The most recent manifestation of hypertension is an increase in pressure.
It usually increases the pressure of hypertension but in installation when testing the pulse.When you feel pulse on the radial artery, a solid pulse (p. Durus) is determined due to increasing intra-internal pressure and the tonic reduction of artery walls.However, due to the fact that the Lumen of the average caliber of artery with hypertension decreases slightly, charging the pulse slightly changes.During graphic recording of impulse oscillations (in the sphigommod), the pulse is low, rounded, has the excitement of lifting and descent (Pulsus Tardus);Dicrotski wave is inconspicuous.
The study of blood pressure auscultative method is still the best way to determine systolic, diastolic and impulse pressure at the same time.With hypertension, all three values usually increase.Sistolic increases the most;Diastolically increases to a lesser extent.
If we compare the percentage of the magnification of systolic and diastolic pressure for hypertension in relation to the average values and pressure in the norm, then the rise will be almost equal.Thus, if we take the normal value for systolic pressure number of 120 mm, and for diastolic pressure - 70 mm Hg.Art., Then in blood pressure equals 160 mm Hg.Art.(maximum) and 90 mm Hg.Art.(Minimum), increasing against the standard in relation to both values will be almost the same (90 compared to 70 and 160 compared to 120).With an indicator of 180/100 mm Hg.Art.At first glance, simor seems to be increasingly increasing from the diastolic (180 compared to 120 and 100 compared to 70);If you compare to a normal ratio then the increase in percentage is almost equal.
Often in the initial period (phase I) hypertension, there is an increase in systolic or diastolic pressure (often first, less often else).Perhaps it depends on the initial level that has in front of the disease (each person individually).
The ratio of diastolic and systolic pressure affects:
- The degree of elasticity of the walls of large arteries,
- Socratic heart strength.
It is known that the reduction of the elasticity of arteries helps increase systolic pressure (in the fastest form is in the atherosclerosis of the central arteries).
Changes in the elasticity of large vessel walls are noticed with hypertension, which is reflected in the increase in pulses pressure.In the same conditions, when the heart starts weakening, amplitude becomes less: systolic pressure reduces, diastolic remains increased.
Already at the beginning of the disease, the pressure of pressure on reactions is noticed.The measurement of arterial pressure shows that on some patients does not go over the upper boundary of the age standard, but is obtained when the size of the larger than usual for a particular person, while in others, the upper limit of the age norm.Increased pressure with hypertension adheres to the influence of different effects - mental, emotional, reflex - and stored at an increased level of minutes to several hours.
The first dimension usually gives larger numbers (random pressure) from repeated measurements recorded after 5-10-15 minutes.The difference between the amount of random and basic pressure is marked "additional pressure";Its value in people suffering from hypertension is much greater than in healthy.The main pressure obtained in the conditions of studying the main exchange is considered to be main (I.e. in bed, in the morning after sleep, on an empty stomach).The smallest value of the indicator after repeated measurements in the usual environment is conditionally called "almost main pressure".
"Additional pressure" undoubtedly expresses the degree of mental (emotional) of the patient's mental or tension and the degree of excitement of his nervous, which regulates the blood pressure of the apparatus.Experience shows that in the prefectronic period in patients, the value of additional pressure is usually more significant than in people who have not found the tendency to develop hypertension.
Comparing the degree of the pressure influence of certain nervous influences, it should be noted that the most obnible is the incentive.Therefore, it will not be an exaggeration that it says that the influence of the second signaling system in the greatest measure affects the level of increased pressure for hypertension and in people who are predisposed to it.
Samples for associated pressure with hypertension
They tried to determine the preference of hypertension by reflex irritations.In this regard, special attention is paid to a cold sample.In the study after a short period of rest, blood pressure is measured in a false position, and then the second hand brush immersed at a temperature of 4 °;At the time of immersion, then every 30 seconds, the level is measured until leased.Increasing systolic pressure is more than 20 mm Hg.Art., Diastolic for more than 15 mm Hg.Art.It serves as an indicator of increasing pressure reactivity.The persons who discovered that they called him "Hyperreactors", who did not find - "hyporeactors".Among healthy people, hyperreactors are 15%.
The cold sample received a contradictory assessment.In the effect of pressure, with this sample, the conditions in which the sample is performed play a major role.The pressed reaction to the cold in the person who is warm, due to the reduced tone of his vessels is lower than the same person in the conditions of the external refrigerator temperature.The reflex reaction to the cold depends on the usual temperature influences, on the profession, living conditions.It is known that people get used to the temperature factor.For hardened people, the cold test can be weak, and in humans sensitive to cold, it can be strongly expressed.
The cold pattern is based on the reflex reaction of the Vasomotor Center in response to suddenly caused by heat (and part of pain) irritation on the outskirts.The response reaction to the cold is weak after taking alcohol, bromine, barbiturat.
Sometimes the cold pattern is answered paradoxically: increased pressure in hypertension does not happen, and occasionally it is even declining.
