Hypotension - a characteristic symptom that reflects the unique degree of lowering blood pressure.People have to thirty years the presence of hypotension is defined in terms of blood pressure in mm Hg.Article below 100/60, after thirty - below 105/65, while the older age groups of children - systolic blood pressure may be lower than eighty.Typically, these conventional boundaries can occur in apparently healthy people, athletes and those who engage in hard physical nature.Therefore, this category of people involved in the group of arterial hypotension, which develops as a consequence of physiological etiological factors, and all others are pathological hemodynamic disturbances that cause a decrease in pressure in the arterial system.
In medical practice are two types of occurrence of hypotension.Firstly, it can be manifested in acute or chronic pathological be within.
for acute hypotension is characterized by the development of a collapse (sudden pressure drop) as a result of
But chronic form can manifest primary arterial hypotension, as well as secondary (symptomatic).In the first case there are functional disorders of hemodynamics TSNR.Some experts believe this form of hypotension independent pathological condition, such as hypotension.However, in the practice of medicine, the diagnosis of primary hypotension is almost never used, and generally treated as cardiopsychoneurosis hypotensive type.For secondary chronic form characterized by the development as a result of organic pathologies SSS, endocrine and / or nervous system, intoxication infectious, non-infectious and medical origin, and as a result of irradiation.In this subgroup include hypotension, which develops as a result of neurosis dysfunction vegetative-vascular system.
This state multifactor nature, characterized by the simultaneous decrease in blood pressure systolic and diastolic pressure below normal.As a rule, hypotension classified according to NSMolchanov on the physiological and pathological, the latter divided into primary (essential), secondary (symptomatic) and orthostatic.
under physiological hypotension decreases blood pressure in such cases, as an individual organism, increased fitness of the athletes, the adaptation of the organism in the process of life in the mountains, the tropics and subtropics.
primary pathological hypotension is a functional disorder SSSas a result of violations of the primary regulation of vascular tone of the neuroendocrine system, and is characterized by a decrease in blood pressure below normal, which is expressed syndrome asthenic character, cardiac symptoms and subjective genesis of congestive heart failure.
The main predisposing and causative factors of developing primary arterial hypotension include constitutional and hereditary inferiority of vasomotor centers of higher level;asthenic kind of vascular constitution that is inherited;a variety of mental and emotional stress and psychosocial origin;long-occurring mental strain;brain injury and skull.
In addition, an infection in the nasopharynx, which is often exacerbated by a child, has a constant influence of the toxic nature of the brain and helps to reduce the pressure.Also arterial hypotension may be caused by severe infectious diseases, malnutrition, factors such as intense noise, vibration, overheating, ionizing radiation, as well as physical stress and overload in the sport.Thus, 80% of primary arterial hypotension caused neurocirculatory dystonia, as well as depression, lack of sleep and constant fatigue.
The development of secondary hypotension is influenced by different underlying disease.Among these pathologies can be noted anemia, peptic ulcer, hypothyroidism, arrhythmias, heart failure, infectious diseases, diabetic neuropathy, myocarditis, tumors, low back pain, etc..
from acute flowing of the pathological state reveals a massive one-step blood loss, sudden disturbances of the heart, anaphylacticshock, trauma, dehydration.The pressure is reduced in the shortest time and is the result of circulatory disorders expressed somatic organs.
Chronic hypotension is characterized by a prolonged course, in which the body adapts to low performance, so pronounced symptoms of impaired blood flow is virtually nonexistent.
pressure may decrease as a result of a lack of vitamin B, E, C;compliance with a strict diet;overdose of drugs.
Such a pathological condition as hypotension mostly occurs in children and young generation to 25 years.In this case, patients are placing a lot of complaints.As a rule, they have a weakness, reduced mental and physical performance significantly decreases exercise tolerance predictive in nature, that is, these people are unable to concentrate their attention, focus quickly, they are difficult to assimilate new teaching material, thus deteriorating memory.
