|ICD-10||I 95 95.|
|ICD-9-KM||458, 458.8 and 458.9|
Hypotension (from other Greek ὑπό - under, below and lat. tensio - voltage) - lowering blood pressure by more than 20% from baseline / normal values or in absolute numbers - below 90 mm Hg. Art. systolic pressure or 60 mm Hg. Art. mean arterial pressure. The decrease in pressure can be acute and chronic.
Acute hypotension (collapse, shock) usually occurs when the heart is disturbed, there is a lot of blood loss, dehydration, and quickly leads to hypoxia of the brain and internal organs. Thus, acute hypotension - always a complication of a disease or external influence, always has an obvious cause that must be considered during treatment.
Chronic hypotension is due to very different reasons than acute. In people with low blood pressure, its regulation is usually impaired, the true causes of which may be of a different nature.
People with low blood pressure do not have such a high risk of heart attack and stroke as high blood pressure, therefore, the standards and methods for treating chronic hypotension are less well developed. At the same time, the quality of life of hypotonia can be very low due to constant weakness, headaches, decreased activity and other symptoms.
Causes of hypotension
There are the following types of arterial hypotension:
- Acute hypotension
- Chronic hypotension
- Primary chronic arterial hypotension
- Secondary chronic arterial hypotension
Acute symptomatic hypotension (sharp pressure drop). For example, acute myocardial infarction, pulmonary thromboembolism, severe arrhythmias, intracardiac blockades, allergic reactions, blood loss, etc., are often accompanied by very low pressure. Emergency medical care is required.
Physiological (chronic) hypotension manifested in trained athletes and as a hereditary predisposition to low blood pressure, not exceeding the norm.
Primary (otherwise idiopathic or essential) hypotension - This is an independent disease.
According to one theory, primary hypotension is a special form of neurosis-like disease of the vasomotor centers of the brain, since in its development a very large role may belong to prolonged psycho-emotional overstrain and stress.
Secondary hypotension arises against other diseases (for example, osteochondrosis of the cervical spine, stomach ulcers, anemia, hepatitis, pancreatitis, cystitis, tuberculosis, rheumatism), arrhythmias, alcoholism, diabetes, diseases of the endocrine system or respiratory organs, tumors, shock, brain injury , cirrhosis of the liver, psychological trauma, circulatory disorders, heart failure, intoxication, as a side effect of some drugs (for example, their overdose in the treatment of hypertension), etc.
Hypotension may also develop as a result of fasting and lack of vitamins E, C, B and pantothenic acid (B5).
Hypotension can also occur in healthy people, for example, in athletes with constant physical exertion. This is the so-called "hypotension fitness." In this case, low blood pressure acts as a kind of protective measure of the body. It turns out that with constant overloads the body begins to work in the “economical” mode, the heart rate becomes less frequent and the pressure decreases.
Pressure decreases when a person adapts to an abrupt change in climatic or weather conditions. In addition, the pressure level is affected by: high humidity, the influence of electromagnetic fields, radiation, etc.
Most often, low blood pressure is associated with impaired vascular tone. Normally, the vessels, if necessary, should quickly narrow and expand, but in hypotonic patients this reaction is slowed down. So it turns out that because of this, the blood stops flowing in sufficient quantities to the organs and tissues. As a result, the systems of the body and organs, in particular, the brain and the heart, experience oxygen starvation and are not able to work optimally.
Some doctors explain the reduced tone of the venous vessels by the body's congenital predisposition to hypotensive reactions.
Causes of hypotension Volzhskaya HPP
Volzhskaya HPP (earlier Stalingrad hydroelectric station, Volzhskaya HPP named after the XXII Congress of the CPSU) - hydroelectric station on the Volga River in the Volgograd region, between the cities of Volgograd and Volzhsky. The largest hydropower plant in Europe, in 1960-1963, was the largest hydroelectric power plant in the world. Included in the Volga-Kama hydroelectric cascade, as its lower stage. The Volga Hydroelectric Power Station plays an important role in ensuring the reliability of the Unified Energy System of Russia, and also provides large-tonnage shipping, water supply, and irrigation of drylands. The owner of the Volzhskaya HPP (with the exception of the shipping lock, as well as road and railway crossings) is PJSC RusHydro.
