Therapeutic exercises for angina pectoris, a set of exercises. Physiotherapy exercises for progressive angina pectoris. Are there any restrictions for physical education

Modern medical research has shown that various factors can contribute to the development of coronary heart disease (IHD + and angina pectoris. As a rule, it is impossible to get rid of the hereditary predisposition of the body to the disease. But it is entirely within your power to avoid another etiology.) First of all, this is alcohol abuse, psychotropic and narcotic drugs; smoking; stressful condition; violation of normal metabolism, which caused an improper diet; overwork in a chronic form, physical inactivity.

Terms: Physical inactivity is a weakened muscle condition caused by a sedentary lifestyle.

It is necessary to carry out a competent correction of the lifestyle, revise the canons of life in better side, which will avoid the above factors. First of all, and this applies to any person who does not even have complaints, it is worth observing the daily regimen, eating right, leading an active and healthy lifestyle, not smoking, not taking drugs and not drinking alcohol.

What are the benefits of physical activity (exercise) for angina and coronary artery disease?

regular repetition of physical exercises will constantly keep the muscles in good shape;
physical activity leads to an increase in "useful" blood lipids and prevents atherosclerosis;
the likelihood of blood clots decreases;
general well-being and positive attitude improves;
reduces body weight and prevents the appearance of diabetes mellitus and much more.

Angina and sports

Many people ask the question: is it possible to play sports, run, go to workouts and do physical exercises with angina pectoris. Here the answer is unambiguous - you can. But there is one condition. Exercise therapy for angina pectoris is selected by a doctor. This is because in the process of physical education, the myocardium will require even more oxygen than before.

And acute oxygen deprivation will lead to pain and discomfort. If exercises for angina pectoris are prescribed by the attending physician, the situation will look different. This does not mean that the set of exercises will provide only joy, there will be difficulties. But moderate physical activity will benefit, and not vice versa.

Respiratory gymnastics for angina pectoris

Doing physical therapy is useful, but it is worth remembering about correct breathing, in which the myocardium is fully saturated with oxygen. You can do breathing exercises following the example of yogis:

Sit on a chair; keep your back straight; think of something good and positive until you relax. Then take a deep breath in with your nose 1-2-3, hold your breath for 1-2 and exhale with your mouth 1-2-3-4-5. At the moment of exhalation, it is recommended to bend your elbows and, like a bird, hit the chest... It is worth repeating such a breathing set of exercises 10-15 times. Three times a day.
For people suffering from angina pectoris, doctors recommend walking every day on foot in the fresh air, mentally imagining oxygen saturation of the myocardium.

Exercise therapy for angina and heart failure

Preventive treatment and further recovery the body after treatment needs a set of special therapeutic exercises. For coronary artery disease, the following exercises are recommended:

Sit on a chair and lower your arms to the floor. Inhaling air, the arms are raised at an angle of 180 degrees, and exhaling, they are returned to the starting point. Such manipulations with ischemia are advised to be repeated five times.
Sitting on a chair, lock your hands on your belt. Then, alternately unbend one arm after the other and counter them to the starting point, repeating the exercise five times.
For ischemia, place your feet shoulder-width apart. With your arms bent at the elbows, raise them at chest level. In the process of inhaling, open your arms and turn the body to the side. When the patient returns to the starting position, you can exhale. Repeat the exercise four to six times.
If there are problems with running, then a moderate pace of walking is advised for half a minute, and then a fast pace for a minute. During this time, the body will not have time to be very depleted before the onset of acute pain.

Sit on a chair and lock your hands in the lock on your knees. Then gently raise your arms to shoulder level so as to turn your palms in the opposite direction. Repeat the exercise six to eight times in one go.
Sitting on a chair, put your right leg forward and your left leg behind the chair. In this case, it is recommended to rest your hands on the seat. The point is in alternating the position of the legs. Repeat the exercise eight to ten times.
There are also exercises while lying down. In this case, lie on your stomach so that your arms are extended along the body, palms down. Then slowly raise your legs up in any order. The main thing is that the knees are not bent. Do the exercise four to six times on each leg.
You can practice walking with a temporary acceleration for three minutes.
Place your feet shoulder-width apart and your hands on your waist. Produce circular rotation head 180 degrees, first in one direction and then in the other direction. It is recommended to repeat such therapeutic manipulations from four to six times in each direction.
Stand near a chair and grab the back with your hands. When inhaling, sit down, and when leaving, stand at the starting point. Repeat the exercise four to six times.

Always give preference to physical activity and exercise that is enjoyable. Doing such a therapeutic exercise, and even going in for sports, must be in a good mood and with positive thoughts. Only then will exercise therapy for coronary artery disease go for the future.

If you live in a multi-storey building, walking up the stairs can be a good start to your physical activity. In this case, you should not abruptly climb to the ninth floor, losing consciousness. Gradually, as you increase the floor, do small "feats". And without realizing it, you will notice how you go home without an elevator.
For a gradual increase in physical activity, getting to work, go to the bus stop earlier. This is especially important for those people who work in the office while sitting at a computer and are prone to the development of physical inactivity.
If walking alone is only boring, buy a small dog. It is more fun to walk with her, and you will regularly go out into the fresh air. At the same time, no one says that you need to run after your pet in the park at breakneck speed. Calm and easy walking outside is always good.

How much pressure does the load increase?

Sport is a positive stress for the body. Changes in human pressure during physical activity are very common, due to the characteristics of the body and the preferred sport. Exercise stimulates the release of adrenaline, which plays an important role in a person's adaptation to environmental factors. Systematic sports activities help to strengthen the vascular wall, stabilize breathing, and also increase the saturation of tissues with useful substances and oxygen.

The reasons for the increase in blood pressure during exercise

An increase in the concentration of adrenaline in the blood is associated with the activation of the sympathetic link nervous system... During exercise, breathing becomes more frequent, and the circulation of fluid in the body improves. This requires additional costs from the body. Blood pressure often rises in Everyday life- while lifting weights, walking for a long time, as well as in case of nervous tension.

The following body systems are involved in increasing blood pressure:

cardiovascular - the blood moves faster, saturating the tissues with useful substances, the tone of the arteries and veins improves;
respiratory - the lungs expand and fill with air, internal organs get more oxygen;
humoral - the metabolism in the body is accelerated, the synthesis of certain hormones increases, and muscle mass grows.

In trained people whose activities involve sports or other activities physical activity, changes in hemodynamic parameters during and after the exercises done may not be observed at all. The important thing is how long it takes for the increased rates to return to normal. If they persist for several hours, this may indicate hypertension.

Why does blood pressure rise after exercise?

A physically weak body reacts to new exercises with a short-term increase in blood pressure. An increase of 15–20 mm Hg. Art. within an hour is a variant of the norm. Long-term preservation of high rates indicates hidden problems of the vascular system. Arterial hypertension at the initial stage is observed only in stressful situations, not manifesting itself in a calm environment.

If high pressure occurs during exercise, and within an hour the blood pressure indicators have not returned to normal, a person may experience:

dizziness, accompanied by redness of the eyes, flickering "flies" in the field of vision, nausea and vomiting;
pain in the heart of a aching, constricting character, up to an attack of angina pectoris due to spasm of the coronary vessels;
lethargy and lethargy, numbness of the extremities, as well as impaired diction may indicate ischemia of brain tissue;
external signs - facial flushing, excessive sweating, constant shortness of breath, sudden attacks of coughing.

It is more difficult to deal with hypertension caused by one of the options for physical labor than with the usual increase in blood pressure. Stabilization of hemodynamic parameters depends on the individual characteristics of the organism. People prone to vascular diseases should carry a pill that normalizes blood pressure with them, and carefully monitor their well-being when performing new exercises.

