Medicines for hypertension in the elderly

Perhaps there is no person who has not experienced the symptoms of high blood pressure or heard complaints about them from people at any age. Almost every third representative of the adult age group has a diagnosis of arterial hypertension. Most often, this disease is independent and has no connection with a hereditary predisposition. Only one patient out of ten develops secondary hypertension against the background of the existing pathology with the presence of complications. Usually, some diseases of the kidneys, lungs and endocrine glands entail circulatory disorders and, as a result, an increase in pressure in vessels of various calibers. Naturally, more often the symptoms of hypertension are observed in the elderly, since all the protective and regenerative forces of the body weaken with age.

Terminology of the disease

In the absence of treatment, the disease of hypertension causes a number of serious consequences not only for the circulatory system, but also for other organs. The disease can provoke severe circulatory disorders, turning into a heart attack or ischemic stroke. The kidneys can also fail, ceasing to perform a filtration function. Vision may be significantly reduced with loss of night vision. A complex of complications leads to loss of working capacity and a general decrease in the quality of life, up to disability.

Nevertheless, the statistics reflect a deplorable picture of the incidence of hypertension worldwide. The psychological mood of the population often aggravates the course of the disease, and drug treatment is often carried out in vain in the form of a careless attitude of people to their health and a complete disregard for a healthy lifestyle. So, only a third of Americans are aware of their pathology, and only a third of them take the necessary medications. In the field of the post-Soviet space, things are even worse.

In medical terminology, the concept of "arterial hypertension" is considered more correct. That it implies a direct increase in vascular pressure.

Hypertension is translated as increased vascular tone, which does not always cause an increase in pressure. Sharp jumps in pressure are possible with normal and reduced tone, or, in general, in the conditions of its complete absence in the elderly.

Worldwide, there is one indicator of normal blood pressure values, which does not change at any age. The optimal pressure should not exceed 130/85 mm Hg. Numbers 140/90 mmHg already reflect the diagnosis of arterial hypertension.

Accepted all over the world and two display pressure indicators. The first number reflects the pressure in the aorta at the time of systolic contraction of the heart, the second - the pressure at the time of cardiac relaxation. For older people, mean arterial pressure is indicative, which reflects the functionality of the heart muscle. It is calculated as the product of systolic and double diastolic, divided by three.

The generally accepted causes of hypertension are an increase in the output of blood by the heart and an increase in vascular tone, which is what the main points of the treatment of the disease are aimed at.

In medicine, all hypertension is strictly classified in accordance with two large groups.

The first group: an essential increase in pressure. Previously called "hypertensive disease" develops independently, without being influenced by the heart, kidneys and endocrine glands.

The second group: secondary hypertension. They are also called symptomatic.

Certain diseases of some organs directly cause an increase in pressure inside the vessels:

• The renal etiology of hypertension is observed in glomerulonephritis and other inflammatory diseases of parts of the kidneys.
• A disease of central origin occurs when the brain is damaged, as a result of trauma or infection.
• Hemodynamic pressure increase may be due to aortic valve insufficiency in the elderly, or direct damage to the aorta by infectious agents.
• A disease of the endocrine nature most often occurs due to hormonal imbalance from the thyroid gland or adrenal glands.

The main advantage of this classification is that the course of treatment for each hypertension is immediately clear to the doctor. Thus, symptomatic pathology requires the treatment of the underlying disease, and antihypertensive drugs are prescribed only for crises. High blood pressure goes away on its own along with the underlying disease.

Primary hypertension can also be triggered by a number of factors:

1. Most often, pressure tends to increase in neurotic conditions. Positive and negative emotions become the basis for the release of significant doses of hormones, to which the vessels are sensitive.
2. Some drugs, if taken uncontrolled, can bring hypertension to a crisis. This effect is observed in caffeine and drinks containing it, as well as in various stimulants.
3. Modern scientists have identified another condition that provokes high blood pressure. It is observed during sleep with moments of difficulty in breathing. Such a syndrome can be congenital, or it can be acquired over time and develop in the elderly.

Diagnosis and therapy

The diagnosis of hypertension is formed on the basis of certain diagnostic measures. Usually, the initial procedure is to record a blood pressure profile. The indicator is measured throughout the day at a certain time with an interval of at least three hours. In a hospital, observation is possible around the clock with an additional recording of an electrocardiogram.

In the diagnosis of hypertension, other innovative and proven methods are also used. If there are suspicions of secondary high pressure, an ultrasound examination of the kidneys, heart, endocrine glands is performed. In renal pathology, vascular angiography may be preferred.

An important point in the diagnosis is to check the condition of the cardiovascular system. In addition to the usual ECG of the heart of patients, they are examined using Holter monitoring and a treadmill test.

Long-term studies have shown that the inner shell of the eye, namely, the fundus, is a kind of mirror displaying the vascular state of the whole organism, especially in the elderly. Therefore, in case of hypertension, it is important to consult an ophthalmologist with a specialization in cardiology.

The fact is that a chronic increase in pressure in the vessels not only weakens the vascular wall, but also affects the heart with the development of its insufficiency and even a heart attack. This is detrimental to the brain, where a stroke can occur, and to the eyes and kidneys, which reduce their functionality in both young and old.

It is also believed that in antihypertensive therapy, doctors prescribe such a treatment to reduce the pressure to such a level that the patient feels good. But this is also fundamentally wrong, since the optimal value of pressure indicators is recognized all over the world. Therefore, all drugs prescribed by a therapist or cardiologist should, in case of arterial hypertension, reduce pressure to 140/900 mm Hg. Art. No concept of "working pressure" on the part of the patient should be taken into account.

