Faster, higher, blue: why hypertension is more dangerous than hypotension


More than a third of the world’s population suffers from hypertension. And according to the World Health Organization, every fourth person complains of low blood pressure. What problems are hidden behind the indicators on the tonometer, why hypertension is considered worse than hypotension, and whether it is possible to reduce the suffering of patients before the ambulance arrives – in the material of Izvestia.

Less – more

As a rule, people themselves know whether they have a tendency to high or low blood pressure. Given their characteristics, they can track negative points. But if the pressure surge happened for the first time or such symptoms are rare, then doctors advise focusing on signs that will tell you that something is wrong with health.

– High blood pressure is manifested by headache, nausea, vomiting. There may be dizziness, tinnitus, a feeling of pulsation in the temples. Vision also deteriorates: fuzziness appears, flies seem to flash before the eyes. Low blood pressure is characterized by general weakness, malaise, dizziness, lethargy, as they say – pre-syncope. It seems like a person is about to fall, – says Associate Professor of the Department of Osteopathy of the North-Western State Medical University. I.I. Mechnikov, osteopath, neurologist Vladimir Belash.

Low blood pressure in its most critical manifestation threatens the risk of loss of consciousness. According to the neurologist, against the background of low numbers, the so-called syncope occurs, that is, fainting. It is believed that when a person is very worried, the pressure rises sharply. But people faint and from experiences. For example, the pressure can drop sharply in the treatment room when a person is afraid of the upcoming manipulations. Therapist Anastasia Timoshchenko also associates a sharp decrease in pressure with profuse fluid loss (with vomiting, diarrhea, and blood loss) or with intoxication.

Photo: Global Look Press/Ute Grabowsky/ via

The neurologist believes that from the standpoint of health risks, the increased numbers represent the greatest danger. In this case, the so-called risk of vascular accidents, such as stroke and myocardial infarction, increases significantly. Of course, we are talking about constant jumps and instability, a one-time episode may not affect your well-being. But still, in every sense, you should keep your finger on the pulse.

– A lot depends on the accompanying problems. If a person has atherosclerotic vascular changes and increased blood clotting, then a rise in pressure significantly increases the risks. Thrombi can form, and this is also fraught with damage to the atherosclerotic plaque, as a result of which a piece can come off of it and enter the artery through the bloodstream, clogging it, warns Vladimir Belash.

When is it good to lie down?

According to the neurologist, if a person is on drug therapy and for some reason missed taking the drug for pressure, then he needs to drink important funds for him as soon as possible. In the case when there are no such drugs at hand, basic non-drug methods, as doctors call them, will come to the rescue.

– A person needs to be laid or seated so that he can lean back in a chair or armchair; release him from restrictive clothing so that he can breathe calmly; provide fresh air. If a hypertensive crisis was provoked by some emotional factor, then it is necessary to calm the patient, distract him with a conversation, – says Vladimir Belash.

Photo: RIA Novosti / Ilya Pitalev

The neurologist reminds about the benefits of breathing exercises. To help yourself, you can take a deep breath, hold your breath a little and try to exhale with noise. This, according to the doctor, helps to slightly reduce pressure and distract a person from suffering, switches his attention, helping to alleviate the condition before the ambulance arrives. Doctors with the help of drugs will help to gradually reduce the pressure, and if the situation is critical, they will offer hospitalization – with a hypertensive crisis, jokes are bad. According to the therapist Anastasia Timoshchenko, this condition is characterized by a sharp increase in blood pressure with the manifestation of neurological symptoms in the form of impaired consciousness, intense headache, dizziness, flies and vomiting.

– If there is no effect from taking the drugs recommended by the attending physician, it is necessary to call the patient an ambulance. Specialists will adjust the blood pressure figures, gradually reducing the figures. If the patient has confusion or loss of consciousness, then it is strictly forbidden for him to give any drinks, Anastasia Timoshchenko warns.

With low blood pressure, according to Vladimir Belash, it is easier to deal with. Sometimes it is enough to offer a person strong sweet tea or weak coffee with sugar for the patient to come to his senses and cheer up. Moreover, tea in this case is better – it has a milder effect.

Photo: Global Look Press/Sergey Petrov

– You can just give something sweet, if such a product is at hand. It is also good to lay the person down with their legs slightly raised. In most cases, this is enough to help. You can also rub your earlobes. It is difficult to say how effective this procedure is, but such a recommendation is found in some guidelines, the neurologist continues.

The harm of self-medication

Doctors remind that, according to international recommendations, the maximum allowable numbers on the tonometer are 140 to 90. With such indicators, the patient’s condition can be monitored and regulated with the help of medicines. If the numbers are higher, then more drastic measures need to be taken – hospitalization is indicated. However, the neurologist emphasizes that in recent years, the society of cardiology recommends adhering to other indicators – 130 to 80.

