Почти половина людей, перешагнувших 40-летний рубеж, по разным причинам сталкиваются с проявлениями гипертонической болезни, а врачи ежегодно отмечают тенденцию к увеличению количества гипертоников.
Эта категория пациентов, если они обращались к врачу, отличается хорошей информированностью относительно препаратов, которые им следует принимать, и образа жизни, который следует вести. Но что делать, если обнаруживается низкое давление у гипертоника, причины которого зачастую таят смертельную опасность? Остановимся на этом вопросе подробнее.
Бывает ли низкое давление у гипертоника?
Пациенты, которые настолько свыклись с болезненным состоянием, что уже не представляют своего артериального давления ниже 150 мм рт/ст, могут усомниться в возможности резкого падения АД. В самом деле, бывает ли низкое давление у гипертоника? Есть ли причины для этого? Оказывается, есть, бывает, и нередко.
- Наибольшую опасность представляет выраженное падение артериального давления в первые дни после инсульта. Резкое понижение показателей тонометра свидетельствует о неблагоприятном течении болезни. Причина в том, что артериальное давление в высоких пределах (не ниже 160 мм) в первые сутки после инсульта обеспечивает нормальное кровообращение мозга, или мозговую перфузию, и является своеобразной компенсаторной, защитной функцией организма в ответ на инсульт. Низкие показатели АД говорят о более быстром развитии патологического процесса, становясь причиной ухудшения дальнейшего прогноза.
- Нередко может наблюдаться понижение давления в утренние часы, когда пациент, только поднявшись с постели, внезапно теряет равновесие из-за головокружения или вообще теряет сознание по причине скачка АД вниз. Иногда ортостатическая гипотензия (так называется это состояние) проявляется менее яркими симптомами и пациент, не измерив утреннего давления, привычно выпивает гипотензивную таблетку, по причине чего происходит усугубление его состояния.
- Резкое падение давления может возникнуть и у больных, не имеющих понятия о своей гипертонической болезни и продолжающих вести чрезмерно активный образ жизни с неадекватными для своего состояния физическими нагрузками, работой в жарком помещении и т. д. Снижение АД в этом случае сигнализирует о неспособности организма компенсировать силы, затраченные на циркуляцию крови, сосуды расслабляются, и по этой причине давление становится низким.
Бывают и другие ситуации, когда гипертоник внезапно превращается в гипотоника. Но почему у гипертоника стало низким давление, может ответить только врач, осмотрев и обследовав больного.
Наиболее распространенные причины пониженного давления
Причины
Человеку, страдающему артериальной гипертензией, не лишне узнать о причинах, вследствие которых высокое давление может ощутимо понизиться:
- при анафилактическом шоке или снижении уровня глюкозы в крови при сахарном диабете;
- при отеке легких (сопровождается бледностью, тахикардией до 120 ударов в минуту, иногда кашлем с кровавой пеной);
- при инфекционных заболеваниях с высокой температурой тела и выраженной интоксикацией;
- из-за различных видов депрессии — ангедонической (отсутствует чувство радости), апатической (равнодушие к происходящему), астенической (хроническая усталость, потеря веса);
- по причине интенсивных кровотечений, особенно внутренних, о которых человек может не догадываться;
- при различных патологиях почек и надпочечников, участвующих в выработке ацетилхолина и адреналина — гормонов, которые обеспечивают тонус кровеносных сосудов;
- из-за приема медикаментов гипотензивного (то есть понижающего АД) действия, особенно в совокупности с другими лекарствами, усиливающими это действие;
- при вегето-сосудистой дистонии (ВСД) — неврологическом расстройстве, развивающемся по причине эмоциональной перегрузки;
- при сердечной недостаточности, когда изношенная сердечная мышца не справляется с полноценной перекачкой крови.
Понятно, что гипертоники, у которых имеются какие-либо сопутствующие патологии из перечисленных выше, принадлежат к группе риска по резкому падению АД.
Опасно ли понижение АД для болеющего гипертонией?
- Ввиду того, что выраженное снижение АД означает снижение объема циркулирующей крови (ОЦК), сердце и головной мозг подвергаются риску ишемизации из-за нехватки кислорода и необходимых микроэлементов.
