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Arterial hypertension
– this is a persistent increase in blood pressure more than 140/90 mmHg.
Target (what you need to strive for) blood pressure is blood pressure below 140/90 mm Hg. In patients with diabetes, the target blood pressure should not be more than 130/80 mmHg. Maintaining blood pressure at this level can significantly reduce the risk of such life-threatening complications as myocardial infarction and cerebral stroke.
With antihypertensive (pressure-lowering) therapy already selected, it is important to measure blood pressure twice a day: in the morning and in the evening.
When selecting antihypertensive therapy, there may be a period when blood pressure and pulse rate need to be measured up to 5-6 times a day and recorded in a self-monitoring diary:
- Based on measurements taken immediately after sleep, it is possible to judge how effective antihypertensive drugs taken in the evening or at night are.
- It is advisable to measure blood pressure 2-3 hours after taking morning antihypertensive therapy. For most drugs, this period of time accumulates in the blood the maximum concentration of the drugs taken, which means the hypotensive effect is most pronounced. When taking several antihypertensive drugs, an “overlapping” effect is possible and, as a result, a sharp decrease in blood pressure. In order to avoid this undesirable “swing” effect, this measurement is needed: in the future, you can “space out” the intake of drugs over time, in order to avoid a sharp drop in blood pressure.
- The next few measurements (for example, every three hours) will indicate how effectively blood pressure is controlled during the day and evening (whether the medications are helping and whether the prescribed doses are “enough”)
- The last, mandatory measurement of blood pressure and pulse rate is carried out at night.
Measurements of blood pressure and heart rate in this number of times should be carried out approximately 1,5 – 2 weeks. This is based on the fact that, of course, the drug has a first “pressure-lowering effect” (sometimes very weakly expressed), but in order for it to have a stable antihypertensive effect, it must be given time to “accumulate” in the body when it is constantly present “base” concentration. Usually this is 1-2 weeks. Therefore, it is possible to judge whether the prescribed treatment regimen “helps” (or “does not help”) after this period of time.
Pressure Measurement Rules
- Sitting on a chair.
- Your back should lean against the back of the chair
- The hand should lie on a stand or table: the cuff should be at the level of the heart.
- Legs should be straight. Crossing, leg-to-leg posture are unacceptable
- After the cuff is put on, sit for one to two minutes.
- The interval between the first and second blood pressure measurements should be at least 2 minutes
Failure to comply with these rules entails distortion of measurement results (for example, when crossing legs, overestimations of up to 20 mmHg are possible).
Antihypertensive drugs
Currently, there are several groups of drugs used to correct high blood pressure.
Why is it advisable to use modern drugs, and not such “widely known” drugs in our country as adelfan, raunatin, etc.? Firstly, their effectiveness (proven in studies involving a large number of patients) is higher than that of the latter. In addition, they do not have the side effects that are inherent in the “old” drugs.
But there is one more important property: in addition to the “simply” blood pressure-lowering effect, they have a powerful protective effect on target organs (heart, blood vessels, kidneys). That is why doctors recommend taking some of them constantly, even when blood pressure seems to be normal.
The development of new drugs is ongoing. But this does not mean that short-acting (on average 4-6 hours), “honored figures” such as the well-known captopril (Capoten), nifedipine (Corinfar, Cordaflex), propranolol (Anaprillin, Obzidan) have left the arena. It’s just that at this point in time, in each of the groups of drugs, of which they were the “founders,” there are drugs whose action, by itself or as a result of a special “device” of the tablet (the “retard” form), can last from 12 to 24 hours. This means that these drugs can be taken 1-2 times a day. Therefore, they are used for “basic” therapy. And such drugs as capoten, corinfar, anaprillin, as a rule, can be used additionally when sudden increases in blood pressure occur against the background of constantly monitored blood pressure using selected constant therapy.
It is difficult to navigate the variety of drugs from different companies in the pharmacy window. On the packaging of the drug, the brand name is always written in large names, and under it the active substance. For example: bisoprolol is the active substance, and Concor, Bisogamma, Coronal are brand names (all three drugs are produced by different pharmacological companies). Despite this, when a pharmacy offers you to replace one drug of a group with another, you should consult a cardiologist, because There are many nuances even in the action of drugs of the same group.
Arterial hypertension is a chronic disease
When medications are prescribed, the goal is not to treat another increase in blood pressure, but to prevent it!
As a result of constantly elevated blood pressure, changes occur in the walls of blood vessels, kidneys, and heart. (Think! What will happen to an oil pipeline pipe through which oil “flows” under greater pressure than what the strength of this pipe is designed for?)
By controlling and lowering blood pressure, you are not treating abstract elevated numbers, you are protecting your organs from unwanted structural and functional changes that could one day lead to disaster.