Blood pressure in various arterial vessels. Blood pressure in various parts of the vascular system

Blood pressure level is measured in mmHg and is determined by a combination of different factors:

1. The pumping force of the heart.

2. Peripheral resistance.

3. Volume of circulating blood.

Pumping force of the heart. The main factor in maintaining blood pressure levels is the work of the heart. Blood pressure in the arteries fluctuates constantly. Its rise during systole determines maximum (systolic) pressure. In a middle-aged person, in the brachial artery (and in the aorta) it is 110–120 mm Hg. The drop in pressure during diastole corresponds to minimum (diastolic) pressure, which averages 80 mm Hg. It depends on peripheral resistance and heart rate. The amplitude of oscillations, i.e. the difference between systolic and diastolic pressure is pulse pressure is 40–50 mm Hg. It is proportional to the volume of blood ejected. These values ​​are the most important indicators of the functional state of the entire cardiovascular system.

Blood pressure averaged over the time of the cardiac cycle, which represents the driving force of blood flow, is called average pressure. For peripheral vessels it is equal to the sum of diastolic pressure + 1/3 of pulse pressure. For the central arteries it is equal to the sum of diastolic + 1/2 pulse pressure. The average pressure decreases along the vascular bed. As you move away from the aorta, systolic pressure gradually increases. In the femoral artery it increases by 20 mm Hg, in the dorsal artery of the foot by 40 mm Hg more than in the ascending aorta. Diastolic pressure, on the contrary, decreases. Accordingly, pulse pressure increases, which is caused by peripheral vascular resistance.

In the terminal branches of the arteries and in the arterioles, the pressure decreases sharply (to 30–35 mmHg at the end of the arterioles). Pulse fluctuations significantly decrease and disappear, which is due to the high hydrodynamic resistance of these vessels. In the vena cava, the pressure fluctuates around zero.

mm. Hg Art.

The normal level of systolic pressure in the brachial artery for an adult is usually in the range of 110-139 mm. Hg Art. The normal limit for diastolic pressure in the brachial artery is 60-89. Cardiologists distinguish the following concepts:

optimal level Blood pressure when systolic pressure is slightly less than 120 mm. Hg Art. and diastolic – less than 80 mm. Hg Art.

normal level– systolic less than 130 mm. Hg Art. and diastolic less than 85 mm. Hg Art.

high normal level– systolic 130-139 mm. Hg Art. and diastolic 85-89 mm. Hg Art.

Despite the fact that with age, especially in people over 50 years of age, blood pressure usually gradually increases, at present it is not customary to talk about the age-related rate of increase in blood pressure. When systolic pressure increases above 140 mm. Hg Art., and diastolic above 90 mm. Hg Art. It is recommended to take measures to reduce it.

An increase in blood pressure relative to values ​​​​defined for a particular organism is called hypertension(140–160 mm Hg), reduction - hypotension(90–100 mm Hg). Under the influence of various factors, blood pressure can change significantly. Thus, with emotions, a reactive increase in blood pressure is observed (passing exams, sports competitions). So-called advanced (pre-start) hypertension occurs. There are daily fluctuations in blood pressure; during the day it is higher; during restful sleep it is slightly lower (by 20 mm Hg). When eating food, systolic pressure increases moderately, diastolic pressure decreases moderately. Pain is accompanied by an increase in blood pressure, but with prolonged exposure to a painful stimulus, a decrease in blood pressure is possible.

During physical activity, systolic increases, diastolic can increase, decrease, or remain unchanged.

Hypertension occurs:

When cardiac output increases;

When peripheral resistance increases;

An increase in the mass of circulating blood;

When both factors are combined.

In the clinic, it is customary to distinguish between primary (essential) hypertension, which occurs in 85% of cases, the causes are difficult to determine, and secondary (symptomatic) hypertension - 15% of cases, it accompanies various diseases. Hypotension is also distinguished between primary and secondary.

When a person moves to a vertical position from a horizontal position, a redistribution of blood occurs in the body. Temporarily decreased: venous return, central venous pressure (CVP), stroke volume, systolic pressure. This causes active adaptive hemodynamic reactions: narrowing of resistive and capacitive vessels, increased heart rate, increased secretion of catecholamines, renin, vosopressin, angiotensin II, aldosterone. In some people with low blood pressure, these mechanisms may be insufficient to maintain normal blood pressure levels when the body is upright, and blood pressure drops below acceptable levels. Orthostatic hypotension occurs: dizziness, darkening of the eyes, possible loss of consciousness - orthostatic collapse (fainting). This can happen when the ambient temperature increases.

Peripheral resistance. The second factor determining blood pressure is peripheral resistance, which is determined by the state of resistive vessels (arteries and arterioles).

The amount of circulating blood and its viscosity. When large amounts of blood are transfused, blood pressure increases, and when blood loss occurs, it decreases. Blood pressure depends on venous return (for example, during muscular work). Blood pressure constantly fluctuates from a certain average level. When recording these oscillations on the curve, the following are distinguished: first order waves (pulse), the most frequent, reflect the systole and diastole of the ventricles. Second order waves (respiratory). As you inhale, blood pressure decreases and as you exhale, it increases. Third-order waves reflect the influence of the central nervous system; they are more rare, perhaps due to fluctuations in the tone of peripheral vessels.

Methods for measuring blood pressure

In practice, two methods of measuring blood pressure are used: direct and indirect.

Direct (bloody, intravascular) is carried out by introducing a cannula or catheter into the vessel connected to a recording device. It was first carried out in 1733 by Stefan Health.

Indirect (indirect or palpable), proposed by Riva-Rocci (1896). Used clinically in humans.

The main device for measuring blood pressure is sphygmomanometer. A rubber inflatable cuff is placed on the shoulder, which, when air is pumped into it, compresses the brachial artery, stopping blood flow in it. The pulse in the radial artery disappears. By releasing air from the cuff, monitor the appearance of the pulse, recording the pressure value at the moment of its appearance using a pressure gauge. This method ( palpable) allows you to determine only systolic pressure.

In 1905 I.S. Korotkov suggested auscultatory method by listening to sounds (Korotkoff sounds) in the brachial artery below the cuff using a stethoscope or phonendoscope. When the valve opens, the pressure in the cuff decreases and, when it drops below systolic pressure, short, clear tones appear in the artery. The systolic pressure is noted on the manometer. Then the tones become louder and then fade, and the diastolic pressure is determined. The tones may be constant or rise again after fading. The appearance of tones is associated with turbulent blood movement. When laminar blood flow is restored, the sounds disappear. With increased activity of the cardiovascular system, the sounds may not disappear.

In most cases, the clinic uses either a Riva-Rocci apparatus or a tonometer (the only difference is in the manometer - mercury or mechanical). But at home, modern devices (usually automatic) are usually used.

However, there are a number of nuances in the interpretation of measurement results. It is clear that with age, as well as with the occurrence of a number of diseases, the mechanisms of blood pressure regulation are disrupted. But we do not think about the issue of the relationship between upper and lower pressure.

However, it is worth considering the reasons for changes in upper and lower pressures separately. Understanding these reasons can provide an opportunity to act in the right direction.

Blood pressure

The characteristics of blood pressure are two important values ​​- upper and lower pressure:

• Upper pressure (systolic).
• Lower pressure (diastolic).

Cardiac cycle

The entire cardiac cycle in a healthy person takes about 1 second. Stroke volume is approximately 60 ml of blood - this is the amount of blood that the adult heart expels in one systole, and in a minute approximately 4 liters of blood are pumped by the heart.

The process of ejection of blood into the ventricles during contraction of the atria is called systole. At this time, while the atria are contracting, the ventricles are resting - they are in diastole.

Remembering your visit to the therapist, remember the sensations that occur when air begins to be released from the tonometer cuff - at some point pulsations begin. Actually, this device was called a tonometer for the reason that the doctor listens to the tone (for us this is pulsation) and measures the number of clicks (Korotkoff sounds).

The first beat that the doctor hears (and we feel it as the beginning of pulsations), and the numerical value is recorded by a pressure gauge for this moment, is called the upper pressure, systolic. It corresponds to the systole of the ventricles, which, compared to the atria, bear a much greater load. Therefore, the weight of the ventricles is greater, since they pump blood through two circulation circles.

If we briefly characterize the cardiac cycle (the sequence of work of the atria and ventricles), it looks like this:

• Atrial systole – ventricular diastole.
• Ventricular systole – atrial diastole.

That is, when we talk about systole, we mean ventricular systole (the ventricle works - pushes blood), and when we talk about diastole, we mean ventricular diastole (the ventricle rests).

The harmonious and coordinated work of the heart and all its 4 chambers allows each other to rest. This is achieved by the fact that during the work of the atria the ventricles of the heart rest, and vice versa.

If you indicate the stages of such a process in order, it will look like this:

• From throughout the body, venous blood enters the right atrium through the systemic circulation.

This is how the heart ensures the movement of blood, rich in various nutrients for cells and oxygen, through the systemic and pulmonary circulation.

Pressure rises and falls

In the case of hypertension, the blood exerts higher than normal pressure on the walls of blood vessels. The vessels, in turn, resist blood flow. In this case, both upper and lower pressure can increase. This resistance depends on a number of reasons:

• Preservation of the lumen (patency) of blood vessels. The higher the vessel tone, the lower the blood capacity.
• Length of the bloodstream.
• Blood viscosity.

Here, according to the laws of physics, everything is explained very simply - the smaller the lumen of the vessel, the more it will resist the advancing blood. The same will happen when blood viscosity increases.

In the practice of cardiologists, the phenomenon of arterial hypotension is quite common - a decrease in pressure below 90/60 mmHg. From the presented figures it is clear that in this case there is a decrease in the upper and lower pressure.

Low lower pressure can be within 50 mm Hg. Art. and below. This is a dangerous situation and requires emergency medical care, since when the diastolic pressure is 40 mmHg. Art. Hardly reversible and poorly controlled processes develop in the human body.

Upper pressure

If any arterial vessels do not have time to adapt and expand to the required caliber in a timely manner, or there is an obstacle in the path of blood flow (atherosclerotic plaque), then the outcome will be increased systolic pressure.

There are a number of parameters on which the upper pressure indicator directly depends:

• Force of contraction of the heart muscle.
• Blood vessel tone and resistance.
• Heart rate over a specific period of time.

The optimal systolic pressure is mm Hg. Art. But, for example, when classifying arterial hypertension, there is a certain scale in which the indicator is 139 mm Hg. Art. classified as normal high. This is already a harbinger of hypertension.

Even in a healthy person, systolic pressure can fluctuate throughout the day, which may be caused by:

• Alcohol.
• Smoking.
• Taking large amounts of salty food, coffee, tea.
• Mental overload.

Increase in upper pressure

There are also pathological reasons that lead to increased upper pressure:

• Kidney pathology.
• Heredity.
• Vascular spasm.
• Changes in hormonal levels of any origin.
• Overweight.
• Excessive intake of fluids and/or salt.
• Atherosclerosis.
• Aortic valve lesions.
• Age-related characteristics and changes.

Patients suffering from persistent arterial hypertension with predominant increases in upper pressure, even without measuring it, know that it is elevated, as they experience the following symptoms:

• Headache, most often in the occipital region.
• Dizziness.
• Nausea.
• Difficulty breathing.
• Flickering of flies before the eyes, blurred vision.

Lowering the upper pressure

• Physical activity.
• Changes in climatic conditions.
• Weather change.
• Pregnancy (first trimester).
• Fatigue.
• Professional activity that is associated with lack of sleep, work in a hot climate, and increased sweating.

But there are also a number of pathologies in which a persistent decrease in upper pressure develops:

• Bradycardia.
• Pathology of the valve apparatus.
• Intoxication.
• Brain injuries.
• Diabetes mellitus.
• Vegetative-vascular dystonia.
• Neuroses.
• Blood loss.
• Cervical spine injuries.
• Cardiogenic shock, shock - arrhythmogenic, hemorrhagic, anaphylactic, septic, hypovolemic.
• Starvation.
• Consequences of uncontrolled use of antihypertensive drugs.

A person who has low upper blood pressure feels:

• Fatigue.
• Loss of strength.
• Bad mood.
• Apathy.
• Drowsiness.
• Irritability.
• Increased sweating.
• Memory loss.
• Decreased ability to concentrate on anything.

In any case, regardless of whether the upper pressure is high or low, it is necessary to monitor your body, diagnose and treat if necessary.

What does lower pressure mean?

The indicators of this value depend on the following factors:

• Elasticity of the walls of the aorta and arteries.
• Pulse rate.
• Total blood volume.

If it happens that when measuring diastolic pressure, it turns out to be elevated in rare cases, then this is not considered a pathology. This reaction of our cardiovascular system can be caused by:

• Psycho-emotional overload.
• Vigorous physical activity.
• Meteor dependence.

The same can be said about a decrease in diastolic pressure, but in most cases, low lower pressure and its causes are subject to careful diagnosis,

Increased lower pressure

We can talk about hypertension in cases where diastolic pressure is persistently elevated. Low blood pressure is high in the following situations:

• Kidney diseases.
• Renal hypertension.
• Spine pathology.
• Dysfunction of the thyroid gland, adrenal glands.