- По этой причине при снижении артериального давления вероятность развития инфаркта или инсульта увеличивается в несколько раз.
- Резкое снижение АД может вызвать головокружение, помутнение рассудка, потерю сознания — то есть состояния, крайне опасные еще и в плане травм.
Поэтому ни в коем случае не следует игнорировать низкое давление при гипертонии. Причины его могут быть разные, а последствия, как правило, серьезные.
Что делать, если при гипертонии АД 100 на 60?
Во избежание тяжелых последствий, приносимых необыкновенно низким давлением у гипертоников, причины этого состояния должны быть сведены к минимуму.
- Любые гипотензивные средства следует принимать только по назначению врача и в строго установленных дозах.
- Прием гипотензивных средств должен осуществляться только после предварительного измерения АД.
- В случае его низких показателей, например, если у гипертоника давление 100 на 60, гипотензивный препарат принимать не следует.
- Необходимо регулярно обследоваться на наличие сопутствующих заболеваний и их причин, особое внимание уделять функции почек и надпочечников, дыхательной, нервной и сердечно-сосудистой системам.
Но если уже обнаружилось низкое давление при гипертонии, что делать человеку в этом случае?
Симптомы
Для начала определимся, какие цифры считаются патологически низким давлением для гипертоника, независимо от причин, ведь норма в данном случае — понятие индивидуальное. Все зависит от самочувствия пациента и клинических проявлений, которыми сопровождается внезапная артериальная гипотония у гипертоника. Вот факторы, при наличии которых можно заподозрить острую фазу гипотонии: 
- кожные покровы бледнеют;
- синеют губы или носогубный треугольник;
- холодеют конечности;
- выступает холодный пот;
- в пальцах конечностей чувствуется покалывание;
- ухудшается слух, шумит в ушах, темнеет в глазах;
- пациент проявляет расстройства сознания — потерянность во времени, шаткость походки, бессвязную речь.
Если измерение АД на фоне этих симптомов дает низкие показатели (100/60 или ниже), больному необходима срочная помощь.
Что делать?
Чем можно помочь человеку с явными признаками острой гипотонии, что делать при низком давлении у гипертоника до приезда врача?
- Больного следует перевести в горизонтальное положение. Это обеспечит приток крови к верхним отделам туловища и обезопасит от падения при вероятной потере сознания. Ноги можно приподнять.
- Для облегчения дыхания следует снять с больного плотно облегающую одежду или хотя бы расстегнуть ее в области грудной клетки.
- Неплохой эффект дает массаж ушей, начиная с мочек, а затем и всей ушной раковины.
- Если отмечаются позывы к рвоте, необходимо повернуть голову пациента набок и подставить какую-нибудь емкость.
- Если пациент испытывает озноб, можно укрыть его пледом.
Медикаменты
Использовать медикаментозные средства для поднятия низкого давления при гипертонии, причины которого неизвестны, нежелательно. Можно выпить одну таблетку Цитрамона, который наверняка найдется в домашней аптечке. Есть и другие лекарственные средства, которые могут пригодиться в этом случае, но по согласованию с врачом:
- Допамин;
- Эпинефрин;
- Норадреналин и другие препараты из группы антихолинергических средств.
Все эти медикаменты могут вызвать побочные эффекты и имеют списки противопоказаний, по этой причине они должны применяться строго по назначению врача.
Полезное видео
Из следующего видео можно узнать, почему скачет давление:
Резкое снижение давления у гипертоника приводит к обморочному состоянию. Дело в том, что организм уже привык к постоянно повышенным показателям и если происходит их резкое снижение, то больной испытывает массу неприятных симптомов. Это состояние опасно развитием ишемических нарушений.
Причины резкого падения давления
Резкие перепады давления, когда у человека, страдающего гипертонией, падает АД, возникают в таких ситуациях:
- При сердечной недостаточности. Болезнь характеризуется нарушением насосной функции сердца, что обычно сопровождается снижением давления крови в артериях.
- При вегето-сосудистой дистонии. Это расстройство работы вегетативной нервной системы. Полностью вылечить дистонию нельзя. Возможно, только улучшить самочувствие с помощью правильного режима дня и стабилизации эмоционального состояния.
