Some of these causes are sleep apnea, kidney disease, and adrenal gland disease.
Hypertension is very common and is more common in older people. One in four people has hypertension, while in the elderly (over 65 years old) the ratio is 1 to 2.
Doctor Myasnikov about hypertension
Dr. Myasnikov has a clear point of view on hypertension. Alexander Leonidovich said on one of the TV programs that medications must be taken for life if a hypertensive crisis occurs. If the numbers have jumped to significant levels, there is no need to figure out how to treat such a disease with folk remedies. Medicines for hypertension should be selected by a cardiologist, often in combination with other medications to adjust the indicators.
Dr. Myasnikov speaks categorically about hypertension: trying to quit a drug regimen in such a situation is the same as refusing to wear a crutch to a legless person. This is physically impossible. Once the drug is removed from the body, which happens in less than 48 hours, the levels return to baseline levels. This means the likelihood of damaging the tissue of the kidneys, heart, brain, and blood vessels. This indicates the likelihood of associated complications.
In addition, Myasnikov claims that an increase in blood pressure, contrary to popular belief, is very difficult to correct. Also, according to the famous doctor Myasnikov, the concept of hypertension and hypertensive crisis should be separated. The expert emphasizes that hypertension therapy is selected correctly and treatment is carried out in courses; crises should not occur. In most cases, in his opinion, crises and persistent increases in blood pressure are caused only by the patient’s dishonest attitude towards his health.
About the doctor
Myasnikov Alexander Leonidovich is a practicing doctor who has extensive work experience and quite a lot of regalia that allows him to treat patients at the best level.
He is a candidate of medical sciences and a doctor of medicine from the USA, a doctor of the highest category. Myasnikov’s main specialization is cardiology and family medicine. He works as chief physician at Moscow City Clinical Hospital No. 71. Practices in his own clinic.
Dr. Myasnikov often acts as a consultant to foreign colleagues. People turn to him for cardiological help. Alexander Myasnikov’s goal is to inform people about the dangers of cardiac diseases and hypertension as well.
Therefore, the doctor hosts the television program “About the Most Important Thing with Doctor Myasnikov.” The medical radio program “Consultations of Doctor Myasnikov” is also on air.
These programs are helpful because doctors are usually the last thing people turn to. Therefore, by listening and watching such programs, they learn about the causes, symptoms and complications of pathologies, and modern treatment methods.
In addition to participating in television and radio programs, Dr. Myasnikov wrote many books about hypertension and other diseases. They talk about various ailments of the cardiovascular system, infectious and oncological pathologies and, in general, about medicine and drugs. There are seven of them in total. For those who have hypertension, or who are interested in this topic, the following publications are useful:
- “About the most important things with Dr. Myasnikov”;
- “How to live longer than 50: an honest conversation with your doctor about drugs and medicine.”
What are antihypertensive drugs?
The following four classes are considered first choice therapy:
- diuretics,
- angiotensin inhibitors,
- calcium antagonists,
- beta blockers.
Other medications used when medications are ineffective or poorly tolerated:
- Alpha blockers,
- Renin inhibitors,
- Aldosterone antagonists,
- Centrally acting medications
- Accelerated vasodilators.
Antihypertensives are the most well-studied medications in medicine. Many studies involving several thousand patients with hypertension who were followed for several years have shown that at least five classes of first-line drugs are extremely effective not only in lowering blood pressure, but also in protecting the organs affected by them, and prevention of cardiovascular complications (stroke, heart attack, etc.). In addition, they have few side effects, which are very rarely serious. Medicines that had frequent or serious side effects were withdrawn from circulation.
Diuretics
Diuretics initially increase urine output and decrease salt and water retention and therefore blood volume. With long-term daily administration, they usually do not cause increased diuresis, but reduce the tension of small arteries.
They can be administered separately, but are especially useful in cases where a combination of drugs is required.
The most common side effect is a decrease in potassium levels in the blood. Rarely, it causes an increase in uric acid, depletion of sodium, and an increase in sugar levels, especially when given in high doses.