The most common symptoms of high blood pressure are:

• Pain in the chest area.
• Dizziness.
• Difficulty breathing.
• Visual impairment (with a long process).

Decrease in lower pressure

• Tuberculosis.
• Allergy.
• Aortic dysfunction.
• Dehydration.
• Pregnancy.

When low blood pressure is low, a person may experience the following symptoms:

• Lethargy.
• Brokenness.
• Weakness.
• Drowsiness.
• Pain in various parts of the head and dizziness.
• Poor appetite or lack of it.

Pressure norm

For systolic pressure, the norm can range from a maximum of 110 to 139 mmHg. Art., and for diastolic pressure the norm is not less than 70 and not more than 89 mm Hg. Art.

In a healthy state of the body, the optimal blood pressure is 120/80 millimeters of mercury (mmHg).

Pressure in the cardiovascular system is created by the coordinated work of the heart and blood vessels, and therefore each of the pressure indicators characterizes a certain stage of the heart’s activity:

• Upper (systolic) pressure - demonstrates the level of pressure during systole - the maximum contraction of the heart.

In addition to the norm of such indicators as upper and lower pressure, the difference between them is also taken into account, which is also an important figure.

Since normal human blood pressure is 120/80 mm Hg. Art., it is clear that the normal difference between systolic and diastolic pressure is considered to be 40 mm Hg. Art. This difference is called pulse pressure. If such a difference increases or decreases, then we are talking about the pathology of not only the cardiovascular system, but also about a large number of other diseases.

The level of pulse pressure is primarily affected by the distensibility of the aorta and those vessels located nearby.

The aorta has a high ability to stretch. The older a person gets, the more its elastic properties decrease due to tissue wear. Over time, the elastic fibers in the aorta are replaced by connective tissue - collagen fibers, which are no longer as stretchable, but are more rigid.

In addition, the aging of the human body leads to the fact that cholesterol, lipids, calcium salts and other substances begin to be deposited on the walls of blood vessels, which interfere and prevent the aorta from fully realizing its functions.

That is why, with a high pulse pressure in older people, it is recommended to adhere to medical recommendations, as this indicates a high risk of developing strokes and other cardiovascular complications.

How to measure correctly

Pressure is measured in millimeters of mercury. The devices currently used to determine blood pressure are quite easy to use. This allows everyone to control their blood pressure numbers at any time of the day, even while walking.

Nevertheless, there are rules that must be followed in order to correctly measure upper and lower pressure:

• Before measuring blood pressure, you need to rest for 5-10 minutes.
• When measuring pressure, you must sit, your back should rest on the back of the chair, and the arm on which the pressure is measured should be located comfortably and motionlessly on the table from the elbow to the fingers.
• The shoulder should not be compressed by clothing.
• The blood pressure cuff should be placed with the center of the inflatable bag directly over the brachial artery.
• The lower edge of the cuff should be fixed 2-3 cm above the elbow.
• The inflatable bag itself should be at heart level when measuring pressure.
• Keep your legs bent and your feet flat on the floor.
• The bladder must be emptied.

The given rules relate to the procedure for measuring pressure with a tonometer. But the rules for measuring with automatic devices for home use are specified in the instructions for the device. However, the basic provisions in these instructions are the same, with the exception of the location of the device itself and the position of the hand with the device.

If these conditions are not met, the real pressure figures are distorted and the difference will be approximately as follows:

• After smoking – 6/5 mmHg. Art.
• After drinking coffee, strong tea - by 11/5 mm Hg. Art.
• After alcohol – 8/8 mmHg. Art.
• With a full bladder – 15/10 mmHg. Art.
• Lack of arm support – 7/11 mm Hg. Art.
• Lack of back support - fluctuations in systolic pressure by 6-10 mHg. Art.

Options for the ratio of upper and lower pressures

In different situations, the blood pressure picture may be different:

• The upper pressure is high, the lower pressure is low/normal - this phenomenon is characteristic of isolated arterial hypertension. This type of hypertension can be primary or secondary. The primary process occurs due to age-related vascular changes and is more common in elderly patients.

Treatment

Treatment of an imbalance of upper and lower pressure must begin with a thorough diagnosis, because there are many reasons for their changes. It is not always possible to completely return blood pressure to normal, but it can be reliably controlled with the help of antihypertensive drugs and other means.

Forecast

A decrease in upper and lower pressure can also lead to unpleasant consequences - strokes, cardiogenic shock, collapse, loss of consciousness.

With hypotension, the body, heart and blood vessels are completely rebuilt, which leads to the development of a special form of hypertension, which is very difficult to treat.

It must be remembered that any fluctuation in upper or lower pressure should be a reason to consult a doctor.

These articles may also be interesting

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What is sinus rhythm of the heart, what can it tell you about.

Myocardial cardiosclerosis

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Blood pressure

Blood pressure in the cavities of the heart and blood vessels

Blood pressure is one of the leading parameters of hemodynamics, characterizing the force exerted by the blood flow on the walls of blood vessels.

Blood pressure depends on the amount of blood pumped by the heart into the arteries and on the total peripheral resistance that the blood encounters as it flows through the arteries, arterioles, and capillaries.

To determine the value of blood pressure in a person, they use the method proposed by N.S. Korotkov. For this purpose, the Riva-Rocci sphygmomanometer is used. In humans, the value of blood pressure in the brachial artery is usually determined. To do this, a cuff is placed on the shoulder and air is pumped into it until the arteries are completely compressed, which can be indicated by the cessation of the pulse.

If the pressure in the cuff is raised above the level of systolic blood pressure, the cuff completely blocks the lumen of the artery and blood flow in it stops. There are no sounds. If you now gradually release air from the cuff, then at the moment when the pressure in it becomes slightly below the level of systolic arterial blood, the blood overcomes the compressed area during systole. The impact of a portion of blood on the wall of the artery, moving with high speed and kinetic energy through the compressed area, generates a sound heard below the cuff. The pressure in the cuff at which the first sounds in the artery appear corresponds to the maximum, or systolic, pressure. With a further decrease in pressure in the cuff, a moment comes when it becomes below diastolic, blood begins to flow through the artery both during systole and during diastole. At this point, the sound in the artery below the cuff disappears. The value of the minimum, or diastolic, pressure is judged by the pressure in the cuff at the moment the sounds in the artery disappear.

The maximum pressure in the brachial artery in an adult healthy person is on average equal to mm Hg. Art., and the minimum is mm Hg. Art. An increase in blood pressure leads to the development of hypertension, a decrease leads to hypotension.

Normal blood pressure values ​​depending on age

The difference between the maximum and minimum pressure is called pulse pressure.

Arterial blood pressure increases under the influence of various factors: when performing physical work, during various emotional states (fear, anger, fright, etc.); it also depends on age.

Rice. 1. The value of systolic and diastolic pressure depending on age

Blood pressure in the cavities of the heart

Blood pressure in the cavities of the heart depends on a number of factors. Among them are the force of contraction and the degree of relaxation of the myocardium, the volume of blood filling the cavities of the heart, the blood pressure in the vessels from which blood flows during diastole and into which blood is expelled during systole. Blood pressure in the left atrium ranges from 4 mm Hg. Art. in diastole up to 12 mm Hg. Art. in systole, and in the right - from 0 to 8 mm Hg. Art. The blood pressure in the left ventricle at the end of diastole is 4-12 mm Hg. Art., and at the end of systole - mm Hg. Art. In the right ventricle it is 0-8 mmHg at the end of diastole. Art., and at the end of systole - mm Hg. Art. Thus, the range of fluctuations in blood pressure in the left ventricle is mmHg. Art., and in the right - 0-28 mm Hg. Art. Blood pressure in the cavities of the heart is measured during cardiac probing using pressure sensors. Its values ​​are important for assessing the condition of the myocardium. In particular, the rate of increase in blood pressure during ventricular systole is one of the most important characteristics of myocardial contractility.

Rice. 2. Graph of changes in blood pressure in various parts of the cardiovascular system

Blood pressure in arterial vessels

Blood pressure in arterial vessels, or blood pressure, is one of the most important indicators of hemodynamics. It occurs as a result of the influence of two oppositely directed forces on the blood. One of them is the force of the contracting myocardium, the action of which is aimed at promoting blood in the vessels, and the second is the force of resistance to blood flow, due to the properties of the vessels, the mass and properties of the blood in the vascular bed. Blood pressure in arterial vessels depends on three main components of the cardiovascular system: the work of the heart, the condition of the vessels, the volume and properties of the blood circulating in them.

Factors that determine blood pressure:

• blood pressure is calculated using the formula:

BP = MOC OPSS, where BP is blood pressure; MOC - minute blood volume; TPR - total peripheral vascular resistance;

strength of heart contractions (MCF);

vascular tone, especially arterioles (OPSS);

aortic compression chamber;

blood viscosity;

circulating blood volume;

intensity of blood outflow through the precapillary bed;

the presence of vasoconstrictor or vasodilator regulatory influences

Factors determining venous pressure:

• residual driving force of heart contractions;
• vein tone and their general resistance;
• circulating blood volume;
• contraction of skeletal muscles;
• respiratory movements of the chest;
• suction action of the heart;
• change in hydrostatic pressure at different body positions;
• the presence of regulatory factors that reduce or increase the lumen of veins

The magnitude of blood pressure in the aorta and large arteries determines the blood pressure gradient in the vessels of the entire systemic circulation and the magnitude of volumetric and linear blood flow velocities. Blood pressure in the pulmonary artery determines the nature of blood flow in the vessels of the pulmonary circulation. The value of blood pressure is one of the vital constants of the body, which is regulated by complex, multi-circuit mechanisms.

Methods for determining blood pressure

Due to the importance of this indicator for the life of the body, blood pressure is one of the most frequently assessed indicators of blood circulation. This is also due to the relative availability and simplicity of methods for determining blood pressure. Its measurement is a mandatory medical procedure when examining sick and healthy people. When significant deviations of blood pressure from normal values ​​are detected, methods for its correction are used, based on knowledge of the physiological mechanisms of blood pressure regulation.

Pressure measurement methods

• Direct invasive pressure measurement
• Non-invasive methods:

• • Riva-Rocci method;
  • auscultatory method with registration of sounds N.S. Korotkova;
  • oscillography;
  • tachooscillography;
  • angiotensotonography according to N.I. Arinchina;
  • electrosphygmomanometry;
  • 24-hour blood pressure monitoring

Arterial blood pressure is determined by two methods: direct (blood) and indirect.

In the direct method of measuring blood pressure, a hollow needle or glass cannula is inserted into the artery and connected to a pressure gauge by a rigid-walled tube. The direct method of determining blood pressure is the most accurate, but it requires surgery and is therefore not used in practice.

Later, to determine systolic and diastolic pressure N.S. Korotkov developed an auscultatory method. He suggested listening to vascular sounds (sound phenomena) arising in the artery below the site of application of the cuff. Korotkov showed that in an uncompressed artery there are usually no sounds during blood movement. If you raise the pressure in the cuff above systolic, then the blood flow in the compressed brachial artery stops and there are also no sounds. If you gradually release air from the cuff, then at the moment when the pressure in it becomes slightly lower than systolic, the blood overcomes the compressed area, hits the wall of the artery, and this sound is picked up when listening below the cuff. The reading on the pressure gauge when the first sounds appear in the artery corresponds to systolic pressure. As the pressure in the cuff decreases further, the sounds first intensify and then disappear. Thus, the pressure gauge reading at this moment corresponds to the minimum - diastolic - pressure.

The external indicators of the beneficial result of tonic activity of blood vessels are: arterial pulse, venous pressure, venous pulse.

Arterial pulse is a rhythmic oscillation of the arterial wall caused by a systolic increase in pressure in the arteries. A pulse wave occurs in the aorta at the moment of expulsion of blood from the ventricle, when the pressure in the aorta rises sharply and its wall is written as it grows. The wave of increased pressure and the vibration of the vascular wall caused by this stretching propagate at a certain speed from the aorta to the arterioles and capillaries, where the pulse wave dies out. The pulse curve recorded on a paper tape is called a sphygmogram.

On sphygmograms of the aorta and large arteries, two main parts are distinguished: the rise of the curve - anacrota and the decline of the curve - catacrota. Anacrosis is caused by a systolic increase in pressure and stretching of the arterial wall by blood ejected from the heart at the beginning of the expulsion phase. Catacrota occurs at the end of ventricular systole, when the pressure in it begins to fall and the pulse curve declines. At the moment when the ventricle begins to relax and the pressure in its cavity becomes lower than in the aorta, the blood thrown into the arterial system rushes back to the ventricle. During this period, the pressure in the arteries drops sharply and a deep notch appears on the pulse curve - an incisura. The movement of blood back to the heart is obstructed, since the semilunar valves, under the influence of the reverse flow of blood, close and prevent its flow into the left ventricle. The blood wave reflects off the valves and creates a secondary wave of increased pressure called dicrotic rise.

Rice. 3. Arterial sphygmogram

The pulse is characterized by frequency, filling, amplitude and tension rhythm. The pulse is of good quality - full, fast, filling, rhythmic.

Venous pulses are noted in large veins near the heart. It is caused by difficulty in the flow of blood from the veins to the heart during systole of the atria and ventricles. A graphic recording of the venous pulse is called a venogram.

