Blood pressure in different parts of the vascular bed is not the same: in arterial system it is higher, in the venous lower. This is clearly visible from the data presented in table. 3 and in Fig. 16.
Table 3. The value of the average dynamic pressure in various parts of the human circulatory system
Rice. 16. Diagram of pressure changes in different parts of the vascular system. A - systolic; B - diastolic; B - medium; 1 - aorta; 2 - large arteries; 3 - small arteries; 4 - arterioles; 5 - capillaries; 6 - venules; 7 - veins; 8 - vena cava
Blood pressure- blood pressure on the walls of blood vessels - measured in pascals (1 Pa = 1 N/m2). Normal blood pressure is necessary for blood circulation and proper blood supply to organs and tissues, for the formation tissue fluid in capillaries, as well as for the processes of secretion and excretion.
The amount of blood pressure depends on three main factors: the frequency and strength of heart contractions; quantities peripheral resistance, i.e., the tone of the walls of blood vessels, mainly arterioles and capillaries; volume of circulating blood.
There are arterial, venous and capillary blood pressure. Blood pressure in a healthy person is fairly constant. However, it is always subject to slight fluctuations depending on the phases of cardiac activity and respiration.
There are systolic, diastolic, pulse and average arterial pressure.
Systolic(maximum) pressure reflects the state of the myocardium of the left ventricle of the heart. Its value is 13.3-16.0 kPa (100-120 mm Hg).
Diastolic(minimum) pressure characterizes the degree of tone of the arterial walls. It is equal to 7.8-10.7 kPa (60-80 mm Hg).
Pulse pressure is the difference between systolic and diastolic pressure. Pulse pressure is necessary to open the semilunar valves during ventricular systole. Normal pulse pressure is 4.7-7.3 kPa (35-55 mm Hg). If systolic pressure becomes equal to diastolic pressure, blood movement will be impossible and death will occur.
Average blood pressure is equal to the sum of diastolic and 1/3 of pulse pressure. Mean arterial pressure expresses the energy of continuous blood movement and is a constant value for a given vessel and body.
The value of blood pressure is influenced by various factors: age, time of day, state of the body, central nervous system, etc. In newborns, the maximum blood pressure is 5.3 kPa (40 mm Hg), at the age of 1 month - 10.7 kPa (80 mm Hg), 10-14 years - 13.3-14.7 kPa (100-110 mm Hg), 20-40 years - 14.7-17.3 kPa (110-130 mmHg). With age, the maximum pressure increases to a greater extent than the minimum.
During the day, there is a fluctuation in blood pressure: during the day it is higher than at night.
A significant increase in maximum blood pressure can be observed during heavy physical activity, during sports competitions, etc. After stopping work or finishing competitions, blood pressure quickly returns to its original values. An increase in blood pressure is called hypertension. The decrease in blood pressure is called hypotension. Hypotension can occur as a result of drug poisoning, severe injuries, extensive burns, or large blood losses.
Persistent hypertension and hypotension can cause organ dysfunction, physiological systems and the body as a whole. In these cases, qualified medical assistance is necessary.
In animals, blood pressure is measured using a bloodless and bloody method. In the latter case, one of the large arteries (carotid or femoral) is exposed. An incision is made in the wall of the artery through which a glass cannula (tube) is inserted. The cannula is secured in the vessel using ligatures and connected to one end of a mercury manometer using a system of rubber and glass tubes filled with a solution that prevents blood clotting. At the other end of the pressure gauge, a float with a scribe is lowered. Pressure fluctuations are transmitted through the liquid tubes to a mercury manometer and a float, the movements of which are recorded on the sooty surface of the kymograph drum.
In humans, blood pressure is determined by auscultation using the Korotkov method (Fig. 17). For this purpose, it is necessary to have a Riva-Rocci sphygmomanometer or sphygmotonometer (membrane-type manometer). The sphygmomanometer consists of a mercury manometer, a wide flat rubber cuff bag and a rubber pressure bulb connected to each other by rubber tubes. A person's blood pressure is usually measured in the brachial artery. A rubber cuff, made inextensible by the canvas cover, is wrapped around the shoulder and fastened. Then, using a bulb, air is pumped into the cuff. The cuff inflates and compresses the tissues of the shoulder and the brachial artery. The degree of this pressure can be measured using a pressure gauge. The air is pumped until the pulse in the brachial artery can no longer be felt, which occurs when it is completely compressed. Then, in the area of the elbow bend, i.e., below the point of compression, a phonendoscope is applied to the brachial artery and they begin to gradually release air from the cuff using a screw. When the pressure in the cuff drops so much that the blood during systole is able to overcome it, characteristic sounds - tones - are heard in the brachial artery. These tones are caused by the appearance of blood flow during systole and its absence during diastole. The pressure gauge readings, which correspond to the appearance of tones, characterize the maximum, or systolic, pressure in the brachial artery. With a further decrease in pressure in the cuff, the tones first intensify, and then subside and cease to be audible. The cessation of sound phenomena indicates that now, even during diastole, blood is able to pass through the vessel. The intermittent flow of blood turns into a continuous one. Movement through the vessels in this case is not accompanied by sound phenomena. The pressure gauge readings, which correspond to the moment the sounds disappear, characterize the diastolic, minimum, pressure in the brachial artery.
Rice. 17. Determination of blood pressure in humans
Arterial pulse - these are periodic expansions and lengthenings of the walls of the arteries, caused by the flow of blood into the aorta during systole of the left ventricle. The pulse is characterized by a number of qualities that are determined by palpation, most often of the radial artery in the lower third of the forearm, where it is located most superficially.
The following pulse qualities are determined by palpation: frequency- number of beats in 1 minute, rhythm- correct alternation of pulse beats, filling- degree of change in arterial volume, determined by the strength of the pulse beat, voltage- characterized by the force that must be applied to compress the artery until the pulse completely disappears.
The condition of the artery walls is also determined by palpation: after compression of the artery until the pulse disappears, in the case of sclerotic changes in the vessel, it is felt as a dense cord.
The resulting pulse wave spreads through the arteries. As it progresses, it weakens and fades at the level of the capillaries. The speed of propagation of the pulse wave in different vessels of the same person is not the same; it is greater in vessels of the muscular type and less in elastic vessels. Thus, in young and elderly people, the speed of propagation of pulse oscillations in elastic vessels ranges from 4.8 to 5.6 m/s, in large arteries of the muscular type - from 6.0 to 7.0-7.5 m/s With. Thus, the speed of pulse wave propagation through the arteries is much greater than the speed of blood movement through them, which does not exceed 0.5 m/s. With age, when the elasticity of blood vessels decreases, the speed of propagation of the pulse wave increases.
For a more detailed study of the pulse, it is recorded using a sphygmograph. The curve obtained by recording pulse fluctuations is called sphygmogram(Fig. 18).
Rice. 18. Sphygmograms of arteries recorded synchronously. 1 - carotid artery; 2 - radial; 3 - finger
On the sphygmogram of the aorta and large arteries, the ascending limb is distinguished - anacrotic and the descending knee - catacrota. The occurrence of anacrota is explained by the entry of a new portion of blood into the aorta at the beginning of left ventricular systole. As a result, the wall of the vessel expands, and a pulse wave appears that spreads through the vessels, and the sphygmogram shows an increase in the curve. At the end of ventricular systole, when the pressure in it decreases and the walls of the vessels return to their original state, catacrota appears on the sphygmogram. During ventricular diastole, the pressure in their cavity becomes lower than in the arterial system, therefore conditions are created for the return of blood to the ventricles. As a result, the pressure in the arteries drops, which is reflected in the pulse curve in the form of a deep notch - incisura. However, on its way the blood encounters an obstacle - the semilunar valves. Blood is pushed away from them and causes the appearance of a secondary wave of increased pressure. This in turn causes a secondary expansion of the arterial walls, which is recorded on the sphygmogram as a dicrotic rise.
Related information.
Being in good health, people usually do not think about their blood pressure readings.
It is unlikely that anyone questions how important blood pressure indicators are for the body.
An increase in blood pressure does not initially affect the patient’s well-being. The first symptoms appear only in advanced stages of the disease.
Blood pressure in the vessels does not coincide with its indicators in the atmosphere. Thanks to this fact, proper blood circulation and blood supply to all organs and systems is possible.
