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Diagnosis and treatment of hypertensive crisis


All people has a different value norms of blood pressure: some standard 120/80, others these numbers may be higher or lower, but health is normal, does not suffer and performance. A sharp jump in HELL, arise for different reasons - this is a hypertensive crisis requiring urgent attention and emergency treatment.

Why the disease develops

The main background for the development of hypertensive crisis - already existing problems with AD of various etiologies. It can be actually essential hypertension, and symptoms, including recurrent or persistent increase in blood pressure:

  • Kidney disease;
  • Diabetes mellitus;
  • Periarteritis nodosa;
  • Systemic lupus erythematosus;
  • Aortic atherosclerosis;
  • Disease and syndrome Itsenko - Kushinga;
  • Pheochromocytoma (a tumor of the substance of the adrenal glands);
  • Nephroptosis (omission kidneys);
  • Nephropathy pregnant.

There are external factors that can cause hypertensive crises: these include weather sensitivity, alcohol abuse, excessive psychological stress (anxiety and stress).

The sudden pressure rise can occur as a reaction to the cancellation of the usual antihypertensive drugs.

The types of crises and their symptoms

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Sharp jumps in blood pressure associated with cardiac output and the resistance of peripheral vascular. Sometimes both of these factors overlap each other. Thus, the classification of hypertensive crises is depending on the growth mechanism of AD.

The following types of crises:

  • Hyperkinetic;
  • Hypokinetic;
  • Eukinetic.

Hyperkinetic hypertensive crisis occurs due to increased cardiac output and peripheral vascular resistance remains normal or even slightly reduced.

The symptoms of hyperkinetic crisis are to increase the systolic ("upper") pressure, while the diastolic ("lower") the pressure increases very moderately and smoothly. In addition to the high numbers on the blood pressure patients note the sudden appearance of headache, to which are added:

  • Trembling of the body;
  • Flies flashing before my eyes;
  • Sweating, fever;
  • Felt sick;
  • Frequent palpitations and increased pulse pressure.

Such crises are most often in the early stages of hypertension: they are fast - literally within minutes or hours, causing severecomplications.

Hypokinetic hypertensive crisis - a result of a sharp increase in peripheral vascular resistance by decreasing the level of cardiac output, so the measurement of blood pressure shows a significant increase in diastolic blood pressure.

If done during hypokinetic crisis the electrocardiogram, it would register quite significant disorders in the heart.

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Hypokinetic crises often occur in the later stages of hypertension and are characterized by the increase of symptoms - headache, nausea, lethargy, visual disturbances.

Such crises last for several days, their danger is a high probability of developing severe complications such as cerebral stroke or heart attack.

After calming down hypertension hypokinetic type in the urine can lead to changes in protein cylinders and of erythrocyte.

Eukinetic type of crisis develops when a normal level of cardiac output and increase in peripheral vascular resistance. It is characterized by a uniform increase in the numbers of systolic and diastolic blood pressure and rapid growth of other symptoms - headache, nausea, blurred vision and coordination, pain in the heart area.

Eukinetic hypertensive crisis occurs in the later stages GB and may be complicated by left ventricular heart failure, which causes pulmonary edema.

In lab tests of urine of such patients also found changes: there are red blood cells, protein and cylinders.

There is another classification of hypertensive crises: they are divided into complicated and uncomplicated.

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Uncomplicated attacks pass quickly and end in complete recovery of patients. Complicated called crises resulting in disruption of other organs - brain, heart, lungs, kidneys.

Such complications include:

  • Ischemic and hemorrhagic strokes;
  • Myocardial infarction;
  • Subarachnoid hemorrhage;
  • Swelling of the body, the brain, the lungs;
  • Retinopathy;
  • Eclampsia;
  • Cardiac left ventricular failure;
  • The dissection of the aneurysm.

Hypertensive crisis of any kind requires urgent treatment. Even seemingly small increase in blood pressure is accompanied by sharp deterioration of General condition, in need of assistance and monitoring specialists.



Treatment of crisis you need to startimmediately - even before arrival of a brigade "first aid". Around need to do the following:

  • To put the patient, lifting his head;
  • To unbutton the collar of the shirt or blouse, loosen the tie;
  • To ensure the flow of fresh air;
  • To supervise a blood pressure, measuring it every 10 to 15 minutes before the arrival of professionals;
  • To give a drug that usually takes the patient for the treatment of hypertension.

Drug therapy crises

The pressure should be reduced properly - that is, gradually. Its sharp decline can lead to heart attack, cause brain ischemia and kidneys, so for the first two hours of AD can be lowered only by 20-25 percent.

Depending on the type of hypertensive crisis, the patient can be assigned to different regimens.

Therapy of uncomplicated hyperkinetic crisis

Hypertensive crisis of hyperkinetic docked the easiest: it requires the use of any one drug, for example, 5-30 mg of nifedipine or 25-50 mg capoten. The tablets should be swallowed or dissolved under the tongue.

Hypokinetic and eukinetic crisis forms require combination therapy that includes not only the use of the above drugs, but with no effect - adding intravenous injection of droperidol, proxodolol or furosemide.

The predominant symptoms on the part of the brain needs to use of Dibazol, magnesium sulphate or aminophylline. The dosage is determined by the physician.