The possibility of constructing the Volga Hydroelectric Power Station (originally at an alignment in the Kamyshin region) has been considered since the early 1930s under the “Big Volga” plan, which provided for the regulation of the Volga by a cascade of hydroelectric complexes. The construction of the station was begun in 1950 and was announced as one of the “Great Construction Workers of Communism”. Initially, construction work was carried out under the control of the Ministry of Internal Affairs of the USSR using the labor of prisoners, from 1953 until the completion of construction in 1962, the station was built by freelance personnel. The station became the basis of a new territorial production complex, most of whose enterprises are located in the city of Volzhsky, which grew out of the hydro builders village. At the same time, the construction of the station and the Volga-Kama cascade as a whole led to a number of adverse social and environmental consequences — flooding of lands and resettlement of people, blocking of spawning paths of valuable fish species, changes in the water regime of the Volga-Akhtuba floodplain.
Wladimir Klitschko - Lymon Brewster
Wladimir Klitschko - Lymon Brewster (eng. Wladimir Klitschko vs. Lamon Brewster) - a twelve-round heavyweight boxing match for the vacant WBO world champion title, which from 2000 to 2003 belonged to Wladimir Klitschko. The fight took place on April 10, 2004 at the Mandalay Bay Resort & Casino hotel and entertainment complex (Las Vegas, USA).
The fight initially took place with the advantage of the Ukrainian athlete. In the third round, Klitschko sent a rival to a knockdown, but in the fifth round he began to tire, as Brewster took advantage of, sending him to a knockdown of his counterpart. After this round was over, a referee became between the boxers. Vladimir caught on his leg and fell - he was completely exhausted and could not get up. As a result, the victory by technical knockout was awarded to Brewster.
Before the fight with Brewster, Klitschko was considered the favorite of the World Boxing Organization, and an unexpected defeat had a negative impact on his popularity in the boxing world. After the battle, a number of assumptions were made about the reasons for the completion of the fight. There was, in particular, the version of Klitschko’s poisoning on the eve of the battle, but she did not find confirmation.
Causes of hypotension
The causes of hypotension are multiple, since a drop in blood pressure can occur with a variety of physiological and pathological conditions of the human body.
Among the leading causes of hypotension, the following factors can be identified:
Neurocircular dystonia. Scientists consider this complex of cardiovascular disorders of a functional nature the most fertile ground for the onset of hypotension. According to experts, neurocircular dystonia leads to hypotension in 80% of cases,
One of the leading roles in the development of hypotension is given to pronounced stress and long-term situations that traumatize the psyche. Chronic overwork, depressive moods and inadequate night rest directly participate in the occurrence of primary hypotension,
Hypotension may be the result of diseases that already exist in humans, including:
Dumping syndrome after complete resection of the stomach, gastric ulcer,
Myocarditis, cardiomyopathy, arrhythmia, heart failure,
Disruption of the peripheral nervous system in the presence of diabetes mellitus (neuropathy of diabetic origin),
Diseases of infectious nature,
Benign and malignant tumors,
Spinal injuries and other diseases.
They lead to a sharp drop in blood pressure, massive bleeding, dehydration of the body,
Hypotensive reflexes can work when you receive a serious injury, with poisoning, anaphylactic shock,
The mechanism of pressure reduction is triggered when there is a sudden disturbance of cardiac activity,
Vitamin deficiency can lead to the development of hypotension. Especially in this regard, the deficiency of vitamins C, E and B is dangerous,
Often hypotension is a consequence of debilitating diets,
Taking certain medicines may cause a drop in blood pressure. In this regard, you should be more careful with the use of drugs for the treatment of high blood pressure,
Physiological hypotension can occur even against the background of absolute health, if there is a genetic predisposition to it. Such hypotension is registered with sudden changes in the weather, with increased physical exertion. Often low pressure is observed in trained athletes
Too long night rest can lead to an excessive decrease in blood pressure. It has been established that in healthy people the pressure level during sleep decreases by 10-20%. If the pressure drops by more than 20%, then this can be dangerous, especially for older people. Experts attribute this drop to endogenous disorders of neurohumoral regulation.
