drugs should be based on contraindications. Initially, the doses are minimal.

Among the main drugs: Hydrochlorothiazide, Indapamide, Metoprolol, etc. Additional medications may be prescribed: Aspirin, Atorvastatin, Simvastatin, etc.

When the pressure is stabilized and the patient feels better, treatment will be considered sufficient. In other cases, outpatient monitoring will be required.

A mandatory feature of a hypertensive crisis is a sudden rise in blood pressure. Not only hypertension as a factor can cause an exacerbation, but also traumatic brain injury or burns. A sudden increase in blood pressure is affected by stopping medication, surgery, alcohol, drugs, salt or stress.

The body reacts to these factors reflexively. Pain, anxiety, hyperthermia appear, and renal blood flow worsens.

Patients with a hypertensive crisis often complain of nosebleeds and headaches, shortness of breath and chest pain, muscle tremors and nausea may appear.

Symptoms of a hypertensive crisis:

chest pain – 27%;
headache and rapid heartbeat – 22%;
psychomotor agitation – 21%.

The standard of care for hypertension cannot be achieved without a clear pattern of questions.

If there is a sudden increase in blood pressure, the doctor should ask the patient:

Have there been increases in blood pressure before?
What are the maximum values?
What are the symptoms?
Is therapy prescribed and what antihypertensive drugs is the patient taking?
How long ago did the symptoms appear?
How did the patient lower his blood pressure before?
Did you have a stroke and do you have heart and vascular diseases?
Does the patient feel convulsions and worsening of his condition, has there been vomiting and shortness of breath?

The doctor must assess the general condition of the patient, taking into account breathing, position, color of the skin, the condition of the blood vessels - can they swell and pulsate, is there swelling, what is the pulse, pressure readings on both arms, heart rate, etc.

After diagnosis, the doctor must take the following actions:

The patient's head should be higher than the body level.
If the patient has lost consciousness, place him on his side.
Measure your heart rate and blood pressure every fifteen minutes.
Start drug therapy with one drug or in combination.
Assess the effectiveness of taking medications at least half an hour after administration.
Deliver to the hospital in a supine position.

Next, the standard treatment of hypertension in a hospital begins to work.

Taking into account the manifestations of a hypertensive crisis, the doctor prescribes drugs that can relieve the symptoms. They are auxiliary and should be used with caution.

For nausea and vomiting, the doctor will most likely prescribe Metoclopramide or Droperidol, for convulsions - Magnesium Sulfate and Diazepam, to reduce headaches they use Metamizole sodium, Metamizole sodium, Diphenhydramine intravenously.

The drugs have side effects. Dibazol may cause a short-term increase in blood pressure, nausea, fever, dizziness or allergies. Magnesium sulfate causes sweating or respiratory and central nervous system depression. "Eufillin" is contraindicated for epileptics and patients with the acute phase of a heart attack.

Diagnostic measures

Even before the patient is hospitalized, a specialist from the ambulance team carries out primary diagnostics: measures pressure using a tonometer and, in some cases, performs electrocardiography. In addition, the patient is questioned about existing symptoms and concomitant diseases.

assesses medical history;
interviews the patient;
carries out an initial inspection.

During diagnosis, the patient's blood pressure is often measured, taking into account the time of day and the conditions under which this is done. Cardiography and consultation with an ophthalmologist are prescribed to examine the fundus.

a urine test is taken to detect protein, glucose, nitrogen, creatinine;
blood test to detect hematocrit and hemoglobin.

Treatment of hypertension

Non-drug therapy of hypertension and prevention

It is also possible to treat hypertension with folk remedies, but only in the early stages. If a doctor sees a patient’s potential to be cured without the use of pharmacological drugs, he can put him on a diet, prescribe physiotherapy, a set of therapeutic exercises, or send him to a sanatorium-resort treatment.

In the early stages of hypertension, blood pressure can be normalized by changing lifestyle, including nutrition.

The easiest way to prevent the disease at home is to set aside time for regular walks, which will act as moderate physical activity; diet correction is also necessary: you should limit the consumption of salt and hot, spicy spices. Limit the consumption of fatty foods, in particular, fried meats, sweet confectionery, etc. Black coffee and strong black tea are contraindicated for hypertensive patients.

Sufficient physical activity, adherence to a rational daily routine, and sufficient night sleep are required. If necessary, excess weight should be adjusted. Overheating (baths, saunas, exposure to heat) is contraindicated.

Bad habits need to be quit - this applies to both smoking and alcohol. It is better to prevent pathology than to spend a long and painful time treating hypertension.

First aid for hypertensive crisis

If a patient has been diagnosed with hypertension, the standards of treatment must include first aid. The patient is taught by the doctor, and the patient himself is obliged to tell loved ones about the rules.

The first important step is to eliminate panic, since it does not contribute to the normalization of the patient’s life. To do this, you should seek the help of sedatives, including herbal ones.
Restoration of breathing is carried out by calm and deep inhalations and exhalations. A supply of fresh air should be provided if the patient is indoors.
The patient needs to take a reclining position, leaning back on something. You also need to ensure peace and warmth, and isolate drafts.
Apply a cold compress to your head and warm heating pads or mustard plasters to your feet for 15 minutes.
You need to take a dose of pills. If you have chest pain, you should take nitroglycerin and urgently call an ambulance.
For diagnosed hypertension, the following drugs are prescribed: captopril, nifedipine, Corinfar, Cordaflex. Their use and dosage should be agreed with your doctor. When a crisis occurs, you should take 10 mg of nifedipine or half a tablet of captopril (if the dosage is 25 mg). Use sublingually (under the tongue).
Measure the pressure every 15-20 minutes.