– In general, everything should be approached individually. If a person is hypotonic with a working pressure of 100 to 60, then for him an indicator of 130 to 80 will be critical. In the case when the patient has arterial hypertension, the initial figure is 130 to 80 and he is on drugs, then for him the condition at 140 to 80 and even 160 to 80 can go unnoticed, explains Vladimir Belash.

If any ailment occurs, self-medication, looking for the names of drugs on the Internet, of course, should not be done. This also applies to the normalization of blood pressure.

Photo: Izvestia/Alexander Kazakov

– Self-medication can lead to serious problems, which are inevitable due to the lack of information about the possible risks of taking drugs without a doctor’s recommendation. For example, some medicines can speed up the heartbeat. Others, on the contrary, can slow down the pulse and lead to a deterioration in well-being, and sometimes cause dizziness and loss of consciousness, says Diana Derevyankina, a cardiologist at the Budu online health management service.

Before prescribing a particular drug, specialists always clarify the nature of concomitant diseases, as well as information about the drugs that the patient is already taking. All drugs, including those that lower blood pressure, have features of interaction with the body and other drugs, the cardiologist emphasizes. Uncontrolled medication without a doctor’s prescription can increase the risk of heart attack and stroke – there is a big load on the cardiovascular system. Moreover, you can overdo it and “bring down” the numbers sooner than necessary. The desire for a quick normalization of pressure, according to doctors, is the wrong step.

– All antihypertensive drugs are divided into ambulance drugs that provide a quick onset of effect, and long-term cumulative drugs. One of the most common mistakes is to take several medications at once, without waiting for the effect of the previously applied therapy, continues Anastasia Timoshchenko.

Photo: TASS/Artem Geodakyan

Such actions are tolerated by the body even worse than just high blood pressure, because as a result, unwanted vascular reactions occur.

When registering high blood pressure, you should try to reduce blood pressure slowly – by 20% within three hours. With a rapid change in numbers, there may be a violation of the blood supply to the brain, which again can provoke a stroke. Of course, in this situation, professional action is necessary.

“There is a worldwide trend towards phasing out short-acting drugs to quickly lower high blood pressure. Now doctors prefer the selection of long-acting combination drugs. But the pressure should be reduced with emergency drugs most often with an increase in blood pressure and the appearance of a neurological deficit (impaired vision, speech, weakness or decreased mobility in the limbs, confusion, chest pain, shortness of breath), the cardiologist explains.

According to the therapist, it is important to select an adequate dose according to the characteristics and individual indications, as well as monitoring indicators for at least 14 days. The effect comes gradually, as the drug accumulates.

Photo: RIA Novosti / Maxim Bogodvid

Coma weather

Often people complain about health problems during a change in weather. Anastasia Timoshchenko warns that an increase in atmospheric pressure, as a rule, causes an increase in arterial pressure. Hypertensive patients know about this and prepare in advance for natural disasters. This is correct, because with a sharp jump in atmospheric pressure, the risk of a hypertensive crisis proportionally increases.

– With a decrease in atmospheric pressure, on the contrary, hypotensive patients become the most vulnerable. Blood pressure numbers are significantly reduced and limit the physical activity of patients, says Tymoshchenko.

As measures to prevent high blood pressure, doctors recommend maintaining a normal body weight, giving up bad habits, and avoiding excessive salt intake.

It is recommended to resist hypertension and strengthen vitality in case of hypotension with an active lifestyle. You should make it a habit to exercise at work or get up at least several times a day to walk and stretch. It is important to observe the daily routine, maintain a healthy sleep rhythm (sleep for at least seven hours), do not stay too long in front of the monitor, and monitor the drinking regimen.

Photo: Izvestiya/Mikhail Tereshchenko

For those who seek to take pressure indicators under control, dosed physical activity is recommended in the form of daily cardio loads lasting at least 150 minutes a week. We are talking about the classic 10 thousand steps a day. The importance of quitting smoking, drinking alcohol, and taking psychoactive substances is not even discussed. People should also keep emotional overload under control, avoid stressful situations – all this helps to maintain the health of the cardiovascular system for a long time.

Cardiologist Diana Derevyankina notes that much attention has recently been paid to a nutrition system designed to maintain normal blood pressure levels. The diet uses foods that contain a minimum amount of sodium, rich in calcium, magnesium and potassium. The menu is dominated by unlimited vegetables and fruits, low-fat dairy and whole grains, nuts, fish and poultry. Red meat, sweets and sugary drinks are allowed with restrictions.


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