- При патологиях почек и надпочечников. Надпочечниками вырабатываются гормоны вроде адреналина и ацетилхолина, которые обеспечивают тонус сосудов. Под воздействием адреналина давление в артериях возрастает, повышается тонус организма, а ацетилхолин, наоборот, способствует снижению АД, вызывает чувство усталости и раздражительности. Если эти гормоны вырабатываются в ненормальном количестве вследствие патологий надпочечников, то происходят скачки показателей.
- В результате употребления некоторых лекарственных средств. В качестве побочного эффекта определенных медикаментов выступает резкое снижение АД. Такой эффект наблюдается после употребления антибактериальных препаратов, обезболивающих и спазмолитических средств. сердечных гликозидов и бета-адреноблокаторов. Превышение дозы успокоительных лекарств снижает давление ниже допустимой нормы.
- При интенсивных кровотечениях. Внутренние кровотечения заметить вовремя достаточно трудно. Главным симптомом этого состояния является сильная боль в верхней части живота.
- При отеке легких. Это опасная проблема, сопровождающаяся бледностью кожных покровов, тахикардией, кашлем, проступанием кровавой пены изо рта.
- При инфекционных патологиях. К сильной интоксикации организма и повышению температуры тела присоединяются резкие перепады АД.
- В результате резкого снижения уровня глюкозы в крови у диабетиков. Это состояние называют гипогликемией. Оно может стать причиной серьезных осложнений.
- При различных депрессиях. Они могут быть астеническими, когда человек быстро худеет и постоянно испытывает усталость, апатическими, проявляющимися равнодушием к людям и событиям, ангедоническими, у больного в этом случае отсутствует чувство радости.
У гипертоника низкое давление приводит к тяжелым осложнениям, поэтому при первых признаках необходимо стабилизировать показатели.
Симптомы
Если у человека на протяжении длительного времени артериальное давление выше нормы, то он привыкает к этому и часто не обращает внимания на проявления проблемы.
Больному трудно заметить незначительное снижение АД. Некоторые, если самочувствие ухудшилось, думают, что дело в гипертонии и принимают повторную дозу гипотензивных препаратов.
Это только усугубляет ситуацию и усиливает проявления гипотонии. Поэтому гипертоникам важно знать, признаки гипотонического криза. Это состояние сопровождается:
- бледностью кожных покровов;
- посинением губ и области носогубного треугольника;
- выделением липкого холодного пота;
- похолоданием верхних и нижних конечностей;
- западанием венозных сосудов;
- онемением рук и ног и покалыванием в кончиках пальцев;
- шумом в ушах и снижением слуха;
- потемнением в глазах;
- изменениями поведения в виде шаткости походки, потери ориентации в пространстве и времени.
Отсутствие своевременной помощи грозит потерей сознания и развитием инсульта.
В чем опасность
Резкое падение давления у гипертоника не менее опасно, чем постоянно повышенные показатели. При гипертонии возникают серьезные нарушения кровообращения в головном мозге и сбои в работе сердца. При низком АД таких последствие быть не может.
Но считать это состояние безопасным нельзя. У гипотоников постоянно наблюдается слабость, сонливость, ухудшается качество жизни. При гипотонии хронической формы организм приспосабливается к возникшей ситуации и больной хорошо себя чувствует даже без лекарств.
Но, если резко снижаются показатели давления в артериях при гипертонии. В результате употребления гипотензивных препаратов АД падает достаточно быстро. Это опасно развитием нарушений мозгового кровообращения.
По этой причине при наличии гипертонического криза нельзя сбивать давление быстро, так как существует высокий риск ишемического инсульта. Несоблюдение этого правила приводит к тому, что:
- Кровеносные сосуды быстро расширяются, но количество крови остается прежним, так как ее приток не может увеличиваться за такой короткий срок.
- Сосуды головного мозга резко сужаются. Так организм реагирует на экстремальную ситуацию.
- Снабжение головного мозга кровью нарушается, что сопровождается развитием кислородного голодания, кровоизлиянием в мозг и мгновенной смертью.
Именно поэтому, если резко упало давление у гипертоника до 80/60 мм. рт. ст., необходимо срочно оказать первую помощь. В случае когда проблема вызвана употреблением медикаментов, достаточно внести корректировки в схему лечения.
