Arterial hypotonia – permanent or regular lowering of arterial pressure is lower than 100/60 mm Hg. Arterial hypotonia proceeds with dizzinesses, passing violations of sight, fatigue, drowsiness, tendency to faints, thermal control violation etc. Diagnosis of arterial hypotonia is based on determination of level HELL (including daily monitoring HELL), inspection of a condition of cardiovascular, endocrine and nervous systems (the ECG, EhoKG, EEG, biochemical blood test and so forth). In treatment of arterial hypotonia methods are applied non-drug (psychotherapy, massage, balneotherapy, FTL, acupuncture, an aromatherapy) and medicamentous (vegetable adaptogens, tserebroprotektor, nootropic medicines, tranquilizers).
Arterial hypotonia (arterial hypotension) - the syndrome of the lowered arterial pressure which is characterized by resistant indicators of level of systolic (top) pressure less than 100 mm hg, and diastolic (lower) — less than 60 mm hg. Arterial hypotonia young women and teenagers have more often. At advanced age, against the background of defeat of vessels atherosclerosis, the atherosclerotic arterial hypotension caused by loss of a vascular tone owing to atherosclerotic changes meets.
Classification of arterial hypotonia
Because arterial hypotonia can occur at healthy faces, accompany the course of various diseases or be an independent nosological form, uniform classification of hypotonic states is used. In it allocate physiological, pathological (primary) and symptomatic (secondary) arterial hypotonia.
Carry arterial hypotension as the individual norm (having hereditary constitutional character), adaptive compensatory hypotension to options of physiological arterial hypotonia (at inhabitants of highlands, tropics and subtropics) and hypotension of the increased fitness (occurs among athletes).
Pathological primary arterial hypotonia as independent disease, includes cases of idiopathic orthostatic hypotension and neurocirculator hypotension with an unstable reversible current or permanent manifestations (a hypotonic disease).
Among symptomatic (secondary) arterial hypotonia are considered sharp (at a collapse, shock) and the chronic forms caused by organic pathology of cardiovascular, nervous, endocrine system, hematologic diseases, intoxications and so forth.
Reasons of arterial hypotonia
Arterial hypotonia should be considered as the multifactorial state reflecting lowering of blood pressure in arterial system at various physiological and pathological states. Neurocirculator dystonia is the reason of primary arterial hypotonia in 80% of cases. According to modern theories, primary hypotension represents a special form of neurosis of the sosudodvigatelny centers of a brain in which development the leading role is allocated for stresses and the long psychoinjuring situations. Psychological injuries, chronic fatigue and a sleep debt, depressions can serve as the immediate making causes.
Secondary arterial hypotonia is a symptom of other available diseases: anemias, stomach ulcers, dumping syndrome, hypothyroidism, cardiomyopathy, myocarditis, arrhythmia, diabetic neuropathy, osteochondrosis of cervical department of a backbone, tumors, infectious diseases, heart failure, etc.
Sharp arterial hypotonia can be a consequence of massive one-stage blood loss, dehydration, trauma, poisoning, anaphylactic shock, sharp violation of work of heart at which hypotensive reflexes work. In these cases arterial hypotension develops in a short space of time (from several minutes to hours) and involves the expressed violations of blood supply of internals. Chronic arterial hypotonia tends to a long current; at the same time the organism is adapted to the lowered pressure owing to what the expressed symptoms of disorder of blood circulation are absent.
Arterial hypotonia can also develop against the background of a lack of vitamins B, With, E; observance of a diet, overdose of medicines, for example, at treatment of arterial hypertension. Physiological arterial hypotonia can be observed at healthy people with hereditary predisposition to the lowered pressure, at the trained athletes, in the conditions of adaptation to sharp change of weather or climatic conditions.
Pathogenesis of arterial hypotonia
Despite abundance of the possible reasons, the mechanism of development of arterial hypotonia it can be connected with four major factors: reduction of minute and shock emission of heart; reduction of OTsK; decrease in resistance of peripheral vessels; reduction of venous inflow of blood to heart.