The highest blood pressure is in the central arterial vessels: aorta, pulmonary trunk, subclavian arteries.
From these vessels depart many smaller vessels that carry blood throughout the body, literally to every cell.
During the contraction of the heart, or systole, blood is released from the heart into the bloodstream. At this moment, the highest blood pressure numbers are observed in the arteries. This parameter is called systolic, but most people know it as the upper one.
The lower value when measuring pressure is called diastolic or lower.
The difference between the two is also an important indicator. This is pulse blood pressure, changes in which are also a sign of the development of pathologies.
There is a special table from the European Union of Cardiologists, which doctors use when assessing the blood pressure of patients.
The magnitude of blood tension depends on many factors: the cardiac ejection fraction, the diameter of the vascular lumen, the work of the myocardium and the resistance of the vascular wall.
Measuring blood pressure norms
Since ancient times, healers have understood that many ailments of people depend on the condition of their blood vessels.
Thus, an invasive method of measuring blood pressure was invented.
A special needle was inserted into the blood vessel, which measured the tension of the fluid circulating in the vessels.
Today, a gentle method of measuring blood pressure is used. It is important to carry out the measurement and bring minimal risk to the patient’s health.
The modern measurement method is the Korotkoff method.
To perform this method, a tonometer is required, which includes a sphygmomanometer and a stethophonendoscope.
Measurements should be taken at regular hours, with a certain periodicity. Don't forget to keep a blood pressure diary.
Measurements are usually carried out three times, with a break between measurements. It is important to measure blood pressure in both arms, as readings may vary.
Before the intended measurement, you should not smoke, drink coffee, tea, or alcohol. You should not use nasal decongestant drops (Nazivin, Naphthyzin, Farmazolin, etc.). This group of drugs has a vasoconstrictive effect and leads to vasoconstriction.
Before starting the procedure, the patient is asked to rest for a quarter of an hour.
During this event, a person sits leaning on the back of a chair (armchair), relaxing the upper and lower limbs.
The arm being examined is at the same level as the probable projection of the heart. It is recommended to place support under your arm, such as a pillow.
The hand should be bare. The cuff is applied a couple of centimeters above the elbow fold. It is necessary to leave a distance between the surface of the arm and the cuff.
The head of the phonendoscope is placed in the projection of the brachial artery.
Blood pressure and its norms in adults
Normal blood pressure in adults fluctuates by several divisions.
In this case, it depends on the constitution, characteristics of physiology and metabolic metabolism.
The age norm sometimes depends on gender.
Many people believe that only a pressure of 110 over 80 is normal, and at the same time, a pressure of 110 over 70 is normal, and a pressure of upper 120 to lower 70 is also normal. Patients often worry about such jumps, but all of the numbers listed are within the age norm.
The following blood pressure standards exist:
- upper norm, or systolic;
- lower norm, or diastolic;
- normal pulse blood pressure.
Pressure 120 over 70, what this means, is of interest to every patient suffering from disorders of the cardiovascular system.
Systolic blood pressure should not exceed a value of more than 139 millimeters of mercury.
If the numbers exceed this value, a diagnosis of arterial hypertension is made.
If the pressure drops beyond normal limits, then the opposite diagnosis is made - hypotension.
There are many reasons for changes in blood pressure standards. The list includes age indicators (elderly blood vessels react poorly to pressure), gender, and lifestyle.
When blood pressure levels change, appropriate therapy is prescribed:
- For small fluctuations, the patient’s lifestyle should be considered and taken into account. It's normal enough to just change your habits. You should quit smoking, increase regular physical activity, proper rest and sleep. It has long been proven that there is a relationship between lifestyle and the condition of patients’ blood vessels.
- When values rise above, special pharmacological therapy is prescribed. Antihypertensive blood pressure medications are used. When the numbers reach 110-130 for the systolic state, the optimal dose is established.
- In case of a sudden jump or hypertensive crisis, emergency antihypertensive treatment which, ideally, is carried out by an emergency physician.
- Concomitant treatment of additional pathologies is also used to lower blood pressure, since any heart disease, diabetes mellitus, circulatory failure, renal failure, thyroid problems entail an increase in systemic, intracranial and intraocular blood pressure.
You should carefully monitor and understand what normal blood pressure is, as incorrect interpretation and treatment can lead to complications.
The most common complications are:
- acute coronary syndrome, also known as myocardial infarction of varying severity;
- strokes of various origins;
- hypertensive crises;
- disturbances in the blood supply to various organs;
- dilatation of the heart chambers;
- cardiac hypertrophy;
- hypertensive angiopathy;
- visual impairment.
As a complication, the patient may develop renal failure.
Lower limits of blood pressure and pressure indicators during pregnancy
Not only an increase in the upper level of blood pressure poses a danger to the patient.
In this regard, the patient should know the norm of the lower limit and what pressure is normal for him.
The lower limit scale ends at 70 millimeters.
Anything lower can lead to a collapsed state.
Reasons for changes in the norm of lower blood pressure:
- Shocks of various origins - infectious-allergic, toxic, cardiogenic, anaphylactic.
- Bleeding.
- Adrenal insufficiency.
- Brain dysfunction.
These conditions are very dangerous due to their detrimental effect on the renal glomeruli. If systemic blood pressure drops below 50, the kidneys refuse to work properly and acute kidney failure develops.
A feature of the pregnant body is the blood supply not only to itself, but also to the developing fetus.
Eclampsia is a dangerous condition for mother and child. It is characterized by high jumps in blood pressure, as a result of which the mother may experience cardiovascular failure, placental abruption and fetal death.
The first signs of gestational hypertension are functional noise in the ears, dizziness, sudden deterioration in health, increased heart rate, increased heart rate. Pregnant women often develop vomiting and nausea.
Many people note that before an attack occurs, everything begins to spin before their eyes.
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Cardiologists and therapists take into account indicators of upper and lower blood pressure. To make a diagnosis of hypertension or essential hypertension, a simultaneous increase in both indicators is required. Treatment of hypertension is carried out with the help of drugs that regulate not only upper, but also increased lower pressure.
What does lower blood pressure represent?
To understand pressure indicators, you need to know how both numbers are formed:
- the upper pressure or systolic illustrates the pumping function of the heart. The indicator is formed at the moment blood is pushed out of the left ventricle, so it is higher than the lower pressure;
- the lower pressure or diastolic is recorded by the device at the moment of diastole, or relaxation of the heart muscle. It is formed at the moment of closing aortic valve and illustrates the state of vascular elasticity, their tone and response to cardiac ejection fraction.
Normal lower pressure is at the level of 60 – 89 mm. Hg Art. It can increase or decrease, which characterizes various pathologies. For example, lower pressure is reduced with renal artery stenosis. It is often called “renal”, since the condition of this indicator is often associated with kidney pathologies. And the upper pressure is called heart pressure.
Blood pressure is determined by systolic (upper) and diastolic pressure (lower)
High lower pressure: what is the danger of the condition?
The danger of increased lower pressure lies in the pathogenetic mechanisms of the process. The state of the body changes gradually:
- The heart pumps blood in an increased mode, then both pressure indicators increase, or the heart pumps blood in a normal mode, then the lower pressure increases.
- Normal functioning of the heart and an increase or decrease in lower pressure indicate that in the aorta and other blood vessels changes occurred in the walls. The circulatory system is in a state of tension, which leads to wear and tear of the vessels.
- Wear and tear of the vascular wall causes it to rupture and cause a stroke or heart attack.
- A gradual change in the wall causes the deposition of atherosclerotic plaques on it, which also leads to strokes and heart attacks. Atherosclerosis also becomes the impetus for the development of senile dementia, decreased intelligence and cognitive abilities, and the appearance of diabetes mellitus second type.
- Over time, along with atherosclerotic plaques, calcifications and blood clots are deposited on the vessels. Thrombosis and thromboembolism are possible.
- Arterial stenosis develops in the kidneys over time, which provokes gradual tissue shrinkage or atrophy of the organ parenchyma. The kidneys do not remove metabolic products in the same volume, which is characterized by the development of chronic renal failure and intoxication of the body.
Diastolic pressure shows the level of blood flow pressure on the vascular membrane when the heart muscle is relaxed, when the volume of blood in the vessels decreases
How to recognize high blood pressure?
