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Neurology, Ophthalmology, Cardiology, Oncology, Obesity, Endocrinology, Vascular surgery - Causes, Symptoms, Diagnosis, Treatment, description of the disease.

Monday, 27.03.2023, 03:30
Main » Cardiology » Treatment of hypertension 
Treatment of hypertension

Treatment of hypertension

As we have noted, in many cases, hypertension is asymptomatic, it is not manifesting itself outwardly. The patient learns that he has high blood pressure only under a doctor checkup.

There is just a question: whether to treat an increase in blood pressure if it does not bother the patient. In response to this question, we turn our attention to the results of a study that was conducted in the USA in 1967 (Veterans Administration). It was the first large-scale study on secondary prevention of hypertension. So, the results of this study showed that treatment of mild, moderate and severe hypertension can reduce the incidence of complications of the disease within five years from 55% to 18%!

Reduction of diastolic blood pressure by only 5 - 6 mm Hg is associated with reduced mortality from complications of the cardiovascular system by 21%, the frequency of stroke - 42%, and myocardial infarction - 14% (data from Mac Mahon, 1990).

Treatment of hypertension most effectively reflected in prevention of complications caused by vascular lesions:
  • hemorrhagic stroke,
  • retinopathy,
  • malignant hypertension,
  • aneurysm of the aortic wall and the bundle,
  • hypertensive encephalopathy.

In addition, effective treatment of hypertension and the prevention of heart failure caused by high blood pressure.

Less effective treatment of arterial hypertension affects the prevention of renal failure and complications of atherosclerosis, myocardial infarction, sudden cardiac death, angina, atherosclerosis of the carotid arteries and vessels of the lower extremities.

Of great importance is treatment of hypertension for elderly patients. The results of several large studies have shown that antihypertensive therapy reduces the incidence of stroke by 42% -57%, and reduce the risk of myocardial infarction, and vascular dementia (dementia).

Therefore, the treatment of hypertension can significantly reduce the risk of complications of this disease and premature death. The benefits of treatment as demonstrated for the light, and for severe hypertension. However, the effectiveness of treatment was high in patients with the highest risk of complications.

When you need to begin treatment of hypertension

Currently, there is evidence that even slightly reduce high blood pressure patients reduces both the frequency of cardiovascular complications of hypertension, and mortality from these complications.

But it is worth noting that the blood pressure by itself is not the only decisive factor that determines the prognosis of hypertension. Besides him, there are other factors that influence the rate, first and foremost, they are:
  • Advanced age,
  • Male sex,
  • Family history.

Forecast for the treatment of hypertension significantly deteriorated in the presence of pathology of the heart, kidneys, and also at a high level of cholesterol in the blood (called dyslipoproteinemia, when disturbed balance of different kinds of fats in the blood) and diabetes mellitus. Therefore, when choosing a treatment the physician should consider not only the numbers of blood pressure, and risk factors.

For example, at a moderate to severe hypertension in a patient, medication shall be appointed at once, no matter if they have any additional risk factors. This is due to the fact that the increase in blood pressure to such figures is the high risk in terms of complications.

In identifying the light (first) degree of hypertension is recommended not to start therapy immediately. BP measurement should be repeated several times during the four weeks. We found that in 20% -30% of cases with repeated measurements of blood pressure is normal. In such cases, is usually recommended re-measurement of blood pressure every 3 months during the year.

If in this period, regular repeated measurements of blood pressure remains high (up to the level of 140-159/90-99 mm Hg.), Then usually recommend non-drug therapy, and then solved by the application of specific drugs for the treatment of hypertension. In the case where the patient along with high blood pressure, there are certain risk factors for cardiovascular complications of hypertension, diseases, medication should be administered immediately.

Among the risk factors that determine the need for early use of antihypertensive therapy are the following:
  • smoking,
  • high levels of cholesterol in the blood,
  • diabetes,
  • advanced age (over 60),
  • male gender,
  • women after menopause,
  • cardiovascular disease in relatives
  • heart disease (angina, myocardial infarction), kidney disease, cerebrovascular accident (stroke), peripheral arterial disease and retinopathy.

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