Hypotension

Hypotension.  Photo from www.sciencephoto.com

Arterial hypotension— A condition in which the blood pressure reduced to a tangible person limit. The magnitude of this reduction is individual, but usually below 100/60 mmHg for men and 95/60 mm Hg for women.

Arterial hypotension may be acute or chronic.

Acute hypotension (Collapse [sharp drop in vascular tone], shock [paralytic vasodilatation]) is usually accompanied by a reduction of oxygen to the brain (hypoxia) and decreased function of vital organs, which requires immediate medical attention. Severity of the condition is not so much determined by the magnitude of blood pressure as the speed and the degree of its decline.

Acute arterial hypotension may occur in acute heart failure, severe poisoning (alcohol, drugs, medications, especially fast-and short-range, such as clonidine, nifedipine, captopril, nitroglycerin, etc.), severe infection and sepsis, blood loss, dehydration. Thus, acute hypotension is often a complication of the disease, has an obvious cause, which should primarily be considered in emergency treatment.

People who are prone tochronic arterial hypotension, as a rule, are not affected in the long run such a high risk of cardiovascular complications, such as "high blood pressure" and the unfairly paid much less attention. At the same time, in the elderly hypotension increases the risk of ischemic stroke, and the young — affects the quality of life and reduces work capacity.

Why did this happen?

Chronic hypotension may be an individual variant of the norm: to appear as a consequence of high fitness (the athletes), as a mechanism of adaptation (the inhabitants of highland tropics, the Arctic). In these cases, it is not a disease and the person feels.

At the same time, chronic arterial hypotension may be an independent manifestation of a disease or other illness. It leads to a violation of vascular tone (eg, dystonia, some endocrine diseases) or decrease in cardiac output (heart failure, aortic stenosis, arrhythmia).

How does it manifest?

A specific and sometimes the main manifestation of hypotension of any nature may be orthostatic (postural) hypotension — additional pressure drop immediately after the transition from horizontal to vertical. Usually it continues for 1-3 minutes. Orthostatic hypotension is more likely to occur in the morning, accompanied by a deterioration of blood supply of the brain — dizziness, blackouts tinnitus. Sometimes it leads to fainting (the risk of ischemic stroke) or fall (with the possibility of injuries and fractures), especially in the elderly. Orthostatic hypotension contributes to prolonged bed rest, serious illness, surgery, many medications.

Chronic hypotension, in addition to the above, can be manifested by weakness, fatigue, nervousness, fatigue in the morning, low capacity for work, headaches, tendency to fainting, and sometimes pain in the heart. Characterized as poor tolerance to cold, heat, lack of air, exercise, chill.

Diagnostics

Hypotension can detect systematic change in blood pressure at different times of day (eg, the pressure profile). In some cases, you may need daily monitoring of pressure.

Diagnosis must include the search for the disease, which has led to a decrease in pressure. For this purpose, cardiologist in addition to a detailed interview and examination of the patient may appoint an electrocardiogram (ECG including with exercise, and daily monitoring of ECG), Doppler echocardiography, and other studies.

Treatment

Treatment of chronic arterial hypotension usually complex. It includes normalization of life (rational alternation of work and rest, adequate sleep), nutrition, elimination of bad habits. An important component of the treatment are dosed exercise (physiotherapy), walks in the fresh air, douche.

Of medication use natural tonics of ginseng, Eleutherococcus, Aralia, lemongrass and other plants.

Of course, ifhypotensiondeveloped as a complication of another disease requires treatment of the underlying disease.

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