If the lower pressure is increased, the patient will not complain about the direct manifestations of this condition. An isolated increase in lower pressure will not manifest itself in the form of headaches or asthma attacks. Such symptoms are characteristic only of increased upper and lower pressure.
Elevated diastolic pressure can be detected incidentally during examination of the patient.
It is also possible over time that complaints about accompanying pathologies and the consequences of increased lower indicators in the form of:
- memory and cognitive impairment;
- frequent urination in small volumes (pollakiuria);
- thromboembolism or thrombosis.
The loss of vascular elasticity is accompanied by a disruption in the blood supply to organs, namely, it becomes difficult for oxygen in red blood cells to penetrate the vascular wall. Ischemia of organs develops. This can cause the development of coronary artery disease, which will subsequently provoke a heart attack against the background of constant tension in the myocardium.
Promotion normal indicators speaks of a constant tense state of blood vessels
Why does high blood pressure develop?
An essential increase in lower pressure occurs no more often than in 25% of cases. If only the lower indicators increase, then the reason is often secondary diseases. An increase in lower pressure will provoke an increase in the systolic parameter in the future.
The doctor should suspect changes and examine such body structures as:
- adrenal glands and kidneys;
- organs of the endocrine system;
- pituitary;
- heart and its developmental defects;
- neoplasms in the body that produce hormones.
It is important to determine the level of hormones, namely:
- aldosterone;
- cortisol;
- thyroxine;
- vasopressin;
- renina.
More often, the increase occurs due to a decrease in the lumen of the renal artery, and main function kidneys - maintaining blood balance in blood vessels and arteries
An increase in systolic and diastolic pressure requires drug treatment. More specifically about pathologies that become causes of pressure surges:
- Diseases of the kidneys and adrenal glands.
The kidneys contain receptors that affect the body's blood pressure. In organs, the renin-angiotensin-aldosterone system (RAAS) is activated with the help of electrolytes and hormones, which ensures the interaction of renin, angiotensin and aldosterone. Due to them, the amount of urine excreted varies, the level of fluid and bcc in the body is regulated. Some substances are produced by the adrenal glands, for example, cortisol, corticosteroids. Mineralocorticoids of the aldosterone type have a hypertensive effect and remove potassium from the body, increasing the amount of sodium. To examine the function of these structures, CT and excretory urography are prescribed.
- Pathologies of the thyroid gland.
Thyroid diseases are characterized not only by their effect on blood pressure, but also by changes in the central nervous system. Pathologies with excess thyroid hormones can increase lower blood pressure. The substances have a hypertensive effect and also affect the condition of the heart, changing the structure of the myocardium. They increase both upper and lower pressure. The effect on the tonometer readings is one of the first symptoms of thyroid damage; it appears before other signs.
- Diseases associated with the musculoskeletal system.
An increase in upper and lower blood pressure can be explained not only by vascular pathologies. If the openings in the spine through which the arteries pass narrow due to pathology or injury, then the readings on the tonometer increase, and the elasticity of the vascular wall is lost due to compression of the structures.
In medicine, the following factors are identified: improper functioning of the thyroid gland
- Excessive amount of fluid in the body.
This condition is due to the intake of excess water or the restriction of fluid excretion associated with the kidneys. The increase in lower pressure is influenced by aldosterone and the amount of sodium ions. Water is retained in the tissues of the body if you eat salty foods. Water helps dilute excess salt in the body and is not excreted in urine. To reduce the lower pressure, you can remove the water using physical activity, use of diuretic decoctions and drugs.
- Atherosclerosis.
A pathology in which the elasticity of blood vessels decreases due to the deposition of lipid plaques on the vascular wall, which over time turn into calcifications. The pathology develops over years and does not manifest itself in early stages. Increased lower pressure is detected when there are changes in the aortic wall and hypertension with increased systolic pressure joins the pathology.
Changes in the vascular wall and increases in lower blood pressure can be provoked by autoimmune vasculitis and systemic lupus erythematosus. The disease manifests itself more often in girls aged 20–25 years.
Ways to reduce high diastolic pressure
If the patient is not bothered by the symptoms of increased diastolic pressure, but is only concerned about the tonometer readings, then metabolic drugs, as well as angioprotectors, can be taken. Products such as Asparkam, Panangin, ATP, and Tonginal are effective for cardiac and vascular activity. Potassium supplements nourish the myocardium and prevent it from depleting. It is important to take these drugs according to the instructions, with breaks in courses. Potassium in excessive quantities can cause fibrillation of the heart chambers and even stop them in systole.
Medicines are prescribed exclusively by the attending physician after a comprehensive examination
Diuretics can be used together with potassium supplements. They are prescribed if the patient is bothered by swelling. You can prepare your own diuretic teas based on:
- horsetail;
- bearberry;
- raspberries and currants;
- lingonberry leaves.
Pharmacies sell diuretic decoctions with instructions for brewing teas and use. Such remedies will reduce both lower and upper pressure. Aldosterone antagonists, Spironolactone, also known as Veroshpiron, are most often prescribed as diuretic medications. The drug begins to act after three to four days of regular use.
The drugs “Hypochlorothiazide”, “Sidnocarb”, “Torsid” are often used. They are potent, so the dosage is calculated strictly by a specialist. Products such as Triamterene, which conserve potassium, increase the amount of the mineral in the body, and therefore also require consultation with a doctor and testing for electrolytes. Diuretics are not prescribed during pregnancy.
Therapy for high lower blood pressure
If isolated or combined increased lower pressure is observed (from 95 mm Hg or higher), then doctors prescribe centrally acting antihypertensive drugs:
- "Moxonidine" is an alpha2 adrenergic blocker and imidazoline receptor antagonist.
Medicines are taken after a comprehensive examination
- "Methyldopa" is an alpha2 adrenergic blocker responsible for inhibiting the sympathetic nervous system.
- "Albarel" is an alpha2 adrenergic blocker that suppresses sympathomimetic activity.
The drugs eliminate vasospasm by inhibiting the sympathetic nervous system and reducing the number of receptors that bind substances that increase blood pressure. As a result of taking it, both upper and lower pressures decrease, and the indicators normalize. You can purchase the drug only on the basis of prescriptions written by a specialist.
Basic therapy for high blood pressure is supplemented with conventional antihypertensive drugs in the form of ACE inhibitors or ARA2. Before prescribing medications, it is important to check the degree of renal artery stenosis. A significant degree of narrowing is a contraindication to taking ARA2 and ACE inhibitors. If renal artery stenosis is detected, it is necessary to choose calcium antagonists or new drugs - renin antagonists. A representative of this group is Aliskiren.
The following are used as ACE inhibitors:
- "Captopril"
- "Enalapril"
- "Lisinopril"
- "Pirindopril."
They are often combined with diuretics. You can take APA2 drugs in the absence of contraindications, namely:
- "Losartan"
- "Valsartan"
- "Candesartan".
These groups have the least number of contraindications and side effects. They are well tolerated by patients during long-term therapy for two months.
To find out exactly what to do if your blood pressure (systolic or diastolic) is elevated, you need to consult your doctor and check the readings on a tonometer. You can keep a notebook yourself and write down the results of examinations in it to track the indicator over time. It is necessary to measure up to five times a day and at the time of indisposition.
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Tachycardia at low pressure
What happens to blood vessels at high and low pressure?
Features of the circulatory system of the heart
The most important system of the body, the blood circulation of the heart, is responsible for ensuring normal human life. Naturally, the heart organ is fundamental in this system. Blood circulation occurs from the heart and back, the task of which, on the one hand, is the timely delivery of nutrients and oxygen, and on the other, to remove harmful toxins and carbon dioxide.
Organ structure
To understand the role of the heart in blood circulation, one should take a closer look at its structure.
Blood transportation is carried out thanks to the uninterrupted contractions of a hollow organ, that is, the heart. This peculiar cone-shaped pump is located in the chest cavity, or more precisely, slightly to the left of the central part. The organ is surrounded by a pericardial sac, which contains fluid that reduces friction during contractions.
The mass of the hollow organ varies from 250 to 300 g. The structure of the heart is quite complex.
It is necessary to distinguish between the presence of four cameras:
- left and right atria;
- left and right ventricles.
The dimensions of the atria, as well as the thickness of the walls, are smaller. A solid partition is installed between both parts.
This design of the main pump can be explained by the fact that each cavity has its own function. Blood flows in only one direction - from the atria to the ventricles, and these, in turn, help push blood into the circulation.