There are many reasons that can provoke hypotension.
However, the mechanism of its development is always associated with 4 main factors, including:
The weakening of the resistance of peripheral vessels. This occurs mainly in anaphylactic shock, in the collapse of toxic or infectious genesis,
Reduction in cardiac output (percussion and minute). This is often observed in severe heart disease, for example, in myocardial infarction, in severe arrhythmias, etc.
Reducing the volume of circulating blood in the body. The main reasons in this case are blood loss due to internal or external bleeding,
Deterioration of the venous blood supply to the heart. The cause of this condition may be pleurisy, or massive ascites.
Symptoms of hypotension
If a decrease in blood pressure is of a physiological nature, then, as a rule, the person does not notice the symptoms of hypotension. In other cases, the clinical picture of the disease will vary, so it is more rational to consider the signs of pathology, based on its origin.
Symptoms of orthostatic hypotension
Especially pronounced symptoms of orthostatic hypotension in the elderly. A drop in pressure is observed for several minutes, when a person changes from a horizontal position to a vertical one. At the same time systolic pressure decreases by 20 mm. Hg Art., and diastolic - 10 mm. Hg Art.
On the background of orthostatic hypotension, the patient experiences symptoms such as:
Shaky gait, down to the possibility of falling,
Disruption of the heart.
In rare cases, panic attacks and fainting are observed.
Symptoms of postprandial hypotension
This form of hypotension is characteristic of healthy people. Most often it is observed in old age. A drop in pressure occurs after eating, usually within 2 hours after eating. If a person does not have any other diseases, then, as a rule, he does not notice the symptoms of hypotension.
However, on the background of cerebrovascular pathologies, the following signs may appear:
Impaired speech and vision
A person can independently associate all these symptoms with food intake.
Hypotension in the face of stress and physical overwork
Hypotension against the background of stress, active physical and intellectual activity is most often observed in athletes, as well as in patients with diabetes mellitus or circulatory pathologies.
Symptoms of a drop in blood pressure during mental and physical strain are as follows:
Numbness of extremities, sensation of "wadded" legs.
This is primary hypotension, which is characterized by persistent signs and most often occurs in young women.
The clinical picture of primary hypotension is as follows:
All patients complain of headaches, fatigue and dizziness. These symptoms go away if the pressure rises,
Patients are prone to increased anxiety and depressed moods,
There are disorders of the autonomic nervous system. So, from time to time a person has an unmotivated feeling of heat or cold, numbness of the extremities, increased perspiration,
One third of men with hypotension have problems with potency,
About 50% of patients suffer from regular panic attacks, fainting, orthostatic insufficiency,
Doctors often hear complaints about cardiac abnormalities. Patients suffer from shortness of breath, which often occurs at the peak of emotional excitement or against the background of pronounced fatigue.
The flow of such hypotension is undulating. People depend on meteorological conditions, on the intensity of loads in everyday life. Often with age, such hypotension passes.
Symptoms of secondary hypotension
Secondary hypotension occurs against the background of existing diseases, of which there is a huge variety. It is the symptoms of the main disease come to the fore. At the same time, patients note in themselves weakness, drowsiness, fatigue, headaches, deterioration of cognitive abilities, sweating of the feet and palms.
What is dangerous hypotension?
Primary hypotension, as a rule, has a favorable prognosis. But over time, when it passes, it is often replaced by arterial hypertension. At the same time, people very poorly tolerate even a slight increase in pressure.
Fear should cause progressive hypotension, as it threatens with the development of the following complications:
The risk of developing cardiovascular pathologies increases,
As a result of hypotonia, the vascular tone is constantly reduced, which leads to a slower blood flow, which means that the body experiences oxygen starvation. First of all, the brain and internal organs are affected,
Severe hypotension is dangerous fainting. If you lose consciousness, a person can get serious bruises and injuries.