Causes of pressure reduction during exercise

The regulation of vascular tone is carried out with the help of the sympathetic and parasympathetic links of the nervous system. In people with sympathicotonia, blood pressure rises in stressful situations. The predominance of the parasympathetic nervous system is one of the factors in the development of hypotension, which is worth remembering when performing sports exercises.

Lead to a decrease in blood pressure:

hypotensive type of vegetative-vascular dystonia;
discrepancy between the selected set of exercises physical capabilities human;
depletion of the body's resources (vitamin deficiency, overwork);
heart defects, mitral valve prolapse;
a history of angina attacks.

If blood pressure decreases only during exercise and quickly returns to normal values within an hour after exercise, this may indicate asthenia. Improper nutrition sedentary image life, excess weight and lack of exercise in the past make the body especially vulnerable. Thoughtful training with a predominance of a dynamic component will help the body to strengthen.

Why does blood pressure drop after exercise?

Many people complain of weakness and dizziness after exercise. Providing good rest, their condition quickly returns to normal. If low blood pressure persists for a long time after exercise, this may indicate a decrease in vascular tone, which leads to VSD and persistent hypotension.

Decrease in indicators by 10–20 mm Hg. Art. characterized by:

dizziness, drowsiness;
severe weakness;
blurred eyes, blurred vision;
chest pain;
feeling of lack of oxygen.

Drop in blood pressure to 90 to 60 mm Hg. Art. and below can lead to unexpected loss of consciousness. In order to prevent the development of collapse, you need to be careful about your condition during training. For hypotonic people, walking, exercise therapy and swimming are best suited to strengthen the vascular system.

Control of hemodynamic parameters

Even experienced athletes having high endurance, they must control their condition during training. Before the first lesson, it is recommended to visit a doctor, who should assess the level of blood pressure, pulse tension, respiratory rate and then give recommendations about the desired sport.

To improve the state of the circulatory system during training, you need:

ensure sufficient heat dissipation through quality clothing ( correct size corresponding to the season);
measure blood pressure 20 minutes before training and 10 minutes after each exercise;
choose professionally equipped premises with good ventilation and lack of near production facilities;
drink enough clean water (not less than 2 liters daily).

Those wishing to play sports should remember about proper nutrition. Love for fatty and fried foods, as well as alcohol abuse, negatively affects the state of blood vessels. It is worth limiting the amount of coffee and black tea you drink. To improve vascular tone, more foods containing K and Mg should be included in the diet.

In medical practice, for many centuries, the indicator of normal blood pressure was set at 120/80 mm Hg. Art. Sports exercises, which are positive stress for the body, can lead to a slight increase in blood pressure. The indicators that are optimal for a particular person are called "workers". If a person feels good, having indicators of 100/70, this is not a cause for concern.

Normal blood pressure depends on a person's gender:

for men 18-50 years old - 120-130 / 80-85 mm Hg. Art .;
for women 18-50 years old - 110-120 / 80-85 mm Hg. Art .;
the figure is 140/90 mm Hg. Art. is the boundary indicating the development of arterial hypertension.

During intense sports, the pressure of a previously untrained person under load can increase by 15-25 mm Hg. Art. Normally, the indicators should return to "working" in half an hour. Persistence of elevated blood pressure for several hours indicates hypertension. The first stage of hypertension implies indicators of 140-159 / 90-99 mm Hg. Art. and allows light loads if the recommendations are followed. The transition of the disease to the second and third stages is a serious obstacle to sports.

Contraindications for physical activity

It is better to refrain from intense exercise during the period of exacerbation of chronic diseases, with severe heart pathologies, as well as in the case of an alleged pregnancy.

Physical activity should be abandoned for people suffering from:

frequent sudden changes in pressure in everyday life;
thrombosis of the vessels of the lower extremities;
violation of cerebral circulation.

If the pressure has not returned to normal after half an hour, you should think about other types of physical activity. In case of a sharp deterioration in the condition that has arisen against the background of physical activity, sports should be temporarily discontinued.

Medicines for hypertension: what they are

Hypertension is a persistent increase in blood pressure: systolic "upper" pressure> 140 mm Hg. and / or diastolic "bottom" pressure> 90 mmHg. The main word here is “sustainable”. Hypertension cannot be diagnosed on the basis of a single random blood pressure measurement. Such measurements should be carried out at least 3-4 in different days, and every time the blood pressure rises. If, nevertheless, you have been diagnosed with arterial hypertension, then you will most likely need to take pills for pressure.

These are drugs that lower blood pressure and relieve symptoms - headaches, flies before the eyes, nosebleeds, etc. But the main goal of taking drugs for hypertension is to reduce the risk of heart attack, stroke, kidney failure and other complications.

It has been proven that pressure pills, which come in 5 main classes, significantly improve cardiovascular and renal prognosis. In practice, this means that taking medication gives a delay of several years in the development of complications. Such an effect will be only if the hypertensive person takes his pills regularly (every day), even when he has no pain and his state of health is normal. What are the 5 main classes of drugs for hypertension - detailed below.
What is important to know about medicines for hypertension:

If the “upper” systolic blood pressure is> 160 mm Hg, then you should immediately start taking one or more medications to lower it. Because with such high blood pressure, there is an extremely high risk of heart attack, stroke, kidney and vision complications.
More or less safe pressure is considered to be 140/90 or lower, and for diabetic patients 130/85 or lower. To reduce the pressure to this level, you usually have to take more than one drug, but several at once.
It is more convenient to take not 2-3 pressure tablets, but a single tablet containing 2-3 active ingredients. A good doctor is one who understands this and tries to prescribe combined pills, and not separately.
Treatment of hypertension should be started with one or more drugs in small doses. If after 10-14 days it turns out that it does not help enough, then it is better not to increase the dosage, but add other drugs. Taking pressure pills in maximum doses is a dead-end path. Check out the article "Causes of Hypertension and How to Eliminate Them." Follow the recommendations that are set out in it, and do not just bring down the pressure with pills.
It is advisable to be treated with pressure pills, which are sufficient to take once a day. Most modern drugs are just that. They are called long-acting hypertension medications.
Medicines that lower blood pressure prolong life even for older people aged 80 and over. This has been proven by the results of long-term international studies involving thousands of elderly patients with hypertension. Pressure pills definitely do not cause senile dementia, or even inhibit its development. Moreover, it is worth taking medications for hypertension in middle age, so that a sudden heart attack or stroke does not happen.
Medication for hypertension must be taken continuously, every day. Unauthorized breaks are prohibited. Take the antihypertensive pill that you are prescribed, even on days when you are feeling well and your blood pressure is normal.

The pharmacy sells up to a hundred different types pills for pressure. They are divided into several large groups, depending on their chemical composition and the effect on the patient's body. Each has its own characteristics. To choose which pills to prescribe, the doctor examines the patient's test data, as well as the presence of concomitant diseases, in addition to high blood pressure. After that, he makes a responsible decision: what medicine for hypertension and in what dosage to prescribe to the patient. The doctor also takes into account the patient's age. For more details, read the article “What medicines for hypertension are prescribed for the elderly”.

Advertisements often promise that your life will become just “candy” as soon as you start taking this or that new antihypertensive (blood pressure lowering) drug. But in reality, everything is not that simple. Because all "chemical" drugs for hypertension have side effects, more or less severe. Only natural vitamins and minerals that normalize blood pressure can boast of a complete absence of side effects.

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Below we will discuss in detail what groups of drugs for hypertension exist and in which cases drugs from a particular group are prescribed to patients. After that, you can read individual detailed articles about the specific pressure pills you are interested in. You and your doctor may decide that it is best to change your antihypertensive (blood pressure lowering) medication, i.e. start taking a drug of a different class. If you are savvy in the question of what drugs are for hypertension, you will be able to ask competent questions to your doctor. In any case, if you are well versed in medicines and the reasons why they were prescribed to you, it will be easier for you to take them.