Daily blood pressure monitoring - measurement of blood pressure for 24 hours in automatic mode, followed by decoding of the recording. Blood pressure parameters vary throughout the day. In a healthy person, blood pressure begins to increase at 6.00, reaches its maximum values ​​​​at 14.00-16.00, decreases after 21.00 and becomes minimal during night sleep.

Rice. 4. Daily fluctuations in blood pressure

Systolic, diastolic, pulse and mean hemodynamic pressure

The pressure exerted on the wall of an artery by the blood in it is called blood pressure. Its value is determined by the strength of heart contractions, blood flow into the arterial system, cardiac output, elasticity of vessel walls, blood viscosity and a number of other factors. There are systolic and diastolic blood pressure.

Systolic blood pressure is the maximum pressure value observed at the moment of heart contraction.

Diastolic pressure is the lowest pressure in the arteries when the heart relaxes.

The difference between systolic and diastolic pressure is called pulse pressure.

Mean dynamic pressure is the pressure at which, in the absence of pulse fluctuations, the same hemodynamic effect is observed as with naturally fluctuating blood pressure. The pressure in the arteries does not drop to zero during ventricular diastole; it is maintained due to the elasticity of the arterial walls, stretched during systole.

Rice. 5. Factors determining mean arterial pressure

Systolic and diastolic pressure

Systolic (maximum) blood pressure is the greatest amount of pressure exerted by the blood on the arterial wall during ventricular systole. The value of systolic blood pressure depends primarily on the work of the heart, but its value is influenced by the volume and properties of circulating blood, as well as the state of vascular tone.

Diastolic (minimum) blood pressure is the lowest level to which blood pressure in the large arteries decreases during ventricular diastole. The value of diastolic blood pressure depends primarily on the state of vascular tone. However, an increase in diastolic blood pressure can be observed against the background of high values ​​of IOC and heart rate with normal or even reduced total peripheral resistance to blood flow.

The normal level of systolic pressure in the brachial artery for an adult is usually within mmHg. Art. The normal limits for diastolic pressure in the brachial artery are mmHg. Art.

Cardiologists distinguish the concept of an optimal level of blood pressure when the systolic pressure is slightly less than 120 mm Hg. Art., and diastolic less than 80 mm Hg. Art.; normal - systolic less than 130 mm Hg. Art. and diastolic less than 85 mm Hg. Art.; high normal level at systolic pressure mmHg. Art. and diastolic mm Hg. Art. Although blood pressure usually gradually increases with age, especially in people over 50 years of age, it is not currently accepted to talk about the age-related rate of increase in blood pressure. When systolic pressure increases above 140 mm Hg. Art., and diastolic above 90 mm Hg. Art. It is recommended to take measures to reduce it to normal values.

Table 1. Normal blood pressure values ​​depending on age

Blood pressure, mm Hg. Art.

An increase in blood pressure above a high normal level (above 140 mm Hg systolic and above 90 mm Hg diastolic) is called hypertension (from the Latin tensio - tension, stretching of the vessel wall), and a decrease in pressure beyond the lower limit ( below 110 mm Hg for systolic and 60 mm Hg for diastolic) - hypotension. Also denotes the most common diseases of the cardiovascular system. Often these diseases are called the terms hypertension and hypotension, which emphasize that the most common causes of an increase or decrease in blood pressure is an increase or decrease in the tone of smooth myocytes in the walls of arterial vessels of the muscular type. There are cases of an isolated increase in only systolic blood pressure and, if this increase exceeded 140 mm Hg. Art. (with diastolic pressure less than 90 mm Hg), it is customary to talk about isolated systolic hypertension.

An increase in predominantly systolic blood pressure is a natural physiological reaction of the cardiovascular system to physical activity associated with the need to increase the volumetric and linear speeds of blood flow in the body. Therefore, one of the requirements for correctly measuring blood pressure in a person is to measure it at rest.

Table 2. Types of blood pressure

Pressure rises to maximum during systole

Reduction of pressure to a minimum during diastole

Amplitude of pressure fluctuations throughout the cardiac cycle

Pressure averaged over the time of the cardiac cycle, i.e. is the pressure that would be in the vascular system without a rise in systole, a decline in diastole and the work of the heart in the form of a constant pump

The force with which blood acts on the wall of a vessel

The sum of potential and kinetic energies possessed by blood moving in a certain area of ​​the vascular bed

Difference between end and side pressure

Pulse pressure

The difference between the values ​​of systolic (BP syst) and diastolic (BP diast) blood pressure is called pulse pressure

The most important factors influencing the value of pulse pressure are the stroke volume (SV) of blood expelled by the left ventricle and the compliance (C) of the aortic wall and arteries. This is reflected by the expression P p = VO/C, showing that pulse pressure is directly proportional to stroke volume and inversely proportional to vascular distensibility.

From the above expression it follows that with a decrease in the distensibility of the aorta and arteries, even under conditions of a constant stroke volume of blood, the pulse pressure will increase. This is exactly what happens in older people due to sclerosis of the aorta and arteries and a decrease in their elasticity and distensibility.

The value of pulse pressure can change both under normal conditions and in diseases of the cardiovascular system. For example, during physical activity in a healthy person, pulse pressure increases, but this can also occur with isolated systolic hypertension, mentioned above. A decrease in blood pulse pressure in patients with heart disease may be a sign of a deterioration in its pumping function and the development of heart failure.

Average dynamic pressure

Average hemodynamic pressure (BP sgd). Blood pressure changes during the cardiac cycle from maximum during systole to minimum during diastole. For most of the duration of the cardiac cycle, the heart is in diastole and the blood pressure value is closer to the blood pressure diast. Thus, blood pressure during the cardiac cycle can be expressed as an average value, or blood pressure sgd, which provides a volumetric blood flow equal to the blood flow created by changing blood pressure from systolic to diastolic. The blood pressure gradient is the main driving force of blood flow and its magnitude changes during the cardiac cycle, so blood flow in the arterial vessels is pulsatile. It accelerates in systole and slows down in diastole. The value of blood pressure sgd for large central arteries is determined by the formula

According to this formula, the average hemodynamic pressure is equal to the sum of the diastolic and half the pulse pressure. For peripheral arteries, blood pressure sgd is calculated by adding a third of the pulse pressure value to the blood pressure diast indicator:

Using the blood pressure sgd indicator is convenient when analyzing factors affecting the level of blood pressure in the vessels and identifying the reasons for its deviation from the norm. To do this, we need to recall the formula of the basic equation of hemodynamics that we previously considered:

Transforming it, we get:

From this formula it follows that the main factors on which the value of blood pressure depends and the reasons for its change are the minute volume of blood ejected by the left ventricle into the aorta (i.e., the state of the pumping function of the heart), and the value of OPS to the blood flow.

A person of middle age and body weight needs an IOC of about 5 l/min for normal functioning of the body in a state of physiological and psychological rest. If OPS is equal to 20 mm Hg. Art./l/min, then to ensure an IOC of 5 l/min, it is necessary that the average hemodynamic pressure of 100 mm Hg be maintained in the aorta. Art. (5 * 20 = 100). If in such a person the OPS increases (this can occur due to the narrowing of resistive vessels as a result of increased tone of smooth muscle fibers, narrowing of arterial vessels as a result of their sclerosis), for example, up to 30 mm Hg. Art./l/min, then to ensure sufficient IOC (5 l/min) it will be necessary to increase blood pressure sgd to 150 mm Hg. Art. (5 * 30 = 150). To achieve higher blood pressure, sgd must be higher systolic and diastole and blood pressure.

To restore normal blood pressure levels in this case, the person will be advised to take drugs that reduce OPS (vasodilators, lower blood viscosity, and prevent vascular sclerosis).

To understand the mechanisms and correct diagnosis of circulatory disorders, it is important to know not only the magnitude of systolic, diastolic, pulse and average hemodynamic pressure, but also their relationship, as well as the factors influencing them. Thus, with a rapid increase in blood pressure, to lower it, the use of not only vasodilators is indicated, but also a complex effect on the causative factors on which the value of blood pressure depends (heart function, the volume and properties of circulating blood, the condition of blood vessels). Since IOC = SV * heart rate, it and blood pressure can be reduced by using drugs that block β1-adrenergic receptors and (or) calcium channels of cardiomyocytes. At the same time, both heart rate and stroke volume decrease. In addition, the use of calcium channel blockers is accompanied by relaxation of smooth myocytes of the vascular wall, vasodilation and a decrease in OPS, which contribute to a drop in blood pressure. To reduce blood volume, as another powerful factor influencing blood pressure, they resort to the use of diuretics. Taking a comprehensive approach to correcting blood pressure will usually produce the best results.

Blood pressure. Systolic and diastolic blood pressure

/ Hemodynamic parameters

Hemodynamic parameters. Correlation of the main parameters of systemic hemodynamics. The parameters of systemic hemodynamics - systemic arterial pressure, peripheral vascular resistance, cardiac output, cardiac function, venous return, central venous pressure, circulating blood volume - are in complex, finely regulated relationships, which allows the system to ensure the performance of its functions. Thus, a decrease in pressure in the sinocarotid zone causes an increase in systemic blood pressure, an increase in heart rate, an increase in total peripheral vascular resistance, cardiac function and venous return of blood to the heart. The minute and systolic volume of blood can change ambiguously. An increase in pressure in the sinocarotid zone causes a decrease in systemic blood pressure, a slowdown in heart rate, a decrease in general vascular resistance and venous return, and a decrease in cardiac function. Changes in cardiac output are pronounced, but ambiguous in direction. The transition from a horizontal to a vertical position of a person is accompanied by the consistent development of characteristic changes in systemic hemodynamics. These changes include both primary and secondary compensatory changes in the circulatory system, which are schematically presented in Table. 9.5. It is important to maintain a constant ratio between the volume of blood contained in the systemic circulation and the volume of blood located in the organs of the chest (lungs, heart cavity). The vessels of the lungs contain up to 15%, and the cavities of the heart (in the diastole phase) - up to 10% of the total blood mass; Based on the above, the central (intrathoracic) blood volume can account for up to 25% of the total amount of blood in the body.

The distensibility of the pulmonary vessels, especially the pulmonary veins, allows a significant volume of blood to accumulate in this area with an increase in venous return to the right half of the heart. Accumulation of blood in the pulmonary circle occurs in people during the transition of the body from a vertical to a horizontal position, while up to 600 ml of blood can move into the vessels of the chest cavity from the lower extremities, of which approximately half accumulates in the lungs. On the contrary, when the body moves to a vertical position, this volume of blood passes into the vessels of the lower extremities. The blood reserve in the lungs is used when urgent mobilization of additional blood is necessary to maintain the proper cardiac output. This is especially important at the beginning of intense muscular work, when, despite the activation of the muscle pump, the venous return to the heart has not yet reached a level that ensures cardiac output in accordance with the body’s oxygen demand.

One of the sources providing cardiac output reserve is also the residual blood volume in the ventricular cavity. In a horizontal position of a person, the residual volume of the left ventricle is on average 100 ml, and in a vertical position - 45 ml. Values ​​close to these are also characteristic of the right ventricle. The increase in stroke volume observed during muscular work or the action of catecholamines, not accompanied by an increase in heart size, occurs due to the mobilization, mainly, of part of the residual blood volume in the ventricular cavity. Thus, along with changes in venous return to the heart, the factors that determine the dynamics of cardiac output include: the volume of blood in the pulmonary reservoir, the reactivity of the pulmonary vessels and the residual blood volume in the ventricles of the heart.

Blood pressure is the pressure that blood exerts on the walls of blood vessels, or, in other words, the excess of fluid pressure in the circulatory system over atmospheric pressure, one of the important signs of life. Most often this concept refers to blood pressure. In addition to it, the following types of blood pressure are distinguished: intracardiac, capillary, venous. With each heartbeat, blood pressure fluctuates between the lowest (diastolic) and highest (systolic)

Blood pressure is one of the most important parameters characterizing the functioning of the circulatory system. Blood pressure is determined by the volume of blood pumped per unit time by the heart and the resistance of the vascular bed. Since blood moves under the influence of the pressure gradient in the vessels created by the heart, the highest blood pressure will be at the blood exit from the heart (in the left ventricle), slightly lower pressure will be in the arteries, even lower in the capillaries, and the lowest in the veins and at the entrance heart (in the right atrium). The pressure at the outlet of the heart, in the aorta and in the large arteries differs slightly (by 5-10 mm Hg), since due to the large diameter of these vessels their hydrodynamic resistance is small. In the same way, the pressure in the large veins and in the right atrium differs slightly. The greatest drop in blood pressure occurs in small vessels: arterioles, capillaries and venules.

The top number is systolic blood pressure, shows the pressure in the arteries at the moment when the heart contracts and pushes blood into the arteries, it depends on the force of contraction of the heart, the resistance exerted by the walls of the blood vessels, and the number of contractions per unit time.

The bottom number is diastolic blood pressure, shows the pressure in the arteries at the moment the heart muscle relaxes. This is the minimum pressure in the arteries and reflects the resistance of peripheral vessels. As blood moves through the vascular bed, the amplitude of blood pressure fluctuations decreases; venous and capillary pressure depend little on the phase of the cardiac cycle.

