Causes of arterial hypotension
Last reviewed: 23.04.2024
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The level of arterial pressure in a person is determined by a combination of various factors that make up the functional system (by the definition of Academician PK Anokhin), which maintains its constancy by the principle of self-regulation.
At present, the primary arterial hypotension is considered as a polyethological disease, in the occurrence of which exogenous and endogenous factors take part, also hereditary predisposition is important.
Hereditary predisposition
Until now, the genes responsible for the development of arterial hypotension are unknown. At the same time, in persons with a hereditary predisposition to arterial hypotension, the disease is more severe. Hereditary predisposition to primary arterial hypotension can be traced in families of sick children in 15-70% of cases. More often predisposition to arterial hypotension is transmitted on the maternal (in 36-54% of cases), less often - on paternal (20-23%) or both (13%) lines.
Constitutional features
The role of the constitution in arterial hypotension was further emphasized by the founder of the theory of hypotonic states A. Ferranini (1903), who introduced the concept of "constitutional hypotension". At the same time, the connection of arterial hypotension with the asthenic constitution was taken into account. However, other researchers did not confirm this pattern.
Arterial hypotension in pregnant women and perinatal pathology
In women with arterial hypotension, the general condition during pregnancy often deteriorates. In such cases, low blood pressure becomes a risk factor for the birth of a child with perinatal CNS pathology. Reduction of blood pressure in pregnant women is below 115/70 mm Hg. Should be considered as a risk factor for impaired development of the fetus. Low blood pressure during pregnancy causes a decrease in the respiratory function of the utero-placental and fetoplacental barrier. In women with arterial hypotension, in 1/3 of cases there is a threat of termination of pregnancy, in 15% - miscarriages occur, early discharge of amniotic fluid, premature birth. The fetus experiences intrauterine hypoxia, often develops fetal hypotrophy and immaturity, hypoxic damage to the central nervous system occurs. When analyzing the pathology of labor, depending on the severity of the clinical manifestations of arterial hypotension, it is established that in the severe course of the disease, childbirth occurs more often with complications (prolonged labor, frequent operational benefits), asphyxia and / or fetal hypoxia.
Thus, the unfavorable course of the ante- and perinatal period, especially the decrease in blood pressure in the mother during pregnancy, have a pathogenic effect on the developing organism and contribute to the formation of a child's autonomic dysfunction with a tendency to lower blood pressure.
Age
The period of puberty may be a trigger factor contributing to the occurrence of arterial hypotension. Many researchers drew attention to the fact that it is during this period that the frequency of arterial hypotension increases significantly. This is probably due to a violation of the vegetative-endocrine regulation of arterial pressure in the pubertal period. The relationship between over-accelerated physical development (acceleration), as well as the delay in physical development and the occurrence of arterial hypotension.
Characterological features of personality
They play an important role in the development of arterial hypotension. Patients suffering from arterial hypotension present a large number of subjective complaints reflecting sensory disorders. Typical complaints include cephalgia such as "hoop", "pulling bandages", cardialgia with a sense of lack of air, a sensation of a lump in the throat, parasthesia in the extremities, myalgia, sleep disturbances. Among personal characteristics, one can note increased vulnerability, excessive sense of duty, "intense weakness", an overestimated self-esteem, which often leads to intrapersonal conflicts. In recent years, it has been suggested that masked depression and arterial hypotension are manifestations of the same disease.
Among the exogenous factors contributing to the development of arterial hypotension, great importance is attached to chronic psychoemotional stress. In families of children with arterial hypotension, there are often psychotraumatic events (parents' alcoholism, incomplete families, poor housing and social conditions, death of close relatives and serious illnesses of relatives). The state of chronic psychoemotional stress is promoted by the peculiarities of the upbringing and education of schoolchildren. A large training load often leads to mental fatigue and hypodynamia. The frequency of arterial hypotension is significantly higher among children attending specialized schools, compared with that in general schools.
Chronic inflammatory diseases
Foci of chronic infection and a high infectious index also contribute to the development of arterial hypotension. Changing the reactivity of the body, they violate the sensitivity of the central nervous system and its vasomotor center to various kinds of influences.
Thus, arterial hypotension occurs against a background of hereditary predisposition under the influence of various endogenous (perinatal pathology, foci of chronic infection, pubertal period) and exogenous (psychogeny, unfavorable socioeconomic conditions, disturbance of the daily regimen, mental overwork, hypodynamia) factors.
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