High upper pressure with normal lower pressure: causes and what to do

Pressure in a general sense is an integral indicator of the state of the cardiovascular system and human health in general.

Adequate numbers, according to specialized research by scientists and practitioners, are in the range from 100 to 140 by 70-90, with minor variations and deviations in both directions.

There is also the concept of an individual norm, which may differ slightly from generally accepted tonometer indicators (no more than 10 mm Hg).

But if the upper pressure is high and the lower pressure is normal or below the adequate limit, so-called isolated systolic arterial hypertension or ISAH for short occurs. We are talking about numbers of more than 140 at less than 90 mmHg.

This condition is much more dangerous than the classic increase in blood pressure, since it carries a greater risk of complications to internal organs that are dangerous to health and even life.

Causes of the primary form of ISAH

The primary form is extremely rare in practice. These are isolated cases, described in the literature; only 10% of clinical situations occur in the primary form of the disease.

As the name suggests, pathology with increased upper pressure (so-called essential hypertension) has a pronounced vascular origin and occurs in three cases:

• Congestive heart failure with the development of cardiac arrhythmias. The more pronounced the condition, the more elevated the upper pressure, while the lower reading remains normal.

• Stroke in the recent past. There is an adaptive mechanism. We can talk about either a temporary decrease in blood pressure due to an emergency condition or isolated hypertension.

Patients with ISAH need to be monitored more carefully; the high probability of relapse does not allow either doctors or the patient to relax.

• Previous heart attack. In the period up to 6 months (early rehabilitation), you need to carefully monitor the patient's health. Repeated cases of ischemia of the heart muscle are possible. Since isolated systolic hypertension often accompanies patients, problems are likely.

Hereditary factors also play a significant role. Most relevant sources directly indicate this. There is a correlation, and the likelihood of developing isolated systolic hypertension is higher, the more hypertensive people there are in the family.

Even the presence of one relative is enough to increase the risk of pathology in the phenotype of future offspring by almost 50%.

Of course, this is not a verdict. The situation can be corrected if you carefully follow the rules of prevention and do not play with your own life and health.

Age is also given some importance. As the body ages, phenomena that increase blood pressure increase:

• Decreased receptive function of special cells of blood vessels and heart.
• Impaired glomerular filtration.
• A decrease in general blood flow and local renal, cerebral and muscular hemodynamics due to a decrease in the intensity of cardiac output, all this is the cause of increased upper pressure in the elderly.

What is the danger?

The situation when systolic pressure increases one-time due to temporary reasons (for example, strong emotional overexcitation) is not quite dangerous. As soon as a person manages to cope with his experiences, the pressure normalizes on its own.

A frequent increase in the indicator is a rather dangerous phenomenon that can lead to all sorts of complications:

• hypertensive crisis;
• circulatory disorders in the brain - stroke;
• acute myocardial infarction;
• rapid development of heart failure;
• rapid development of irreversible kidney pathologies.

One of the most dangerous complications of increased upper pressure is the development of malignant hypertension. This pathology cannot be treated: 2-3 months after the development of the disease, the patient dies due to the appearance of associated complications.

Factors in the development of the secondary form of ISAH

Secondary isolated arterial hypertension, when high upper pressure with normal lower pressure, is much more common and, as the name suggests, has an indirect origin, due to the course of a particular disease.

The list of such pathologies is quite impressive:

• Diabetes. With the development of such a disease, blood pressure constantly increases in different ways. ISAH phenomena are possible in the most unfavorable case.

The general hemodynamics of the body is disrupted, since diabetes affects all systems and organs.

Patients with such a severe endocrinological diagnosis should be regularly checked and fully treated so as not to miss the moment.

Attention:

Diabetics often develop persistent, resistant types of hypertension if treatment is not started on time.

• Prolonged stressful situations. Strictly speaking, psycho-emotional stress is not a disease.

However, it triggers a pathological mechanism for the production of large amounts of catecholamines and corticosteroids, which cause a sharp jump in the thermometer reading, which is not always uniform.

This is a risk factor for early stroke or heart attack. It is necessary to control yourself so that your health does not fail at the wrong time.

• Atherosclerosis of blood vessels, especially the aorta. Accompanied by severe stenosis or blockage of the lumen of the blood supply structure.

As a result, a plaque or area of ​​narrowing is formed. Blood cannot overcome the obstacle, cardiac output increases - this is why the upper pressure rises, while the lower remains normal.