A typical healthy person's arterial blood pressure (systolic/diastolic) = 120 and 80 mmHg. Art., pressure in large veins by several mm. Hg Art. below zero (below atmospheric). The difference between systolic blood pressure and diastolic (pulse pressure) is normally 30-40 mmHg. Art.

Blood pressure is the easiest to measure. It can be measured using a sphygmomanometer (tonometer). This is what is usually meant by blood pressure.

Modern digital semi-automatic tonometers allow you to limit yourself to only a set of pressure (until a sound signal), further release of pressure, registration of systolic and diastolic pressure, and sometimes pulse arrhythmias, the device carries out itself.

Automatic blood pressure monitors themselves pump air into the cuff; sometimes they can produce data in digital form for transmission to a computer or other devices.

Factors that determine the value of blood pressure: the amount of blood, the elasticity of the vascular wall and the total size of the lumen of the vessels. As the amount of blood in the vascular system increases, the pressure increases. With a constant amount of blood, dilation of blood vessels (arterioles) leads to a decrease in pressure, and their narrowing leads to an increase.

There are no pulse fluctuations in blood pressure in small and medium veins. In large veins near the heart, pulse fluctuations are observed - the venous pulse, which is caused by difficulty in the outflow of blood to the heart during systole of the atria and ventricles. When these parts of the heart contract, the pressure inside the veins increases and their walls vibrate. It is most convenient to record the pulse of the jugular vein (v. jugularis).

On the pulse curve of the jugular vein - jugular venogram - of a healthy adult, each cardiac cycle is represented by three positive (a, c, v) and two negative (x, y) waves (Fig.), reflecting mainly the work of the right atrium.

The “a” wave (from the Latin atrium - atrium) coincides with the systole of the right atrium. It is caused by the fact that at the moment of atrium systole, the mouths of the vena cava flowing into it are clamped by a ring of muscle fibers, as a result of which the outflow of blood from the veins into the atria is temporarily suspended. Therefore, with each atrial systole, there is a short-term stagnation of blood in the large veins, which causes stretching of their walls.

The “c” wave (from the Latin carotis - carotid [artery]) is caused by the impulse of the pulsating carotid artery, which lies near the jugular vein. It occurs at the beginning of right ventricular systole when the tricuspid valve closes and coincides with the beginning of the rise of the carotid sphygmogram (systolic wave of the carotid pulse).

During atrial diastole, blood access into them again becomes free and at this time the venous pulse curve falls sharply, a negative “x” wave (systolic collapse wave) appears, which reflects the accelerated outflow of blood from the central veins into the relaxing atrium during ventricular systole. The deepest point of this wave coincides in time with the closure of the semilunar valves.

Sometimes, on the lower part of the “x” wave, a notch “z” is determined, corresponding to the moment of closure of the pulmonary artery valves and coinciding in time with the II sound of the FCG.

The “v” wave (from the Latin ventriculus - ventricle) is caused by an increase in pressure in the veins and difficulty in the outflow of blood from them into the atria at the moment of maximum filling of the atria. The top of the "v" wave coincides with the opening of the tricuspid valve.

The subsequent rapid flow of blood from the right atrium into the ventricle during cardiac diastole is manifested in the form of a negative wave of the venogram, which is called the wave of diastolic collapse and is indicated by the symbol “y” - rapid emptying of the atria. The deepest negative point of the “y” wave coincides with the III tone of the PCG.

The most striking element on the jugular venogram is the wave of systolic collapse “x”, which gave reason to call the venous pulse negative.

Pathological changes in the venous pulse

with bradycardia, the amplitude of waves “a” and “v” increases, another positive wave “d” can be recorded

with tachycardia, the “y” wave decreases and flattens

in case of tricuspid valve insufficiency, a positive venous pulse or a ventricular form of the venous pulse is recorded, when an additional positive wave i is recorded between waves “a” and “c”, which is caused by regurgitation of blood through an open valve. The severity of wave i correlates with the degree of deficiency.

with mitral stenosis, there is an increase in the amplitude of the “a” wave and a decrease in the amplitude of the “v” wave

with adhesive pericarditis, a double negative wave of the venous pulse is observed - increased amplitude of the “a” and “v” waves and deepening of the “x” and “y” waves

with atrial fibrillation and flutter - a significant decrease in the amplitude of the “a” wave and an increase in its duration

in the atrioventricular form of paroxysmal tachycardia, waves “a” and “c” merge, forming one large wave

with an atrial septal defect – an increase in the amplitude of the “a” wave, and when blood is shunted from left to right, its bifurcation

circulatory failure - changes in waves “a”, “v”, “y”

aortic stenosis - decreased amplitude of the "c" wave

insufficiency of the aortic valves, patent ductus arteriosus - increased amplitude of the “c” wave, etc.

Rhythmic oscillations of the arterial wall, caused by a systolic increase in pressure in the arteries, are called the arterial pulse. The pulsation of the arteries can be easily detected by touching any artery that can be felt: the radial, femoral, digital artery of the foot.

A pulse wave, in other words a wave of increased pressure, occurs in the aorta at the moment of expulsion of blood from the ventricles, when the pressure in the aorta rises sharply and its wall is stretched as a result. The wave of increased pressure and the resulting vibration of the arterial wall propagates at a certain speed from the aorta to the arterioles and capillaries, where the pulse wave dies out.

The speed of propagation of the pulse wave does not depend on the speed of blood flow. The maximum linear speed of blood flow through the arteries does not exceed 0.3-0.5 m/sec, and the speed of propagation of the pulse wave in young and middle-aged people with normal blood pressure and normal vascular elasticity is 5.5-8.0 m in the aorta /sec, and in peripheral arteries - 6-9.5 m/sec. With age, as the elasticity of blood vessels decreases, the speed of propagation of the pulse wave, especially in the aorta, increases.

A detailed analysis of arterial pulse fluctuations is performed on the basis of a sphygmogram.

In the pulse curve (sphygmogram) of the aorta and large arteries, two main parts are distinguished:

anacrotic, or rising curve

catacrota, or descent of the curve

Anacrotic rise reflects the flow of blood into the arteries ejected from the heart at the beginning of the ejection phase, which leads to an increase in blood pressure and the resulting stretch to which the arterial walls are subjected. The top of this wave at the end of ventricular systole, when the pressure in it begins to fall, turns into a descent of the curve - catacrota. The latter corresponds in time to the phase of slow expulsion, when the outflow of blood from the stretched elastic arteries begins to prevail over the inflow.

The end of ventricular systole and the beginning of its relaxation leads to the fact that the pressure in its cavity becomes lower than in the aorta; blood thrown into the arterial system rushes back to the ventricle; the pressure in the arteries drops sharply, and a deep notch appears on the pulse curve of large arteries - an incisura. The lowest point of incision corresponds to the complete closure of the semilunar valves of the aorta, which prevent blood from flowing back into the ventricle.

The wave of blood is reflected from the valves and creates a secondary wave of increased pressure, again causing stretching of the arterial walls. As a result, a secondary, or dicrotic, rise appears on the sphygmogram - stretching of the aortic walls due to the reflection of the blood wave from the closed semilunar valves. The subsequent smooth descent of the curve corresponds to a uniform outflow of blood from the central vessels to the distal ones during diastole.

The shapes of the pulse curve of the aorta and the large vessels extending directly from it, the so-called central pulse, and the pulse curve of the peripheral arteries are somewhat different (Fig.).

Arterial pulse examination

By simply palpating the pulse of superficial arteries (for example, the radial artery in the hand), important preliminary information about the functional state of the cardiovascular system can be obtained. In this case, a number of pulse properties (pulse quality) are assessed:

Pulse rate per minute - characterizes the frequency of heart contractions (normal or rapid pulse). When assessing heart rate, remember that children have a higher resting heart rate than adults. Athletes have a slower heart rate. An acceleration of the pulse is observed during emotional excitement and physical work; at maximum load in young people, the heart rate can increase to 200/min or more.

Rhythm (rhythmic or arrhythmic pulse). Your heart rate may fluctuate according to your breathing rhythm. When you inhale, it increases, and when you exhale, it decreases. This “respiratory arrhythmia” is observed normally, and it becomes more pronounced with deep breathing. Respiratory arrhythmia is more common in young people and in people with a labile autonomic nervous system. Accurate diagnosis of other types of arrhythmias (extrasystoles, atrial fibrillation, etc.) can only be made using an ECG.

Height - pulse amplitude - the amount of oscillation of the arterial wall during a pulse impulse (high or low pulse). The amplitude of the pulse depends primarily on the magnitude of the stroke volume and the volumetric velocity of blood flow in diastole. It is also influenced by the elasticity of shock-absorbing vessels: with the same stroke volume, the greater the elasticity of these vessels, the smaller the pulse amplitude, and vice versa.

Pulse speed is the speed at which the pressure in the artery increases at the moment of anacrotic and decreases again at the moment of catacrotic (fast or slow pulse). The steepness of the rise in the pulse wave depends on the rate of pressure change. At the same heart rate, rapid changes in pressure are accompanied by a high pulse, and less rapid changes are accompanied by a low pulse.

A fast pulse occurs with aortic valve insufficiency, when an increased amount of blood is ejected from the ventricles, part of which quickly returns through the valve defect into the ventricle. A slow pulse occurs when the aortic ostium narrows, when blood is expelled into the aorta more slowly than normal.

Pulse tension or hardness (hard or soft pulse). Pulse voltage depends mainly on mean arterial pressure, since this characteristic of the pulse is determined by the amount of force that must be applied so that the pulse in the distal (located below the point of constriction) section of the vessel disappears, and this force changes with fluctuations in mean arterial pressure. Pulse voltage can be used to approximate systolic pressure.

The pulse waveform can be examined using relatively simple techniques. The most common clinical method involves placing sensors on the skin that record either changes in pressure (sphygmography) or changes in volume (plethysmography).

Pathological changes in arterial pulse

By determining the shape of the pulse wave, it is possible to draw important diagnostic conclusions about the hemodynamic shifts occurring in the arteries as a result of changes in stroke volume, vascular elasticity and peripheral resistance.

In Fig. The pulse curves of the subclavian and radial arteries are shown. Normally, the pulse wave recording shows a rise during almost the entire systole. With increased peripheral resistance, such a rise is also observed; when the resistance decreases, a primary peak is recorded, followed by a lower systolic rise; then the amplitude of the wave quickly decreases and passes into a relatively flat diastolic section.

A decrease in stroke volume (for example, as a result of blood loss) is accompanied by a decrease and rounding of the systolic peak and a slower rate of decrease in wave amplitude in diastole.

A decrease in aortic distensibility (for example, in atherosclerosis) is characterized by a steep and high leading edge, a high location of the incisura and a gentle diastolic decline.

With aortic defects, changes in the pulse wave correspond to hemodynamic shifts: with aortic stenosis, a slow, gentle systolic rise is observed, and with aortic valve insufficiency, a steep and high rise is observed; in severe cases of insufficiency - disappearance of incisura.

The time shift of pulse curves recorded simultaneously at different points (the slope of the dashed lines in the figure) reflects the speed of propagation of the pulse wave. The smaller this shift (i.e., the greater the slope of the dashed lines), the higher the speed of propagation of the pulse wave, and vice versa.

Practically important data for judging cardiac activity in some of its disorders can be obtained by simultaneously recording an electrocardiogram and a sphygmogram on the same photographic film.

Sometimes a so-called pulse deficit is observed, when not every wave of ventricular excitation is accompanied by the release of blood into the vascular system and a pulse impulse. Due to the small systolic ejection, some ventricular systoles turn out to be so weak that they do not cause a pulse wave reaching the peripheral arteries. In this case, the pulse becomes irregular (pulse arrhythmia).

Sphygmography is a technique for graphically recording arterial pulses. There are two types of methods for recording pulse curves, which V. L. Kariman (1963) proposed to call direct and volumetric sphygmography. A straight, or ordinary, sphygmogram characterizes the degree of deformation of the vascular wall in a given limited area of ​​the arterial vessel, which occurs under the influence of variable blood pressure during the cardiac cycle (Savitsky N. N., 1956). The sphygmogram is usually recorded using peloton sensors or receivers, as well as funnels with air transmission, applied to places where vascular pulsation is usually clearly palpable.

For occlusive and stenotic lesions of the arteries of the extremities, it is advisable to use volumetric sphygmography, which records the total fluctuations of the vascular wall, converted into fluctuations in the volume of the studied area of ​​the limb, and creates a general idea of ​​the collateral and main blood supply of the limb at the level under study. Volumetric sphygmography allows you to register blood flow and pulsation at any level of the limb, while direct sphygmography allows you to record pulse fluctuations only at certain points of the arm and leg. Volumetric sphygmography is a highly informative method that allows you to obtain data on the nature of damage to the arterial system of the extremities along its entire length and choose a method of treating the patient (conservative, surgical), as well as evaluate the effectiveness of the treatment.