There is only one exception, when doctors prescribe drugs that maintain vascular tone. If the patient has a narrowing of the arteries in the kidneys, and for some reason surgical intervention cannot be performed, the patient needs to maintain high pressure for the normal functioning of the excretory organs.

Drugs to eliminate arterial hypertension are prescribed in such a way that they reduce the pressure gradually. Thus, the vascular bed manages to adapt as much as possible to the changing load on its wall without disturbances from all organs and systems.

A one-time decrease in indicators by a quarter of the values ​​​​from the initial level is considered acceptable.

Age Therapy

Contrary to the trend of all diseases in the world to rejuvenate, hypertension remains the predominant disease in old age. But modern medicine does not stand still and shows very satisfactory results in the treatment of the disease even after 65 years.

From adulthood, people tend to have high blood pressure. This condition requires an immediate visit to a doctor who will prescribe certain drugs.

In the absence of comorbidities, treatment of hypertension is usually started with a diuretic medication. The drug of choice is usually a thiazide diuretic. The doctor selects a certain dosage, taking into account the anatomical features of the patient. It should not be neither low nor high. In old age, a high dose of a diuretic provokes a failure of cholesterol metabolism, and a low dose simply will not cause an effect.

Before prescribing a specific therapy, the doctor gets acquainted with the acid-base state of the patient's blood. Reduced potassium or sodium levels require treatment with a combination of thiazide diuretics with potassium-sparing ones. Older age does not allow additional medicine with a potassium content, as this threatens to increase the burden on the kidneys, which may already be weakened.

Beta-blockers may be an alternative for diuretic treatment. Their appointment should be balanced, since receptors for drugs of this type are also present in the bronchi, which is fraught with complications from the respiratory system. These medicines are contraindicated for people with bronchial asthma and other chronic diseases of the bronchi and lungs.

As many years of medical experience shows, it is difficult to achieve success in the treatment of arterial hypertension with a single drug. It is difficult to normalize pressure with a diuretic alone, but its combination with a beta-blocker gives an effective effect. Currently, several drugs have been developed in several combinations.

Antihypertensive drugs are prescribed with a certain dosage. But the minimum dose of each drug may not show a certain effect, which entails an increase in the amount of the drug. However, an increase in the dose may not produce symptomatic therapy, which is why studies on combinations of drugs have been launched. Reception of any antihypertensive agent begins with a certain dose. It was found that it is the combined drugs that eliminate arterial hypertension faster and with minimal side effects.

Taking several drugs at the same time reduces their required dose. This causes the negation of the negative effects of drugs and the possibility of an overdose. This is also important for the elderly, who have a decrease in intestinal absorption.

It is necessary to combine drugs in accordance with the characteristics of each patient.

The following combinations have proven themselves the most:

1. Beta blocker and diuretic.
2. Beta and alpha blockers.
3. ACE inhibitors and diuretics.
4. ACE inhibitors and drugs that are calcium antagonists.
5. Calcium antagonists and any diuretic.

Often, pharmaceutical companies combine several active ingredients against arterial hypertension in one dosage form. Uniform medical preparations are convenient both for doctor's prescriptions and for use by patients.

The older generation often produces a sharp increase in pressure, referred to as a hypertensive crisis. To stop such conditions, several means are also used. There are fast-acting drugs for resorption under the tongue: nifedipine, capoten. High arterial tone decreases after ten minutes.

Therapy for arterial hypertension is long-term. Often prescribed drugs have to be used by patients for the rest of their lives.

This happens if irreversible changes in the walls of blood vessels have already occurred due to prolonged high pressure, and their former tone can no longer be restored. However, continuous antihypertensive treatment can stop its detrimental effect on other organs and systems.

Successful management of high blood pressure requires a rehabilitation program. They are extensively carried out in health centers and sanatoriums.

The restoring effect on the vessels and organs affected by arterial hypertension is exerted by:

• Baths with mineral water and coniferous decoctions;
• diet with restriction of salt and saturated fats;
• drinking herbal medicine;
• cocktails enriched with oxygen;
• aromatic therapy;
• physiotherapy activities;
• health-improving exercises physical education;
• climatotherapy.

Physiotherapy in the form of electrophoresis, electrosleep, laser therapy has an excellent supporting effect on patients with arterial hypertension. With the advent of the laser, its beneficial effect on the state of blood vessels, the brain, heart and kidneys was noticed.

Normalization of pressure is carried out by various baths: mineral, coniferous, carbonic, radon or sulfite. They also boost the immune system.

In the sanatorium, obligatory loads of physiotherapy exercises and long walks are provided for hypertensive patients.

Often, patients with hypertension in old age resort to healing folk remedies.

The following recipes have become proven helpers in eliminating high pressure over time:

1. Significantly reduce vascular tone grapefruit and fresh strawberries.
2. Regular consumption of a tablespoon of a mixture of walnuts with honey leads to stabilization of the systolic blood pressure indicator.
3. The use of tea from the mulberry root will strengthen the vascular wall and increase its resistance in case of possible hypertensive crises.
4. Herbalists prepare shepherd's purse infusions in cold water. The infusion should stand for at least a day and be used daily.
5. A decoction of a mixture of lilac leaves, mulberry and quince has an excellent aromatherapy effect. Strained broth is recommended to drink as often as water.
6. You can add a pinch of cinnamon to the evening intake of kefir. The cleansing and toning effect will not keep you waiting.

The elderly require a carefully considered approach in therapy of any kind. The complex effect of non-traditional methods should not contradict drug treatment as the basis of any therapy.