The heart wall consists of 3 layers:
- Epicardium.
- Myocardium.
- Endocardium.
Why is there rhythmic contraction and relaxation in the organ? Because in the middle layer, that is, the myocardium, bioelectric impulses arise. The place where they appear is called the “sinus node.” It is localized in the right atrium. If we talk about the processes occurring in the body of an adult, then in a normal state, about 80 impulses are generated by the node in one minute. Accordingly, the myocardium contracts the same amount.
But when the blood supply to the sinus node is disrupted or its work is inhibited due to some negative factors, arrhythmia is diagnosed.
The heart contracts for 0.3 seconds, then rests for 0.4 seconds. The performance of the organ is truly fantastic. It is capable of pumping approximately 14 tons of blood per day. How better blood circulation will function, the more efficient the heart will work. Providing the organ with oxygen and substances depends on the condition of the coronary arteries.
Features of the blood supply system
There is a certain blood circulation pattern.
In the area where the heart is located, blood vessels intertwine and, accordingly, form blood circulation circles:
- big;
- small.
The right ventricle is where the pulmonary circle originates. From it, venous blood enters the pulmonary trunk. This is the largest vessel in size. central part small circle - lungs.
Each circle has its own goal. If the large one is responsible for the blood supply to all organs without exception, then the task of the small one is gas exchange in the pulmonary alveoli and heat transfer.
In addition, it is necessary to say about the presence of additional circles of blood flow:
- placental (when maternal blood containing oxygen flows to the developing fetus);
- Willisian (deals with blood saturation of the brain and is located at its base).
The blood supply system is characterized by some features:
- Arteries have more high level elasticity, but their capacity is less than that of veins.
- Despite its isolation, the vascular system boasts a large branching of blood vessels.
- Tubular formations have a variety of diameters - from 1.5 cm to 8 microns.
General characteristics of vessels
If the blood circulation functions without disturbances, there will also be no disruptions in the heart.
Blood circulation in the human body is carried out thanks to five types of vessels:
- Arteries. They are the most durable. Through them, blood flows from the fibromuscular hollow organ. Muscle, collagen, and elastic fibers form their walls. For this reason, the diameter of the arteries increases or decreases depending on the amount of blood that passes through them.
- Arterioles. Vessels that are slightly smaller in size than the previous ones.
- Capillaries are the thinnest and shortest tubular formations. Consist of single-layer epithelium.
- Venulam. The formations, although small, are responsible for the removal of blood containing carbon dioxide.
- Venam. Wall thickness is medium. They carry blood to the heart. They contain more than 70% liquid mobile connective tissue.
The movement of blood through the vessels is due to the functioning of the heart and the resulting pressure difference.
Not long ago there was an opinion that veins have a passive role. However, according to the results of the study, scientists were able to discover that these vessels are a kind of reservoir, thanks to which the amount of circulating blood is controlled. Thus, the human body relieves the heart muscle of excess load or increases it as needed.
When the blood flow puts pressure on the walls of both blood vessels and the heart, this phenomenon is called blood pressure. Normal material metabolism and urine formation depend on this parameter.
The pressure can be:
- Arterial. It occurs when the ventricles contract as blood flows out of them.
- Venous. Tension created in the right atrium.
- Capillary.
- Intracardiac. Its formation occurs at a time when the myocardium is relaxed.
The heart is an organ, although small in size, but truly amazing and resilient. It has been proven that age does not affect its functioning. In the absence of diseases and moderate physical activity, it works effectively for anyone. If the load is continuous and nutrients are supplied irregularly, in a short time it appears oxygen starvation and fatigue of the heart muscle. Accordingly, these factors contribute to rapid wear of the organ.
Therefore, the better a person takes care of his health, the less likely he is to end up in a hospital bed.
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- pharmachologic effect
- Pharmacokinetics
- Indications for use
- Dosage
- Side effects
- Contraindications
- Pregnancy and breastfeeding
- Drug interactions
- Overdose
- Release form
- Storage conditions and periods
- Compound
- Use of metoprolol
- Dosage forms: tartrate and succinate
- Clinical researches
- Comparison with other beta blockers
- Prices in online pharmacies
- Dosage of metoprolol for various diseases
- How to switch to bisoprolol or carvedilol
- Patient reviews
- Frequently asked questions and answers
- conclusions
Metoprolol is a medicine that doctors often prescribe for hypertension, coronary heart disease, chronic heart failure, as well as for the prevention of first and recurrent heart attacks. Used since the 1980s, well studied. Metoprolol comes in two dosage forms: tartrate and succinate. There are differences between them that are important to understand. They are described in detail below in the article. According to the classification, metoprolol is classified as a beta blocker. It reduces the effect of adrenaline and other stimulating hormones on the heart muscle. Thanks to this, the pulse becomes slower, blood pressure normalizes, and the load on the heart is reduced. Below you will find instructions for use written in accessible language. Read the indications for use, contraindications, dosages. Find out how to take metoprolol - before or after meals, for how long, in what dosage.
Metoprolol: instructions for use
| pharmachologic effect | Selective beta1-blocker. Reduces the stimulating effect that adrenaline and other catecholamine hormones have on cardiac activity. Thus, the medicine prevents an increase in heart rate, cardiac output, and increased contractility of the heart. At emotional stress And physical activity There is a sharp release of catecholamines, but blood pressure does not increase as much. |
| Pharmacokinetics | Metoprolol is quickly and completely absorbed. Taking it with food can increase its bioavailability by 30–40%. Extended-release tablets contain microgranules, from which the active substance, metoprolol succinate, is slowly released. Therapeutic effect lasts more than 24 hours. Fast-acting metoprolol tartrate tablets stop working no later than after 10-12 hours. This medication undergoes oxidative metabolism in the liver, but approximately 95% of the administered dose is excreted by the kidneys. |
| Indications for use |
Important! Heart failure, reduction in mortality and re-infarction rates are indications only for metoprolol succinate, extended-release tablets. Fast-acting metoprolol tartrate tablets for heart failure and after suffered a heart attack should not be prescribed. |
Watch also the video about treatment of ischemic heart disease and angina
| Dosage | Read more about the dosage of metoprolol succinate and tartrate for hypertension, angina, heart failure here. The tablets can be divided in half, but must not be chewed or crushed. Can be taken with food or on an empty stomach, whichever is more convenient. The dose must be selected individually for each patient and increased slowly so that bradycardia does not develop - pulse below 45-55 beats per minute. |
| Side effects | Common side effects:
For any rare or severe side effects, consult your doctor immediately! |
| Contraindications |
|
| Pregnancy and breastfeeding | The use of fast- or “slow-acting” metoprolol tablets during pregnancy is possible only if the benefits to the mother outweigh the risks to the fetus. Like other beta blockers, metoprolol can theoretically cause side effects such as bradycardia in the fetus or newborn. A small amount of the drug is excreted into breast milk. When prescribing average therapeutic doses, the risk of side effects for the infant is not high. However, you need to carefully monitor the child for possible signs of beta-adrenergic blockade. |
| Drug interactions | Nonsteroidal anti-inflammatory drugs weaken the effect of metoprolol in lowering blood pressure. Other medications for hypertension, on the contrary, increase it. This drug should not be taken at the same time as verapamil or diltiazem. The list of drug interactions with metoprolol is not complete. Tell your doctor about all the medications, supplements, and herbs you take before you are given a prescription for medications for hypertension and heart disease. |
| Overdose | Symptoms include low heart rate and other heart problems. Also, depression of lung function, impaired consciousness, possible uncontrolled trembling, convulsions, increased sweating, nausea, vomiting, fluctuations in blood sugar. Treatment - first of all, reception activated carbon and gastric lavage. Further - resuscitation measures in the intensive care unit. |
| Release form | Tablets of 25 mg, 50 mg, 100 mg, 200 mg, film-coated. |
| Storage conditions and periods | Store at a temperature not exceeding 30 °C, shelf life - 3 years. Do not use after the expiration date stated on the package. |
| Compound | The active substance is metoprolol succinate or tartrate. Excipients: methylcellulose; glycerol; corn starch; ethylcellulose; magnesium stearate. Film shell: hypromellose, stearic acid, titanium dioxide (E171). |
How to take metoprolol
First of all, make sure that you have been prescribed a drug whose active ingredient is metoprolol succinate. There is currently no reason to use older tablets containing metoprolol tartrate. They need to be taken several times a day, which is inconvenient for patients. They cause spikes in blood pressure. This is harmful to blood vessels. Take the medicine Betaloc ZOK or Egilok S in the dosage prescribed by the doctor, and for as long as the doctor recommends. These medications need to be taken for a long time - several years, or even for life. They are not suitable for situations where you need to quickly lower blood pressure or relieve an attack of chest pain.