• Increased concentrations of calcium and sodium in the circulatory system. Both substances provoke fluid retention, as a result of which the filtering function of the kidneys is impaired.
• Itsenko-Cushing syndrome with symptoms of hypercortisolism. A condition where the adrenal glands produce excess amounts of cortisol.

The reason for this is tumors of the glands or disruption of the pituitary gland with excessive synthesis of corticotropin, which stimulates the production of corticosteroids.

It is not difficult to identify such patients even by eye: a characteristic physique, arterial hypertension, problems with bones, muscles, and the reproductive system.

High upper pressure with normal or low diastolic pressure can form due to aortic valve insufficiency.

• Hyperthyroidism. Another significant risk factor for the development of isolated hypertension. In this case, there is an excess of thyroid hormones or active substances produced by the thyroid gland.

• Kidney failure.
• Prolonged increase in body temperature to significant levels.
• All kinds of congenital heart defects that were not diagnosed in time
• Anemia of any etiology.

The two states are easily differentiated. If there is no evidence for objective pathological processes that could cause ISAH, a diagnosis of the primary form is made.

The pulse rate in this case is important only within the framework of determining the etiology of the process. It does not indicate any specific disease.

When the heart rate increases, the cause must be sought in the heart, blood vessels, hormonal status, and kidneys. A low pulse indicates an anemic process and some other pathologies.

Causes of pathology

Secondary form of ISAH

Secondary ISAH is a complication of a number of pathologies:

Primary form of ISAH

Primary, or essential, ISAH develops through the interaction of two or more risk factors (these risk factors are the same for any form of arterial hypertension):

• genetic defect;
• age-related changes in the vascular wall (decreased elasticity) and metabolic disorders (increased activity of pressure-stimulating hormones);
• atherosclerosis;
• smoking;
• excess weight with impaired fat metabolism;
• diabetes;
• female gender (incidence is twice as high).

Is it possible to develop isolated hypertension during pregnancy?

Yes, such a scenario is quite possible. The mother's body optimizes its activity, devoting all its strength to the benefit of the fetus.

Depending on the initial parameters, such as general health, endocrine status, the presence or absence of bad habits, the nature of professional activity, physical activity, normal blood pressure before pregnancy, we can talk about certain conditions during gestation.

Women more often have arterial hypotension, that is, low blood pressure. But everyone cannot be assessed by one criterion. ISAH also occurs. As a rule, the condition returns to normal after childbirth and stabilizes within the first month.

In any case, it is recommended to be observed by a cardiologist, especially if childbirth does not improve the situation.

High lower pressure: causes, symptoms

By lower or diastolic pressure we mean the force with which the blood flow acts on the vessels during the diastole (relaxation) phase of the heart. Its value depends on the degree of vascular resistance, an increase in which is observed in the following pathological conditions:

• atherosclerosis - the elasticity of the walls of blood vessels decreases, their lumen decreases, which increases tone and resistance to blood flow;
• kidney pathology leads to vasoconstriction due to the implementation of the renin-angiotensin-aldosterone reaction;
• anatomical and functional changes in the myocardium (dilation of the heart chambers, arrhythmia);
• thyrotoxicosis – a high concentration of thyroid hormones in the blood causes vasospasm;
• diabetes mellitus – vascular patency is impaired;
• tumor of the pituitary gland and adrenal glands - the release of catecholamines into the blood, which constrict blood vessels;

According to statistics, the elderly population and men of any age often suffer from high blood pressure. Signs of its increase are sharp pain in the head, dizziness, tinnitus, and attacks of shortness of breath. Painful discomfort in the cardiac region is possible. Long-term high diastolic pressure threatens the development of a heart attack or stroke.

How can you reduce the upper pressure without affecting the lower reading?

It is impossible to solve such a survey on your own. Qualified medical assistance is required.

Moreover, if the systolic pressure is in the range of 170-180 or higher, you should not wait, you need to call an ambulance to resolve the issue of hospitalization in a cardiology hospital.

Before doctors arrive, you need to take a semi-sitting position with your legs bent to normalize blood flow in the brain.

Taking pills is strictly prohibited; this can lead to unpredictable consequences, including a stroke or heart attack.

The maximum that can be done is to take mild sedatives in tablet form, such as motherwort or valerian, Valocordin.