Phlebography (from the Greek phléps, genitive phlebós - vein and graphy), 1) a method of x-ray examination of veins by introducing radiopaque agents into them (see also Angiography); used in varicose veins and other diseases. 2) A method for studying the blood circulation of humans and animals by graphically recording pulse oscillations of the walls of the veins (venous pulse) - phlebosphygmography. Recording of curves (phlebograms) on paper, usually using a mirror phlebosphygmograph, is carried out mainly from the external jugular vein. There are several waves, reflecting primarily the cessation of blood flow from the vena cava into the right atrium during its contraction, the transfer of pulsation of the carotid artery to the adjacent jugular vein during ventricular systole and the filling of the right ventricle and large veins with blood during ventricular diastole. F. allows you to determine the duration of cardiac phases and the tone of the right atrium; used in the diagnosis of heart defects, increased pressure in the pulmonary circulation, etc.

Rheography (from the Greek rhéos - flow, flow and graphy), a method of studying the blood supply of any part of the body by graphically recording fluctuations in its electrical resistance. Used in physiology and medicine. The method is based on the fact that when an alternating current of sound or supersonic frequency (16-300 kHz) is passed through an area of ​​the body, the role of a current conductor is performed by the liquid media of the body, primarily blood in large vessels; this makes it possible to judge the state of blood circulation in a certain area of ​​the body or organ (for example, limbs, brain, heart, liver, lungs). Blood supply is affected by vascular tone and the total amount of blood, so R. gives an indirect idea of ​​the peripheral resistance to blood flow in the vessels and the volume of circulating blood. The rheogram is recorded using a rheograph, consisting of a power supply, a high-frequency current generator, an amplifier, a recording device and electrodes. In medicine, R. is used as one of the diagnostic methods for diseases of the heart and blood vessels, other internal organs, as well as for blood loss and shock.

Plethysmography is the recording of changes in the volume of an organ or part of the body, usually used to assess the dynamics of their blood supply. Used to study vascular tone and its regulation.

Blood pressure (BP) is the pressure of blood in the large arteries of a person. There are two indicators of blood pressure: systolic (upper) blood pressure is the level of blood pressure at the moment of maximum contraction of the heart, diastolic (lower) blood pressure is the level of blood pressure at the moment of maximum relaxation of the heart. Blood pressure is measured in millimeters of mercury and is designated “mmHg.” Art." It is with the measurement of blood pressure (tonometry) that it is necessary to begin the search for the cause of such common symptoms as headache, weakness, and dizziness. In many cases, constant monitoring of blood pressure is necessary, and measurements should be taken several times a day.

Blood pressure (BP) assessment

To assess blood pressure levels, the World Health Organization (WHO) classification is used.

Classification of arterial hypertension by blood pressure level

Systolic blood pressure (mm Hg)

Diastolic blood pressure (mm Hg)

Increased normal blood pressure

1st degree (“soft”)

2nd degree (moderate)

3rd degree (severe)

* If systolic BP and diastolic BP are in different categories, the higher category is assigned.

** The risk of cardiovascular complications and mortality is the lowest.

The terms “mild”, “borderline”, “severe”, “moderate” given in the classification characterize only the level of blood pressure, and not the severity of the disease itself.

How is blood pressure (BP) measured?

Two methods are used to measure blood pressure.

Korotkoff method developed by the Russian surgeon N. S. Korotkov in 1905 and involves the use of a simple device consisting of a mechanical pressure gauge, a cuff with a bulb and a phonendoscope. The method is based on complete compression of the brachial artery with a cuff and listening to the sounds that occur when air is slowly released from the cuff.

Oscillometric method is based on the registration by a special electronic device of air pressure pulsations that occur in the cuff as blood passes through a compressed section of the artery.

The blood pressure level is not a constant value; it fluctuates continuously depending on the state of the body and the effect of various factors on it. Fluctuations in blood pressure in patients with arterial hypertension are significantly higher than in people without this disease. Blood pressure can be measured at rest, during physical or psychoemotional stress, and also at intervals between various types of activity. Most often, blood pressure is measured in a sitting position, but in some cases it is necessary to measure it in a lying or standing position.

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The value of blood pressure is mainly determined by two conditions: the energy that is supplied to the blood by the heart, and the resistance of the arterial vascular system, which the flow of blood flowing from the aorta has to overcome. Thus, the value of blood pressure will be different in different parts of the vascular system. The highest pressure will be in the aorta and large arteries; in small arteries, capillaries and veins it gradually decreases; in the vena cava the blood pressure is less than atmospheric pressure. Blood pressure will also be unequal throughout the cardiac cycle - it will be higher at the time of systole and lower at the time of diastole. Fluctuations in blood pressure during systole and diastole of the heart occur only in the aorta and arteries. In arterioles and veins, blood pressure is constant throughout the cardiac cycle. The highest pressure in the arteries is called systolic, or maximum, and the lowest is called diastolic, or minimum. The pressure in different arteries is not the same. It can be different even in arteries with equal diameters (for example, in the right and left brachial arteries). In most people, the value of blood pressure is not the same in the vessels of the upper and lower extremities (usually the pressure in the femoral artery and arteries of the leg is greater than in the brachial artery), which is due to differences in the functional state of the vascular walls. At rest in healthy adults, systolic pressure in the brachial artery, where it is usually measured, is 100-140 mmHg. Art. (1.3-1.8 atm) In young people it should not exceed 120-125 mm Hg. Art. Diastolic pressure is 60-80 mmHg. Art. , and usually it is 10 mm higher than half the systolic pressure. A condition in which blood pressure is low (systolic below 100 mm) is called hypotension. A persistent increase in systolic (above 140 mm) and diastolic pressure is called hypertension. The difference between systolic and diastolic pressure is called pulse pressure, usually 50 mmHg. Art. Blood pressure in children is lower than in adults; in older people, due to changes in the elasticity of the walls of blood vessels, it is higher than in young people. Blood pressure in the same person is not constant. It changes even during the day, for example, it increases when eating, during periods of emotional manifestations, and during physical work. Blood pressure in humans is usually measured indirectly, which was proposed by Riva-Rocci at the end of the 19th century. It is based on determining the amount of pressure required to completely compress the artery and stop blood flow in it. To do this, a cuff is placed on the subject’s limb, connected to a rubber bulb used to pump air, and a pressure gauge. When air is pumped into the cuff, the artery is compressed. At the moment when the pressure in the cuff becomes higher than systolic, the pulsation at the peripheral end of the artery stops. The appearance of the first pulse impulse when the pressure in the cuff decreases corresponds to the value of the systolic pressure in the artery. With a further decrease in pressure in the cuff, the sounds first intensify and then disappear. The disappearance of sounds characterizes the value of diastolic pressure. The time during which the pressure is measured should not exceed 1 minute. , since blood circulation below the cuff site may be impaired.

Only half of people with high blood pressure receive treatment for hypertension.

The state cardiology program includes identifying hypertension in the early stages. That's why clinics can measure blood pressure in the pre-doctor's office. Prevention days are held in pharmacies, and advertising has appeared in television programs.

How is blood pressure formed?

Blood flows as a liquid and fills the vascular bed. According to the laws of physics, the pressure inside the vessels must be constantly higher than atmospheric pressure. This is an indispensable condition of life.

Most often we think about blood pressure, but we should not forget that there are also indicators of intracardiac, venous and capillary levels.

A heartbeat is caused by the contraction of the ventricles and the release of blood into the arteries. Due to their elasticity, they spread the wave from larger vessels to the smallest capillaries.

Measuring blood pressure on the ulnar artery shows 2 numbers:

• the upper one determines the systolic or “cardiac” pressure (indeed, it depends on the strength of the heart muscle);
• lower - diastolic (it shows the ability of the vascular bed to maintain tone during a short period of the cardiac relaxation phase).

The highest pressure is created in the cavity of the left ventricle. When leaving it in the aorta and large vessels, it is slightly lower (by 5–10 mm Hg), but exceeds the figures at the level of the ulnar artery.

The diagram shows two circles of blood circulation, showing areas of maximum pressure (highest pressure) and lowest (lowest pressure)

What does upper and lower pressure depend on?

Not only a strong heart muscle is able to maintain systolic pressure. This is facilitated by:

• the number of contractions or rhythm per minute (with tachycardia, increased cardiac pressure is observed);
• the resistance force of the walls of blood vessels, their elasticity.

Diastolic pressure is maintained only by the tone of small arteries in the periphery.

As you move away from the heart, the difference between the upper and lower pressure decreases, and the venous and capillary pressures no longer depend on the strength of the myocardium.

The difference between systolic and diastolic levels is called pulse pressure. Under normal conditions it is equal to 30–40 mmHg. Art.

What standards has WHO established for the definition of hypertension? Should high blood pressure be considered a symptom or hypertension? What causes the disease? You can find out this and much more on our website from the article “Hypertension: what kind of disease is this?”

The dependence of systolic and diastolic blood pressure levels on physiological conditions is shown in the table.

What is the danger of high blood pressure?

This significantly increases the risks of diseases such as cerebrovascular accident (stroke), acute myocardial infarction, and contributes to the early formation of heart failure and irreversible kidney pathology.

In cases where hypertension is detected even in the presence of these diseases, it is appropriate to support scientists who figuratively call hypertension a “silent killer.”

A particularly severe form of the disease is malignant hypertension. It is detected in one in 200 hypertensive patients, more often in men. The course is extremely severe. Hypertension cannot be treated with medications. Medicines even worsen the patient's condition. The patient dies from complications after 3–6 months.

Can only systolic blood pressure increase?

Most often, with hypertension, an increase in both the upper and lower levels above 140/90 mm Hg is detected. Art. But there are cases when only systolic high pressure is determined with normal diastolic numbers.

The causes of increased cardiac pressure are associated with the adaptation of the myocardium with age to work in conditions of arteries affected by atherosclerosis.

It has been established that systolic pressure normally increases up to 80 years of age, and diastolic pressure only up to 60 years, then it stabilizes and can even decrease on its own.

With a lack of collagen, blood vessels lose elasticity, which means they are not able to bring a wave of blood to the periphery, and the oxygen supply is disrupted. The situation worsens even more when the lumen of the arteries is narrowed by atherosclerotic plaques or atherosclerosis of the aorta.

In older people, the heart must contract with greater force to “push” blood through the altered vessels

How does high blood pressure manifest?

The symptoms of hypertension often cannot be distinguished from other conditions unless your blood pressure is measured. Most often a person feels:

• headaches in the back of the head and crown;
• dizziness;
• tendency to nosebleeds;
• rush of blood and heat in the upper parts of the body.

With a sharp rise in pressure (hypertensive crisis), symptoms appear suddenly:

• severe headache;
• nausea and vomiting;
• impaired vision, “darkening” in the eyes;
• trembling in the body;
• shortness of breath, lack of air at rest;
• increased heart rate, arrhythmias.

What examination needs to be done?

To prescribe treatment, the doctor needs to know how affected the target organs are (heart, kidneys, brain), since medications have side effects, and undesirable effects on the heart rate and renal blood flow cannot be allowed.

Hypertension should be confirmed by a recorded elevated blood pressure within 2–3 days if the person is at rest.

The picture of the fundus “tells” about the tone of the blood vessels, so all hypertensive patients are referred to an ophthalmologist. An ophthalmologist not only helps diagnose hypertension, but also establishes its stage of progression.

An electrocardiogram (ECG) reveals a malnutrition of the heart muscle, arrhythmias, and hypertrophy (overload) of the myocardium.

Ultrasound of the heart allows you to examine and measure blood flow through the cardiac chambers, the volume and force of systolic ejection, and the size of the heart.

The increase in the size of the left ventricle is seen by the radiologist when interpreting the fluorogram. If there are pronounced changes, he calls the patient through a therapist for further examination and checks the size of the heart and large vessels in more detail using radiography.

Damage to the kidney tissue is indicated by the presence of protein and red blood cells in the urine test (normally they should not be present). This indicates impaired filtration through the renal tubules.

The examination should help determine the cause of hypertension. This is necessary for therapy.

What you will have to give up, how to change your diet and diet

This also relates to one of the problems of early mortality.

If you have high blood pressure, you must stop working night shifts and beware of excessive nervous and physical stress. In your daily routine, you need to devote time to rest, walks, and ensure good sleep with herbal tea with honey, lemon balm or mint.

Smoking should be stopped; alcohol is allowed in a dose of no more than 150 ml of dry red wine once a month. Steam rooms and saunas are contraindicated. Physical exercise is limited to morning exercises, walking, swimming.

The diet is aimed at preventing heart pathology and atherosclerosis. It is necessary to avoid salty and spicy foods; hot sauces, fried and smoked fatty meats, sweets, soda, and coffee are not recommended. It is better to switch to fish, vegetables and fruits, vegetable oils, cereals, dairy products, green tea.

If you are overweight, you should arrange low-calorie fasting days.

You can independently control your blood pressure both at home and in the country.

How to treat high blood pressure?

When prescribing therapy for hypertension, the doctor must use drugs that protect the vessels of the heart and brain and improve their nutrition. The patient’s age, existing other diseases, and risk factors are taken into account.

Drugs from the group of adrenergic blockers remove the unnecessary effect of sympathetic impulses on the vessels. Currently, there are long-acting medications that allow you to take one tablet only in the morning.