Angiotensin inhibitors
Prevents the formation of a substance called angiotensin. Angiotensin causes the arteries to constrict and increase the secretion of another substance, aldosterone, which increases sodium (salt) and water retention.
They are useful medicines in patients with hypertension, heart failure, post-operative, nephropathic and diabetes mellitus.
The most common side effect is a persistent dry cough. In rare cases, narrowing of the arteries in the kidneys (both kidneys) can lead to decreased organ function.
Angiotensin II receptor antagonists inhibit the action of angiotensin at its site of action, resulting in vasodilation and decreased renal salt and water retention.
They are considered useful drugs in people with heart failure due to hypertension, myocardial hypertrophy, after an attack, with nephropathy and diabetes.
Their side effects are rare. In rare cases, renal artery stenosis leads to decreased kidney function.
Calcium antagonists
Prevent calcium from entering the muscle cells of the artery wall, which leads to vasodilation. There are two categories: dihydropyridine and non-dihydropyridine.
These medications are required for hypertension and angina (chest pain from ischemia). Bradycardic calcium antagonists are also useful for arrhythmias.
Their most common side effect appears to be swelling of the legs (especially in the ankles). This swelling is associated with local vasodilation and is considered harmless. Does not go away after using diuretics, but only with dose reduction or discontinuation. Rarely, dihydropyridines (especially older ones with a short duration of action) may cause hot flashes (headache) or tachycardia. Bradycardic calcium antagonists (non-dihydropyridines) may cause constipation, headache or bradycardia.
Beta blockers
Beta blockers reduce the action of a vasopressor substance called norepinephrine by blocking it). Reduce heart rate and cardiac output.
They are required to be taken after a heart attack, angina, failure and arrhythmia.
The most common side effects appear to be fatigue, bradycardia (less than 50 beats per minute) and bronchospasm (causing shortness of breath) in patients with asthma or chronic obstructive pulmonary disease (chronic bronchitis). Some beta blockers also have vasodilating properties, which results in fewer side effects.
Alpha blockers
A1 blockers block the action of a substance that causes vasoconstriction (norepinephrine) by affecting its specific receptors located on the vascular wall (α1 receptors).
They are used for hypertension, usually as a third or fourth additional drug, preferably at bedtime. They are also useful in relieving the symptoms of prostate hypertrophy.
May cause fatigue or a severe drop in blood pressure the first time they are used (first dose hypotension).
Renin inhibitors
They block the renin-angiotensin system by inhibiting its activity at the onset of action.
Their side effects are rare. However, they have not been studied as other renin-angiotensin system blockers and are used only alternatively if the former are not tolerated.
Aldosterone antagonists
They counteract the action of aldosterone, which is secreted by the adrenal glands and acts on the kidneys, which leads to the retention of salt and water.
They are usually useful as an additional drug in cases of resistant form (unregulated blood pressure corrected by at least 3 drugs, one of which is a diuretic).
More common side effects are painful breast swelling (which is reversible when treatment is stopped) and hyperkalemia, especially in patients with renal failure.
Central alpha2-adrenergic receptor agonists
They act on certain areas of the brain (α2 and I1 receptors), which leads to a decrease in the activity of the vasoconstrictor system, which acts through the substances adrenaline and norepinephrine.
Used only for treatment. One of them, methyldopa, is the safest option for pregnancy hypertension.
The main side effects are drowsiness and dry mouth. Methotrexate may cause anemia or liver dysfunction.
Vasodilators
They act directly on the arterial wall, resulting in vasodilation.
Rarely used in complex cases in combination with other medications.
The main side effects are increased heart rate, hirsutism and decreased kidney function.
Reasons for the development of persistent pathology
Among the reasons causing the development of persistent, difficult-to-treat hypertension, Alexander Leonidovich and his colleague Anton Rodionov name the following factors:
- Incorrect medication intake.
