School of Arterial Hypertension

Do you know that:

  • One in five adults has increased blood pressure (BP).
  • Only half of people with high blood pressure know about it. Many people avoid visiting a doctor, while the only way to diagnose arterial hypertension is to regularly measure blood pressure
  • Only half of patients with high blood pressure receive proper treatment. Many patients do not know that feeling well with high blood pressure is not a reason to refuse treatment, since untreated hypertension is a “time bomb.”
  • Only half of the patients actually follow all the doctor’s recommendations. Many patients voluntarily stop taking recommended medications or reduce their dosage, which often leads to an exacerbation of the disease.

Arterial hypertension is one of the most common and most dangerous diseases today, which leads to severe complications: stroke, myocardial infarction, heart failure, renal dysfunction, and also accelerates the development of atherosclerosis and coronary heart disease. The increase in blood pressure, regardless of the cause, is based on complex dysregulation of the circulatory apparatus, manifested primarily by an increase in the tone of the arterial vessels. As a rule, the progression of hypertension is a long-term, gradual process, due to which the patient’s body “gets used” to high blood pressure, and hypertension is asymptomatic until one of the complications occurs. This is why AG is called the “silent killer.” Due to the absence of clinical manifestations of the disease for a long time, many patients do not take it seriously, do not want to admit that high blood pressure poses a threat to their lives, and neglect the advice of doctors about the need for drug therapy that can reduce the risk of complications of the disease, increase the duration and quality of the disease. life.

A health school for patients with arterial hypertension has been organized at the 1st City Clinical Hospital .

What is a Health School for patients with arterial hypertension?

The school allows the patient to learn how to independently control their health, learn how to reduce the adverse effects of behavioral risk factors on the body (nutrition, physical activity, stress management, giving up bad habits). Also here you will be taught how to provide first aid in cases of exacerbations and crises.

The training program includes 8 structured lessons of 90 minutes each:

  • Lesson 1: What do you need to know about arterial hypertension?
  • Lesson 2: Healthy eating. What does a patient need to know about nutrition for arterial hypertension?
  • Lesson 3: Obesity and arterial hypertension.
  • Lesson 4: Physical activity and health.
  • Lesson 5: Smoking and health.
  • Lesson 6: Stress and health.
  • Lesson 7: Drug treatment of arterial hypertension. How to increase patient adherence to treatment.
  • Lesson 8: Final lesson.

During training at the School of Health, patients become familiar with external and internal negative conditions that have a damaging effect on the body. Patients are taught the rules for measuring blood pressure, learn what level of pressure should be considered normal, and draw up an individual action plan to eliminate risk factors. Two classes at the School of Health are devoted to the rules of healthy eating, what the diet of a healthy person should be, and the effect of nutrition on blood pressure levels is explained. For patients with increased body weight, the causes of obesity are determined, the basic principles of diet therapy are discussed, and various types of diets are given. At the Health School, patients become familiar with the components of tobacco smoke and their impact on individual health. The type of smoking behavior is assessed, a negative attitude towards smoking and motivation to quit smoking are formed, and modern methods of treating tobacco smoking are examined. Under the supervision of an experienced physician, patients assess their level of fitness, learn how to increase daily physical activity, how to build a training program, and also avoid complications during physical activity. At the Health School, patients learn to distinguish between acceptable and harmless levels of stress, become familiar with methods of self-assessment of stress levels, and learn the conditions for overcoming stress reactions. At the last lesson, the cardiologist will introduce the general principles of drug therapy, what modern medications exist with minimal side effects that lower blood pressure, and teach how to provide first aid for a hypertensive crisis.

Recommendations for self-measurement of blood pressure:

  • 30 minutes before measurement you should not smoke, drink strong coffee or tea;
  • Measurements should be taken after a 5-minute rest, 1-2 hours after eating;
  • During the measurement, you should not actively move or talk;
  • In the absence of concomitant diseases, standard sitting measurements are sufficient. Elderly people are recommended to additionally measure blood pressure while standing and lying down;
  • To measure blood pressure, the hand must be relaxed and freed from clothing;
  • The position of the hand should be such that the elbow bend is approximately at the level of the heart;
  • Place the cuff on the shoulder so that its lower edge is 2 cm or 2 fingers above the elbow;
  • In case of heart rhythm disturbances, it is advisable to take several measurements in a certain period of time (for example, 4 measurements in 15 minutes at rest). Record the measurement results in a diary.

The ideal, or optimal, blood pressure is 120/80 mm Hg.

Normal blood pressure is no more than 130/85 mmHg.

“Mild” hypertension, latent or also called borderline blood pressure, is 130-139/85-89 mmHg.

Only a doctor can prescribe drug treatment for arterial hypertension. What causes high blood pressure?

Factors that influence the occurrence of arterial hypertension are called risk factors . There are many of them, and there is not one that would definitely lead to illness - it is necessary for several “troubles” to develop. But don't relax. According to experts, in 93% of men after 35 years of age, examination will certainly reveal at least one of the risk factors, and in many, one or more. It has been proven that the combination of several risk factors significantly increases the likelihood of the occurrence and development of cardiovascular diseases.

Fighting them can help lower blood pressure and reduce the dose of medications, which you will agree is beneficial, given the prices of medications in our country. So what are these factors?