In old age, hypotension can cause ischemic stroke,
Scientists believe that frequent pressure surges increase the risk of developing dementia.
Can hypertension go into hypotension?
Often, patients wonder whether hypertension can turn into hypotension. Cardiologists say that hypertension cannot transform itself into hypotension. However, this does not exclude the possibility that high pressure may drop sharply to low values.
For example, this often happens when the heart does not function properly, in particular after an acute myocardial infarction or stroke. This is a very dangerous condition that requires prompt and competent medical action.
Hypotension Treatment Methods
Methods of treatment of arterial hypotension directly depend on what is its cause. If it is caused by any disease, then to eliminate it will need to get rid of the underlying disease. If arterial hypotension is triggered by neurovegetative disorders, it is necessary to correct the existing imbalance.
For this, it is possible to use methods of drug and non-drug correction, including:
Normalization of wakefulness and rest. The load should be selected sparing, at night should be no less than 8 hours. People with hypotension are recommended to sleep with a raised headboard. At the same time, you should not be in a horizontal position for too long,
Correction of diet. Meals should be frequent, but in small portions. Preference should be given to light and not too hot food. It is possible to increase the amount of salt to 10-20 g per day, if there are no contraindications for this. At the same time you need to drink water at least 2 liters. It is recommended to give up alcohol,
Visiting the masseur's office,
Hydrotherapy, which includes the Scottish shower, hydromassage, mineral baths, Charcot's shower, etc.,
Physiotherapy techniques, for example, electric and electrophoresis of the neck area,
Performing physical therapy complexes, including swimming, walking, gymnastics.
As for the medical correction of arterial hypotension, then for its treatment use drugs from different groups:
Vegetable adaptogens: tincture of lemongrass, ginseng, aralia,
The drug Midodrin. It contributes to an increase in venous return to the heart, improves the health of patients and rarely causes side effects.
Adrenomimetics: Phenylephrine, Ephedrine, Caffeine,
Cerebroprotectors: Vinpocetine, Actovegin, Cinnarizin,
Nootropic drugs: Piracetam, Glycine,
Antioxidants and vitamin complexes,
Antidepressants and tranquilizers.
If a patient has an acute drop in blood pressure, then the fastest stabilization is shown by administering vasoconstrictors (Dopamine and Mezaton) and cardiotonics. Perhaps the use of glucocorticosteroids, colloidal and saline solutions.
First aid for hypotension
First aid for hypotension is reduced to the following actions:
It is necessary to lay the patient on a comfortable surface, putting a roller under his feet,
You can seat the patient in such a way that he lowered his head below the knees,
It is important to help the person to follow the breath. It should be smooth, but not deep,
If a person loses consciousness, then you can offer him a sniff of a cotton pad moistened with ammonia,
When the patient's condition improves, you need to give him a cup of sweet tea or coffee. The drink should not be very hot.
If improvement does not occur, you should immediately call the ambulance brigade.
Education: A diploma in "Cardiology" received at the Moscow State Medical University named. I.M. Sechenov (2015). Here the postgraduate study was completed and the diploma “Cardiologist” was obtained.
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The main symptoms of low blood pressure are weakness, dizziness, and fatigue. Most often they occur in adolescence and youth, worsen the health of young people, reduce mood, do not allow to fully learn and work. The appearance of such symptoms is due to several factors:
Many people underestimate the seriousness of the problem of low blood pressure, although this is a direct signal of a violation in the body that spoils human life. The whole difficulty lies in the impossibility of normalizing the pressure once and for all.
It often happens that the pressure in hypotensive drops so much that it is hard for them to even move. As a rule, in such cases it is advised to drink coffee or eat chocolate, however, this is all limited. And then such patients themselves begin to look for drugs that increase blood pressure. We provide a large list of drugs that increase blood pressure.