Diuretics or diuretics are prescribed depending on the condition of the kidneys. For this purpose, potassium-sparing drugs or stronger ones are chosen, which are not taken constantly, but according to a schedule.

A group of ACE inhibitors and calcium antagonists allow you to dilate blood vessels by acting on muscle cells and nerve endings.

In the absence of symptoms of decompensation, hypertension should be treated in sanatoriums. Physiotherapeutic procedures, baths, acupuncture, and massage are used here.

You can get rid of hypertension only if it is secondary and the underlying disease responds well to treatment. Hypertension has not yet been cured; constant monitoring is necessary. But it is possible to avoid dangerous complications with the help of treatment and a positive attitude of the patient.

What is the highest blood pressure a person can have?

Blood pressure is the pressure that blood exerts on the walls of blood vessels. This parameter, reflecting the condition of the vascular walls, the functioning of the heart and kidneys, is one of the most important for human health. Maintaining it at a constant level is one of the main tasks of the body, since adequate blood supply to the organs, commensurate with the load, occurs only under conditions of optimal blood pressure.

Normal pressure is defined as the range within which adequate blood supply to organs and tissues is ensured. Each organism has its own range, but in most cases it ranges from 100 to 139 mmHg. Conditions in which the systolic pressure level falls below 90 mmHg are called arterial hypotension. And those conditions in which this level rises above 140 mm Hg are called arterial hypertension.

This is an increase in blood pressure, which is an important symptom of pathological conditions accompanied by either an increase in vascular resistance, or an increase in cardiac output, or a combination of both. WHO (World Health Organization) recommends calling arterial hypertension a level of systolic pressure above 140 mm Hg, and a diastolic pressure above 90 mm Hg. provided that the person was not taking antihypertensive medications at the time of measurement.

Table 1. Physiological and pathological blood pressure values.

Initially, arterial hypertension (AH) is divided into two large groups: primary and secondary. Primary hypertension is called hypertension, the causes of which still remain unclear. Secondary hypertension occurs due to a specific cause - pathology in one of the blood pressure regulation systems.

Table 2. Causes of secondary hypertension.

Despite the fact that the causes of hypertension are not fully understood, there are risk factors that contribute to its development:

1. 1. Heredity. This means a genetic predisposition to the occurrence of this disease.
2. 2. Features of the neonatal period. This refers to persons who were premature at birth. The lower the child's body weight, the higher the risk.
3. 3. Body weight. Excess weight is a key risk factor for developing hypertension. There is evidence that every extra 10 kg increases systolic blood pressure by 5 mmHg.
4. 4. Nutritional factors. Excessive daily consumption of table salt increases the risk of developing arterial hypertension. Consuming more than 5 grams of salt per day is considered excessive.
5. 5. Bad habits. Both smoking and excessive alcohol consumption have a detrimental effect on the condition of the vascular walls, which leads to an increase in their resistance and a rise in pressure.
6. 6. Low physical activity. In people who lead an insufficiently active lifestyle, the risk increases by 50%.
7. 7. Environmental factors. Excessive noise, environmental pollution, and chronic stress always lead to an increase in blood pressure.

In adolescence, due to hormonal changes, fluctuations in blood pressure are possible. Thus, by the age of 15, a maximum surge in hormone levels occurs, so symptoms of hypertension may appear. At the age of 20, this peak usually ends, so if blood pressure remains high, it is necessary to exclude secondary arterial hypertension.

The highest blood pressure figures are observed during a hypertensive crisis. This is an acute, pronounced increase in pressure with characteristic clinical symptoms, requiring immediate, controlled reduction in order to prevent multiple organ failure. Most often, a crisis appears when the numbers rise above 180/120 mmHg. Indicators from 240 to 260 systolic and from 130 to 160 mmHg diastolic pressure are critical.

When the upper level reaches 300 mm Hg. a chain of irreversible events occurs that leads the body to death.

An optimal level of pressure maintains sufficient blood supply to organs and tissues. During a hypertensive crisis, the indicators can be so high and the level of blood supply so low that hypoxia and failure of all organs begin to develop. The most sensitive to this is the brain with its unique circulatory system, which has no analogues in any other organ.

It is noteworthy that the blood reservoir here is the vascular ring, and it is this type of blood supply that is evolutionarily the most developed. It also has its weaknesses - such a ring can function only in a strictly defined range of systolic pressure - from 80 to 180 mm Hg. If the pressure rises above these figures, the automatic regulation of the tone of the vascular ring is disrupted, gas exchange is severely disrupted, vascular permeability rapidly increases, and acute brain hypoxia occurs, followed by ischemia. If the pressure remains at the same level, the most dangerous event develops - ischemic stroke. Therefore, relative to the brain, the highest pressure in a person should not exceed 180 mm Hg.

Hypertension implies the presence of certain symptoms, but at the very beginning the disease can be asymptomatic, hidden:

1. 1. Symptoms caused directly by high blood pressure. These include: headaches of various localizations, most often in the back of the head, appearing, as a rule, in the morning; dizziness of varying intensity and duration; feeling of heartbeat; excessive fatigue; noise in the head.
2. 2. Symptoms caused by vascular damage in arterial hypertension. This may include nosebleeds, blood in the urine, visual disturbances, shortness of breath, chest pain, etc.
3. 3. Symptoms of secondary arterial hypertension. Frequent urination, thirst, muscle weakness (with kidney disease); weight gain, emotional instability (for example, with Itsenko-Cushing syndrome), etc.

It is important to understand that with arterial hypertension, not only blood vessels are affected, but also almost all internal organs. With prolonged persistent progression, the retina, kidneys, brain and heart are affected.

When the above symptoms appear, as well as when the readings increase above 140/90 mm Hg. you need to consult a general practitioner. During the consultation, the doctor will definitely assess risk factors that can be eliminated, rule out the possibility of secondary arterial hypertension and select the right drug for treatment. The goal of therapy is to reduce the long-term risk of developing vascular accidents (heart attacks, strokes) as much as possible. It must be remembered that the target level in this case is figures less than 140/90 mmHg.

The therapist will prescribe an additional examination, which includes a study of blood counts, electrocardiography, consultation with an ophthalmologist to examine the fundus, submitting urine for a general analysis and a special study (detection of microalbuminuria as an indicator of target organ damage in hypertension), ultrasound of the vessels of the neck, etc. Then Taking into account the data obtained, the doctor will select the correct treatment regimen.

If, at the first appointment, figures above 180 mm Hg are detected, treatment is prescribed immediately.

The first key link in the treatment of arterial hypertension is lifestyle changes, which include:

• quitting smoking;
• reduction and stabilization of body weight;
• reducing alcohol consumption;
• reducing table salt consumption;
• physical activity - regular dynamic exercise for at least 30 minutes a day;
• increasing the consumption of fruits and vegetables, reducing the consumption of fatty foods.

The second link is the prescription of drug therapy. Among the many antihypertensive drugs, the doctor will choose the optimal one based on blood pressure numbers, examination data and the presence of concomitant pathologies.

If you suspect a hypertensive crisis, you must immediately call an ambulance team. In an uncomplicated version of the crisis, it is very important to reduce the pressure carefully and slowly. Even the highest blood pressure in a person must be reduced by no more than 25% in 2 hours. If you reduce it quickly, there is a high risk of developing circulatory disorders in organs and tissues, called hypoperfusion. You can take Captopril (Capoten) or Nifedipine sublingually on your own. The widely known clonidine is currently used less and less, however, it is also effective in this type of crisis.

A complicated hypertensive crisis always occurs with life-threatening complications, which include cerebral stroke, acute coronary syndrome, developing pulmonary edema and other conditions. In pregnant women, a crisis can be complicated by preeclampsia or eclampsia with a characteristic picture. A complicated version of the crisis requires immediate controlled reduction with drugs administered parenterally, therefore, when it develops, it is necessary to wait for the ambulance to arrive, and then decide on hospitalization.

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The aorta has the highest pressure

Blood pressure is created by contraction of the ventricles of the heart; under the influence of this pressure, blood flows through the vessels. Pressure energy is spent on friction of blood against itself and the walls of blood vessels, so that along the bloodstream the pressure constantly decreases:

• in the aortic arch the systolic pressure is 140 mmHg. Art. (this is the highest pressure in the circulatory system),
• in the brachial artery – 120,
• in capillaries 30,
• in the vena cava -10 (below atmospheric).

The speed of blood depends on the total lumen of the vessel: the larger the total lumen, the lower the speed.

• The narrowest point of the circulatory system is the aorta, its lumen is 8 square meters. cm, so here the highest blood speed is 0.5 m/s.
• The total lumen of all capillaries is 1000 times larger, so the blood speed in them is 1000 times less - 0.5 mm/s.
• The total lumen of the vena cava is 15 square meters. cm, speed – 0.25 m/s.

Tests

849-01. Where does blood move at the slowest speed?

A) in the brachial artery

B) in the inferior vena cava

D) in the superior vena cava

849-02. In which vessels of the systemic circulation of the human body is the highest blood pressure recorded?

D) large veins

849-03. Blood pressure on the walls of large arteries occurs as a result of contraction

B) left ventricle

B) leaf valves

D) semilunar valves

849-04. In which human blood vessel is the maximum pressure achieved?

A) pulmonary artery

B) pulmonary vein

D) inferior vena cava

849-05. Of the listed blood vessels, the lowest speed of blood movement is observed in

A) skin capillary

B) inferior vena cava

B) femoral artery

D) pulmonary vein

849-06. At what stage of the cardiac cycle does maximum blood pressure occur?

A) relaxation of the ventricles

B) ventricular contraction

B) atrial relaxation

D) atrial contraction

849-07. The lowest blood pressure is observed in

Relationship between high blood pressure and vascular condition

Problems with blood pressure are observed in the majority of residents of the country and their number is only growing every year.

If low blood pressure only brings discomfort and unpleasant symptoms, then high blood pressure can lead to adverse consequences and possibly death.

The main causes of high blood pressure are the condition of the blood vessels. So do blood vessels dilate or contract when blood pressure is high?

To reduce blood pressure while preserving blood vessels, it is better to add it to tea in the morning before breakfast.

What does blood pressure depend on?

There are a number of reasons that can destabilize blood pressure. One of them is incorrect lifestyle.

It is the consequences of an incorrect lifestyle that gradually worsen the condition of the blood vessels and the entire cardiovascular system as a whole:

1. constant stressful situations. They are the ones who deplete the nervous system and, as a result, the vascular system;
2. genetic predisposition. This does not mean that if one of the family members has hypertension, it will necessarily manifest itself. This is only possible when the disease is provoked. In modern life, this is not difficult at all;
3. poor quality food. Excessively fatty or salty foods can cause hypertension. This also applies to drinking alcohol, including wine and beer, smoking, taking drugs;
4. sedentary lifestyle, emotional or physical stress.

All these factors provoke wear and tear of blood vessels, their elasticity decreases. The result is high blood pressure.

From a physiological point of view, an increase in blood pressure occurs for the following reasons:

• increasing the number of platelets in the blood (increasing its viscosity);
• increased blood volume (for example, during pregnancy);
• disruptions in the functioning of the heart (the strength of contractions and the pace changes, which leads to an increase in blood pressure);
• pathological changes that led to a narrowing of the lumen.

Blood vessels and high blood pressure

There is ignorance among people that with high blood pressure, blood vessels are dilated or narrowed. In various sources you can find information that drinking, for example, alcohol, increases the pressure in a person’s blood vessels. Is this true?

Stages of vasoconstriction

An increase in blood pressure can occur due to a significant decrease in the lumen of small and large blood vessels. Blood pressure can also increase due to prolonged narrowing of the arterial muscles, which provokes the development of hypertension.

Veins are much more likely to undergo narrowing than arterial ones. This can be noticed in people belonging to risk groups: patients with diabetes mellitus, thrombophlebitis, and those with heart problems.

It is extremely dangerous for hypertensive patients to provoke situations where a rapid increase in blood pressure is possible, and later its sharp decrease.

This is explained by the fact that insufficiently elastic vessels may not withstand the pressure of the blood flow. This may manifest itself in a rupture of its wall or subsequent stroke.

The situation gets worse if cholesterol is deposited on the inner walls. It is a fat that, when deposited, is converted into cholesterol plaque.

The plaque also contains blood cells and scar tissue. The more such plaques there are inside the vessels, the smaller their lumen. A dangerous condition is when cholesterol completely clogs their lumen. This entails many adverse consequences, one of which is death.

Blood pressure control

Constant monitoring of blood pressure helps to identify this disease at the earliest stages of development. This is necessary in cases where deviations were previously noticed during pressure measurements.

If there are problems with indicators in intravascular pressure (increased or decreased), systemic blood pressure is additionally determined.

This is the force that acts on the large arteries when the heart contracts. Determining this indicator is also used to monitor the effect of medications and anesthesia on blood pressure. It is also measured if there has been trauma or sepsis.

Diagnostic measures

The most reliable information about the condition of blood vessels from the inside will be provided by an invasive diagnostic method - angiography.

It consists of an X-ray examination with contrast. This method gives a picture of blood flow inside an organ or in certain sections (for example, cervical, abdominal, etc.).

The non-invasive method is also popular. It is based on an MRI examination. More suitable for examining the brain, internal organs, and limbs. Gives a complete picture of the state of blood flow throughout the body.