Indications for prescribing drugs for hypertension

Medicines for hypertension are prescribed by the doctor to the patient if the risk of complications exceeds the risk of side effects:

Blood pressure> 160/100 mm. rt. Art .;
Blood pressure> 140/90 mm. rt. Art. + the patient has 3 or more risk factors for complications of hypertension;
Blood pressure> 130/85 mm. rt. Art. + diabetes mellitus or cerebrovascular accident, or ischemic heart disease, or renal failure, or severe retinopathy (damage to the retina).

Diuretic drugs (diuretics);
Beta blockers;
Calcium antagonists;
Vasodilators;
Angiotensin-1 converting enzyme (ACE inhibitor) inhibitors;
Angiotensin II receptor blockers (sartans).

When prescribing a drug for hypertension to a patient, the physician should give preference to drugs belonging to the groups listed in this note. Hypertension pills from these groups not only normalize blood pressure, but also reduce the overall mortality of patients and prevent the development of complications. Each of the groups of pills that lower blood pressure has its own special mechanism of action, its own indications, contraindications and side effects.

Groups of drugs for hypertension

Indications	Diuretics	Beta blockers	ACE inhibitors		Calcium antagonists
Heart failure	Yes	Yes	Yes	Yes
		Yes	Yes
Diabetes	Yes	Yes	Yes	Yes	Yes
Chronic kidney disease			Yes	Yes
Preventing Re-Stroke	Yes		Yes

Indications

Diuretics (diuretics)
Thiazide diuretics	Elderly age African origin
Loop diuretics	Renal failure Congestive heart failure
Aldosterone antagonists	Congestive heart failure Postponed myocardial infarction
Beta blockers	Angina pectoris Postponed myocardial infarction Congestive heart failure (with individual selection of the minimum effective dose) Pregnancy Tachycardia Arrhythmia
Calcium channel blockers	Elderly age
Dihydroperidine	Angina pectoris Peripheral vascular disease Carotid artery atherosclerosis Pregnancy
Verapamil, Diltiazem	Angina pectoris Carotid artery atherosclerosis Cardiac supraventricular tachycardia
ACE inhibitors	Congestive heart failure Left ventricular dysfunction of the heart Postponed myocardial infarction Non-diabetic nephropathy Type 1 diabetes nephropathy
Angiotensin II receptor blockers	Type 2 diabetes nephropathy Diabetic microalbuminuria (protein albumin detected in urine) Proteinuria (presence of protein in the urine) Left ventricular hypertrophy Cough after taking ACE inhibitors
Alpha blockers	Benign prostatic hyperplasia Hyperlipidemia (problems with blood cholesterol levels)

Additional aspects to look out for when choosing medicines for hypertension:

Groups of drugs for hypertension

Indications


Thiazide diuretics	Osteoporosis
Beta blockers	Thyrotoxicosis (in short courses) Migraine Essential tremor Postoperative arterial hypertension
Calcium antagonists	Raynaud's syndrome Certain heart rhythm disorders
Alpha blockers	Hypertrophy of the prostate

Thiazide diuretics	Gout Severe hyponatremia
Beta blockers	Bronchial asthma Obstructive pulmonary disease Atrioventricular block II - III degree
ACE inhibitors and angiotensin II receptor blockers	Pregnancy

The choice of drugs for hypertension in certain comorbid conditions (2013 recommendations)

Concomitant condition

Suitable medicines


Left ventricular hypertrophy
Asymptomatic atherosclerosis	Calcium antagonists, ACE inhibitors
Microalbuminuria (there is protein in the urine, but not much)	ACE inhibitors, sartans
Decreased kidney function while still without symptoms of kidney failure	ACE inhibitors, sartans

Postponed stroke	Any medications to lower blood pressure to a safe level
Postponed myocardial infarction	Beta blockers, ACE inhibitors, sartans
Angina pectoris	Beta blockers, calcium antagonists
Chronic heart failure	Diuretics, beta blockers, sartans, calcium antagonists
Aortic aneurysm	Beta blockers
Atrial fibrillation (to prevent episodes)	Sartans, ACE inhibitors, beta blockers, aldosterone antagonists
Atrial fibrillation (to control the ventricular rate)	Beta blockers, non-dihydropyridine calcium antagonists
High protein in urine (overt proteinuria), end-stage kidney disease (dialysis)	ACE inhibitors, sartans
Lesion of peripheral arteries (vessels of the legs)	ACE inhibitors, calcium antagonists

Isolated systolic hypertension in the elderly	Diuretic drugs, calcium antagonists
Metabolic syndrome	ACE inhibitors, calcium antagonists, sartans
Diabetes	ACE inhibitors, sartans
Pregnancy	Methyldopa, beta blockers, calcium antagonists

Notes:

Sartans - angiotensin-II receptor blockers, also called angiotensin-II receptor antagonists;
Calcium antagonists - also called calcium channel blockers;
Aldosterone antagonists are drugs called spironolactone or eplerenone.

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Diuretic medicines for hypertension

In the 2014 guidelines, diuretics (diuretics) retain their position as one of the leading classes of drugs for hypertension. Because they are the cheapest and enhance the effect of any other pressure pills. Hypertension is called malignant, severe, or resistant only if it does not respond to a combination of 2-3 drugs. Moreover, one of these drugs must necessarily be a diuretic.

Most often, the diuretic medicine indapamide is prescribed for hypertension, as well as the good old hydrochlorothiazide (aka dichlothiazide and hypothiazide). Manufacturers are trying to get indapamide out of the market for hydrochlorothiazide, which has been used for about 50 years. For this, numerous articles are published in medical journals. It is assumed that indapamide does not have a harmful effect on metabolism. It has been proven to reduce the risk of heart attack and stroke in hypertensive patients. But it does not lower blood pressure more than low-dose hydrochlorothiazide and probably does not reduce the risk of complications of hypertension much better. And it costs much more.

Spironolactone and eplerenone are special diuretics, aldosterone antagonists. They are prescribed for severe (resistant) hypertension as a 4th drug if a combination of 3 drugs does not work enough. First, patients with severe hypertension are prescribed a blocker of the renin-angiotensin system + a conventional diuretic + a calcium channel blocker. If the pressure does not drop enough, spironolactone or a newer eplerenone that has fewer side effects is added. Contraindications for the appointment of aldosterone antagonists - an increased level of potassium in the blood (hyperkalemia) or the glomerular filtration rate of the kidneys below 30-60 ml / min. In 10% of patients, hypertension occurs due to primary hyperaldosteronism. If tests confirm primary hyperaldosteronism, then the patient is automatically prescribed spironolactone or eplerenone.

Diuretics (diuretics) - general information;
Dichlothiazide (hydrodiuril, hydrochlorothiazide);
Indapamide (Arifon, Indap);
Furosemide (Lasix);
Veroshpiron (Spironolactone);

Calcium antagonists in the treatment of hypertension

Calcium antagonists (calcium channel blockers) are arguably the world's most popular hypertension medications. They are especially indicated if high blood pressure is combined with coronary heart disease, cardiac arrhythmias, chronic kidney disease. Calcium channel blockers increase urinary sodium excretion. It is advisable to prescribe them if it is proven that the patient has hypertension due to excessive consumption of table salt. In recent years, dihydropyridine calcium antagonists have come to the fore, among them amlodipine.

For chronic kidney disease, amlodipine can be added to an ACE inhibitor or angiotensin II receptor blocker (sartan). It has been proven that this combination of drugs inhibits the development of renal failure. But the independent use of a dihydropyridine calcium antagonist, without an ACE inhibitor or sartan, is considered undesirable in chronic kidney disease. If severe (resistant) hypertension, then American experts consider it possible to prescribe a combination of a dihydropyridine and non-dihydropyridine calcium antagonist as a 5-6 "line of defense" to patients.