In primary arterial hypotension people quite quickly tired, becomes irritable, emotionally labile with signs of depression.In addition, these patients do not sleep at night and difficult to wake in the morning and in the afternoon feel completely overwhelmed and drowsy.Closer to the hour of the day behave more actively, but for 16-17 hours once reduced emotional and physical activity, and at this moment the patients sluggish, sleepy and in urgent need of rest.
characteristic feature of arterial hypotension is a headache that occurs in 95% of patients with different localization, intensity and duration.Basically it is an ongoing, intensive, oppressive or pulsating character with localization at the back, quite often on the forehead and temples.
Most patients feel the brunt of a permanent nature in my head.In some cases, the pain occurs in the morning, then slowly rises, weakened slightly by midday to re-gain in the afternoon, in the evening.The cause of such pain is considered to be violation of the outflow of venous blood from the brain as a result of the low tone of the veins of the brain.Sometimes pain are migrenopodobny character with the appearance of nausea and vomiting.
In addition, 30% of patients complain of whirling head with a characteristic pain.Vertigo observed mainly in the morning after getting up sharp or sudden rise of the head.But during the day can head begin to spin due to prolonged standing, performing physical activities, travel in public transport, while deflating the subway, on the background of rapid breathing, in a stuffy room, the sauna and the long-term food intake.Thus there is noise in the ears, may darken in the eyes, it begins to feel sick and may vomit.
Another characteristic primary symptoms of hypotension include pain in the heart.She says almost half of the patients by reducing the pressure in the coronary arteries, and can also be neurotic character.Generally, these pains are aching, stabbing and less constricting in nature, while troubling the sick for most of the day with localization in the apex of the heart.Sometimes the pain radiating to the left arm and shoulder blade.
In most patients, hypotension observed the beating of the heart, and felt some shortages in this field on a background of emotional and physical loads of character.Also, these patients do not have enough at this point the air, especially in certain physical activities or when you stay in a room that is poorly ventilated;They have hands and feet become cold and numb to the touch;often begin to hurt muscles and joints.In addition, the disorder may be a chair, and in men broken erection noted and ejaculation prematurely.
Hypotension is also apparent fainting.During the inspection of such patients have hyperhidrosis, hands and feet wet and cold to the touch, can be present minor akrotsianoz appear characteristic red spots on the chest and neck, that is expressed dermographism.
In the study of SSSidentify labile pulse with a characteristic bradycardia, respiratory arrhythmia and sometimes with extrasystolic arrhythmia.Normally defined heart border and tones - clear, although sometimes bugged low noise systole at the top of the heart or its base.Often auscultated fibrillation, and 7% - paroxysmal tachycardia.BP sharply reduced.
Very rarely may arise from the dysfunction of the gastrointestinal tract and gall bladder in the form of epigastric pain, flatulence, pain at the time of palpation of the right hypochondrium, gall bladder and colon.It's associated with dyskinesia of the gastrointestinal tract and gallbladder.But hepatomegaly and splenomegaly were observed.
Quite often arises when primary arterial hypotension appears nephroptosis first and second degree on the right, especially in asthenic body type.After examination of the nervous system revealed tendon reflexes, pronounced weakness syndrome irritable character, anxiety due incurability of the disease.
In addition, almost 20% of patients with hypotension develop complications such as fainting and hypertensive crises.During fainting sick sharply pale, beads of sweat appear on his forehead, dark eyes, could make noise in the ears, dramatically weakened leg muscles, which can result in the loss of consciousness in the further decrease in blood pressure.Fainting can last from twenty seconds to a few minutes at a dead faint.
For hypotensive crisis characterized by aggravating the disease process, due to the negative psycho-emotional impact, density, pain sharp features, lack of sleep and others. This manifestation of arterial hypotension is characterized by the acute onset of weakness, profuse sweating, severe headaches, severe whirlinghead, dark appearance in the eyes, pain in my heart, dyspepsia, decreased blood pressure.Furthermore, it can significantly released into the blood insulin and is symptomatically manifested sweating, a feeling of hunger, sometimes transient twitching of individual muscles, numbness of the tongue and lips.
