Treatment of arterial hypotension

Non-drug treatments for arterial hypotension

Non-drug methods of treating arterial hypotension include normalizing the daily routine, engaging in dynamic sports, massage, diet, taking diuretic herbs, physiotherapy, and psychological methods.

Basic non-drug treatments for arterial hypotension

• Normalization of the daily routine:
  • sleep at least 9 hours a day, with the head of the bed elevated, which promotes the formation of pressor amines;
  • daily stay in the fresh air for at least 2 hours;
  • You should avoid taking hot baths, hyperventilation, and prolonged exposure to the sun;
  • morning exercises followed by water procedures (contrast and fan showers in the morning).
• Dynamic sports: skating, skiing, cycling, slow running, fast walking, rhythmic gymnastics, dancing, swimming, tennis.
• Massage. General massage, massage of the collar zone, hands, massage of the calf muscles, feet with hair brushes.
• Diet. It is advisable to include tonic drinks (tea or coffee).
• Diuretic herbs (lingonberry leaf, bearberry, birch buds). They are prescribed sequentially (1 course for 1 month per quarter).
• Physiotherapy.
  • Procedures with a stimulating effect are used.
    • Vermel electrophoresis with solutions of 5% sodium bromide, caffeine, brom-caffeine, phenylephrine.
    • Electrosleep with a frequency of 10 Hz.
    • Acupuncture.
  • You can limit yourself to one of the above procedures or perform 2 in sequence.
    • Water treatments are aimed at restoring vascular tone. Baths (salt-pine, sage, radon), Charcot shower, fan and circular shower are used.
• Psychological methods of treating arterial hypotension.

It is necessary to establish the cause of psycho-emotional stress and indicate possible ways to resolve conflicts in the family and school. Chronic psycho-emotional stress is the main pathogenetic factor in the development of cardiovascular diseases. Psychotherapy helps to eliminate or reduce the severity of psycho-emotional stress, which is accompanied by an improvement in the functional state of the adaptation systems: humoral and vegetative.

Drug treatment

If non-drug treatments for arterial hypotension are ineffective, basic therapy is indicated. Drug treatment for arterial hypotension should be carried out taking into account the severity of its clinical manifestations.

Plant adaptogens have a mild stimulating effect on the central nervous system. These include tinctures of Chinese magnolia vine, ginseng, zamaniha, and senticosus. These drugs have a stimulating effect on the central nervous system, stimulate the cardiovascular system, eliminate mental and physical fatigue, increased drowsiness, and increase blood pressure. Dosage of drugs: 1 drop per 1 year of life 2 times a day (morning, afternoon), before meals.

Nootropic drugs and GABAergic substances

Indications for prescribing drugs of this group are memory loss, cerebral insufficiency, immaturity of brain structures according to electroencephalogram data. Nootropic drugs have a direct activating effect on the integrative mechanisms of the brain, increase its resistance to aggressive effects, and improve cortico-subcortical connections.

• Piracetam. In its chemical structure, piracetam is similar to γ-aminobutyric acid. It has a positive effect on metabolic processes and blood supply to the brain, stimulates oxidation-reduction processes, enhances glucose utilization, and improves blood flow in ischemic areas of the brain. The body's energy potential is increased by accelerating ATP turnover, increasing the activity of adenylate cyclase, and inhibiting nucleotide phosphatase. Improved metabolic processes under the influence of piracetam lead to increased resistance of the brain to hypoxia and toxic effects. The drug improves the integrative activity of the brain, promotes memory consolidation, and facilitates the learning process. 1 capsule contains 0.2 or 0.4 g of the active substance. Prescribe 1 capsule 3 times a day.
• Gamma-aminobutyric acid activates energy processes, increases the respiratory activity of the brain, improves thinking, memory, has a mild psychostimulating effect, and alleviates vestibular disorders. The drug has a positive effect on endogenous depressions with a predominance of asthenohypochondriacal phenomena. One tablet contains 0.25 g of the active substance; 1 tablet is prescribed 3 times a day (before meals). The course of treatment can be from 4 weeks to 2 months.
• Aminophenylbutyric acid has a tranquilizing effect, reduces tension, anxiety, fear, and improves sleep. The drug is prescribed for severe neurotic symptoms; it does not have anticonvulsant activity. One tablet contains 0.25 g of the active substance; 1 tablet is prescribed 3 times a day (before meals). The course of treatment can be from 4 weeks to 2 months.
• Pyritinol activates metabolic processes in the central nervous system, reduces excessive lactic acid formation, and increases the brain's resistance to hypoxia. The drug is prescribed for mild depression, asthenic conditions, migraines, and neurosis-like disorders. It can cause psychomotor agitation, sleep disturbances, irritability, and is contraindicated in cases of increased convulsive readiness. One tablet contains 0.05 g or 0.1 g of the active substance; 1 tablet is prescribed 2 times a day (30 minutes after meals). The course of treatment can last from 2 weeks to 3 months.
• Cerebrolysin helps to enhance metabolic processes in the brain, has a neuroprotective effect, prevents the death of neurons in hypoxic conditions, has a positive effect on cognitive disorders, improves concentration, memorization and reproduction of information, mental activity, mood, and helps to form positive emotions. The drug is released in 1 ml ampoules. It is prescribed daily intramuscularly once for 10 days, the course is repeated after 3 months.