Calcium antagonists - general information;
Nifedipine (Adalat, Corinfar, Cordipin, Fenigidin);
Amlodipine (Norvasc, Normodipin, Tenox);
Lerkamen (Lercanidipine);
Felodipine (felodip);

ACE inhibitors

Dozens of rigorous studies have been carried out, according to the results of which it has been proven that ACE inhibitors in hypertension reduce the risk of heart attack and stroke, protect blood vessels and kidneys. These drugs are primarily prescribed to patients who have high blood pressure against the background of acute or chronic ischemic heart disease, heart failure, diabetes mellitus, chronic kidney disease.

Medicines for hypertension, which contain 2 active ingredients in one tablet, are in great demand. These are usually combinations of an ACE inhibitor with a diuretic or calcium antagonist. Unfortunately, 10-15% of people who take ACE inhibitors develop a chronic dry cough. This is considered a common side effect of this class of drugs. If patients read less about this, then their coughs would develop less often. In such cases, ACE inhibitors are substituted for sartans, which have the same effect, but do not induce a cough.

ACE inhibitors - general information
Captopril (Capoten)
Enalapril (Renitek, Berlipril, Enap)
Lisinopril (Diroton, Irumed)
Perindopril (Prestarium, Perineva)
Fosinopril (Monopril, Fozicard)

Angiotensin II receptor blockers (sartans)

Since the early 2000s, indications for the use of angiotensin II receptor blockers have expanded significantly, including in hypertension as the first choice drug. These drugs are well tolerated. They cause side effects no more often than placebos. It is believed that with hypertension they reduce the risk of heart attack and stroke, protect blood vessels, kidneys and other internal organs no worse than ACE inhibitors.

Perhaps sartans are a better choice than ACE inhibitors in uncomplicated hypertension, and in type 2 diabetic patients with diabetic nephropathy (complications of diabetes to the kidneys). In any case, they are prescribed if the patient develops an unpleasant dry cough from taking an ACE inhibitor. The only problem is that angiotensin II receptor blockers are still less studied. Many studies have been done on them, but still less than on ACE inhibitors.

For hypertension, angiotensin II receptor blockers are widely used in tablets that contain fixed combinations of 2 or 3 active ingredients. Common combination: sartan + thiazide diuretic + calcium channel blocker. Angiotensin II receptor antagonists can be combined with amlodipine as an ACE inhibitor. This combination helps to reduce leg edema in patients.

Angiotensin II receptor blockers for hypertension are also prescribed in the following situations:

coronary heart disease;
chronic heart failure;
type 2 diabetes mellitus;
type 1 diabetes mellitus, regardless of whether kidney complications have already developed.

Sartans are still prescribed not as drugs of first choice, but mainly for intolerance to ACE inhibitors. This is not due to the fact that angiotensin-II receptor antagonists are weaker, but to the fact that they have not yet been sufficiently studied.

Angiotensin II receptor blockers - general information
Losartan (Lorista, Kozaar, Lozap)
Aprovel (Irbesartan)
Mikardis (Telmisartan)
Valsartan (Diovan, Valz, Valsakor)
Teveten (Eprosartan)
Candesartan (Atacand, Candecor)

Beta blockers

Beta blockers have been attacked in the medical press but still retain their position as one of the leading classes of hypertension drugs. Prescribing these pills is especially justified in patients who have suffered myocardial infarction, have a diagnosis of angina pectoris, chronic heart failure, heart rhythm disturbances or chronic kidney disease. Also, beta-blockers help with hypertension in young and middle-aged patients who have hyperthyroidism, glaucoma, or increased concentration catecholamines in the blood.

Hyperthyroidism is an excess of thyroid hormones in the blood. Catecholamines are the hormones adrenaline, norepinephrine, and others that are produced by the adrenal glands. These hormones cause vasospasm, “speed up” the heart, and in other ways increase blood pressure. Glaucoma is an increase in intraocular pressure that can lead to blindness.

For older patients with hypertension, beta-blockers are prescribed if there is concomitant coronary artery disease or chronic heart failure. This is called secondary prevention of cardiovascular complications. But if in an elderly person hypertension is not complicated, that is, the risk of a heart attack is low, then it is not considered advisable to be treated with beta-blockers.

Carvedilol and nebivolol have less harmful effects on metabolism than other beta-blockers. Therefore, they are considered the drugs of choice for hypertensive patients with type 2 diabetes or metabolic syndrome. Carvedilol and nebivolol are special beta-blockers that have the added effect of relaxing and dilating blood vessels.

Beta blockers - general information
Carvedilol (Dilatrend, Coriol)
Nebivolol (Nebilet, Binelol)
Bisoprolol (Concor, Bidop, Biprol, Bisogamma)
Metoprolol (Betalok, Vasokardin, Corvitol, Egilok)
Propranolol (Anaprilin, Obsidan)

Second-line hypertension medications

Second-line drugs for hypertension tend to lower blood pressure as well as drugs in the 5 main groups discussed above. Why were these drugs given supportive roles? Because they have significant side effects or are simply not well understood, there has been little research on them. Second-line hypertension medications are prescribed in addition to the main pills.

If a patient with hypertension has a prostate adenoma, the doctor will prescribe him an alpha-1-blocker. Methyldopa (dopegit) - drug of choice for control high blood pressure during pregnancy. Moxonidine (Physiotens) supplements the combined treatment of hypertension in persons with concomitant type 2 diabetes, metabolic syndrome, and also if kidney function is reduced.

Clonidine (clonidine) powerfully lowers blood pressure, but has severe side effects - dry mouth, lethargy, and drowsiness. Do not treat hypertension with clonidine! This drug causes significant jumps in blood pressure, "roller coasters" that are harmful to blood vessels. With clonidine treatment, heart attack, stroke, or kidney failure will happen much faster.

Aliskren (Rasillosis) is a direct renin inhibitor, one of the new drugs. It is currently used to treat uncomplicated hypertension. It is not recommended to combine Rasillosis with ACE inhibitors or angiotensin II receptor blockers.

Methyldopa (Dopegit)
Clonidine (Clonidine)
Physiotens (Moxonidine)
Coenzyme Q10 (Kudesan)

Should the patient take the time to understand well how different pills for hypertension differ from each other? Of course yes! After all, it depends on how many more years the hypertensive person will live and how "high quality" these years will be. If you switch to a healthy lifestyle and choose the right medications, then, it is likely, you can avoid the fatal complications of hypertension. After all, a sudden heart attack, stroke or kidney failure can easily turn an energetic person into a frail disabled person. Scientists are aggressively investigating new, more advanced groups of drugs for hypertension that will help reduce the incidence of complications.

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How to choose a medicine for hypertension: general principles
How to take medicines for hypertension for an elderly person

Everyone knows such clinical forms of coronary heart disease (formerly called "angina pectoris"), such as angina pectoris or myocardial infarction, resulting from spasm of the coronary vessels and disturbances in the supply of blood to the heart.

Performing available gymnastic exercises in calm intervals between attacks will help improve your condition, prevent emergence of critical situations and further worsening of the disease. Depending on the tolerance of physical activity in angina pectoris (that is, the appearance of pain in the heart or pathological changes on the electrocardiogram), 4 functional types are distinguished.

The first functional type includes patients who tolerate physical activity well. They rarely have attacks of angina pectoris, and pain in the heart occurs only when performing unusually large loads or with significant neuropsychic stress. They are capable of performing muscular work with a power of more than 100 watts. Patients with ischemic heart disease with functional class I can walk at any pace for a long time. Many of them also practice slow jogging.