При падении артериального давления в результате патологических состояний, необходимо определить причину и провести соответствующее лечение.
Что делать: первая помощь
Часто резкое падение АД у человека, страдающего гипертонией, приводит к потере сознания. В домашних условиях в этой ситуации нужно поступить так:
- Вызвать скорую медицинскую помощь.
- Уложить больного в постель так, чтобы ноги находились на возвышении.
- Освободить от давящей одежды и обеспечить доступ свежего воздуха.
- Помассировать уши, но не слишком интенсивно.
- Напоить сладким чаем и дать съесть кусочек шоколада.
- Растереть ноги и хорошо их укутать.
Чтобы состояние больного не ухудшилось, нельзя давать ему понюхать нашатырный спирт, обливать водой низкой температуры, поить алкоголем или каплями для сердца, в составе которых есть спирт. К таким относятся Корвалол и Барбовал.
Обострения хронических заболеваний или возрастные изменения в организме пожилых людей приводят к тому, что подобные приступы становятся более частыми.
Известны случаи, когда гипертоники с годами превращались в гипотоников. За состоянием таких больных должен постоянно следить врач. Близкие должны знать, как оказывать первую помощь, чтобы избежать серьезных осложнений.
Если у гипертоника упало давление, то врач может назначить препараты для устранения проблемы. Повышения АД добиваются с помощью:
- Альфа-адреномиметиков. Они способствуют сужению сосудов и сокращению гладких мышц.
- Антихолинергическими препаратами, которые также сужают сосуды;
- Адаптогенов, стимулирующих функции сердечно-сосудистой системы и устраняющих признаки гипотензивных нарушений.
- Препаратов-стимуляторов. Они усиливают функции Центральной нервной системы и устраняют сонливость и усталость.
Существуют также народные средства для стабилизации показателей артериального давления. Немного поднять АД можно с помощью крепкого чая, кофе, сладостей, массажа. Но использовать эти методики без ведома врача нельзя.
При резком снижении давления у гипертоника необходимо пройти обследование, чтобы определить причины нарушений и устранить их. При первых симптомах приступа следует оказать больному первую помощь вызвать бригаду медиков. До приезда врачей никакие лекарства давать больному нельзя.
Что делать, если упало давление
Пониженное давление хоть и является неприятным, но в целом лучше, чем высокое. Его можно понять, выпив чаю или кофе, что гораздо полезнее фармацевтических препаратов. Однако падение давления опасным признаком становится для гипертоников. Низкое давление для людей с нормальными показателями является просто дискомфортным, но у больных гипертонией оно приводит к обморочному состоянию.
Определение и симптомы
Нормальное давление для большинства людей – 70/120. О чрезмерно пониженном говорят, когда эти показатели становятся меньше 70/105. Но у гипертоников «нормальное» и «пониженное» давление сильно отличается от нормативов. Ориентировочным показателем может являться лимит падения в 20 мм рт. ст. если упало сильнее, то нужно предпринимать меры. При серьёзном снижении (более 30 мм рт. ст.) необходимо обратиться к врачу.
Основные симптомы следующие:
- слабость и снижение работоспособности;
- раздражительность;
- головная боль;
- головокружение;
- тошнота;
- бледность кожи.
Разумеется, все признаки слишком неспецифичны, поэтому пить таблетки или вызывать специалиста нужно лишь после измерения давления.
Причины быстрого падения
Чтобы избежать резкого падения в будущем и адекватно выбрать меры по повышению давления, необходимо выяснить причины таких скачков.
- Сердечная недостаточность. Разновидностей болезней сердца много, но при любом виде всегда есть один симптом – резко снижается давление. Происходит это по простой причине – больному сердцу труднее качать кровь. Частыми причинами сердечной недостаточности становятся воспалительные процессы (миокардиты, эндокардиты).
- Вегетососудистая дистония (ВСД). Вегетативная нервная система отвечает за тонус сосудов, поэтому нередко гипотензия говорит о дистонии. ВСД – неврологическое расстройство, которое является следствием психического перенапряжения. Интересно, что при дистонии таблетки от головной боли или давления плохо помогают, а вот полноценный отдых снимает все симптомы.