Doppler ultrasound (ultrasound with Doppler) is used less frequently. Suitable for primary examinations of the cervical spine, as well as organs that are abundantly supplied with blood.

Consequences of narrowing or blockage of blood vessels

A narrow clearance has dangerous consequences. Cholesterol plaques can clog it completely.

With an increased level of platelets in the blood, there is a risk of blood clots.

Blockage of the lumen can occur with it. An additional danger to life may be the detachment of a blood clot from the vessel wall.

Moving through narrow vessels (and even with cholesterol deposits), it can block the lumen anywhere. For example, if a blood clot enters the brain, an embolism develops, which is a harbinger of an ischemic stroke.

Serious complications to the entire cardiovascular system can result from deterioration of the aorta. Which vessel has the highest blood pressure? It is in the aorta. It is 140/90 mmHg. Art. Deterioration can manifest itself both in the form of the appearance of cholesterol plaques and thickening of its wall on the inside and outside (aneurysm). This phenomenon requires constant monitoring and, if necessary, surgical intervention.

Narrow blood vessels not only provoke an increase in blood pressure, but can also reduce performance, causing pain in the limbs. With narrow vessels, the symptoms appear as follows:

• frequent numbness of the limbs, weak pulsation of the arteries;
• the skin of the lower extremities becomes dry, bluish in color, sometimes pale with a marbled pattern;
• the appearance of muscle pain, which intensifies at night;
• trophic ulcers that may appear on the lower extremities.

As a rule, specialists prescribe blood-thinning drugs, as well as those that improve the elasticity of the walls of blood vessels. These are also medications that clear them of cholesterol plaques (if any). Traditional medicine also takes place. But there is no need to talk about its effectiveness, except in cases where the methods are recognized by traditional medicine.

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Giving up bad habits and coffee, physical activity and regular consumption of garlic are simple measures that will help clean blood vessels. More useful tips in the video:

The narrowing of the walls of blood vessels leads to a number of problems, one of them is increased blood pressure. Abnormally elevated blood pressure leads to hypertensive crisis and pre-infarction conditions. Also, narrowing of the walls leads to more serious consequences: stroke (partial or complete paralysis is possible), thrombophlebitis and trophic ulcers, hemorrhages, heart attack, coronary heart disease and other problems with both the cardiovascular system and other internal organs.

How to defeat HYPERTENSION at home?

To get rid of hypertension and cleanse blood vessels, you need.

• Eliminates the causes of pressure disorders
• Normalizes blood pressure within 10 minutes after administration

The first symptoms of high blood pressure in humans

Blood pressure is the force with which the flow of blood, passing through blood vessels, presses on their walls. With its help, blood circulates throughout the human circulatory system, thereby ensuring the supply of nutrients to the tissues and cells of the body, and also removes their decay products.

Types of Blood Pressure

There are arterial, venous and capillary blood pressure. The highest blood pressure in humans is found in the aorta. When diagnosing various diseases, the concept of blood pressure (BP) is mainly used.

When the left cardiac ventricle contracts, the flow of oxygenated blood is forcefully pushed into the lumen of the bloodstream, but this force is not enough for arterial blood to enter all blood vessels. But nature is wise; under the pressure of blood, the walls of the arteries first stretch, then return to normal sizes.

When the muscles are stretched, the blood pressure in the vessels increases, then the muscles of the artery contract, resulting in such a flow force that the blood is able to pass through the smallest capillaries. During the pause between two contractions, the aortic muscles return to normal and reach a minimum. The highest blood pressure value is observed at the beginning of the artery, and the pressure in the vena cava fluctuates around zero.

For the first time, instruments capable of measuring blood pressure began to be used in the 18th century, and in the 19th century, the tonometer took on the form that is already familiar to us. The principle of operation of the tonometer is based on the Korotkoff measurement method: using a rubber bulb, air is pumped into a cuff placed on the forearm, which compresses the blood vessels in the arm. The stethoscope should be placed in the crook of the elbow, instead of where the pulse sounds of the blood artery will be most audible. Then the air from the cuff is slowly released, when the first pulse sounds are heard, the value is recorded on the pressure gauge and then the last tone heard is recorded.

The first value of blood pressure, created by the force of contraction of the aortic walls, will mean the value of systolic pressure, the second – diastolic. In some cases, measuring blood pressure on the leg is allowed (for example, if the patient is overweight). As can be seen from the description, with this measurement method, it is necessary to listen to pulse noise. The concepts of blood pressure in this method and pulse are inextricably linked, since blood flows through the vessels unevenly, but in jerks, the number of contractions of the muscles of the vessel walls per minute is called the pulse rate.

Attention! In practice, there are such methods of measuring blood pressure as invasive (or direct, a needle connected to a pressure gauge is inserted directly into the bloodstream) and non-invasive (indirect). Measuring blood pressure with invasive methods is more accurate, it is used during operations, rather than invasive or indirect in another way, when measured with a tonometer.

To obtain accurate data about a person’s health, when recording blood pressure, you should adhere to certain instructions:

• Before the procedure you should sit for about 10 minutes;
• blood pressure measurements are taken while a person is sitting or lying down;
• Half an hour before the procedure, you should not smoke or overeat;
• The blood pressure value is recorded on both arms;
• When measuring blood pressure, you should not move or talk.

Normal blood pressure in humans

A person's blood pressure should be within 120/70 mm Hg. Art. fluctuations within 10 units are allowed. If all conditions for measurement are met, and blood pressure is lower or higher by 20 units or more. normal pressure values, this indicates the onset of hypotension or hypertension, respectively. An interesting fact is that blood pressure in children under one year of age is normally 80/50, and increases over time, reaching 120/70 in adulthood.

For older people, an increased blood pressure of 135/90 can be considered normal. This phenomenon is explained by the state of the muscle tone of the arteries, so in infants the muscles do not need to strain much to push blood, and with age, the lumen in the arteries decreases due to deposits on the walls of the vessels, which is why in the elderly we see high blood pressure or hypertension.

During artificial (hardware) circulation (for example, during surgical interventions), blood pressure is maintained at 60 mm Hg. Art. using a special apparatus.

Many factors influence a person's blood pressure:

1. With an active lifestyle, lower blood pressure is noted.
2. In women, this pressure indicator is lower than in men.
3. In pregnant women, a temporary decrease in blood pressure is noted; this phenomenon occurs under the influence of certain hormones, the level of which increases in women in the “position”.
4. If a pregnant woman experiences high blood pressure, protein in the urine and swelling at the end of pregnancy, we are talking about gestosis in pregnant women, in which case the woman is hospitalized, since gestosis is one of the reasons for an emergency cesarean section.
5. Obese people most often suffer from high blood pressure, as their blood vessels are susceptible to atherosclerosis.
6. In some cases, high lower pressure (diastolic) is noted, which indicates disorders within the body, for example, with diseases of the thyroid gland;
7. The highest blood pressure is observed in older people.

Your blood pressure will always be 120/80 if you drink in the morning.

Hypertension and hypotension

When describing the value of blood pressure, concepts such as hypertension and hypotension are used.

Hypertension is high blood pressure in a person. This is how we usually talk about it when an individual’s blood pressure exceeds the norm by more than 20 units.

The main signs of high blood pressure:

• headache;
• pain in the heart area;
• heavy breathing;
• insomnia;
• nosebleeds;
• decreased vision;
• increased platelet count in the blood and thick blood;
• Sometimes with hypertension, loss of consciousness can be observed.

There are 3 degrees of hypertension, so in grade I there is an occasional slight increase in blood pressure, which normalizes with rest; headache, dizziness and occasionally nosebleeds may begin. Stage II hypertension is characterized by sudden changes in blood pressure, pain in the heart area, dizziness, and nausea may occur. Rest no longer brings relief; cerebral circulation may be impaired and, as a result, mental abilities may be impaired. If you do not resort to medication, a so-called pre-stroke condition may develop and, as a result, a stroke.

As a result of stage III hypertension, irreversible conditions develop: stroke, myocardial infarction, heart failure, renal failure, damage to the fundus vessels. This degree of hypertension cannot be normalized at home; the patient must be urgently hospitalized. Sometimes there are conditions in which, without a diagnosis of hypertension, blood pressure still rises. For example, “white coat disease” is known, in which a person’s blood pressure rises when they see a doctor in a white coat.

The causes of hypertension include:

• sedentary lifestyle;
• frequent smoking;
• exposure to stress;
• consumption of alcoholic beverages and drugs;
• excessive consumption of coffee and energy drinks;
• increased body weight;
• eating unhealthy food for hypertension;
• addiction to table salt (first, osmotic pressure increases, which leads to increased blood pressure);
• if you spend a long time at the computer, your blood pressure may increase because the person remains motionless for a long time;
• There are diseases characterized by constant high blood pressure. For example, kidney failure.

For mild hypertension, to avoid worsening the condition, it is recommended to follow a diet and monitor your weight. If you have high blood pressure, give preference to walks in the fresh air and avoid stressful situations as much as possible. There are a number of foods that, when consumed wisely, reduce the risk of hypertension and a sharp jump in blood pressure. The beneficial effects of eating cabbage, legumes, dairy products and red fish are noted. Lemon, orange, pomegranate, kiwi perfectly regulate blood pressure.

In folk medicine, blood-thinning herbs are used to normalize the condition. These herbs not only lower blood pressure, but also thin the blood. Acetylsalicylic acid (aspirin) is also a good blood thinner. It is usually prescribed to hypertensive patients in the early stages of hypertension to avoid the risk of heart attack or stroke. Some conditions require normalization of blood sugar levels. A berry like cranberry perfectly reduces blood pressure, this is due to its diuretic properties.

Hypotension is a blood pressure level that is lower than normal. When diagnosing hypotension, note:

• memory problems;
• increased sweating with low blood pressure;
• pale skin;
• dizziness and fainting;
• general weakness;
• feeling of lack of air;
• with low blood pressure, nausea and sometimes vomiting;
• in laboratory tests, the partial pressure of oxygen (this value measures the ability of hemoglobin to add oxygen) in arterial blood will be low.

Although hypotension does not cause as much harm to the body as hypertension, it still requires close attention, as it often accompanies more serious diseases. With low blood pressure the following is diagnosed:

• vegetative-vascular dystonia;
• hypothyroidism;
• adrenal insufficiency;
• develops against the background of anemia;
• tuberculosis;
• peptic ulcer.

Hypotension can also develop with alcohol consumption, as a result of chronic infections and asthenia. Stressful situations can also lead to a sharp decrease in blood pressure.

Treatment

Treatment depends on the course of the disease, which resulted in a decrease in blood pressure. For example, hormonal medications may be prescribed if the decrease in blood pressure is caused by endocrine disorders. To prevent hypertension, it is recommended to consume foods high in heme iron, establish a work schedule, and avoid overwork. Walking in the fresh air and physical exercise will have a beneficial effect on raising blood pressure. In the treatment of neurotic causes, medications that stimulate the nervous system are used.

Blood pressure is an important indicator that reflects the state of the blood vessel system and overall health. Most often, when talking about pressure, we mean arterial pressure, when blood moves from the heart. It is measured in millimeters of mercury and is determined by the amount of blood that the heart pumps per unit of time and vascular resistance. Blood pressure is not the same in different vessels and depends on their size. The larger the vessel, the higher it is. It is highest in the aorta, and the closer it is to the heart, the higher the value. The pressure in the artery of the shoulder is taken as the norm, this is due to the convenience of measuring it.

Upper blood pressure

Systolic is the pressure experienced by the vascular walls at the time of systole (contraction of the heart muscle). Blood pressure is written as a fraction, and the number on top indicates the systolic level, which is why it is called upper. What does its size depend on? Most often from the following factors:

• contraction forces of the heart muscle;
• tone of blood vessels, and therefore their resistance;
• number of heart contractions per unit time.

The ideal upper blood pressure is 120 mm Hg. pillar Normal ranges from 110 to 120. If it is more than 120 but less than 140, it is said to be prehypotension. If blood pressure is 140 mmHg or higher, it is considered elevated. The diagnosis of “arterial hypertension” is made if a persistent excess of the norm is observed over a long period of time. Isolated cases of increased blood pressure are not hypertension.

Blood pressure can change constantly throughout the day. This is due to physical activity and psycho-emotional stress.

Causes of increased upper blood pressure

Systolic blood pressure may increase in healthy people. This happens for the following reasons:

• under stress;
• during physical activity;
• after drinking alcohol;
• when eating salty foods, strong tea, coffee.

Pathological reasons for the increase include the following:

• renal pathologies;
• obesity;
• disorders of the adrenal glands and thyroid gland;
• vascular atherosclerosis;
• disturbances in the functioning of the aortic valve.

Symptoms of elevated systolic blood pressure

If the upper pressure is elevated, there may be no symptoms, but with prolonged and persistent hypertension the following symptoms appear:

• headache, usually in the back of the head;
• dizziness;
• difficulty breathing;
• nausea;
• flickering of flies before the eyes.

Causes of low systolic blood pressure

It may temporarily decrease in the following cases:

• when tired;
• climate and weather changes;
• in the first trimester of pregnancy;

This condition is not a deviation from the norm and quickly returns to normal without any intervention.