Most people do not adhere to the prescribed treatment regimen, forget about the pills or do not want to take medications for hypertension regularly, stop taking the medications without permission, or take them occasionally. In addition, the exact dosage recommended by the doctor is often not followed. People mistakenly believe that if blood pressure levels drop, treatment can be stopped. Persistent hypertension in such people will not be long in coming. Myasnikov recommends that for hypertension, treatment should be carried out strictly as prescribed by the doctor, then there will be no problems with blood pressure.
- Salt.
This factor ranks second in its ability to have a negative impact on blood pressure levels. Dr. Myasnikov provides the following data: the average resident of Russia consumes twice as much salt as is needed for the body (instead of 5-6 g, 12 g is eaten every day). For an aging body, salt restrictions should be even stricter - in old age it is allowed to consume only about 3 g of salt daily. Salt is dietary sodium. It retains fluid in the body, thereby stimulating an increase in pressure. Another interesting fact that was voiced by the famous TV presenter: since 2007, salt has been considered a powerful carcinogen of stomach cancer.
- Weight.
Body weight, or rather its excess, also significantly contributes to a persistent increase in blood pressure. Without exaggeration, we can say that all overweight people are hypertensive, or are preparing to become so. According to the cardiologist, every extra 10 kg. can add another 5-20 mmHg to the existing pressure level. Art.
- Diabetes.
If this disease is not treated thoroughly, the blood vessels of the kidneys are affected. In response, they stimulate the production of hormones that increase blood pressure.
- Snoring with pauses in breathing.
People who snore at night and suffer from apnea (stopping breathing during sleep) are at increased risk of developing resistant hypertension. The reason for this phenomenon is a serious circulatory disorder.
- Kidney diseases.
Any kidney disease not related to blood vessels will lead to hypertension. Therefore, they cannot be neglected; adequate timely treatment will reduce the level of pressure.
- Narrowing of the renal arteries, atherosclerosis in the kidneys.
The development of atherosclerosis in the renal arteries or a congenital anomaly caused by the narrowness of the vascular lumen is a direct path to a persistent increase in pressure.
- Adrenal tumors.
The adrenal glands produce hormones; any neoplasm will lead to a disruption in the hormonal balance. Excess of certain hormones leads to persistent hypertension.
- Medicines.
Some groups of drugs (vasoconstrictors for the runny nose, non-steroidal anti-inflammatory painkillers for back and joint pain) affect the production of prostaglandins. The latter, in turn, lead to fluid retention in the body and increased blood pressure.
What does Dr. Myasnikov say about hypertensive crisis:
- The first, and almost the only reason for frequent crises is improper medication use. Pressure surges occur when the patient does not take the prescribed medications constantly, in the required dose.
- According to the presenter, when a hypertensive crisis has developed, medications that quickly lower blood pressure should not be given. This can be deadly. It is necessary to offer a long-acting antihypertensive drug, help the person relax, provide him with rest and peace, and give him a sedative. If there are no suitable drugs, it is better not to give anything; it will do less harm than a sharp drop in blood pressure from improper treatment.
Application options
An antihypertensive therapy regimen is developed by a doctor for each sick person individually. The choice of the most suitable option is determined by many factors, such as the coexistence of other problems or diseases (myocardial disease, kidney disease, diabetes mellitus, gout, asthma, chronic bronchitis, etc.), history, as well as various other characteristics such as age, gender, lifestyle, etc.
As a rule, drug therapy is given for life. If treatment is stopped, the disease returns soon (within a few days or weeks), in some cases - after several months.
Treatment usually begins with taking medication. If the pressure is too high or other problems arise (diabetes, previous cardiovascular pathologies, etc.), the doctor may prefer to give 2 drugs (often in one tablet) from the very beginning.
To demonstrate the full effect of the antihypertensive drug, it is usually necessary to continue treatment for at least 3-4 weeks. One week is not enough to know if the medication is effective. This is why you should not rush to change the medicine or increase the dose. The doctor will then decide whether the regimen should be continued or whether the dose of the first remedy needs to be increased, a second one added, or a replacement for the first with another remedy. This decision is determined by pressure values and possible side effects, which are manifested by symptoms or changes in laboratory tests.