Modifiable risk factors:

  • Poor nutrition
  • Low physical activity
  • Smoking
  • Overweight
  • Excessive alcohol consumption
  • Psycho-emotional stress
  • Incorrect alternation of work and rest

Unchangeable risk factors:

  • Gender and age:
    • men over 55 years old
    • women over 65 years old
  • Heredity

The first factor is excess salt intake! Even if it seems to you that you are consuming a small amount of salt, remove the salt shaker from the table, try not to add salt to your food, limit saltiness, and especially smoked foods. The amount of table salt consumed should not exceed 1 teaspoon per day. Just one reduction in salt in the diet can reduce mean arterial pressure by 10 mmHg. Art. To reduce the negative impact of salt on the body, it is necessary to increase the consumption of foods rich in potassium (dried apricots, raisins, baked potatoes in their jackets, tomatoes, legumes). In addition, it has a beneficial effect on the tone of the cardiovascular system.

The second factor is excess body weight! Nowadays it is common to say that you need to love yourself for who you are. Let's rephrase: love yourself and maintain your health. The desire to lose weight should not be an end in itself. To find out if you are overweight, you need to calculate your body mass index using the formula: Weight (kg) : height (m)2 (evaluate your result using Table 2). Normalizing weight helps lower blood pressure, reduces the risk of cardiovascular complications (heart attack and stroke) and the risk of death. The basic principle: the calorie content of food must correspond to the body's energy expenditure. This means that the energy we receive from food should be exactly as much as we can spend. Consumption of foods rich in calories (sugar, chocolate, fat, etc.), especially if you are not engaged in physical labor, can lead to obesity, cholesterol deposition in the walls of blood vessels, and, as a consequence, to atherosclerosis of the arteries and hypertension. Keep in mind that for men aged 40–60 years, whose work does not involve significant physical activity, the number of calories consumed from food per day should not exceed 2000–2400 kcal, and for women, respectively, 1600–2000 kcal. What foods are the most high in calories? Fatty meats, especially fatty beef, offal, cocoa, chocolate, cakes, caviar, lard, baked goods, alcoholic beverages. Agree, you can do without these products. What is recommended to eat? Salt-free, preferably with bran, bread, soups cooked in vegetable broth, lean meats and fish (preferably steamed), about a kilogram of vegetables and fruits per day, dishes and side dishes from cereals and pasta, low-fat dairy products, vegetable oils, low-fat sausage, vinaigrettes, salads dressed with sour cream or olive oil. Agree, the choice of recommended products is quite wide. If you like sausage, choose low-fat varieties, if you like milk or cottage cheese, then choose low-fat products, limit white bread, butter (it is known that the ban on the use of butter in catering establishments in one of the Scandinavian countries helped reduce mortality from myocardial infarction, So let's learn from the experience of others!). The calorie content of some products is indicated in Table 3.

The third factor is physical inactivity! Reduced physical activity leads to low fitness of the cardiovascular system, decreased resistance to stress, excess body weight, and, ultimately, increased blood pressure. You can start by walking; go up to your floor without an elevator if you live in an apartment building. Do morning hygienic exercises, health-improving physical education (walking, swimming, cycling, skiing), play outdoor games (volleyball, tennis). Physical activity has the ability to “thin” the blood and reduce the level of “sugar” in the blood, thus preventing the development of myocardial infarction, cerebral stroke and diabetes. If you decide to start physical training, be sure to consult with your doctor so that he can rule out some contraindications for you and prescribe an exercise regimen that is suitable for you in terms of intensity. There are some general rules for physical exercise: regularity, optimal intensity, stages. Indeed, exercise should be regular, 3 – 5 times a week. The intensity of the load should be controlled using the pulse. This means that initially during physical activity your heart rate should not exceed 50% of the maximum allowable for your age (i.e. 220 minus your age). Then you can gradually increase the intensity of the load until it reaches 60% (energy consumption for the main types of activity is shown in Table 4).

The fourth factor is smoking! The harm of smoking is undeniable! No one will probably argue about the dangers of smoking. However, some facts may be unknown to you. Tobacco smoke contains carcinogens and nicotine. Nicotine has a thrombus-forming effect (promotes the formation of blood clots in the blood vessels of the heart and brain), atherosclerotic effect (promotes damage to the vascular wall and the deposition of cholesterol in it), and increases blood pressure. There are no “light” cigarettes! After all, you can’t talk about “light” poison? If you smoke, you need to quit this bad habit.

What should you be prepared for if you decide to quit smoking? Within 2 weeks to a month, the following withdrawal symptoms may occur: a strong desire to smoke, excitability, anxiety, difficulty concentrating, irritability, worsening mood, feelings of anger, depression, drowsiness, headache, insomnia, tremor (small tremors in the hands), sweating , improved appetite, weight gain, increased cough, feeling of chest congestion, muscle pain, dizziness. Currently, methods of substitution care for smokers are widely used. There are chewing gums and patches containing nicotine, and reflexology is used.

The fifth factor is stress! It is known that patients with hypertension have low resistance to stress. This contributes to the development of the disease and threatens complications.

To overcome stress, use a few tips below:

  1. Strive for the highest available goal and do not fight over trifles;
  2. Treat others the way you would like them to treat you;
  3. Don't try to do everything at once;
  4. Don't forget about rest. Monotonous work tires, changing activities helps maintain strength and health;
  5.  Appreciate the joy of true simplicity of life, avoiding everything superficial, ostentatious, deliberate. This will earn you the favor and love of others;
  6. Try to see the bright side of events and people;
  7. If you need to undertake a depressing and unpleasant task (conversation), do not put it off until “later”;
  8. Before doing anything in a conflict situation, weigh your strengths and the appropriateness of actions;
  9. Try to see your “pluses”, even if you fail in any business (or conversation);
  10. Set realistic and important goals in any endeavor. Reward yourself for achieving your goal.