The second functional type includes patients with rare bouts of exertional angina (that is, appearing during muscular work), arising, for example, when walking too fast, climbing 2-3 floors. Their exercise tolerance ranges from 50 to 100 watts. They tolerate walking well at a moderate pace. To increase their performance and improve their condition, they can train by walking at a leisurely pace twice a day for 30-40 minutes.

The third functional type includes people with coronary heart disease with frequent attacks of angina pectoris that occur with small muscle strains, for example, climbing the 1st floor, walking at a moderate pace on level ground, etc. Their exercise tolerance is less than 50 watts. They tolerate walking at a slow pace and can do it for 40-60 minutes.

Representatives of the fourth functional type are characterized by frequent attacks of angina pectoris of rest and tension. So, pain can occur even with insignificant loads, say, walking 100-150 m. Long walks can be recommended for them, but with mandatory periods of rest.

Recall that among a number of risk factors for angina pectoris is limitation of physical activity. Adequate physical exercise will contribute to the expansion of the coronary vessels, improve the nutrition of the myocardium (heart muscle), improve the emotional and mental state, revitalize metabolic processes and as a result, they will help the body to resist the development of atherosclerosis, against the background of which ischemic heart disease usually occurs.

Below is the exemplary complex exercises available for patients with the first or second functional type. If during the lesson you suddenly feel pain or discomfort in the area of the heart, then you should reduce the load or even interrupt the lesson.

Sitting on a chair, hands down. Hands spread apart to shoulder level, take a deep breath, lower it down - exhale. Repeat 3-5 times.
Sitting, keep your hands at the waist. Right hand lift across the side to shoulder level, inhale, return to starting position, exhale. Same for the left hand. Repeat 3-5 times.
Standing, spread your legs apart, bend your arms horizontally at the elbows and fix in front of the chest. Rotate the body with arms spread - inhale, return to the starting position, exhale. Repeat 4-6 times.
Normal walking (30 sec), then with a slight acceleration (1 minute).
Standing, legs slightly to the sides, arms also to the sides and raised at shoulder level. Perform first in one direction, then in the other, circular movements with the shoulders. Repeat 5-7 times back and forth.
Standing, hands on the back of the head in the lock. Put your left leg to the side on your toes, tilt your body to the left, straighten up and take the starting position. It's the same with the right leg. Repeat 3-5 times.
Standing, hands rest on the back of the chair. Sit down - exhale, stand up - inhale. Repeat 4-6 times.
Standing, hands on the waist. Head spin with full amplitude to the right, then to the left. Run 3-5 times in each direction.
Walking is easy in alternation with acceleration (3 minutes).
Walking is simple (30 sec), then with a high rise of the hip (30 sec).
Standing, make alternate inclinations of the body to the right, then to the left with flexion of the arm of the opposite side (the so-called "pump" exercise), the amplitude is maximum. Repeat 4-6 times in each direction.
Standing, we hold our hands in front of us and spread them a little. We raise left leg and touch the right palm, return to the starting position. It's the same with the right leg. Repeat 4-6 times.
We lie on our stomach, stretch our arms along the body and rest our palms on the floor. We raise our straightened legs one by one. Perform 4-6 times with each leg.
Sitting on a chair, we braid our hands into a "lock", keep them on our knees. Turn your palms out, raising your hands in front of you to shoulder level. Repeat 6-8 times.
Sitting on a chair, the right leg is in front, the left leg is under the chair, hands rest on the seat. Change of position of the legs. Run 8-10 times.

Physical activity for coronary artery disease

According to modern medical data, a large number of factors can contribute to the development of coronary artery disease (ischemic heart disease). Among the most common and "aggressive" are bad heredity, alcohol abuse, smoking, chronic stress, metabolic disorders due to malnutrition, chronic fatigue, and physical inactivity. Of course, it is almost impossible to get rid of a hereditary predisposition to ischemic heart disease, and you cannot completely save yourself from stress. But you can adjust your lifestyle so as to avoid the rest of the above factors. First of all, it is worth quitting smoking, optimizing nutrition and ensuring proper physical activity on the body.

Why physical activity is beneficial:

Regular physical activity allows you to stay in good shape and stay in good shape.
With regular physical activity, the amount of "useful" lipids in the blood increases, which helps to reduce the risk of developing atherosclerosis.
The likelihood of blood clots is reduced.
Blood pressure is normalized, which helps to reduce the risk of cerebral hemorrhage (stroke).
Exercise promotes weight loss and prevents diabetes.
Regular exercise can improve mood, sleep and help you cope with stressful situations.
Due to regular physical activity, the risk of developing osteoporosis is reduced - the most common reason bone fractures in old age.

Regular physical activity is beneficial for everyone, as it helps to protect yourself from the development of many unpleasant diseases. But, unfortunately, the disease itself often pushes us to change the way of life and regular exercise.

For people with coronary artery disease, only certain types of physical activity are suitable.

IHD develops as a result of acid starvation, which leads to the formation of an atherosclerotic plaque. The plaque narrows the artery that supplies the heart with blood, so less oxygen-rich blood reaches the heart muscle. In this case, the intensive work of the heart is hampered and, with heavy loads, angina pectoris develops - a painful attack of the heart muscle.

Naturally, angina attacks require restriction of physical activity. Often, in order to get rid of angina pectoris, it is necessary to resort to medication, and even surgical treatment. In the case of a severe heart attack - heart attack, patients begin to be afraid of physical exertion at all and, trying to "save" the heart, often restrict movement up to refusal to walk.

For patients with angina pectoris and those who have suffered a heart attack, physical activity can have a twofold meaning:

On the one hand, excessive physical activity and intense physical activity can provoke attacks of angina pectoris and lead to a second heart attack - such excessive activity should be avoided.
On the other hand, moderate physical activity and periodic exercise (no more than 40 minutes 5 times a week), on the contrary, are very useful.

Moderate physical activity increases the level of good cholesterol, which prevents the further development of atherosclerosis, reduces the rate of development of heart failure, strengthening the cardiovascular system. Regular aerobic exercise helps to normalize the functioning of collateral blood flow - an inter-arterial connection that redistributes blood flow, which helps to increase the amount of oxygen-rich blood that reaches the heart muscle.

As medical studies show, physical activity in patients who have had a heart attack helps to reduce the risk of re-infarction by 7 times, and reduce mortality by 6 times, compared with patients who prefer to reduce physical activity as much as possible.

Therefore, for patients who have suffered a heart attack, the implementation of normal household loads (light daily housework) is mandatory. After an inpatient course of treatment, it is preferable for such patients to undergo a course of physical rehabilitation under the supervision of specialists in a cardiological sanatorium. If rehabilitation in a sanatorium is impossible for one reason or another, it is necessary to undergo a course of physical rehabilitation on an outpatient basis under the supervision of a cardiologist.

The simplest option for physical activity in this case is daily walking. In this case, you should not reboot yourself: the walk should take place at a slow or moderate (depending on how you feel) pace, for half an hour - an hour, but at least 5 days a week. If during a walk you feel weak or tired, you need to take a break - sit on a bench or slowly return home. Do not be upset - in the process of rehabilitation you will be able to go through more and more. However, the increase in motor loads, exactly like the beginning of physical exercise, after the hospital must be coordinated with an exercise therapy specialist or an attending cardiologist.

Physical activity in any case should not lead to another attack of angina pectoris. During exercise, severe shortness of breath or heart palpitations are unacceptable. During physical exertion, you need to monitor the pulse - its frequency should increase in accordance with the increase in load. At the same time, the optimal increase in heart rate should be determined by the attending physician individually, according to the severity of coronary artery disease and associated pathologies.