Reduction of shock and minute volume of blood meets at heavy dysfunction of a myocardium at a heart attack, myocarditis, severe forms of arrhythmias, overdose of ß-adrenoblokatorov etc. Decrease in a tone and resistance of peripheral vessels (mainly, and prekapillyar) causes development of arterial hypotonia at a collapse of the toxic or infectious nature, anaphylactic shock. Arterial hypotonia as a result of reduction of OTsK arises at external (gastrointestinal) or internal bleeding (at an ovary apopleksiya, a rupture of a spleen, a rupture of aneurism of an aorta, etc.). Bystry evacuation of exudate at massive ascites or pleurisy can lead to arterial hypotonia owing to reduction of venous return of blood to heart as a considerable part of OTsK is late in the smallest vessels.
At various forms of arterial hypotonia violations of vascular regulation by the highest vegetative centers, decrease in the mechanism of regulation of arterial pressure renin-angiotensin-aldosteronovoy system, disorder of sensitivity of vascular receptors to catecholamines, violations of an afferent or efferent part of an arch of a barorefleks can come to light.
Symptoms of arterial hypotonia
Physiological hypotonia in most cases does not deliver to the person of special discomfort. The sharp form of arterial hypotonia proceeds with the expressed oxygen starvation of tissues of brain in this connection such symptoms as dizzinesses, short-term violations of sight, unsteadiness of gait, pallor of integuments, faints develop.
At chronic secondary arterial hypotonia into the forefront symptoms of the main disease act. Besides, at patients weakness, apathy, drowsiness, increased fatigue, headaches, emotional lability, a memory impairment, thermal control violations, perspiration of feet and palms, tachycardia is noted. The long course of arterial hypotonia causes violations of a menstrual cycle in women and a potentiality at men.
At orthostatic arterial hypotonia owing to change of position of a body with horizontal on vertical preunconscious states develop. At arterial hypotonia there can be vegetative crises, as a rule, of vagoinsulyarny character. Such paroxysms proceed with an adinamiya, a hypothermia, plentiful perspiration, bradycardia, falling HELL up to a faint, belly-aches, nausea, vomiting, difficulty of breath owing to a throat spasm.
Diagnosis of arterial hypotonia
In the course of diagnostics it is important not just to establish the fact of existence of arterial hypotonia, but also to find out the reasons by which it is caused. For the correct assessment of level HELL is required triple measurement of arterial pressure with an interval of 3-5 minutes. Daily monitoring HELL allows to define fluctuations in the size and a daily rhythm of arterial pressure.
The exception or confirmation of secondary arterial hypotonia requires comprehensive examination of a condition of cardiovascular, endocrine and nervous systems. Biochemical indicators of blood (electrolytes, glucose, cholesterol and lipidic fractions) are for this purpose investigated, the ECG (at rest and with load tests), orthostatic test, an echocardiography, an electroencephalography etc. is carried out.
Treatment of arterial hypotonia
Start treatment of arterial hypotonia only after establishment of the exact reason of decrease HELL. At secondary symptomatic hypotension as object of influence will serve the main disease. Arterial hypotonia of neurovegetative genesis, first of all, demands correction of a vegetative imbalance with use of medicamentous and non-drug methods.
The complex of medical and improving actions can include normalization of a day regimen and food, various options of psychotherapy; massage cervical zones, aromaterapevtichesky massage; balneotherapy (Scottish shower, circular shower, shower of Vichy, hydromassage, aromatic and mineral bathtubs); acupuncture, physical therapy (an electrophoresis on a vorotnikovy zone, an electrodream); aromatherapy, aeroionoterapiya, LFK.
Drug treatment of arterial hypotonia is carried out by medicines of various groups: vegetable adaptogens (tincture of a magnolia vine, araliya, ginseng); holinolitika, tserebroprotektor (cinnarizine, ); nootropic medicines (glycine, piracetam); antioxidants and vitamins (amber acid, vitamins A, In, E); antidepressants and tranquilizers. At sharp arterial hypotonia for the purpose of bystry increase and stabilization HELL cardiotonics and vazokonstriktor are entered (, dopamine), glucocorticoids, infusion of salt and colloidal solutions is carried out.
Prevention of arterial hypotonia
The general principles of prevention of primary arterial hypotonia come down to observance of a day regimen, maintaining healthy and active lifestyle, to sports activities (swimming, walking, gymnastics), good nutrition, an exception of stresses. The procedures strengthening vessels (a contrast shower, a hardening, massage) are useful.
The prevention of secondary arterial hypotonia consists in prevention of endocrine, neurologic, cardiovascular diseases. Constant control of level HELL, regular observation at the cardiologist is recommended to patients with arterial hypotonia.