Treatment is required if low blood pressure is a symptom of diseases, such as:

• disturbances in the functioning of the heart valve;
• bradycardia (decreased heart rate);
• intoxication;
• diabetes mellitus;
• brain injuries.

Symptoms of low systolic blood pressure

If the upper pressure is low, a person experiences:

• loss of strength;
• drowsiness;
• irritability;
• apathy;
• sweating;
• memory impairment.

Lower blood pressure

It shows the force with which blood presses on the vascular walls at the time of diastole (relaxation of the heart muscle). This pressure is called diastolic and is the minimum. It depends on the tone of the arteries, their elasticity, heart rate and total blood volume. Normal lower pressure is 70-80 mmHg.

Causes of elevated diastolic blood pressure

Isolated cases of its increase are not a pathology, just like a temporary increase during physical activity, emotional stress, changes in weather conditions, etc. We can talk about hypertension only when it increases steadily. You can read more about the causes of increased lower pressure and its treatment here.

An increase may result from:

• kidney disease;
• high kidney pressure;
• disruption of the adrenal glands and thyroid gland (increased hormone production);
• diseases of the spine.

Symptoms of elevated lower blood pressure

When diastolic pressure increases, the following complaints may appear:

• dizziness;
• chest pain;
• difficulty breathing.

With a prolonged increase, visual impairment, cerebral circulation, and the risk of stroke and heart attack may occur.

Causes of low diastolic blood pressure

This symptom is typical for the following pathologies:

• dehydration;
• tuberculosis;
• disorders of the aorta;
• allergic reactions and others.

Diastolic blood pressure may drop in women during pregnancy. This can cause hypoxia (oxygen starvation), which can be dangerous for the unborn child. More information about the reasons for lowering lower pressure and ways to increase it can be found here.

Symptoms of low diastolic blood pressure

If your blood pressure is low, you may experience symptoms such as:

• drowsiness;
• lethargy;
• headaches;
• dizziness.

What should be the difference between upper and lower pressure

We know what pressure is optimal. This is 120/80 mmHg. This means that the normal difference between lower and upper blood pressure is 40 units. It is called pulse pressure. If this difference increases to 65 or more, the likelihood of developing cardiovascular complications increases significantly.

A large gap is most often observed in the elderly, since their age is characterized by an isolated increase in upper blood pressure. With age, the likelihood of developing isolated systolic hypertension only increases, and especially sharply after 60 years.

The level of pulse pressure is affected by the distensibility of the aorta and nearby large arteries. The aorta has high distensibility, which decreases with age due to natural wear and tear of the tissue. Elastic fibers are replaced by collagen fibers, which are stiffer and less elastic. In addition, as many people age, cholesterol, lipids and calcium salts are deposited on the walls of their arteries. Thus, the more calcium salts and collagen, the worse the aorta stretches. The worse the artery walls stretch, the greater the difference between the lower and upper pressure.

High pulse pressure is a major risk factor for strokes and other cardiovascular complications in older people.

Conclusion

It is very important to maintain blood pressure at the optimal level – 120/80 mmHg. column (people with low blood pressure – 115/75). It should be remembered that prehypertension (from 120/80 to 139/89) is a risk of developing cardiovascular complications. Each millimeter of mercury above 120/80 increases this probability by 1-2 percent, especially in people over 40 years of age.

Normal blood pressure in an adult

Causes of increased lower blood pressure and its treatment

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• Treatment of joints
• Weight loss
• Varicose veins
• Nail fungus
• Fighting wrinkles
• High blood pressure (hypertension)

Aortic aneurysm: symptoms and treatment

An aneurysm is a protrusion of the wall of a blood vessel caused by its stretching or thinning due to any acquired or hereditary pathologies. The danger of such a problem largely depends on the location of the vascular defect and the caliber of the artery or vein.

Aortic aneurysm is rightfully included in the list of the most dangerous conditions that can lead to almost instant death. The insidiousness of this disease lies in the fact that the patient may not even be aware of its presence for a long time, and the aorta is the largest vessel of the human body, and if a large aneurysm formed on it ruptures, the patient may die or become seriously ill in a matter of minutes, caused by massive bleeding.

Brief information about the aorta

The aorta is the largest and longest artery of the human body, which is the main vessel of the systemic circulation. It is divided into three parts: ascending, aortic arch and descending. The descending aorta, in turn, is divided into the thoracic and abdominal sections. The length of this large vessel extends from the sternum to the lumbar spine. Such dimensions of the artery indicate that when blood is pumped, the highest pressure is created in it, and that is why areas of protrusion (aneurysm) can often form on it.

Mechanisms and causes of aneurysm development

Also, due to its anatomical features, the aorta is most susceptible to infections, atherosclerotic changes, injuries and death of the medial tunic of the vessel. All of these predisposing factors contribute to the development of aneurysms, dissection, atherosclerosis, or inflammation of the aorta (aortitis). Stretching or thinning of the walls of this largest artery is caused either by age-related changes or by various injuries or diseases (syphilis, atherosclerosis, diabetes mellitus, etc.).

According to statistics, it is atherosclerotic plaques that in most cases are the root cause of this disease. Also, not so long ago, scientists suggested that the development of aortic aneurysm may be facilitated by the herpes virus. At the moment, these data have not yet been conclusively confirmed, and scientific research is under development.

In the initial stages of the disease, aortic aneurysms do not manifest themselves in any way and can be discovered completely accidentally during a patient’s examination for other diseases (for example, when performing an ultrasound of blood vessels, abdominal organs or the heart). Subsequently, atrophy of elastic fibers occurs in the middle wall of this artery. They are replaced by fibrous tissue, and this leads to an increase in the diameter of the aorta and increased tension in its wall. With persistent progression of such pathological processes, the risk of rupture increases significantly.

Types of aneurysms

Aortic aneurysms can vary in structure and shape.

According to its pathological characteristics, an aneurysm can be:

• true - is a protrusion of the vessel wall, which is formed from all vascular layers of the aorta;
• false (or pseudoaneurysm) - is a protrusion of the vessel wall, which is formed from pulsating hematomas; the vessel walls consist of para-aortic connective tissue and sublayer deposits of blood clots.

According to its form, an aortic aneurysm can be:

• saccular - the cavity of the pathological protrusion of the aorta communicates with its lumen through the neck-shaped canal;
• fusiform - most common, its cavity is similar to the shape of a spindle and communicates with the aortic lumen through a wide opening;
• dissecting - a cavity is formed due to dissection of the walls of the aorta and is filled with blood; such an aneurysm communicates with the aortic lumen through the dissecting wall.

Based on clinical manifestations, cardiologists distinguish the following types of aneurysms:

• thoracic aorta;
• abdominal aorta.

Symptoms

The severity and nature of the signs of an aortic aneurysm are determined by its location and stage of development. They are nonspecific, varied and, especially when they are insufficiently expressed or rapidly progressing, are attributed by patients to other diseases. The sequence of their appearance is always determined by the following pathological processes:

• during a tear in the intima of the aorta, the patient experiences pain and a sharp decrease in blood pressure;
• in the process of dissection of the aortic wall, the patient experiences sharp pain of a migrating nature, repeated episodes of decreased blood pressure and organ symptoms (they are determined by the location of the aneurysm, intimal tear and hemorrhage);
• during a complete rupture of the aortic wall, the patient develops signs of internal bleeding (severe pallor, cold sweat, decreased blood pressure, etc.) and develops hemorrhagic shock.

Depending on the combination of all of the above factors, the patient may experience:

• pain of a burning, pressing or tearing nature, localized or radiating to the arm, chest, shoulder blades, neck, lower back or legs;
• cyanosis of the upper part of the body with the development of hemopericardium;
• fainting that develops when the vessels leading to the brain are damaged and irritated or when the patient becomes suddenly anemic due to massive bleeding;
• pronounced bradycardia at the beginning of intimal tear, which is subsequently replaced by tachycardia.

In most patients, aortic aneurysm, especially in the first stages of its development, is asymptomatic. This course of the disease is especially relevant when the pathological protrusion of the vessel wall is located in the thoracic aorta. In such cases, signs of pathology are either detected by chance during an instrumental examination for other diseases, or make themselves felt more clearly if the aneurysm is localized in the area of ​​the bend of the aorta into the arch. In some cases, with vascular irritation, aortic dissection in the area of ​​the coronary vessels and compression of the coronary arteries, the clinical picture of an aortic aneurysm is combined with symptoms of myocardial infarction or angina. When the pathological protrusion is located in the abdominal aorta, the symptoms of the disease are clearly expressed.

During an ECG examination of a patient with an aortic aneurysm, a variable picture may be observed. In 1/3 of cases, no abnormalities are detected, while in others there are signs of focal myocardial lesions and coronary insufficiency. In aortic dissection, these signs are persistent and are detected on several repeated ECGs.

A general blood test reveals leukocytosis and signs of anemia in the patient. With dissection of the aortic aneurysm, the decrease in the level of hemoglobin and red blood cells constantly progresses and is combined with leukocytosis.

Also, patients with this disease may experience some neurological symptoms:

• convulsions;
• disturbances during urination and defecation;
• hemiplegia;
• fainting states;
• paraplegia.

When the femoral and iliac arteries are involved in the pathological process, signs of impaired blood supply to the lower extremities are observed. The patient may experience: pain in the legs, swelling, paleness or cyanosis of the skin, etc.

In the case of dissection of an aneurysm of the abdominal aorta, a pulsating and growing tumor is formed in the abdominal area, and when blood leaks into the pleural cavity, pericardium or mediastinum, when the borders of the heart are tapped, their displacement, expansion and disturbances in heart rhythm up to cardiac arrest are observed.

Symptoms of a ruptured aortic aneurysm

In most cases, a ruptured aortic aneurysm is not accompanied by any specific symptoms. Initially, the patient may experience discomfort and mild pain, and when bleeding begins, signs of hemorrhagic shock join the clinical picture.

In the case of massive and rapid hemorrhage, fainting and intense pain in different parts of the body may occur (if dissection or rupture of the aorta occurs in close contact with the nerve bundle). The further prognosis of such significant blood losses depends on the total volume of blood lost.

Treatment

To treat an aortic aneurysm, the patient must consult a vascular surgeon or cardiac surgeon. Determining its tactics depends on the growth rate, location and size of the aneurysm, which are determined during dynamic observation and constant x-ray monitoring. If necessary, to reduce the risk of developing possible complications or prepare the patient for surgical treatment, anticoagulant, antiplatelet, antihypertensive and anticholesterolemic drug therapy is carried out.

The decision to perform planned surgical treatment is made in the following clinical cases:

• aneurysm of the abdominal aorta with a diameter of more than 4 cm;
• thoracic aortic aneurysm with a diameter of more than 5.5-6 cm;
• a constant increase in the size of a small aneurysm by 0.5 cm or more over six months.

Emergency surgery is performed as quickly as possible, because with massive or prolonged bleeding, the patient dies in a short time. Indications for it may include the following terminal situations:

• embolization of peripheral arteries;
• aortic dissection or rupture.

To eliminate an aneurysm, operations are performed, the purpose of which is to excision and suturing or replacing the damaged area of ​​the aorta with a prosthesis. In the presence of aortic insufficiency, the aortic valve is replaced during resection of the thoracic part of the vessel.

One of the minimally invasive surgical treatment options may be endovascular prosthetics followed by installation of a stent or vascular prosthesis. If it is impossible to perform such operations, traditional interventions are performed with open access to the localization site by resection:

• abdominal aneurysms;
• thoracic aneurysms during left ventricular bypass;
• thoracic aneurysms during artificial circulation;
• aneurysms of the aortic arch during artificial circulation;
• abdominal aortic aneurysm;
• abdominal aortic aneurysm with artificial circulation;
• aneurysms of the subrenal aorta.

After completion of surgical treatment, the patient is transferred to the cardiac intensive care unit, and when all vital functions are restored, to the vascular department or cardiac center. In the postoperative period, the patient is prescribed analgesic therapy and symptomatic treatment.

The prognosis for an aortic aneurysm will be determined by its size, rate of progression and concomitant pathologies of the cardiovascular and other body systems. In the absence of treatment, the outcome of the disease is extremely unfavorable, because due to the rupture of an aneurysm or the development of thromboembolism, the patient will die. According to statistics, about 95% of patients die within the first three years. This is explained by the frequent latent course of the disease and the high risk of rupture of aneurysms, the diameter of which reaches 6 cm. According to statistics, about 50% of patients die per year with such aortic pathologies.

With early detection and planned surgical treatment of aortic aneurysms, the postoperative prognosis becomes more favorable, and the death rate is no more than 5%. That is why, for the prevention and timely detection of this disease, it is recommended to constantly monitor blood pressure levels, lead a healthy lifestyle, undergo regular scheduled preventive examinations and all doctor’s prescriptions for drug therapy for concomitant diseases.

Medical animation on the topic “Aortic aneurysm”:

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TV show “Be Healthy” on the topic “Aortic Aneurysm”:

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Abdominal aortic aneurysm: symptoms and treatment Most often, an aortic aneurysm is formed in its abdominal region, and this dangerous disease has a poor prognosis. Unfortunately, in the last...