- Болезни почек. Надпочечники вырабатывают два важнейших для тонуса сосудов гормона: адреналин и ацетилхолин. Первый повышает давление, активирует ресурсы организма, возбуждает. Второй наоборот – понижает давление, вызывает чувство холода, раздражение, усталость. Разумеется, что болезни почек сказываются на уровне давления.
- У некоторых препаратов побочным эффектом является падение давления. К ним в первую очередь относятся антибиотики, обезболивающие средства, спазмолитики. Помимо них уронить показатели могут бета-адреноблокаторы, нитроглицерин, другие сердечные препараты. Конечно, прием больших доз успокоительных средств также понижает давление.
- При сильных кровотечениях давление понижается естественным образом. Не заметить серьезную рану можно, если она внутренняя, образована при прободении язвы желудка или двенадцатиперстной кишки, обострении панкреатита. Выявить такие проблемы можно по сильной боли в верхней части живота, под солнечным сплетением.
Полезная информация: Патологии внутричерепного давления
- Может упасть давление при трёх типах депрессии:
- астеническая – характеризуется чувством усталости, помимо низкого давления к симптомам добавляется похудение или даже истощение;
- апатическая – при ней наблюдается полное равнодушие к окружающим людям, процессам, событиям, ничего не хочется, цели отсутствуют вообще;
- ангедоническая – главным её симптомом является отсутствие чувства радости из-за пресыщенности положительными эмоциями, чаще наблюдается у успешных и богатых людей.
Действия при падении давления
Если у человека давление упало очень резко и сильно, то нужно оказать экстренную помощь. Желательно сразу вызвать врача или скорую. Больного положить на кровать, при этом приподнять ноги, чтобы кровь притекала к голове. Можно накрыть человека одеялом, так как гипотензия сопровождается чувством холода. У каждого в доме есть Цитрамон, он прекрасно справится с задачей. Дайте сначала одну таблетку, через 30 минут, если должного эффекта нет, дайте вторую.
Врач для повышения давления может использовать большой список препаратов: норадреналин, эпинефрин и другие антихолинергические средства. Также медициной для этих целей используются адаптогены и стимуляторы сердечнососудистой и центральной нервной системы. Можно делать массажи, оказывающие влияние на барорецепторы. Первый заключается в массировании области сонной артерии сверху вниз. Второй – массаж области затылка, верхней части шеи (у основания черепа).
Конечно, можно воспользоваться традиционными проверенными средствами – крепким чаем и кофе. Но эти напитки поднимут давление, только если человек не пьет их ежедневно. Так как при регулярном употреблении вызывается привыкание, и организм перестает реагировать кофеин. Схожим действием обладает корица и мед, их можно принимать в любом варианте. Помогут и отвары различных растений: женьшеня, зверобоя, китайского лимонника. Повышает давление употребление глюкозы в виде конфет и шоколада.
Полезная информация
Все о гипертонии
В этой статье мы рассмотрим возможные последствия резкого падения давления у гипертоников и людей, предрасположенных к гипертонии.
Наши специалисты отвечают на вопросы, которые ежедневно задают десятки пациентов: например, #171;может ли гипертоник стать гипотоником?#187; и #171;почему периодически падает давление у гипертоников?#187;.
Что происходит при резком падении давления?
Сердечно-сосудистая система у людей с пониженным артериальным давлением приспосабливается к функционированию в такой ситуации. Возможно, что качество жизни у гипотоников хуже, чем у людей с нормальным артериальным давлением, но умеренное снижение артериального давления к нарушению мозгового кровообращения не приводит. В случае медикаментозной гипотонии, при резком снижении артериального давления лекарствами, кровоснабжение головного мозга значительно ухудшается, что может привести к печальным последствиям.
Самое важное при лечении гипертонии не стараться снизить артериальное давление любым способом и быстро. Необходим тщательный подбор лекарств, плавно понижающих давление до нормального уровня, в среднем это 120-130/90-80 мм рт. ст. Этим должен заниматься специалист, который будет основываться на объективных показателях состояния пациента.
У людей пожилого возраста уровень нормального артериального давления может быть чуть выше, особенно при тяжелых формах гипертонии.