Symptomatic hypotension picture in children is characterized by volatile and diverse features.At the same time, children often complain of typical symptoms, which reflect changes in the central nervous system, SSSand gastrointestinal tract.In some cases, children can not tolerate travel in transport, can rise in temperature to subfebrile digits, develop seizures lack of air, myalgia and arthralgia.The most frequent complaint in 90% of children are cephalgia, 70% are weakness and fatigue, and emotional lability 72%.
The treatment of hypotension using such treatments as non-drug and use of drugs.In the first case, the basis of treatment include normalization of the daily routine, physiotherapy, diet, massage, diuretic herbs, dynamic sport and the use of psychological methods of treatment.
As a rule, the dream of any man, especially suffering from hypotension, should last no less than nine hours, and for the formation of pressor amines, ensure elevated headboard.It should be every day to be outdoors to two hours.It is important not to take a hot bath, to avoid hyperventilation and do not stay long in the sun.Be sure to do morning exercises, followed by a cold shower and fan in the morning.It is also recommended that such patients skating, skiing and biking.You can slow jog, play tennis, swim, dance, engage in rhythmic gymnastics, and a quick walk.
In addition, the positive effect of having a full body massage or some areas, such as the neck area, hands, calves, feet using a hair brush.Of course, the diet should be included as a tonic drink coffee or tea, herbs diuretic action (birch buds, bearberry, cranberry leaf).Good results show means such as physical therapy, treatments with stimulant properties, electrophoresis Sodium bromide, caffeine, Bromo-caffeine, phenylephrine;electric, acupuncture, bath salt, pine needles, sage, radon, and power shower.
to psychological therapies hypotension are required to establish the causes of the psychological and emotional stress with the ability to specify how to address conflict situations in the school and the family.
main pathogenic factor in the development of diseases SSSIt considered chronic stress as the mind and emotions.Application therapy helps to eliminate or reduce the severity of the stress, resulting in an improved humoral and autonomic systems.
In that case, if you do not manage to achieve positive dynamics nemedikamentozmymi treatments shown basic therapy, depending on the characteristic of symptomatic manifestations.
drugs in arterial hypotension
For the treatment of the disease state using a number of drugs.First of all prescribed herbal adaptogens that gently stimulates the central nervous system.Among them are the infusion of Chinese magnolia vine, ginseng, devil, Eleutherococcus senticosus.All of them stimulate the central nervous system to stimulate SSS help in removing mental and physical fatigue, excessive sleepiness, thereby increasing blood pressure.Dosing of these drugs is conducted in the calculation: one drop per year of life of the drug in the morning and evening, before meals.
indication for neuroprotective drugs and GABAergic substances in hypotension may be available cerebral insufficiency, the immaturity of brain structures on the basis of EEG, and memory loss.Preparations nootropic action directly activate the mechanisms of the brain, helping to be resistant to various influences aggressive nature, improve communication cortico-subcortical properties.
In this case prescribe Piracetam, which is very similar in himstrukture on gamma-aminobutyric acid.He has a positive effect on metabolic processes and blood supply to the brain, while stimulating the oxidation and reduction processes, increasing glucose utilization by improving the blood flow in the ischemic brain regions.The energy potential of the body increases as a result of the accelerated turnover of ATP, increased adenylate cyclase activity.Piracetam helps to improve the integrative brain activity, enhances memory and facilitates the learning process.
gamma-aminobutyric acid is indicated for the activation energy processes, improve the respiratory activity of the brain, improve thinking, memory, reducing vestibular disorders, while providing a mild stimulating effect on the psyche.The positive effect is achieved in the presence of endogenous depression dominated astenoipohondricheskih phenomenon.
Application aminofenilmaslyanoy acid helps relieve stress, anxiety, fear, and having a tranquilizer action, the drug improves the processes of sleep.As a rule, this medicine is used in severe hypotension in the background of neurotic symptoms.