At the first stages of physical rehabilitation, the heart rate can increase by no more than 20 - 30%, about 15 - 20 beats per minute. If the loads are tolerated without complications, an increase in heart rate of more than 30% can be allowed, however, no more than the value calculated using the following formula: 200 is the patient's age. For example, for a patient with coronary artery disease at the age of 60 years, the maximum allowable heart rate should not exceed 140 beats per minute.

Leading specialist of Russia in the field of rehabilitation of patients with heart diseases, Professor D.M. Aronov, developed recommendations for physical activity, depending on the functional class (severity of manifestation) of the disease. According to the tables below, developed by Professor D.M. Aronov, it is possible to determine the permissible load in each specific case.

Remember that depending on the severity of the manifestation, angina pectoris is divided into four functional classes, where I is mild angina, in which attacks occur only with very intense physical exertion, and IV is the most severe angina, in which an attack occurs with the slightest physical activity and even at rest. Prohibited loads are marked with "-", permitted loads - with "+". The number of "+" signs indicates the permissible intensity and volume of loads.

Daily physical activity

Exercise therapy for diseases of the cardiovascular system

It is known that the heart provides the movement of blood through the vessels. But only the force of contraction of the left ventricle is not enough to ensure the normal functioning of the heart. Non-cardiac factors play an important role in blood circulation. For diseases of the cardiovascular system, along with drug treatment, therapeutic exercises are recommended. Classes allow you to maximize the action of extracardiac (non-cardiac) circulatory factors and contribute to the normalization of impaired functions. Physiotherapy is often used for diseases of the circulatory system in the acute period, as well as during recovery, is used in the future as a supportive therapy.

To the main contraindications to exercise therapy should include: acute phase of rheumatism, endo-, myocardium; serious violations of the conducting system of the heart and rhythm; circulatory failure in the third stage, acute heart failure.

Methods of exposure

The exercise therapy technique directly depends on the characteristics of the course of the disease, as well as the degree of insufficiency of the coronary and general circulation. Physical exercises, starting positions and the magnitude of the load are selected based on the motor regimen assigned to the patient.

The action of exercise therapy in diseases of the cardiovascular system

Myocardial infarction: exercise therapy

Myocardial infarction is focal or multiple necrosis of the muscles of the heart, which is caused by acute coronary insufficiency. The tissue subject to necrosis after a while is replaced by a scar. A heart attack is characterized by severe pain in the region of the heart, increased heart rate, decreased blood pressure, drowsiness, and suffocation. ECG allows you to determine the localization of the heart attack and the severity. The first three days are characterized by an increase in body temperature, an acceleration of ESR, and the appearance of leukocytosis.

Rehabilitation of patients with myocardial infarction is divided into three stages. At each stage, the patient undergoes a course of physiotherapy exercises.

The main form of physiotherapy exercises at the first stage is massage, stair walking, and dosed walking. If the patient's heart attack is not complicated, then classes can be started from 2-3 days, by which time the acute symptoms of a heart attack subside. The timing of the beginning of classes, as well as the load is determined strictly individually and directly depends on the nature of the stage, the severity of postinfarction angina.

Forms of physiotherapy exercises at the second stage: remedial gymnastics, walking in strictly defined dosages, walking and exercising on simulators, walking up the stairs, lightweight elements of games, sports and applied exercises, massage, occupational therapy. Classes are practically no different from those that were conducted in the hospital at the first stage. The pace of classes, the number of repetitions is accelerated, exercises at the gymnastic wall, exercises with various objects are used. The procedures are carried out in groups, the duration of the lesson is 30 minutes.

Exercise therapy at the third stage: physical exercises are used that are recommended for people with poor health, reduced physical performance. Therapeutic walking, stair walking, which involves climbing to the 3-5th floor, 2-3 times, lightweight sports games and exercises on simulators, massage are used.

Arterial hypertension is a fairly common disease characterized by an increase in blood pressure. There are three stages of hypertension.

The first stage involves an increase in blood pressure without the involvement of target organs. The second stage - blood pressure is increased and target organs are involved: kidneys, fundus, heart. The third stage - increased blood pressure and affected target organs: renal failure, stroke, heart attack, heart failure.

Tasks Exercise therapy for arterial hypertension are the reduction of blood pressure, prevention of crises, general improvement of the patient's condition. Exercise therapy for arterial hypertension includes: dosed walking, remedial gymnastics, general exercise equipment, therapeutic swimming and exercise in the pool, massage.

Heart defects: exercise therapy

Physiotherapy exercises for heart defects- a combination of active and breathing exercises... Classes are held at a slow pace, without intensification, lasting 10-15 days. In the next 2-3 weeks, the patients are assigned therapeutic exercises.

Ischemic heart disease: exercise therapy

Means of physiotherapy exercises for ischemic heart disease: remedial gymnastics, exercise in water, swimming, dosed walking.

Exercise

A set of exercises for coronary heart disease :

Starting position - hands on the belt, standing over the seat of the chair. We take our hands to the sides - inhale, return our hands to the belt - exhale.
The starting position is the same. We raise our hands up and inhale, bend forward - we exhale.
The starting position is standing by the chair. Sit down - breathe out, stand up - take a breath.
Starting position - sitting, bend your right leg - cotton, return to starting position. Do the same with the left leg.
Starting position - sitting on a chair. Do not hold your breath, sit down in front of the chair, then return to the starting position.
The starting position is the same, legs are straightened, arms forward. We bend our legs at the knees, put our hands on the belt, then return to the starting position.
The starting position is standing. We take the right leg back, hands up - inhale, starting position - exhale. Repeat for the left leg.
Starting position - standing, hands on the belt. Carry out tilts to the right and left.
Starting position - standing, hands in front of the chest. We take our hands to the sides - inhale, starting position - exhale.
The starting position is standing. We take the right leg and arm forward. The same with the left leg.
Starting position - standing, hands up. They sat down, then returned to their original position.
The starting position is the same, hands up, hands in the lock. We carry out the rotation of the body.
The starting position is standing. Take a step with your left foot forward - arms up, return to SP. Repeat for the right leg.
Starting position - standing, hands in front of the chest. Carry out turns to the left and right with arms spread.
Starting position - standing, arms to shoulders. Straighten your arms alternately.
Walking in place.

Exercise therapy for ischemic heart disease is developed depending on the group of the disease.

Group I includes people with angina pectoris without myocardial infarction.
Group II - people who have had a heart attack with acquired cardiosclerosis.
Group III - postinfarction left ventricular aneurysm.

The load during physical therapy is determined depending on the severity of the disease, which can also be conditionally divided into categories:

Stage I (initial) - with coronary insufficiency, no symptoms appear.
Stage II (typical) - coronary insufficiency has certain signs during physical exertion, for example, brisk walking, climbing stairs, or during emotional breakdowns.
Stage III (pronounced) - the clinical picture is pronounced even in a calm state.

Who can do what?

Patients of the first group, that is, who have not suffered a myocardial infarction, can do exercises, involving all muscle groups. Breathing exercises of a dynamic nature. Exercises are calculated in minutes.

People who have had myocardial infarction with cardiosclerosis should exercise slowly and engage small and medium muscle groups. Breathing exercises should be alternated with rest. When measuring the pulse, it can be increased by only 10%. The duration of the exercise is a minute.

Patients from group III are at risk, so exercise should be limited due to the possibility of thromboembolism. They are performed with incomplete amplitude, where small and medium muscle groups are involved. After completing 2-3 exercises, the patient should pause for rest. Exercise takes a minute. If the condition worsened, tachycardia, renal-hepatic failure is observed, shortness of breath or pain in the heart appears, exercise therapy should be stopped immediately for coronary heart disease.

