Treatment of arterial hypertension in the elderly

Treatment of hypertension in the elderly has its own characteristics. Elderly people do not pay too much attention to the first signs of the disease, and therefore, as a rule, hypertension therapy begins when the disease has developed significantly.

In addition, the treatment of hypertension in the elderly largely depends on the age mentality. Old people do not want to go to the doctors, stand in queues, follow the recommendations of doctors, make adjustments to their lifestyle. The last point is the most difficult, since it is difficult for them to change the established daily layout, not so much physically as psychologically.

It is the unwillingness to change something that leads to the fact that such first symptoms as headache, insomnia or "flies" before the eyes of older people are attributed either to fatigue or to minor age-related manifestations. But, in fact, such signs are the beginning of a complex disease - hypertension. And if therapy is not started on time, this pathology can lead to a heart attack, stroke, and kidney failure.

Features of arterial hypertension in the elderly

Although at the present time, hypertension has become much younger, but it still continues to be a disease of people aged. This is due, first of all, to age-related changes, which are a “good platform” for the development of this disease.

A prerequisite for the appearance of hypertension are:

• hypoxic disorders;
• functional changes in diencephalic-hypothalamic brain structures;
• low density of plasma aldosterone;

• transformation of the sympathoadrenal and renin-angiotensin-aldosterone systems;
• decrease in the elasticity of blood vessels;
• increased stiffness of the arteries;
• atherosclerotic deposits on the walls of the blood channels;
• dysfunction of the endothelium of the blood channels;
• changes in blood flow parameters;
• deterioration of blood properties;
• decrease in tissue metabolism;
• obesity;
• low physical activity;
• unhealthy habits.

All of the above factors contribute to the formation of the most common form of hypertension in the older generation - isolated systolic hypertension. With such an ailment, the patient's stiffness of the aorta and other large arteries increases, the damping role of the biological fluid wave decreases, the systolic values ​​of blood pressure increase, and the numerical diastolic values ​​decrease.

This fact is due to the fact that systolic pressure can increase up to eighty years, while diastolic indicators after fifty either remain at the same level or decrease (depending on many factors, including individual characteristics of the organism).

The methods used to install the ISG are similar. Since blood pressure variability increases over the years, blood pressure is measured several times during multiple examinations. When the systolic readings on the tonometer are above 160 mm Hg. Art., and diastolic - below 90 mm Hg. Art., ascertained isolated systolic hypertension.

In addition, elderly people often have a peculiar type of arterial hypertension, manifested by frequent short-term large increases in diastolic pressure, alternating with significant drops in blood pressure. Such manifestations are asymptomatic, occur for no apparent reason, the elderly do not feel much inconvenience, and therefore do not attach much importance, which is very dangerous, since another attack can provoke the most negative consequences.

One of the main causes of this form of hypertension is disturbances in the functioning of the autonomic nervous system, which, in turn, are the result of age-related degenerative changes.

Another feature of arterial hypertension in the elderly is "pseudohypertension". It occurs against the background of increased vascular rigidity, metabolic disorders, variability in blood pressure indicators during the diastolic period due to episodic manifestations of postprandial and orthostatic hypotension, white coat syndrome.

The presence of "pseudohypertension" increases the risk of developing cardiovascular pathologies. In particular, there is a danger of developing left ventricular myocardial hypertrophy, which is a very common cause of sudden death in the elderly.

Treatment of hypertension in the elderly

A feature of the therapy of the elderly is that age-related changes significantly affect bioavailability. That is, the processes occurring in the elderly body interfere with the effectiveness of the effects of drugs.

To reduce the spread of pharmacological substances contribute to:

• restructuring of the gastrointestinal tract;
• decrease in muscle tissue;
• decrease in water in the body;
• change in the rate of pharmacokinetic processes;
• weakening of the dynamics of ion channels;
• decrease in plasma volume in the blood;
• decrease in albumin concentration;
• a drop in the activity of enzyme systems;
• age-related decrease in the mass of the kidneys and the number of functioning glomeruli;
• decreased blood supply to the kidneys;
• an increase in adipose tissue;
• change in receptor density;
• a large number of atherosclerotic deposits on the walls of blood vessels.

Such factors require a special approach to the treatment of hypertension in older people.

The first symptoms that occur in older people during the formation of arterial hypertension are constant fatigue, chronic insomnia, "flies" before the eyes. At the very beginning of the disease, such manifestations may not be permanent. Often, after a short rest, they simply disappear. They become especially expressive when the disease becomes chronic. Doctors recommend starting treatment for AD at an early stage. Otherwise, the progression of the disease can lead to a heart attack, stroke, and significantly reduce life expectancy.

Particular attention should be paid to such manifestations:

• causeless anxiety;
• frequent irritability;
• sweating;
• unexplained chills;
• redness of the face;
• memory impairment;
• low performance;
• feeling of "pulsation" in the cranium;
• increased heart rate;
• arrhythmia.

The appearance of one of these signs (and even more so several) is a serious reason to consult a doctor and undergo a medical examination. These symptoms may indicate hypertension. In this case, it is very important to make a diagnosis in time and start treatment, since with regularly high tonometer readings, irreversible processes occur in the brain, kidneys, and heart.