High-quality blood pressure regulation with one antihypertensive drug is achieved in less than half of patients. In most cases, two or more products are needed to achieve ideal pressure figures.
Drugs with a long duration of action are preferable to be administered only once a day. In some more complex cases, it is acceptable to prescribe twice a day and rarely three times. Antihypertensives should be given every day, usually immediately after waking up in the morning. Today there are many stable combinations (2 or 3 substances in one tablet) that simplify the dosage regimen (one tablet in the morning) and make it easier to correct the disease.
The duration of action of most antihypertensive drugs is about 24 hours and in no case is it 48 hours. That's why they are always given daily.
Treating hypertension is not like taking aspirin for a headache. The introduction of additional medications when blood pressure increases is completely incorrect and should be avoided. High blood pressure does not mean you are at immediate risk of stroke. The adverse effects are long-lasting, just like the adverse effects of smoking. Don't panic if you find that your blood pressure has increased. Usually the increase is temporary and is often related to another problem that is causing the crisis. Repeat the measurement a little later and if you see it persists, consult your doctor.
Treatment of hypertension without drugs
Alexander Leonidovich points out that hypertensive patients need to change their lifestyle, otherwise no treatment will be effective.
As a rule, a person lays the foundation for hypertension himself, in the form of bad habits (smoking, alcohol, strong coffee), excess weight, a sedentary lifestyle, exposure to stress, and an unbalanced diet. To restore your health, you need to lead a healthy lifestyle:
- exclude abuse of alcohol, nicotine, coffee;
- reduce weight;
- regularly engage in feasible physical exercise - up to 40 minutes a day;
- avoid stress and great emotional stress;
- have an acceptable cholesterol level to prevent atherosclerotic formations inside blood vessels;
- Maintain normal sugar levels to avoid diabetes.
- switch to a diet that excludes the consumption of salt, animal fats, fried, smoked foods, pickles, marinades, confectionery, and sweet carbonated drinks.
The basis of nutrition should be fresh vegetables, fruits, herbs, lean boiled meat, fish, dairy products, seafood, natural vegetable oils (especially flaxseed and olive).
What if BP drops too low?
The goal of treatment is to reduce systolic blood pressure below 140 and diastolic blood pressure below 90. This means that systolic blood pressure in some cases may be as low as 120 or 110. These values are not considered too low. Ideal indicators are below 120 to 80.
However, if you notice that low blood pressure values are almost constant, and are accompanied by a feeling of dizziness, especially in an upright position (orthostatic hypotension), you should consult a cardiologist.
Are there cases when antihypertensive therapy can be discontinued?
Very rarely. If treatment is stopped, hypertension usually returns soon. Only if there was an initial misdiagnosis or significant lifestyle changes after starting treatment (for example, a person lost several kilograms) that led to a significant decrease, BP may remain low after stopping treatment. In these cases, it is necessary to monitor indicators for a long time in order to detect early relapse.
Abruptly stopping some drugs, such as beta blockers, can cause significant side effects (tachycardia, sudden and significant increase in blood pressure, or even heart attack in patients with coronary artery disease). The dose is gradually reduced under the guidance of a cardiologist.
“The food industry is killing us even more than the pharmaceutical industry”
— Today, fashion for a healthy lifestyle has begun to actively spread. Are Russians leading this healthy lifestyle correctly? What do they do in vain, and what do they not do in vain?
- We are doing everything wrong. A healthy lifestyle is not about running in the morning. This is exactly the way of life. Some people who obsess over counting calories are a type of nervous disorder like bulimia and anorexia. You just don’t have to be a fanatic, you have to have a head.
5 times a week – physical activity for at least 40 minutes. Proper nutrition with an emphasis on vegetables and fruits. A person should eat half a kilo of vegetables and fruits a day, with a combination of meat and an emphasis on fish.