How long can you take metoprolol?
Metoprolol should be taken for as long as your doctor directs. Visit your healthcare provider regularly for follow-up examinations and consultations. You cannot take breaks without permission, cancel the medicine or reduce its dosage. Live a healthy lifestyle while taking your beta blocker and other medications prescribed to you. This is the main treatment for hypertension and cardiovascular diseases. If you do not follow the recommendations for a healthy lifestyle, then over time even the most expensive pills will stop helping.
How to take metoprolol: before or after meals?
The official instructions do not indicate how to take metoprolol - before or after meals. Authoritative site on English language(http://www.drugs.com/food-interactions/metoprolol,metoprolol-succinate-er.html) says that medications containing metoprolol succinate and tartrate should be taken with meals. Food enhances the effect of the medicine compared to taking it on an empty stomach. Find out what a low-carbohydrate diet is and how it is useful for hypertension and cardiovascular diseases. Talk to your doctor about whether you can follow it.
Are metoprolol and alcohol compatible?
Tablets containing metoprolol tartrate are poorly tolerated, and drinking alcohol further increases their side effects. Hypotension may occur - blood pressure will drop too low. Symptoms of hypotension: dizziness, weakness, even loss of consciousness. Drugs, active substance of which metoprolol succinate is compatible with reasonable alcohol consumption. You can drink alcohol only if you are able to maintain moderation. Getting drunk while taking beta blockers is dangerous. It is advisable not to drink alcohol for the first 1-2 weeks from the start of treatment with metoprolol, as well as after increasing the dose of the drug. During these transition periods, you should also not manage vehicles and dangerous mechanisms. 
Prices for drugs whose active ingredient is metoprolol succinate
Prices for drugs whose active ingredient is metoprolol tartrate
Use of metoprolol
Metoprolol is a popular medicine all over the world for arterial hypertension, coronary heart disease, and heart rhythm disorders. Since the 2000s, additional indications for use have appeared. It also began to be prescribed for chronic heart failure, along with traditional drugs - ACE inhibitors, diuretics and others. Let's figure out how metoprolol works, what dosage forms there are and how they differ from each other.
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Adrenaline and other hormones, which are classified as catecholamines, stimulate the heart muscle. As a result, the heart rate and the volume of blood that the heart pumps with each beat increases. Blood pressure increases. Beta blockers, including metoprolol, weaken (block) the effect of catecholamines on the heart. Due to this, blood pressure and heart rate drop. The load on the heart decreases. The risk of first and second heart attacks is reduced. The life expectancy of people who have developed coronary heart disease or chronic heart failure is increasing.
Dosage forms of metoprolol: tartrate and succinate
Metoprolol tablets contain salts - tartrate or succinate. Traditionally, metoprolol tartrate has been used to produce fast-acting tablets, from which the drug immediately enters the bloodstream. Succinate - for sustained release dosage forms. Extended-release metoprolol succinate tablets are manufactured using CR/XL (Controlled Release/Extended Release) or ZOK (Zero-Order-Kinetics) technologies. Fast-acting metoprolol tartrate has significant disadvantages. It is less effective than newer beta blockers and is less well tolerated.
| How many times a day to take | 2-4 times a day | It is enough to take 1 time per day. Each dose taken lasts about 24 hours. |
| Stable concentration of the active substance in the blood | No | Yes |
| Inhibits the development of atherosclerosis | No | Yes, it slightly enhances the effect of statin drugs |
| Tolerability, frequency of side effects | Less well tolerated than sustained-release metoprolol tablets | Well tolerated, side effects are rare |
| Efficacy in heart failure | Weak | Yes, comparable to other modern beta blockers |
Most studies that have demonstrated the effectiveness of metoprolol for cardiovascular disease have used sustained-release formulations containing succinate. Manufacturers of metoprolol tartrate could not watch this with indifference and took retaliatory measures. In the mid-2000s, a “delayed” tartrate called Egilok retard began to be sold in Russian-speaking countries.
There was a wave of articles in medical journals proving that it helps no worse than metoprolol succinate, in particular, original drug Betalok ZOK. However, these articles are not credible. Because they were clearly financed by the manufacturer of Egilok retard tablets. In such a situation, it is impossible to conduct objective comparative studies of drugs. It was not possible to find any information about sustained-release metoprolol tartrate preparations in English-language sources.
Clinical researches
Metoprolol tablets have been prescribed to patients for hypertension and cardiovascular disease since the 1980s. Dozens of large studies of this beta blocker have been conducted, involving thousands of patients. Their results were published in reputable medical journals.
| Hjalmarson A., Goldstein S., Fagerberg B. et al. Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the metoprolol CR/XL randomized intervention trial in congestive heart failure (MERIT-HF). JAMA 2000;283:1295-1302. | Effect of metoprolol extended-release tablets on overall mortality, hospitalization rates and quality of life in patients with chronic heart failure | Metoprolol succinate in a sustained-release form is effective in heart failure. However, this study did not compare it to other beta blockers. |
| Deedwania PC, Giles TD, Klibaner M, Ghali JK, Herlitz J, Hildebrandt P, Kjekshus J, Spinar J, Vitovec J, Stanbrook H, Wikstrand J. Efficacy, safety and tolerability of metoprolol CR/XL in patients with diabetes and chronic heart failure: experiences from MERIT-HF. American Heart Journal 2005, 149(1):159-167. | Efficacy, safety and tolerability of metoprolol succinate in patients with diabetes and chronic heart failure. Data from the MERIT-HF study. | Patients with type 2 diabetes tolerate metoprolol succinate well, prescribed to them for the treatment of chronic heart failure. The drug improves survival and reduces hospitalizations. However, it does not increase blood sugar. |
| Wiklund O., Hulthe J., Wikstrand J. et al. Effect of controlled release/extended release of metoprolol on carotid intima-media thickness in patients with hypercholesterolemia: a 3-year randomized study. Stroke 2002;33:572-577. | Effect of metoprolol sustained-release tablets on the thickness of the intima-media complex carotid artery in patients with high blood cholesterol. Data from a 3-year study compared with placebo. | Metoprolol sustained-release tablets (succinate) inhibits the development of atherosclerosis when prescribed to patients in addition to statins. |
| Heffernan KS, Suryadevara R, Patvardhan EA, Mooney P, Karas RH, Kuvin JT. Effect of atenolol vs metoprolol succinate on vascular function in patients with hypertension. Clin Cardiol. 2011, 34(1):39-44. | Comparison of the effects of atenolol and metoprolol succinate on vascular function in patients with high blood pressure. | Atenolol and metoprolol succinate reduce blood pressure equally. At the same time, metoprolol better protects blood vessels. |
| Cocco G. Erectile dysfunction after therapy with metoprolol: the hawthorne effect. Cardiology 2009, 112(3):174-177. | Erectile dysfunction while taking metoprolol. | Weakening of potency in men while taking metoprolol succinate in at least 75% of cases is caused by a psychological mood, and not by the actual effect of the drug. Placebo restores potency no worse than tadalafil (Cialis). |
We emphasize that only metoprolol succinate has a solid evidence base. It works well, especially in combination with other medications, and rarely causes side effects. In particular, this beta blocker does not impair male potency. Metoprolol tartrate cannot boast of any special advantages. Today it is no longer advisable to use it, even despite the low price.
Comparison with other beta blockers
Recall that metoprolol is used in medical practice since the 1980s. Even extended-release metoprolol succinate tablets with improved characteristics are no longer new. This beta blocker has a large share of the pharmaceutical market. Doctors know it well and readily prescribe it to their patients. However, other drugs are trying to supplant it.