It is interesting to compare this data with the results of the blood pressure determination after the effect of heat.When heating your hands in people suffering from hypertension, it is often not a decline, but increasing blood pressure (arm lowered in hot water does not blush, it is already spinning pale).Therefore, coldness and heat can sometimes cause the same pressure on the effect of vasoconstrictor.
Temperature effects can hardly be used as a method for assessing the reactivity that regulates increased pressure in hypertension, because they do not reflect the specifics of hypertension disorders.Vascular samples are offered using pharmacological agents.One of them is a sample with glycerol trinitrate.After taking 2 drops Glycerol Trinitrate (under the language), the pressure (systolic and diastical) is significantly reduced.The decrease is more pronounced in people with sharply increased pressure in hypertension.A particularly significant reduction with unstable blood pressure;Sometimes such a fall is perceived with lasting hypertension.In the late phases of hypertension (with the development of arteriolosclerotic changes in kidneys), Nitroglycerin test provides a slight drop in hypertension indicators, which can be used to diagnose the renal forms (or phases) of hypertensive conditions.
The same results (depression effect) give a test to inhalation of isoamilnitrite.Glycerin Trinitrate, such as isoamilnetrite, works mainly through central vascular devices, characterized by increased excitement of these hypertension centers.
Sodium test was a bit of expansion.A studio person in bed gives amyl sodium 0.2 g every hour 3 times;The arterial pressure is measured before preparing the medicine and every half hour after taking (within 3 hours).The difference between the initial and minimum level determines the value of the depression effect.After taking another powder, a dream usually occurs.Usually a sodium currency helps reduce blood pressure not only in the first hours, but also the next days, sometimes even a few days;The patient improves well.However, such an effect is not always observed: some patients have intolerance on medicine.
Unlike nitrite test, causing violent pressure drop, when sodium sodium sodium, it gradually decreases.The degree of reducing its entry is especially important at the beginning of the disease.In the late period, in the presence of arteriolosclerotic changes in the kidneys, the decline is usually small or absent.
Since the effect of barbiturates, undoubted, the central, is the central, sodium test with the Ammal characterized by the state of the instrument - regulation in cortical and support regions.When various doses of the drug (small and large), it is possible to judge the phase conditions of nerve centers vasopressors (sometimes large and small doses give the same effect or small doses to have a depressing effect, difference from large dose).
In addition to samples based on depressor action, there are many carbon dioxide samples, but they are not deprived of the patient's condition, although so in such a manner in such a manner in such a manner in such a way - in the same so - in the same way - in the same thing in the same time - in such a manner.Thus-a coalemic reception.
Discovering the propensity by a short time increase blood pressure in a particular person, it should not be diagnosed immediately, and even more to inform the testing of him.Under favorable environmental conditions, current reactions can be completely passed.
Increased pressure depending on the phase of hypertension
Increased pressure in the initial phase can only be periodically (transient stage).The more difficult in the patient's neuropsychiatric conditions, the more extended and more common periods are increased pressure in hypertension and periods of normal levels of its shorter and rare.It is of great importance therapeutic measures, compliance with the regime.Under the influence of sleep and treatment in the initial passage phase of hypertension with a benign exchange rate, the indicator often decreases to a long time.
All more fortiable inclinations by increasing pressure during hypertension and preserving its pathological level indicates the further development of the disease that goes to another phase.In the phase and the phase II, the arterial pressure was addressed (a labile phase).Its level can fluctuate in large limits.Under the influence of idle, it decreases in a short time to a level near normal, although it is not held at this level for a long time.However, the impact of treatment can be achieved an extended decline in indicators on the norm.
During the day, blood pressure with hypertension can be widely varyed.It is usually lower in the morning than in the evening.After eating, it increases slightly, then it gives a significant decline.During the night sleep, it decreases with hypertension sharply than in healthy.
As the disease advances, blood pressure is tightered at a high level (phase B II phase, stable).True, at this stage, periods of reduction are occasionally noticed.Sometimes remission happens under the influence of longer therapy for a long time.However, this phase usually differs stubborn and high hypertension.Depression tests at this stage indicate the functional nature of increased pressure in hypertension.
In the list III, blood pressure is usually resistant.Hypertension supports a number of factors, including the kidney involvement.However, with reducing the excitement of the Vasopresor centers in stroke or influenced by heart failure (the occurrence of decompensation on the soil of the contracsee of the hypertrophy heart), a reduction in blood pressure was recorded.Moderate heart cover is not reflected in the level of the indicator;Sometimes even increases in this period (a stagnant factor).
As for the venous pressure in hypertension, it usually turned out to be under normal limits, it increases only with heart stall.True, some patients can also be found at an early stage of the disease, which has not yet led to the "Venomotor Center", because we are usually judged, because they are usually judged, because they are usually judged, because they are usuallyjudge, because they are usually judged, because they are usually judged, because they are usually judged, because they are usually judged, because they are usually judged, because it is commonly judged by interethnosis pressure. blood pressure inThe capillaries are inaccessible. The capillary in nail bed is usually determined by narrowing arterial knees of the premixitaire and the spread of the venous knee; the typical variability of the capillar image ("play" them).