Hypotension (arterial hypotension) is a low blood pressure syndrome characterized by persistent indicators of systolic (upper) pressure of less than 100 mm Hg, and diastolic (lower) of less than 60 mm Hg. Young women and adolescents are more likely to suffer from hypotension. At an older age, on the background of vascular atherosclerosis, atherosclerotic arterial hypotension occurs due to a loss of vascular tone due to atherosclerotic changes.
Due to the multifactorial nature of the development of this condition, hypotension is the subject of a study of cardiology, neurology, endocrinology, and other clinical disciplines.
Classification of arterial hypotension
Due to the fact that arterial hypotension can occur in healthy individuals, accompany the course of various diseases or be an independent nosological form, a single classification of hypotonic states is used. It secrete physiological, pathological (primary) and symptomatic (secondary) arterial hypotension.
The variants of physiological hypotension include arterial hypotension as an individual norm (having a hereditary constitutional nature), adaptive compensatory hypotension (in highland, tropical and subtropical residents) and hypotension of increased fitness (found among athletes).
Pathological primary arterial hypotension, as an independent disease, includes cases of idiopathic orthostatic hypotension and neurocirculatory hypotension with an unstable, reversible course or persistent manifestations (hypotonic disease).
In the series of symptomatic (secondary) arterial hypotension, acute (with collapse, shock) and chronic forms caused by organic pathology of the cardiovascular, nervous, endocrine systems, hematological diseases, intoxications, etc. are considered.
Causes of hypotension
Hypotension should be considered as a multifactorial state, reflecting a decrease in blood pressure in the arterial system under various physiological and pathological conditions. The cause of primary arterial hypotension in 80% of cases is neurocirculatory dystonia. According to modern theories, primary hypotension is a special form of neurosis of the vasomotor centers of the brain, in the development of which the leading role is given to stresses and prolonged psycho-traumatic situations. The immediate causes can be psychological trauma, chronic fatigue and lack of sleep, and depression.
Secondary hypotension is a symptom of other existing diseases: anemia, gastric ulcers, dumping syndrome, hypothyroidism, cardiomyopathy, myocarditis, arrhythmia, diabetic neuropathy, osteochondrosis of the cervical spine, tumors, infectious diseases, heart failure, etc.
Acute hypotension can be the result of massive single-stage blood loss, dehydration, trauma, poisoning, anaphylactic shock, a sharp disruption of the heart, in which the hypotensive reflexes are triggered. In these cases, arterial hypotension develops in a short time (from several minutes to hours) and entails pronounced disturbances in the blood supply to the internal organs. Chronic hypotension tends to last for a long time, while the body is adapted to reduced pressure, as a result of which there are no pronounced symptoms of circulatory disorders.
Hypotension may also develop on the background of a lack of vitamins B, C, E, dieting, drug overdose, for example, in the treatment of arterial hypertension. Physiological hypotension can be observed in healthy people with a hereditary predisposition to low blood pressure, in trained athletes, in terms of adaptation to an abrupt change in weather or climatic conditions.
Pathogenesis of arterial hypotension
Despite the abundance of possible causes, the mechanism of development of arterial hypotension may be associated with four main factors: a decrease in cardiac output and stroke, a decrease in BCC, a decrease in peripheral vascular resistance, a decrease in venous blood flow to the heart.
Reducing the stroke and cardiac output is found with severe myocardial dysfunction during myocardial, infarction, severe arrhythmias overdose ß-blockers, etc. D. Reduced tone and peripheral resistance vessels (mainly arterioles and precapillaries) causes the development of hypotension during collapse toxic or an infectious nature, anaphylactic shock. Hypotension as a result of a decrease in BCC occurs when external (gastrointestinal) or internal bleeding (with ovarian apoplexy, rupture of the spleen, rupture of an aortic aneurysm, etc.). Rapid evacuation of exudate with massive ascites or pleurisy can lead to arterial hypotension due to a decrease in venous blood return to the heart, since a significant part of the BCC is retained in the smallest vessels.