Beta blockers - competitors of metoprolol:
| Espinola-Klein C, Weisser G, Jagodzinski A, Savvidis S, Warnholtz A, Ostad MA, Gori T, Munzel T. Beta-Blockers in patients with intermittent claudication and arterial hypertension: results from the nebivolol or metoprolol in arterial occlusive disease trial. Hypertension 2011, 58(2):148-54 | Effect of beta blockers in patients with intermittent claudication and hypertension. Results of a comparative study of nebivolol and metoprolol for circulatory disorders in peripheral arteries. | Metoprolol and nebivolol help patients with circulatory problems in the legs equally well. There is no difference in effectiveness between the drugs. |
| Kampus P, Serg M, Kals J, Zagura M, Muda P, Karu K, Zilmer M, Eha J. Differential effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness. Hypertension.2011, 57(6):1122-8. | Differences in the effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness. | Nebivolol and metoprolol similarly reduced heart rate and mean blood pressure. However, only nebivolol significantly normalizes central SBP, DBP, central pulse pressure and left ventricular wall thickness. |
| Phillips RA, Fonseca V, Katholi RE, McGill JB, Messerli FH, Bell DS, Raskin P, Wright JT Jr, Iyengar M, Anderson KM, Lukas MA, Bakris GL. Demographic analyzes of the effects of carvedilol vs metoprolol on glycemic control and insulin sensitivity in patients with type 2 diabetes and hypertension in the Glycemic Effects in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) study. Journal of the CardioMetabolic Syndrome 10/2008; 3(4):211-217. | Demographic analysis of the effects of carvedilol and metoprolol on glycemic control and insulin sensitivity in patients with type 2 diabetes and hypertension. Data from the GEMINI study. | In patients with type 2 diabetes, carvedilol has a better effect on metabolism than metoprolol. However, the study used metoprolol tartrate rather than succinate. |
| Acikel S, Bozbas H, Gultekin B, Aydinalp A, Saritas B, Bal U, Yildirir A, Muderrisoglu H, Sezgin A, Ozin B. Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery. International Journal of Cardiology 2008, 126(1):108-113. | Comparison of the effectiveness of metoprolol and carvedilol in preventing arterial fibrillation after coronary artery bypass surgery. | In patients undergoing coronary artery bypass surgery, carvedilol is better at preventing atrial fibrillation than metoprolol succinate. |
| Remme WJ, Cleland JG, Erhardt L, Spark P, Torp-Pedersen C, Metra M, Komajda M, Moullet C, Lukas MA, Poole-Wilson P, Di Lenarda A, Swedberg K. Effect of carvedilol and metoprolol on the mode of death in patients with heart failure. European Journal of Heart Failure 2007, 9(11):1128-1135. | The effect of carvedilol and metoprolol on causes of mortality in patients with heart failure. | In patients with heart failure, carvedilol reduces all-cause mortality better than metoprolol tartrate, and especially mortality from stroke. |
Competing beta blockers may be more effective than metoprolol. However, metoprolol succinate extended-release tablets also help well. And doctors are conservative. They are in no hurry to replace medications that they have long been accustomed to prescribing to patients with others. Moreover, metoprolol drugs have a relatively affordable price. In pharmacies, the demand for tablets Betalok ZOK, Egilok S, Metoprolol-Ratiopharm, if it falls, then slowly, or remains consistently high.
Dosage of metoprolol for various diseases
Metoprolol is contained in tablets in the form of one of two salts - tartrate or succinate. They act differently and provide different rates of entry of the active substance into the blood. Therefore, for fast-acting metoprolol tartrate tablets there is one dosage regimen, and for “slow” metoprolol succinate tablets there is another. Please note that metoprolol tartrate is not indicated for heart failure.
| Arterial hypertension | 50–100 mg once daily. If necessary, the dose can be increased to 200 mg per day, but it is better to add another antihypertensive drug - a diuretic, a calcium antagonist, ACE inhibitor. | 25–50 mg twice daily, morning and evening. If necessary, the dose can be increased to 100-200 mg per day or other medications that lower blood pressure can be added. |
| Angina pectoris | 100–200 mg once daily. If necessary, another antianginal drug may be added to therapy. | The initial dose is 25–50 mg, taken 2-3 times a day. Depending on the effect, this dose may be gradually increased to 200 mg per day or another angina medicine may be added. |
| Stable chronic heart failure functional class II | The recommended starting dose is 25 mg once daily. After two weeks of treatment, the dose can be increased to 50 mg once daily. Then double it every two weeks. Maintenance dose for long-term treatment- 200 mg once a day. | Not shown |
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| Stable chronic heart failure of III-IV functional class | It is recommended to start with a dose of 12.5 mg (1/2 tablet of 25 mg) once daily for the first two weeks. The dose is selected individually. After 1–2 weeks from the start of treatment, the dose can be increased to 25 mg once a day. Then, after another 2 weeks, the dose can be increased to 50 mg once a day. And so on. For patients who tolerate a beta blocker, the dose can be doubled every 2 weeks until a maximum dose of 200 mg once daily is reached. | Not shown |
| Heart rhythm disturbances | 100–200 mg once daily. | The initial dose is 25-50 mg 2-3 times a day. If necessary, the daily dose can be gradually increased to 200 mg/day or another drug that normalizes heart rhythm can be added. |
| Maintenance treatment after myocardial infarction | The target dose is 100–200 mg per day, in one or two doses. | The usual daily dose is 100–200 mg, divided into two doses, morning and evening. |
| Functional cardiac disorders accompanied by tachycardia | 100 mg once daily. If necessary, the dose can be increased to 200 mg per day. | The usual daily dose is 50 mg 2 times a day, morning and evening. If necessary, it can be increased to 2 times 100 mg. |
| Prevention of migraine attacks (headaches) | 100–200 mg once daily | The usual daily dose is 100 mg, divided into two doses, morning and evening. If necessary, it can be increased to 200 mg/day, also divided into 2 doses. |
A note on metoprolol succinate dosage for heart failure. If the patient develops bradycardia, that is, the pulse drops below 45-55 beats per minute, or the “upper” blood pressure is below 100 mmHg. Art., you may need to temporarily reduce the dose of the medication. At the beginning of treatment, there may be arterial hypotension. However, after some time, in many patients, the body adapts, and they normally tolerate therapeutic doses of the drug. Drinking alcohol increases the side effects of metoprolol, so it is better to abstain from alcohol.
How to switch to bisoprolol or carvedilol
It may happen that the patient will need to switch from metoprolol to bisoprolol (Concor, Biprol or another) or carvedilol. The reasons may be different. In theory, replacing one beta blocker with another does not provide significant benefit. In practice, the gains may manifest themselves. Because the effectiveness and tolerability of drugs is individual for each person. Or the usual metoprolol tablets may simply disappear from sale and will have to be replaced with another drug. The table below may be helpful to you.
Source - DiLenarda A, Remme WJ, Charlesworth A. Exchange of beta-blockers in heart failure patients. Experiences for the post-study phase of COMET (the Carvedilol or Metoprolol European Trial). European Journal of Heart Failure 2005; 7:640-9.
The table shows metoprolol succinate. For metoprolol tartrate in immediate-release tablets, the equivalent total daily dose is approximately 2 times higher. Bisoprolol is taken 1 time per day, carvedilol - 1-2 times per day.
Patient reviews
Metoprolol succinate in extended-release tablets causes side effects much less often than fast-acting tartrate. It is not surprising that reviews of drugs with controlled release (Egilok S, Betalok LOC) are much more positive than about fast-acting drugs in which active substance- metoprolol tartrate.
If you have high blood pressure and at the same time prediabetes or type 2 diabetes, then you need to study and follow a type 2 diabetes treatment program. This technique normalizes blood pressure and sugar. A glucometer and tonometer will show you the first results in 2-3 days. All this without insulin injections, fasting and low-calorie diets.
Study the article “Causes of hypertension and how to eliminate them.” Get examined as it is written there, and then follow the recommendations for treatment. With a high probability, you will be able to maintain normal blood pressure without medications, and you will not have to experience their side effects.
Heart problems do not arise due to a lack of metoprolol in the body. The real reason is a deficiency of nutrients that the heart needs to function. First of all, it is magnesium and coenzyme Q10. Try taking these medications along with a beta blocker. You will probably feel better. Also pay attention to your diet. Switch from junk fast food to natural products. 
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Proven effective and cost-effective supplements for normalizing blood pressure:
- Magnesium + Vitamin B6 from Source Naturals;
- Taurine from Jarrow Formulas;
- Fish oil from Now Foods.