The treatment of high blood pressure in the elderly occurs not only with the use of pharmacological drugs, but lifestyle changes are also recommended. You should exclude stressful situations, spend more time outdoors, give up bad habits, and engage in simple physical exercises. The treatment of AD in the older generation is somewhat different from the treatment of younger people. It has a special scheme that doctors adhere to in order to get the most effective result.

Methodology for the treatment of the elderly:

• High systolic indicators of the tonometer decrease gradually. With a frequency of 10-15%. In the elderly, the pressure is reduced to normal numbers for several weeks, or even months. Otherwise (with a rapid decrease in DM), the development of kidney and brain failure is possible.

• Pharmacological therapy begins with a small amount of the drug. Initial use involves half the prescribed dose of the drug. This is necessary so that the elderly organism can adapt to treatment. Raise the rate carefully.
• All pharmaceuticals for people of respectable age are selected based on comorbidities and serious illnesses suffered.
• Medicines are selected in convenient packaging, which should be taken no more than once a day.
• The doctor prescribes medicines, taking into account the drugs that the elderly person is already taking. This minimizes side effects.

People of solid age are required to take pharmacological drugs all their lives. Very often, the process of treating arterial hypertension in the elderly combines the means of traditional, traditional medicine and physiotherapy. Therapy is carried out under the regular supervision of a doctor.

Drugs for the treatment of hypertension in older people

Medicines for hypertension (including the isolated form) are attributed to the elderly, taking into account age-related characteristics.

For the treatment of hypertension, drugs of the following groups are used:

• Diuretics. Medicines of this series are attributed in the first place. They are highly effective, the elderly tolerate them well. The action of such pharmacological agents is based on reducing the risk of coronary disease and stroke.
• Beta blockers. Most often prescribed to patients who have suffered a heart attack. But they are contraindicated in case of a history of bronchial asthma, bradycardia, diabetes mellitus.
• calcium antagonists. For treatment, drugs are used for short-term and prolonged exposure. For the treatment of hypertension in the elderly, the latter are most often used, since they have a significantly lower side effect.
• ACE inhibitors. Medicines of this group have a positive effect on the central nervous system and brain, and prevent the progression of kidney damage.

• Alpha blockers. Therapy of hypertension in elderly men can be carried out with drugs of this series, but only if patients have benign prostatic hyperplasia. They also help stop the growth of prostate adenoma.

To increase the effectiveness of therapy in the elderly, the doctor can combine drugs of different categories. This reduces the risk of side effects and reduces their dosage. Combinations of drugs are selected only by a doctor, strictly individually.

To prevent a hypertensive crisis and the development of complications, patients of advanced age are recommended to undergo sanatorium treatment from time to time.

Therapy in special institutions include:

• diet
• radon, carbonic, sulfide baths;

• oxygen cocktails;
• phyto procedures;
• aromatherapy;
• physiotherapy exercises;
• laser therapy;
• electrosleep;
• electrophoresis.

All activities are carried out in parallel with the prescribed drug therapy by the attending physician. Procedures are prescribed taking into account the age of the patient and the characteristics of the pathology.

With regard to non-drug treatment of arterial hypertension in the elderly, it is not used separately. Such therapy is carried out in parallel with the use of medications.

Non-drug treatment, first of all, comes down to lifestyle changes and the elimination of factors that contribute to increased pressure.

First of all, doctors recommend obese people to get rid of excess weight. This will significantly reduce vascular branching, thereby reducing the load on the heart and restoring carbon metabolism.

You will also need to get rid of bad habits such as smoking and alcohol. Since the substances found in tobacco products and alcoholic beverages contribute to a decrease in the elasticity of the walls of blood vessels and a decrease in their diameter.

In addition, the treatment of arterial hypertension in old age involves a change in diet. Older people are advised to adhere to the diet and completely abandon fried foods.

Features of nutrition of elderly hypertensive patients:

1. Prevention of accumulation of excess fluid in the body. This factor is based on minimizing the consumption of table salt. The optimal amount of this product is 1 teaspoon in all dishes. This is due to the fact that salt prevents the removal of water from the body, which leads to an increase in arterial parameters.
2. Limitation of fluid intake. In total, 1.5 liters is enough for an elderly person per day. This applies to all dishes (soups, tea, and so on). You can drink only pure water, green tea, juice or compote. It is forbidden to drink any strong drinks.
3. Balanced diet. It is not recommended to eat rich pastries, fatty red meats or oily fish. Hard cheeses, legumes are also not allowed, flour products are limited. The diet should be dominated by vegetables, fruits, lean soups, dairy products, nuts, cereals. From meat only low-fat fish, poultry, seafood.

Traditional medicine has its own methods of treating hypertension in the elderly. The most commonly used red table beet. Regular use of this root crop in any form helps to increase hemoglobin, oxygenate the blood, and break down fat cells. This vegetable relieves swelling, is a good laxative. People aged are recommended to use it with honey.

It is also recommended to take baths with the addition of valerian in any form (decoctions, infusions).

To relieve an attack of hypertension, traditional healers use leeches. They are placed two or three behind the ear.

Hypertension in the elderly is considered a particularly dangerous disease. In addition to the fact that the elderly are not very attentive to the symptoms that appear, there are significant age-related changes. All this together can lead to the development of cardiovascular pathologies and disruption of the functioning of the brain.