High systolic pressure and low diastolic pressure require hospitalization. Even medications prescribed by a doctor cannot be used: the risks of inadequate pharmaceutical exposure are high.

All recommendations circulated online and in print publications of dubious quality about showers, baths, rubdowns, and folk remedies should be ignored. This is sabotage advice, fraught with dangerous consequences.

Definition

Systolic pressure is called top pressure because it is the top number on the sphygmomanometer screen. This indicator characterizes the pressure that occurs at the moment of contraction of the heart muscle - at the moment of blood ejection from the heart into the arteries.

Doctors call a condition in which the upper blood pressure (BP) is elevated systolic hypertension. Most often, this situation is observed at a time when the lower pressure remains within the normal range and does not go beyond 90 mmHg. Art., and the upper one is determined at a level of 140 mm Hg. Art. and higher.

In 90% of cases, the increase is diagnosed in elderly people who have crossed the age mark of 50 years. Most often, women who have concomitant diseases of the cardiovascular system are at risk.

• High lower pressure - causes and treatment with drugs and folk remedies

Symptoms requiring an ambulance call

It is recommended to call an ambulance in any case as soon as the patient realizes that isolated hypertension is occurring.

The list of manifestations dangerous to health and life is characterized by the following points:

• Headache of significant intensity. Caused by hemodynamic disturbances and stenosis (narrowing) of blood vessels in the brain.
• Dizziness, especially severe.
• Nausea, accompanied by repeated vomiting without signs of mitigation.
• Chest pain of a pressing, aching nature. They give it to the epigastric region, the hands, and do not allow breathing.
• Shortness of breath, as they say, out of the blue without physical exertion. This is explained by a violation of cellular nutrition, which is very dangerous.
• Changes in the nature of the heart rhythm (an increase of more than 100 beats per minute, or a decrease of less than 60).
• Fainting states of any frequency.
• Impairments of consciousness, up to the development of mental disorders.
• Inability to speak normally or control one’s own body.

All these are symptoms that require urgent qualified help. Without treatment, dangerous and even fatal complications are possible. Therefore, amateur activities are excluded. At the first suspicion, you should call doctors and calmly wait for their arrival.

How does a person feel about this?

Due to the fact that the systolic value is increased, various symptoms may be observed.

The main signs that the upper pressure is high and the lower pressure is normal:

• breathing problems;
• reduced visual acuity;
• nausea, vomiting;
• chills;
• nose bleed;
• loss of strength, fatigue;
• excitability, nervousness, anxiety;
• blue skin in the nasolabial area;
• headache in the back of the head.

Among all the manifestations of a high upper limit of blood pressure, the main one is blue lips. This happens because the blood, with little oxygen, begins to darken.

If these signs occur, you should consult a doctor immediately!

Diagnostics

It involves a complete examination of the patient by several specialists: a cardiologist, an endocrinologist, a nephrologist and a neurologist in the system.

An approximate list of diagnostic measures looks like this:

• Questioning the patient. It involves identifying subjective sensations. That is, the actual symptoms of the condition.
• Anamnesis collection. The factors of the presence of bad habits and somatic diseases are established.
• Measuring blood pressure levels on both arms with minor breaks.
• Daily Holter monitoring using an automatic tonometer.
• Electrocardiography. In the right hands it is highly informative.
• Encephalography.
• Study of hormone levels.
• Blood biochemistry, general analysis.
• Urine examination.
• Angiography or Dopplerography as necessary.

The final list of measures is determined by doctors; it can be either shorter or longer.

Difference between systolic and diastolic pressure

There is another term for this indicator - pulse blood pressure. If the difference between the higher and lower tonometer readings exceeds 50, it means that the heart muscle is overly strained when pumping blood.

Pulse BP = systolic minus diastolic

It is equally important to note which blood pressure indicator exceeds or lags behind the norm. In many cases, this helps in determining the cause of the blood pressure problem.

For maximum reliability of blood pressure measurements, they must be done at least twice a day, and on each arm.

The tonometer readings for each arm may vary slightly. A difference of up to five millimeters is acceptable. If the difference is greater, then there is reason to suspect blood flow problems in one of the arms. The situation requires attention if it does not change within several days.

How is isolated arterial hypertension with high systolic values ​​treated?

The set of measures is generally identical to those for classical hypertension. Etiological treatment is necessary to eliminate the underlying disease that caused the pathological condition.