Read more about the technique in the article “Treatment of hypertension without drugs“. How to order hypertension supplements from the USA - download instructions. Bring your blood pressure back to normal without the harmful side effects that Noliprel and other “chemical” pills cause. Improve your heart function. Become calmer, get rid of anxiety, sleep like a baby at night. Magnesium with vitamin B6 works wonders for hypertension. You will have excellent health, the envy of your peers.
Frequently asked questions and answers
Below are answers to questions that often arise in patients taking metoprolol for high blood pressure and cardiovascular diseases.
Metoprolol or Betaloc ZOK: which is better?
Betaloc ZOK is the trade name of a medicine whose active ingredient is metoprolol succinate. It cannot be said that metoprolol is better than Betaloc ZOK, or vice versa, because they are the same thing. Betaloc ZOK is better than any tablet containing metoprolol tartrate. The reasons for this are described in detail above. Metoprolol tartrate today can be considered an obsolete medicine.
Metoprolol or Concor: which is better?
In mid-2015, a study was completed that compared the effectiveness of metoprolol succinate and Concor (bisoprolol) in the treatment of hypertension. It turned out that both drugs lowered blood pressure equally and were well tolerated. Unfortunately, there is no reliable information which of these drugs is better for patients with heart failure, coronary artery disease and angina pectoris. Which is better: Concor, Betalok ZOK or Egilok S? Leave this issue to the discretion of your doctor. However, you should not take tablets whose active ingredient is metoprolol tartrate. They are definitely worse than the drugs listed above.
Is metoprolol good for blood pressure?
Metoprolol succinate helps with blood pressure no worse than other modern beta blockers - bisoprolol, nebivolol, carvedilol. There is no reliable information which of these drugs is better than the others. However, it is known for sure that metoprolol tartrate is an outdated medicine that is better not to use. These tablets must be taken several times a day, which is inconvenient for patients. They cause significant jumps in blood pressure. This is harmful to blood vessels. Metoprolol tartrate does not sufficiently reduce the risk of heart attack and other complications of hypertension.
If your doctor has prescribed metoprolol for your blood pressure, then take Betaloc ZOK or Egilok S. As a rule, these medications should be used together with other medications for hypertension that are not beta blockers. Taking several medications in low doses is better than taking one single drug in a high dosage. Remember that the main treatment for hypertension is a healthy lifestyle. If you do not follow the recommendations for nutrition, physical activity and stress management, then soon even the most expensive pills will no longer help.
Can this beta blocker and lisinopril be taken together?
Yes, metoprolol and lisinopril can be taken together as prescribed by your doctor. These are compatible drugs. Do not take any of the medications listed in this article on your own. Find experienced doctor so that he can select the best high blood pressure medications for you. Before you are prescribed medications, you need to take tests and undergo an examination. Visit your doctor again at least once every few months to adjust your medication regimen based on the results of treatment over time.
I was prescribed the medicine metoprolol (Egilok S) for blood pressure. I started taking it - my vision has deteriorated and I often get up to go to the toilet at night. Ulcers have also appeared on my legs and are healing poorly. This side effects tablets?
No, Egilok tablets have nothing to do with it. Rather, you are experiencing complications of type 2 diabetes. Study the article “Symptoms of Diabetes in Adults,” then go to the laboratory and get blood tests for sugar. If diabetes is detected, treat it.
How quickly does blood pressure drop after taking metoprolol?
Tablets whose active ingredient is metoprolol succinate act smoothly. They are not suitable if you need to quickly stop a hypertensive crisis. Medicines that contain metoprolol tartrate begin to lower blood pressure within 15 minutes. The full effect develops after 1.5-2 hours and lasts about 6 hours. If more is required quick fix, then study the article “How to provide emergency assistance in hypertensive crisis."
Is metoprolol compatible with... such and such a drug?
Read the instructions for the drug you are interested in. Find out which group he belongs to. This may be a diuretic (diuretic), an ACE inhibitor, a blocker angiotensin-II receptors, calcium antagonist (calcium channel blocker). Metoprolol is compatible with all of the listed groups of drugs for hypertension. For example, you are interested in Prestarium. In the instructions you will find that this is an ACE inhibitor. Metoprolol is compatible with it. Indapamide is a diuretic. You can also take it with it. And so on. Typically, patients are prescribed 2-3 medications for blood pressure at the same time. Read more in the article “Combined medications for hypertension are the most powerful.”
Metoprolol is a beta blocker. You should not take two beta blockers at the same time. Therefore, do not take it together with bisoprolol (Concon, Biprol, Bisogamma), nebivolol (Nebilet, Binelol), carvedilol, atenolol, anaprilin, etc. In general, you should not take two medications for hypertension that belong to the same group at the same time.
How much high risk that taking the medicine Egilok S or Betalok ZOK will worsen psoriasis?
No higher than others modern beta blockers. There are no exact data in the literature.
I have hypertension due to nervous work, frequent scandals. The doctor prescribed metoprolol. I read that side effects include depression. And I’m already all on edge. Is it worth taking these pills?
Depression and nervous agitation are opposites. Depression is powerlessness, apathy, melancholy. Judging by the text of the question, you are experiencing the opposite emotions. Taking metoprolol will probably have a calming effect, which will benefit you.
Metoprolol lowered my blood pressure, but my hands and feet began to feel cold. Is this normal or should I stop taking it?
My hands and feet began to feel cold - this is a common side effect of beta blockers, including metoprolol. If you feel that the benefits of taking the medicine are greater than the harm from its side effects, then continue taking it. If you feel unwell, ask your doctor to select another drug for you. Keep in mind that taking beta blockers may make you feel worse in the first week, but then your body will adapt. So it’s worth waiting for some time if the “upper” pressure remains above 100 mmHg. Art. and the heart rate does not drop below 55 beats per minute.
The doctor advised me to replace the hypertension medicine Metoprolol-Ratiopharm with the more expensive Betaloc ZOK. Is it worth doing?
Yes, it's worth it. The active ingredient of the drug from Ratiopharm is metoprolol tartrate, and Betaloc ZOK is succinate. The difference between them is described in detail above. You may not realize how much better the new medicine is at protecting you from a heart attack. But you will probably like that now the tablets can only be taken once a day. Your blood pressure will become closer to normal, and its fluctuations during the day will decrease.
conclusions
Metoprolol is a popular pill all over the world for high blood pressure, coronary heart disease (angina), heart failure and arrhythmia. The article provides all the information about this medicine that doctors and patients may need. Also provided are links to primary sources - the results of clinical studies, for in-depth study.
Currently, only metoprolol succinate, slow-release tablets, are recommended for use. It is enough to take this remedy once a day. Medicines whose active ingredient is metoprolol tartrate should be taken 2-4 times a day. They are less effective than other beta blockers and are less well tolerated. If you are taking them, discuss with your doctor whether you should switch to another drug.
Perhaps bisoprolol, carvedilol and nebivolol help patients better than metoprolol succinate and especially tartrate. This is proven by many articles that have appeared in medical journals since the mid-2000s. However, Betalok ZOK and Egilok S tablets are in no hurry to cede their market share to competitors. Because doctors have been prescribing these medications for a long time, they know their effects well and are in no hurry to abandon them. Moreover, metoprolol drugs have a more attractive price compared to other beta blockers.
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Angioscan - if you have nowhere to spend money
As distrust in domestic medicine grows, so does the number of “enterprising” people trying to mislead patients in a completely legal way, creating useless devices with a completely scientifically proven operating principle. Obviously, Angioscan is one of such devices.
What is Angioscan?
In fact, this is a device that was invented long ago and introduced into medical practice - a pulse oximeter. Not a single modern intensive care unit can do without it, you've probably seen it in the movies - it's like a clothespin on your finger. This “clothespin” is indeed capable of determining several basic characteristics of the pulse (its frequency, speed and filling), as well as blood oxygen saturation, but this is where its capabilities end. The pulse oximeter is used mainly in intensive care wards to monitor cardiopulmonary activity in critically ill patients.
Our “scientists” came up with the idea of putting this “clothespin” on a healthy person and called it Angioscan.
It should be noted that the idea of using a pulse oximeter for diagnostics is quite interesting and not devoid of common sense, why not? A complex computer statistical analysis technique was developed to determine dozens of related parameters. But when it became clear that all this existing data was useless for the doctor and the patient and was of purely scientific interest, the project had to sink into oblivion. After all diagnostic methods are created not to exist just like that, but to provide information that could be used in practice. But someone decided that the device could be brought to the masses by endowing it with “useful” qualities.