In various forms of arterial hypotension, violations of the vascular regulation by higher vegetative centers, reduction in the mechanism of arterial pressure regulation of the renin-angiotensin-aldosterone system, disorder of vascular receptor sensitivity to catecholamines, disorders of the afferent or efferent part of the baroreflex arc can be detected.
Symptoms of arterial hypotension
Physiological hypotension in most cases does not cause a person special discomfort. The acute form of arterial hypotension occurs with a pronounced oxygen starvation of brain tissue, in connection with which symptoms such as dizziness, short-term visual impairment, unsteadiness of gait, pallor of skin, fainting develop.
In chronic secondary hypotension, the symptoms of the underlying disease come to the fore. In addition, patients have weakness, apathy, drowsiness, fatigue, headaches, emotional lability, memory impairment, impaired thermoregulation, sweating of the feet and palms, and tachycardia. The prolonged course of arterial hypotension causes irregularities in the menstrual cycle in women and potency in men.
When orthostatic hypotension due to a change in the position of the body from horizontal to vertical, pre-unconscious states develop. In case of arterial hypotension, vegetative crises can occur, as a rule, of vaginal-insular nature. Such paroxysms occur with adynamia, hypothermia, excessive sweating, bradycardia, a fall in blood pressure and fainting, abdominal pain, nausea, vomiting, difficulty breathing due to a spasm of the larynx.
Diagnosis of arterial hypotension
In the process of diagnosis, it is important not only to establish the presence of arterial hypotension, but also to find out the reasons why it is caused. A correct measurement of blood pressure requires a threefold blood pressure measurement at intervals of 3–5 minutes. Daily monitoring of blood pressure allows you to determine fluctuations in the magnitude and daily rhythm of blood pressure.
To exclude or confirm secondary arterial hypotension, a comprehensive examination of the state of the cardiovascular, endocrine and nervous systems is necessary. For this purpose, biochemical blood parameters (electrolytes, glucose, cholesterol and lipid fractions) are examined, an ECG is performed (at rest and with stress tests), an orthostatic test, echocardiography, electroencephalography, etc.
To determine the need for more in-depth examination, patients with hypotension should be consulted by a cardiologist, a neurologist, an optometrist, and an endocrinologist.
Treatment of arterial hypotension
Treatment of arterial hypotension begin only after establishing the exact cause of lowering blood pressure. In case of secondary symptomatic hypotension, the main disease will serve as the object of influence. Neurovegetative genesis hypotension, first of all, requires the correction of vegetative imbalance using drug and non-drug methods.
The complex of medical and recreational activities may include the normalization of the day regimen and nutrition, various options for psychotherapy, massage of the neck and collar area, aromatherapy massage, water therapy (Scottish shower, circular shower, Vichy shower, hydromassage, aromatic and mineral baths), acupuncture, physiotherapy (electrophoresis on the collar area, electrosleep), aromatherapy, aeroionotherapy, exercise therapy.
Drug treatment of arterial hypotension is carried out with drugs of different groups: herbal adaptogens (infusions of lemongrass, aralia, ginseng), anticholinergics, cerebroprotective agents (cinnarizine, vinpocetine), nootropic drugs (glycine, piracetam), antioxidants and vitamins (succinate, vitamin, antioxidants). ), antidepressants and tranquilizers. In case of acute arterial hypotension, cardiotonics and vasoconstrictors (mezaton, dopamine), glucocorticoids are administered, and glucocorticoids are administered, and saline and colloid solutions are infused in order to rapidly increase and stabilize blood pressure.
Prevention of arterial hypotension
The general principles of prevention of primary arterial hypotension are reduced to the observance of the daily regimen, maintaining a healthy and active lifestyle, playing sports (swimming, walking, gymnastics), good nutrition, elimination of stress. Useful procedures that strengthen blood vessels (douche, hardening, massage).
Prevention of secondary arterial hypotension is the prevention of endocrine, neurological, cardiovascular diseases. Patients with arterial hypotension are recommended to continuously monitor blood pressure levels, regular monitoring by a cardiologist.