Правильная методика снижения давления
При лечении гипертонического криза существует важное правило: не пытаться сразу снизить давление до нормы. Если попытаться это сделать, то у больного может развиться ишемический инсульт, часто встречающийся у гипертоников при резком падении артериального давления. В этот момент происходит следующее: кровеносные сосуды расширились, а приток крови не успел увеличиться. Компенсаторно развивается сужение сосудов головного мозга, нарушается кровоснабжение, развивается гипоксия и инсульт.
Чтобы избежать подобных ситуаций необходимы лекарственные препараты не пролонгированного,а короткого действия.
Таких препаратов всего пять:
Их принимают сублингвально, то есть под язык. При рассасывании действующее вещество попадает сразу в кровоток. Через полчаса следует измерить давление. В идеале в первые два часа давление должно снизиться не более, чем на 1/5 от максимальных цифр.
Ответ на вопрос, может ли гипертоник стать гипотоником #8212; не так однозначен, как кажется на первый взгляд. Подробнейшую информацию по этому вопросу читайте в следующих статьях.
Низкое давление при гипертонии, что это?
Одной из самых распространенных болезней нашего века – это гипертоническая болезнь. Люди, которые 
перешагнули сорокалетний рубеж свое возраста, автоматически попадают в группу риска. Но бывают случаи, когда эта коварная болезнь поражает и совсем молодых людей. Причины ее разнообразны, но главная причина, то есть корень болезни – это неправильный образ жизни человека, нерациональное питание.
Обычно принято считать, что признаком гипертонии является высокое артериальное давление. Однако врачи заявляют, что это не основной признак, поскольку нередко к ним обращаются люди с уже поставленным диагнозом, а жалобы у них на низкое давление. Почему же так бывает?
Пониженное давление при гипертонии можно объяснить двумя факторами.
Во-первых, это так называемая гиподинамия. Это бывает тогда, когда человек очень мало двигается в силу тех или иных причин. При устойчивой гиподинамии организм начинает перестраиваться. Во время гиподинамии к внутренним и органам поступает меньшее количество крови. Меньше крови получает и мозг. В ответ на это мозг посылает сосудодвигательному центру команду – снизить давление. Организм подчиняется команде главного управляющего организма.
Второй фактор – это изношенная сердечная мышца. Повышенное давление заставляет активно работать сердце. И чем выше давление, тем соответственно больше нагрузка на сердечную мышцу. При усиленной работе сердце, говоря простым языком, устает и перестает работать в режиме, который ему задает мозг. В результате – пониженное давление.
Что же делать, если при диагнозе гипертония у вас понижается давление? Первое, что необходимо обязательно сделать, это проверить сократительную способность сердца. Ее можно выявить, сделав просто ЭКГ и эхо сердца. Если оно покажет нормальную сократимость, то в таком случае следует заняться обычной физической культурой. Физкультура устранит симптомы гиподинамии, и артериальное давление вернется к обычным нормальным показателям. Начинать физические нагрузки следует с самых простых физических упражнений. Выполнять их нужно минимальное количество раз, чтобы не переутомить организм. В этом режиме физические тренировки можно продолжать несколько месяцев. Если же во время физических тренировок все же появилась отдышка, дискомфорт в области сердца, головокружение, то нагрузки нужно снизить еще. А вот прекращать занятия совсем не стоит! Все эти симптомы – это признак привыкания организма к новым условиям.
Добиться же средних показателей артериального давления во время гиподинамии могут с успехом помочь рецепты народной медицины. К растениям облегчающим гиподинамии относятся: радиола розовая корень женьшеня, корень аралии, элеутерооккока, листья чертополоха.
Также симптомы гиподинамии легко снимают такие напитки, как кофе, чай с имбирем.
Следует заметить, что гипертоническая болезнь неизлечима. Это значит, что наличие гипотензивных средств в а аптечке никто не отменял, даже при стойкой ремиссии. Еще гипертоникам следует твердо знать, что гипотензивные средства не накапливаются в организме и их нельзя выпить впрок. Эти препараты полностью выводятся из организма в течение двух суток. Длительная ремиссия при диагнозе гипертония очень редкое явление. Она может наблюдаться только у тех людей, которые болеют недавно и болезнь еще диагностируют как начальная стадия гипертонии.
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