In our country, many doctors and private clinics can be interested in promoting the apparatus for material or other benefits. The main thing is to correctly present information about the device: several small, in-house studies with a known result, which will give it the right to life. The patient should be made to understand that it is simply impossible to live without this device. The device also needs to be certified, fortunately this is not very difficult, since it is unlikely that the inspection authorities will refuse to certify an ordinary pulse oximeter complete with a microcomputer. After all, not everyone knows that certificates do not always guarantee that a device is beneficial, but only that it is harmless and safe. But in order not to be unfounded, I will tell you in detail about all those declared qualities of the angioscan in order.
Information from the official website of the developer about what an angioscan can determine.
Arterial wall stiffness – arterial stiffness is thought to be associated with increased cardiovascular risk, that's right. But there is another long-known fact that the stiffness of the arteries increases with age and the older a person is, the higher his risk of dying. In order to understand this, do we need some kind of device? In addition, there are no methods to reduce the stiffness of the arterial wall, then why do we need to know this stiffness?
But it is known that the stiffness of the arterial wall is always higher in patients suffering from ischemic or hypertension, but the stiffness does not affect the diagnosis in any way, since it can neither confirm nor exclude this or that disease. In addition, it is also impossible to influence this rigidity.
Elasticity of the aorta. The aorta is the same artery, only larger, which undergoes changes with age. In elderly people and patients with atherosclerosis, its elasticity is lost, this can be seen from ultrasound of the heart or some features of blood pressure.
The tone of small resistive arteries - let’s say it can be determined, but just like with the stiffness of the arteries, it is not clear why this is necessary.
The value of central arterial pressure, pressure in the aorta - pressure in the aorta can be determined indirectly only through ultrasound with Doppler ultrasound, and then very approximately. This indicator has no practical application.
The operating principle of a pulse oximeter is based on measuring capillary pulse by shining a finger through a bright light source. When pulsating, small capillaries either fill with blood or become empty, as a result of which the fingertip transmits either more or less light, which is detected by a special sensor from the opposite surface of the finger. As you know, the diameter of the capillaries is only 0.01-0.02 millimeters (!), and the aorta - up to 40-50 millimeters. It is not difficult to guess that it is possible to reliably determine the pressure in the aorta from capillary pressure only mathematically, because the diameter of these vessels differs tens of thousands of times. To do this, you need to use mathematical or physical formulas with coefficients that a priori cannot be the same for different people, because we are not talking about a water pipe, but about a complex, variable biological system.
The state of endothelial function in the area of small resistive arteries (microcirculation system) and large muscular arteries - currently, detection of endothelial dysfunction is only possible by determining the level of “endothelin 1” in the blood. At the same time, you are unlikely to find a laboratory nearby that deals with the determination of endothelin 1, and not only because it is expensive, but because it is of purely scientific interest. If Angioscan is able to determine dysfunction, it is indirectly and very approximately with an error of “plus or minus bast shoes”. Most likely, this method is based on how the vessels react to a short-term “light shock”. This is interesting, but nothing more.
The ability of endothelial cells to synthesize nitric monoxide, the most powerful anti-atherogenic agent, is hard to believe, but, for example, a healthy, young or elderly person who has been examined by angioscan will be seen and it will be revealed that endothelial cells synthesize nitric oxide poorly . It would not occur to a sane doctor to prescribe any treatment for him, and the fact that in sick people this indicator will be poor anyway does not raise any doubts. It can be suggested that this parameter may generally be a derivative of the stiffness of the artery - the stiffer the artery, the older the patient and the worse his production of nitrogen monoxide.
The duration of systole, the duration of blood expulsion by the left ventricle, is a brilliant development, if not for the fact that no one uses this indicator anywhere at all, because it has no practical application. But if anyone is very interested, then this can be done using a regular phonendoscope or palpation of the pulse.
The amplitude and time relationships of early and late systolic waves - well, everything is clear here, because for patients it is written - long, abstruse and not clear. Even a specialist cannot understand what is going on. None of the existing recommendations in the world describe this phenomenon, much less indicate what a doctor or patient should do if this very ratio is violated. Probably, a hotel device will soon appear that will interpret this indicator for the average person.
Augmentation index (contribution of a late or reflected wave to the value of pulse pressure) - for those who understand what was discussed in the previous paragraph, it will not be difficult to understand this. Everything is very clear. But seriously, this augmentation is at most of scientific interest for some next meaningless dissertation.
Saturation index (hemoglobin oxygen saturation) - or oximetry, this is the honest truth, a pulse oximeter can do this. The indicator is certainly important; resuscitators usually determine by the level of saturation when it is necessary to connect a patient to a ventilator (artificial pulmonary ventilation) and the effectiveness of its implementation. Saturation is determined by determining the color of the fingertip; you probably know that when a person suffocates, he turns blue. A pulse oximeter or angioscan detects shades of red and blue, thus determining the oxygen saturation of the blood. In general, if you breathe, you don’t have shortness of breath at rest and, God forbid, you don’t turn blue, then you can understand for yourself that your saturation is fine.
Determining the stress index and checking the efficiency of the baroreceptor center is another idea of the creators of the angioscan; nothing useful can be learned from this. Typically, the functioning of the baroreceptor center is checked by blood pressure and pulse in standing, lying and sitting positions. The need for such a check with a doctor occurs every few months.
To find out the age of the vascular system, you can also go to a fortune teller and listen to the cuckoo. Imagine that a person is 45 years old, but the device shows 55, all that remains is to go and drown himself. Or a person is 70, but the angioscan showed 55, you can stop taking pills, maybe you’ll look a couple more years younger.
Check the correctness of the therapy and what effect it has on cardiovascular system medications and biological supplements (BAS) prescribed to the patient. At arterial hypertension Treatment is monitored by measuring blood pressure, and in case of coronary heart disease (CHD) - by the disappearance of chest pain, reduction of edema and shortness of breath, as well as a decrease in cholesterol and glucose levels, electrocardiogram dynamics, etc.
But about dietary supplements - this is a brilliant marketing idea, while traditional medicine To put it mildly, treat dietary supplements with caution; this medical device, it turns out, can evaluate the effectiveness of their action. And here it turns out that the creators and doctors promoting angioscan are not at all against dietary supplements, but even welcome their use. This calls into question, if not the competence, then the common sense of these doctors. Dietary supplements are a separate issue.
Conduct breath test- spend it on your health, it’s just difficult to understand what she will let you know. If you breathe frequently, the saturation will be higher; hold your breath and it will decrease.
Warn the patient about the possibility of developing cardiovascular diseases before they develop. Why are doctors worse than angioscan in this regard? After 50-60 years, the likelihood of heart disease increases and every second or third person can have something. Come for an appointment every year, starting at the age of 45, and you will also be able to be warned in time. This is what our people do: they endure for 3-5 years, and then they are brought in by ambulance.
Early detection of the possibility of kidney problems and impaired endothelial function in the last third of pregnancy. In order to “check the kidneys” you need a urine and blood test and nothing more, if a serious problem is identified.
As you can see from the length of this article, Angioscan is capable of a lot, but from all this it is difficult to single out at least one indicator that could be used in practice to improve the health and quality of life of patients.
The only one the positive side of this device is that the patient with cardiovascular disease and a disregard for oneself when bad results are revealed according to the angioscan data, he will finally run to the doctor. I agree, this is no small thing and can overshadow all its other “useful” qualities. But the opposite situation may also arise - a young, healthy, but very suspicious patient will decide that he is terminally ill, and the doctors will not be able to do anything about it.
Finally, one piece of advice: if you are offered an angioscan examination, ask your doctor how this examination will affect your treatment or clarify the diagnosis. Treat such devices with caution.
You have the information, but the decision is of course yours.
This article is the personal opinion of Dr. Lieberman.
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 departments 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 vary throughout cardiac cycle, - it will be greater at the time of systole and less 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). For most people, blood pressure is not the same in the vessels of the upper and lower limbs(usually the pressure is femoral artery and arteries of the leg more than in the brachial artery), which is due to differences in the functional state of the vascular walls. At rest in adults healthy people systolic pressure in the brachial artery, where it is usually measured, is 100-140 mm Hg. 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 emotional manifestations, 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.