An approximate set of exercises in a post-infarction state in the first period

Exercises alternate with breathing exercises:

Lying on the floor, arms and legs apart, fingers and toes should be bent alternately. After several such exercises, move on to simultaneously bending the fingers and toes. In this case, breathing should be even. Everything is done slowly up to 6 times.
Lying in the same way, arms and legs apart, perform breathing exercises. Inhale freely, then exhale. Repeat 3 times.
From the same position, the legs are spread to the sides, the exercise is done with socks, first they move to the outside, then they turn inward. The pace for this exercise is average, breathing is even.
In the same position, raise your shoulders - inhale, lower - exhale. Repeat 3 times. Breathing is even.
Lying in the starting position, raise your arms at the elbows and legs at the knees, make circular movements with the hand from the elbow and legs from the knee. In the early days, the arms and legs do the exercise alternately, later everything is done simultaneously with the arms and legs. Such actions are carried out 2-6 times. The pace is slightly more intense than the slow one. Breathing is even.
The position of the body is the same, the legs are bent at the knees, tear the hip joint off the floor and inhale, lower it - exhale. Repeat 3 times. In this case, breathing is not disturbed.
Lying, bend your legs at the knees and alternately lower them to the right and then to the left. Each tilt is done 2 times. Slow breathing, average exercise pace.
Lying in the same position, spread your knees in different directions - inhale, close - exhale. Repeat 2-3 times, exercise tempo is average.

Gymnastics is carried out up to 20 minutes on average 3-4 times a day. If the cardiogram gives nice results, then over time it will be possible to increase such activities up to 10 times a day.

Put on physiotherapy exercises, you can proceed to the next stage, when a person can already make turns to the right side and independently climb the stairs. The development of motor functions begins. This is done so that the heart rhythm is not disturbed, shortness of breath and heart pains do not appear. Light exercises are carried out in order to teach the patient to sit, get up, climb stairs, etc.

Classes are aimed at the work of large and medium joints - shoulder and hip. A stick and a rubber ball are used. Exercises focus on coordination, balance and attention. Walking should involve 10 to 100 steps. In this case, you should often rest.

Physiotherapy exercises are done in a sitting or standing position. One breathing is performed every two special exercises. Carrying out time - 40 minutes a day 3-4 times.

After a person begins to move independently, the third period of rehabilitation and physiotherapy exercises begins. At this time, the cardiovascular system and respiration are trained. The emphasis is on walking. At first, it is made on a flat surface, in the future it is worth making descents about ascents. Initially, you should walk up to 500 m, and rest every 5 minutes. You should get 60 steps per minute. Every day, we should increase the distance and so bring it up to a kilometer.

In the future, under the supervision of a doctor, you can hike up to 2 km. These classes are held in a polyclinic or in a sanatorium.

After exercise therapy for ischemic heart disease within the framework of a medical institution has ended, it is necessary to continue classes at home. In this case, an examination should be carried out 2 times a month.

Only after a year can you do more complex types of gymnastics and other exercises, go skiing, ride a bike or visit gyms. But this should only be done with the permission of the doctor.

It is worth remembering that physical activity should be distributed evenly.

Treatment activities in addition to exercise therapy

Health food. Patients with coronary heart disease are advised to include in the diet without fail honey, nuts, dried apricots, raisins, soy products, dairy products, lemons, pumpkin and pumpkin seeds, rose hips.

With increased body weight, fatty meats, margarine, butter should be excluded. Replace animal fats with vegetable ones. This is done in order to lower blood cholesterol. Food should be rich in vitamins and minerals.

Medications. A patient with coronary artery disease must take two main groups of drugs:

Containing nitroglycerin and long acting derivatives. They are needed to relieve spasm in the coronary vessels in order to facilitate the access of oxygen to the heart muscle.
Medicines that improve the composition of the blood, reduce blood clotting to prevent blood clots (such as aspirin).

In addition, it is possible to use drugs to lower blood cholesterol and drugs that accelerate metabolic processes in the body.

It will be useful to prescribe vitamins, especially E, P and ascorbic acid. It is not worth reminding that the treatment should be strictly prescribed by the attending physician.

Physiotherapy for ischemic heart disease

Physiotherapy procedures are very important during the recovery period. They are selected by a physiotherapist.

Balneotherapy involves taking therapeutic baths - radon, carbon dioxide, iodine-bromine, chloride. There may be contraindications to such a procedure, it is pain syndrome, persistent angina pectoris, arrhythmia, hypertension. If the patient has more pronounced angina pectoris, then a sparing method is used in the form of four-chamber baths.

Methods of electrosleep, galvanic collar, electrophoresis with analgesics and sedatives are also used. Recently, a new method of physiotherapy has appeared - laser therapy.

Rehabilitation should take place gradually and only under the supervision of a physician. Ischemic heart disease and angina pectoris can only recede if you follow all the recommendations and take care of your body.

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Terms: Physical inactivity is a weakened muscle condition caused by a sedentary lifestyle.

It is necessary to carry out a competent correction of the lifestyle, revise the canons of life for the better, which will avoid the above factors. First of all, and this applies to any person who does not even have complaints, it is worth observing the daily regimen, eating right, leading an active and healthy lifestyle, not smoking, not taking drugs and not drinking alcohol.

What are the benefits of physical activity (exercise) for angina and coronary artery disease?

regular repetition of physical exercises will constantly keep the muscles in good shape;
physical activity leads to an increase in "useful" blood lipids and prevents atherosclerosis;
the likelihood of blood clots decreases;
general well-being and positive attitude improves;
reduces body weight and prevents the appearance of diabetes mellitus and much more.

Angina and sports

Respiratory gymnastics for angina pectoris

It is useful to engage in physiotherapy exercises, but it is worth remembering about proper breathing, in which the myocardium is fully saturated with oxygen. You can do breathing exercises following the example of yogis:

Sit on a chair; keep your back straight; think of something good and positive until you relax. Then take a deep breath in with your nose for 1-2-3, hold your breath for 1-2 and exhale with your mouth for. At the moment of exhalation, it is recommended to bend your arms at the elbows and, like a bird, hit the chest with “wings”. It is worth repeating such a breathing set of exercises once. Three times a day.
For people suffering from angina pectoris, doctors recommend walking every day on foot in the fresh air, mentally imagining oxygen saturation of the myocardium.

Exercise therapy for angina and heart failure

Preventive treatment and further recovery of the body after treatment requires a set of special therapeutic exercises. For coronary artery disease, the following exercises are recommended:

Sit on a chair and lower your arms to the floor. Inhaling air, the arms are raised at an angle of 180 degrees, and exhaling, they are returned to the starting point. Such manipulations with ischemia are advised to be repeated five times.
Sitting on a chair, lock your hands on your belt. Then, alternately unbend one arm after the other and counter them to the starting point, repeating the exercise five times.
For ischemia, place your feet shoulder-width apart. With your arms bent at the elbows, raise them at chest level. In the process of inhaling, open your arms and turn the body to the side. When the patient returns to the starting position, you can exhale. Repeat the exercise four to six times.
If there are problems with running, then a moderate pace of walking is advised for half a minute, and then a fast pace for a minute. During this time, the body will not have time to be very depleted before the onset of acute pain.

Exercise for ischemic heart disease

Gymnastic exercises for coronary heart disease

Representatives of the fourth functional type are characterized by frequent attacks of angina pectoris of rest and tension. So, pain can occur even with insignificant loads, for example, walking to us. Long walks can be recommended to them, but with obligatory rest periods.

Recall that among a number of risk factors for angina pectoris is limitation of physical activity. Adequate physical exercise will help dilate the coronary vessels, improve the nutrition of the myocardium (heart muscle), improve the emotional and mental state, activate metabolic processes and ultimately help the body resist the development of atherosclerosis, against which coronary heart disease usually occurs.

