A sharp increase in blood pressure (BP) to 220/120 mm. gt; Art. and above are called hypertensive crisis. It is an emergency and requires immediate medical attention. Most often the crisis happens in hypertensive people - people with a stably overpriced blood pressure.
First aid
According to the dynamics of the development of symptoms, the crisis is classified into two groups:
- It develops rapidly (for 3 to 4 hours), characterized by a jump in systolic (upper) pressure and vegetative symptoms: overexcitation and panic, sweating, tremors, tachycardia, pain in the nape, redness of the skin, nausea, chills, flashing "flies" before the eyes, pressure in the temples.
- It develops gradually (several days) and, as a rule, in hypertensive patients "with experience". It differs by a jump in diastolic (lower) pressure. The patient is suffering from a headache, he feels sluggish and exhausted.
Treatment of hypertensive crisis should begin with the provision of first aid:
- Lay the patient.
- Provide emotional, not just physical peace.
- Apply cold to the back of the head to relieve pain.
- To put on the back and caviar mustard plaster.
If the medicine cabinet has a hypotensive (lowering blood pressure) drug, it should be taken immediately. Otherwise, they wait for the doctor. Emergency workers usually inject and leave recommendations for further care of the patient.
In severe cases, the hypertensive crisis is to be treated in a hospital - this is appropriate with the so-called. complicated form, accompanied by stroke, pulmonary edema, subarachnoid hemorrhage, left ventricular failure, eclampsia, acute myocardial infarction and other urgent conditions provoked by the defeat of target organs (kidneys, heart, brain) under the influence of high blood pressure. After the hypertensive crisis, which happened for the first time in my life, the treatment is spent in the hospital.
Uncomplicated form is characterized by a relatively normal state of target organs, and then the standard of modern treatment of hypertensive crisis is only in reducing blood pressure by oral medications.
Treatment of a complicated hypertensive crisis
To reduce blood pressure with a complicated crisis, the following drugs are used:
- Clonidine - tablets or droppers;
- Nifedipine - tablets under the tongue; when swelling of the lungs and heart failure take with caution;
- nitroprusside sodium - injected drip, if the crisis accompanies renal failure , exfoliating aneurysm of the aorta, hypertensive encephalopathy;
- Captopril - tablets under the tongue (with stenosis of the renal arteries, kidney circulation may be difficult);
- Drops or injections of labetalol; is relevant for renal failure and encephalopathy;
- Fentolamine - is administered intravenously in the treatment of hypertensive crisis, which occurred against the background of pheochromocytoma;
- Enalapril - intravenous infusions (injections) with dilution of glucose; the drug is appropriate for exacerbation of coronary heart disease, encephalopathy, chronic heart failure.
Therapy is carried out under the supervision of a doctor, the patient is shown a strict bed rest.
Treatment of uncomplicated hypertensive crisis
In uncomplicated form, oral administration (through the mouth) of drugs for the treatment of hypertensive crisis is prescribed, or if intramuscular injections are required for a rapid effect.
The best medicines are Captopril, Clopheline (clonidine), Nifedipine.
Reminder! Reducing the level of blood pressure should be smoothly - 10 mm Hg. Art. at one o'clock. If the tonometer gives out large numbers, you should not hesitate to call an ambulance. Whether it is necessary to go to the hospital, only the doctor determines!