If these measures do not bring the desired effect, then further treatment is conducted in the hospital. Are delivered in hospital and those patients in a state of hypertensive crisis, which an Ambulance was summoned from public places - from the street or from work.

The cure is complicated hypertensive crises

If the crisis occurs with complications, patients required urgent hospitalization. The choice of drugs depends on symptoms, the treatment appointed strictly individually, and the treatment start back at home or in the Ambulance.

So, with the development of left ventricular failure with pulmonary edema the drugs of choice are nitroglycerin, nitroprusside, in combination with loop diuretics - furosemide or torasemid.

Acute hypertensive encephalopathy requires nitroprusside or fenoldopam.

In acute cerebral infarction demonstrates the use of fenoldopam, nicardipine.

Acute myocardial infarction and unstable angina require the use of nitroglycerin or beta-blockers.

In dissection of an aortic aneurysm is recommended nitroprusside,beta-blockers.

If a hypertensive crisis arose against the backdrop of azotemia (excess accumulation in blood of nitrogen metabolic products in the kidney disease, when the relief requires the use of verapamil, labetalol nicardipine or in combination with loop diuretics - furosemide or torasemid.

After the crisis

So, the crisis happily passed, your condition has improved. You can calm down and continue to live? No! What happened - the undeniable sign that the condition of your vessel leaves much to be desired, and therefore, the development of a new hypertensive crisis is in the offing.

Here is the algorithm the very first steps that must be taken almost immediately:

  1. To pass the examination, which should be identify the causes of high blood pressure. If you are a hypertensive with experience and your concerns long expressed in the form of numerous diagnoses, still pass examination. It will help clarify the situation: perhaps the course of your disease has worsened and requires re-heal.
  2. Monitor pressure by measuring it every morning and every night. Start a diary and note your measurements.
  3. Strictly take medications prescribed by the doctor. Remember that even normal blood pressure parameters does not free you from the constant reception of hypotensive drugs: it is therefore normal that you are being treated.
  4. Rethink your lifestyle, drinking regime, diet. Try to avoid great emotional stress, more rest, not to provoke the development of another hypertensive crisis.
  5. Abstain from strong coffee, alcohol, cigarettes, adjust the salt consumption. Eliminate fried meat (especially pork), too sweet drinks, spicy and fatty foods, put an end to fast food - there are too many hidden salts and harmful food additives.
  6. Do not assign a medication independently or on the advice of friends: each person has his diagnosis, his causes increase in pressure and the type of hypertension. Trust your health only to specialists. Do not adjust the medication on your own even if your personal feelings tell you that the drug is "too much" or "too little": for corrections, please contact the doctor.

Is it possible to cope with the crisis folk remedies?

Hypertension probably has existed as long as humanity exists, however, effective drugs that can "hold" the pressure, created only in recent years.

Naturally, folk medicine for many centuries has accumulated its own experience in the treatment of hypertensive crises, which can also be used for relief of suddenpressure surges.

Traditional methods traditionally used to lower blood pressure, can be divided into two groups in the direction of action:

  • Reflexology;
  • Phytotherapeutic.

Reflexology tools

These include compresses applied on certain areas of the body or limbs, as well as foot and hand baths. Providing local irritant effect on skin receptors, reflexology cause vasodilation, which ultimately leads to a decrease in pressure.

A compress of Apple cider or plain vinegar

Dilute some vinegar with water to reduce its concentration to 5 percent. Pieces of cloth wet in this solution and apply to the soles of his feet. Lie with compress for ten minutes. The remedy is considered strong and fast, so watch out for the well-being and prevent excessive loss AD.

Foot baths with mustard

Pour in a bowl of very warm water so that it was above the ankle, add a spoonful or two of dry mustard, stir. Keep your feet in a basin until then, until the pressure is normalized. It is believed that this bathroom works much faster than tablets, so watch out for health.

Hot tub for hands

In a bowl of hot water, put your hands, soak them in water to improve well-being.

The herbal products

Herbal teas, juice some vegetables contribute to the rapid withdrawal of excess fluid, which in itself significantly reduces AD. To reduce the jumped pressure, can be cooked a little to drink such herbal teas and juices:

Beet juice

One small beet wash, clean, again rinse and grate. Squeeze the juice and drink several times a day one tablespoon, while monitoring the pressure.

Version of the recipe is beet juice with tincture of hawthorn or its juice. The ingredients are mixed in equal proportion and drink a tablespoon after a meal.


A decoction of the leaves or fruit, cranberries, cranberry juice, have a pronounced diuretic effect, so it is important to take courses continuously or when deterioration - especially for edema.

Pomegranate peel

Peel a pomegranate must be finely cut and boiled in boiling water to obtain a brown drink that you can drink almost constantly. With care you need to treat this remedy for people prone to constipation: decoction has a pronounced stabilizing effect.

The berries of honeysuckle

A handful of berries need to brew a glass of boiling water and drink as tea. Tool is one of the most effective.

There are many other folk remedies that have the ability to adjust the pressure, butto rely only on them, still not worth it: crises can occur in different ways and cause sometimes severe consequences.

It is best to seek professional medical help - in the Arsenal of doctors there are effective drugs and diagnostic equipment, and expertise that will help to cope with the crisis.

We recommend you to see the what need a diet for hypertension.