Anticholinergic drugs

• Bellataminal. Film-coated tablets contain belladonna leaves (0.1 mg), phenobarbital (20 mg) and ergotamine (0.3 mg). The drug reduces the excitability of the central and peripheral adrenergic and cholinergic systems of the body. It has a calming effect on the central nervous system.
• Bellaspon has a similar effect. The drug is prescribed 1 tablet 2-3 times a day after meals.

Biogenic stimulants

• Aloe arborescens leaves are used as an extract for injections (1 ml subcutaneously or intramuscularly). The drug can be combined with thiamine.

Alpha adrenergic agonists

They are used for orthostatic disorders and fainting.

• Midodrine is a transport and protected form for the substance 1-2', 5'-dimethoxyphenyl, which has a direct alpha-sympathomimetic effect. The drug increases vascular tone, which leads to an increase in peripheral resistance in the arterial circulation, increases blood pressure and prevents venous stagnation in orthostatic disorders. Due to this, the volume of circulating blood and the level of arterial pressure are maintained at a constant level, oxygen delivery to the organs increases, which leads to the elimination of orthostatic disorders such as morning weakness, drowsiness, dizziness. Midodrine does not affect cardiac activity, but a reflex decrease in heart rate is possible. The drug does not increase the excitability of the central nervous system.

It is available in tablets containing 2.5 mg and 5 mg of midodrine, and in a 1% solution of 10, 20, 25 ml in vials (1 ml contains 10 mg of midodrine). Dosage regimen: children over 12 years of age are prescribed 7 drops 2 times a day or 1 tablet (2.5 mg) 2 times a day in the morning and evening, for younger children the dose depends on body weight.

Tranquilizers

Indications for the prescription of tranquilizers are pronounced neurotic manifestations, emotional tension, anxiety, fear, hypochondriacal mood. Preference is given to tranquilizers with an activating effect (tofisopam, trioxazine).

• Tofisopam is a daytime tranquilizer with an activating effect. 1 tablet contains 50 mg of the active substance. The drug has an anxiolytic effect, not accompanied by a pronounced sedative, muscle relaxant and anticonvulsant effect. Tofisopam is classified as a psychovegetative regulator, it has moderate stimulating activity. It is prescribed 1 tablet 2 times a day.
• Trioxazine has a moderate activating effect, improves mood, does not cause intellectual inhibition and drowsiness. The drug is prescribed for neurotic disorders with a predominance of hyposthenic manifestations. 1 tablet contains 0.3 g of the active substance. Prescribe 1/4-1/2 tablet 2 times a day.

Drugs that improve cerebral hemodynamics and microcirculation

• Vincamine is an alkaloid of the periwinkle plant. The drug improves cerebral circulation, increases cerebral blood flow and oxygen utilization by the brain, reduces and stabilizes the resistance of its vessels, increases mental performance, and improves memory. The drug is prescribed at 10 mg once a day.
• Acetazolamide. Intracranial hypertension syndrome is an indication for the prescription of this diuretic drug (it mainly affects the proximal tubules), which reduces the formation of cerebrospinal fluid. The drug promotes the excretion of potassium ions, so it is necessary to replenish its content (potassium and magnesium aspartate are prescribed). Acetazolamide is prescribed according to the scheme: daily intake for 3 days, followed by a break for one day. 1 tablet contains 0.25 g of the active substance. Depending on age, it is prescribed from 1/4 to 1 tablet once a day, in the first half of the day.