Everything is wrong with us - from eating with excess animal fats, with a passion for sausages, with high-calorie foods, with an emphasis on potatoes, on refined flour. The food industry is killing us even more than the pharmaceutical industry. Sausage departments and deli are just as harmful as tobacco kiosks.
What is a crisis and how to treat it?
This is a common occurrence when the pressure is too high in a random measurement due to a symptom (such as headache or dizziness). The tactics of taking tablets orally or sublingually in such situations are incorrect and are due to the outdated perception that crises can lead to cerebral artery ruptures and bleeding due to a sudden increase in blood pressure.
The risks are long-term, not immediate. Over the course of many years, high blood pressure causes hardening of the arteries (atherosclerosis) and narrowing of their lumen due to the progressive deposition of cholesterol and calcium (atheromatosis). The result is ultimately occlusion (thrombosis) of a vessel, for example, the heart (which provokes an attack) or the brain (stroke). Typically, hypertension does not cause bleeding in the brain, and thrombotic stroke is the result of a prolonged, rather than sudden, increase in blood pressure.
The use of sublingual tablets for rapid reduction is not only not good, moreover, a sudden and intense drop reduces the blood supply from the narrowed arteries, as a result, an attack or stroke is likely, especially in the elderly or patients with atherosclerosis. As a rule, sublingual drugs are not used for hypertension, but only for angina pectoris (chest pain from ischemia).
Emergency downgrading is only required in rare and complex conditions that require hospitalization. Here, a significant increase is usually accompanied by another serious symptom, such as chest pain or difficulty breathing, so the situation requires immediate evaluation by a doctor. The term “hypertensive crisis” is misleading and panic-stricken because it implies the need to directly relate to emergency conditions, which is completely wrong.
Recommendations for prevention
The famous doctor recommends one simple thing to everyone: lead a healthy lifestyle. All the doctors in the world agree with him on this. How to stay healthy?
- Do not drink or smoke.
- Love sports, do exercises every day, take long walks every day.
- Keep cholesterol and blood sugar under control.
- Monitor your blood pressure.
- Stay slim.
- Eat proper, healthy food.
Is there a cure for Dr. Myasnikov’s hypertension? On the Internet you can find a lot of advertisements for dubious drugs for hypertension (for example, “Hypertofort”, “Monastery Tea”), promising a complete cure for the disease and absolute safety for the body.
In advertising videos and articles of this nature, the image of Alexander Leonidovich is often shamelessly exploited. Allegedly, he confirms the effectiveness and usefulness of all these miracle drugs for hypertension and recommends that everyone take them.
There is no special cure from Dr. Myasnikov. Using the authority of a famous doctor, scammers deceive people. This was stated in a special video by the TV presenter himself, who has nothing to do with the advertised products.
The doctor won the respect and love of viewers and readers. Many patients trust Myasnikov. Simply talking about complex medical issues in an accessible manner is the key to his success. The arguments of the famous presenter are logical and consistent, the recommendations are based on solid ground. The main goal of a doctor is to teach people to understand their illnesses and receive proper treatment. How to treat hypertension? The disease, according to a representative of a famous family, is incurable, but controllable. You need to start fighting pathology long before it appears.
How often to visit a doctor?
During the initial period of observation, confirmation of diagnosis, investigation and selection of appropriate treatment, visits to the doctor are made every few weeks until satisfactory adjustment is achieved.
People with a well-adjusted treatment plan should be monitored regularly by their doctor, usually every 6 months. People with other problems (cholesterol, diabetes, smoking, advanced atherosclerosis, cardiac disease, stroke, kidney damage) Should be monitored by a doctor every 2 or 3 months.
Unfortunately, some people with hypertension stop treatment after a period of observation. This happens either because they believe that they have successfully dealt with the disease and no longer need medication, or because they experience side effects, or simply because they neglect their health.
Communication with the physician appears to be the most important condition for effective treatment and achieving long-term treatment goals. Uncontrolled patients are at risk of relapse, and with systematic monitoring and good management this risk can be avoided.