Symptomatic therapy consists of the use of combination drugs or the use of narrowly targeted medications:

• ACE inhibitors.
• Diuretics of various types.
• Calcium channel blockers and beta blockers.

This, however, is not enough. The use of medications is a half-measure. It is necessary to radically change your lifestyle. Quit smoking and alcohol, even in the smallest doses.

It is necessary to optimize the regime of physical activity, no physical inactivity, but you should not bother. Drinking regimen (2 liters of water per day), amount of salt consumed per day (less than one teaspoon).

The diet should contain fresh vegetables and fruits, protein. You need to worry less; stress is one of the risk factors. Although this is not so easy to do.

These methods are quite sufficient to normalize the health of the cardiovascular system.

Therapy

When high systolic blood pressure is detected, complex treatment is prescribed. It includes a number of lifestyle changes that can reduce blood pressure readings to normal values. This also includes the use of medications as needed.

Recommendations for lifestyle adjustments:

• Loss of body weight. This allows you to reduce the systolic value by 1 mmHg.
• Diet correction. The daily menu should be enriched with low-fat dairy products, include more fruits and vegetables, and eliminate or minimize the consumption of unsaturated and saturated fats. This makes it possible to reduce the upper pressure by 8-14 mmHg.
• Consumption of a minimum amount of salt. If you reduce its volume by 6 g (1 teaspoon), you can gradually lower your upper blood pressure by 2-8 mmHg.
• Active physical activity, daily walks in the fresh air. Thanks to this, you can reduce the upper readings on the tonometer by 4-9 mmHg.
• Eliminate or minimize the consumption of alcoholic beverages. This makes it possible to reduce the systolic value by 2-4 mmHg.
• Eliminate stress and anxiety. Against their background, the disease often worsens. If you have a tendency to increase your upper pressure, you should react more calmly to what is happening around you and take measures to quickly calm down in difficult situations.
• Avoid alcoholic drinks and smoking.

In the absence of a history of complex pathologies, such advice is often enough to normalize and stabilize the body’s condition.

If it is not possible to cope without drug therapy, drugs that lower upper blood pressure are administered. It can be:

• thiazide diuretics;
• ACE inhibitors;
• calcium channel blockers.

In difficult cases, 2 or more medications are used.

You cannot take medications on your own! It will not be possible to do this without affecting the lower value on the tonometer.

Only a doctor can prescribe the drug. Self-medication is dangerous due to serious complications!

The adjustment is made taking into account the characteristics of the course of the disease and the rules for lowering blood pressure. So, if systolic readings are above 180 mm Hg. Art., it can be reduced to 160 mm Hg. Art. If this parameter is within 160-180 mmHg. Art., it can be reduced by 20%.

Preventive measures

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Primary and secondary prevention measures do not present any difficulties. It is enough to follow simple recommendations and follow common sense:

• Quit cigarettes and tobacco products altogether.
• Avoid alcoholic beverages.
• Normalize your diet. As many fortified foods as possible, as little fatty, fried, smoked and sweet foods as possible.
• Move more, but don't overexert yourself. This is fraught with a stroke.
• Consume less table salt.
• Regularly undergo examinations by doctors of the profile described above to monitor the state of the cardiovascular system.
• When prescribing therapy, take the prescribed medications in a timely manner.

A set of measures will prevent the development of hypertension in the future.

Treatment of high blood pressure

The main goal of therapy for high blood pressure is to reduce its levels to normal and the maximum possible correction of risk factors (fighting smoking, alcoholism, losing excess weight, doing morning exercises), as well as slowing down the damage to other organs.

Taking into account anamnestic and objective data, various medications are prescribed for hypertension; their main groups are presented below:

• antihypertensive medications to lower blood pressure;
• disaggregants that reduce the risk of hemorrhagic complications;
• statins for correction of lipid metabolism;
• diuretics that indirectly reduce blood pressure;
• according to strict indications, a and/or β-blockers to correct myocardial contractility.

If high blood pressure is a sign of pathology in another organ, then treatment of the underlying disease will be key.

An important aspect in the treatment of high blood pressure is a balanced diet, in which you need to limit salt intake, eat more vegetables, nuts, fruits, healthy vegetable oils (olive, pumpkin). If possible, replace red meat with fish. Reduce the amount of calcium-rich dairy products in your diet.