Below is an approximate set of exercises available for patients with the first or second functional type. If during the lesson you suddenly feel pain or discomfort in the area of the heart, then you should reduce the load or even interrupt the lesson.

A set of exercises for coronary heart disease

Sitting on a chair, hands down. Hands spread apart to shoulder level, take a deep breath, lower it down - exhale. Repeat 3-5 times.
Sitting, keep your hands at the waist. Raise your right hand across the side to shoulder level, inhale, return to the starting position, exhale. Same for the left hand. Repeat 3-5 times.
Standing, spread your legs apart, bend your arms horizontally at the elbows and fix in front of the chest. Rotate the body with arms spread - inhale, return to the starting position, exhale. Repeat 4-6 times.
Normal walking (30 sec), then with a slight acceleration (1 minute).
Standing, legs slightly to the sides, arms also to the sides and raised at shoulder level. Perform first in one direction, then in the other, circular movements with the shoulders. Repeat 5-7 times back and forth.
Standing, hands on the back of the head in the lock. Put your left leg to the side on your toes, tilt your body to the left, straighten up and take the starting position. It's the same with the right leg. Repeat 3-5 times.
Standing, hands rest on the back of the chair. Sit down - exhale, get up - inhale. Repeat 4-6 times.
Standing, hands on the waist. Head spin with full amplitude to the right, then to the left. Run 3-5 times in each direction.
Walking is easy in alternation with acceleration (3 minutes).
Walking is simple (30 sec), then with a high rise of the hip (30 sec).
Standing, make alternate inclinations of the body to the right, then to the left with flexion of the arm of the opposite side (the so-called "pump" exercise), the amplitude is maximum. Repeat 4-6 times in each direction.
Standing, we hold our hands in front of us and spread them a little. Raise the left leg and touch the right palm, return to the starting position. It's the same with the right leg. Repeat 4-6 times.
We lie on our stomach, stretch our arms along the body and rest our palms on the floor. We raise our straightened legs one by one. Perform 4-6 times with each leg.
Sitting on a chair, we braid our hands into a "lock", keep them on our knees. Turn your palms out, raising your hands in front of you to shoulder level. Repeat 6-8 times.
Sitting on a chair, right leg in front, left leg under the chair, hands rest on the seat. Change of position of the legs. Run 8-10 times.

Physical activity for coronary artery disease

Why physical activity is beneficial:

Regular physical activity allows you to stay in good shape and stay in good shape.
With regular physical activity, the amount of "useful" lipids in the blood increases, which helps to reduce the risk of developing atherosclerosis.
The likelihood of blood clots is reduced.
Blood pressure is normalized, which helps to reduce the risk of cerebral hemorrhage (stroke).
Exercise promotes weight loss and prevents diabetes.
Regular exercise can improve mood, sleep and help you cope with stressful situations.
Regular physical activity reduces the risk of osteoporosis, the most common cause of bone fractures in old age.

For people with coronary artery disease, only certain types of physical activity are suitable.

Naturally, angina attacks require restriction of physical activity. Often, in order to get rid of angina pectoris, it is necessary to resort to medication, and even surgical treatment. In the case of a severe heart attack - a heart attack, patients begin to be afraid of physical exertion at all and, trying to "save" the heart, often restrict movement to the point of refusing to walk.

For patients with angina pectoris and those who have suffered a heart attack, physical activity can have a twofold meaning:

On the one hand, excessive physical activity and intense physical activity can provoke angina attacks and lead to a second heart attack - such excessive activity should be avoided.
On the other hand, moderate physical activity and periodic exercise (no more than 40 minutes 5 times a week), on the contrary, are very useful.

Moderate physical activity increases the level of good cholesterol, which prevents the further development of atherosclerosis, reduces the rate of development of heart failure, strengthening the cardiovascular system. Regular aerobic exercise helps to normalize the functioning of collateral blood flow, an inter-arterial connection that redistributes blood flow, which helps to increase the amount of oxygen-rich blood that reaches the heart muscle.

The simplest option for physical activity in this case is daily walking. At the same time, you should not reboot yourself: the walk should take place at a slow or moderate (depending on how you feel) pace, for half an hour - an hour, but at least 5 days a week. If during a walk you feel weak or tired, you need to take a break - sit on a bench or slowly return home. Do not be upset - in the process of rehabilitation you will be able to go through more and more. However, the increase in motor loads, exactly like the beginning of physical exercise, after the hospital must be coordinated with an exercise therapy specialist or an attending cardiologist.

Daily physical activity

Exercise therapy for diseases of the cardiovascular system

Methods of exposure

The action of exercise therapy in diseases of the cardiovascular system

Rehabilitation of patients with myocardial infarction is divided into three stages. At each stage, the patient undergoes a course of physiotherapy exercises.

Arterial hypertension is a fairly common disease characterized by an increase in blood pressure. There are three stages of hypertension.

The tasks of exercise therapy for arterial hypertension are to lower blood pressure, prevent crises, and generally improve the patient's condition. Exercise therapy for arterial hypertension includes: dosed walking, remedial gymnastics, general action equipment, therapeutic swimming and exercise in the pool, massage.

Heart defects: exercise therapy

Physiotherapy exercises for heart defects - a combination of active and breathing exercises. Classes are held at a slow pace, without intensification, the duration of the days. In the next 2-3 weeks, the patients are assigned therapeutic exercises.

Ischemic heart disease: exercise therapy

Means of physiotherapy exercises for ischemic heart disease: remedial gymnastics, exercise in water, swimming, dosed walking.

Exercise

A set of exercises for coronary heart disease:

Starting position - hands on the belt, standing over the seat of the chair. We take our hands to the sides - inhale, return our hands to the belt - exhale.
The starting position is the same. We raise our hands up and inhale, bend forward - we exhale.
The starting position is standing by the chair. Sit down - breathe out, stand up - take a breath.
Starting position - sitting, bend your right leg - cotton, return to starting position. Do the same with the left leg.
Starting position - sitting on a chair. Do not hold your breath, sit down in front of the chair, then return to the starting position.
The starting position is the same, legs are straightened, arms forward. We bend our legs at the knees, put our hands on the belt, then return to the starting position.
The starting position is standing. We take the right leg back, hands up - inhale, starting position - exhale. Repeat for the left leg.
Starting position - standing, hands on the belt. Carry out tilts to the right and left.
Starting position - standing, hands in front of the chest. We take our hands to the sides - inhale, starting position - exhale.
The starting position is standing. We take the right leg and arm forward. The same with the left leg.
Starting position - standing, hands up. They sat down, then returned to their original position.
The starting position is the same, hands up, hands in the lock. We carry out the rotation of the body.
The starting position is standing. Take a step with your left foot forward - arms up, return to SP. Repeat for the right leg.
Starting position - standing, hands in front of the chest. Carry out turns to the left and right with arms spread.
Starting position - standing, arms to shoulders. Straighten your arms alternately.
Walking in place.

Breathing exercises for angina pectoris

breathing exercises for angina pectoris

I suffered greatly from angina pectoris (angina pectoris), the most common form of coronary heart disease. Its main manifestation is attacks of constricting, pressing pain in the chest. Angina pectoris occurs suddenly, lasts from several minutes to half an hour, has varying intensity, and can radiate to the left arm, shoulder blade, shoulder or neck. Often an attack of angina pectoris is accompanied by a feeling of fear. Do not succumb to it and try to immediately relieve the heartache. To do this, always have validol on hand. If an attack of angina pectoris occurs while walking, but there is no validol, you should immediately stop, relax and breathe evenly. Soon the pain will subside.

After another treatment in the hospital, the attending physician told me: "That's it, now you can't live without nitroglycerin."

But contrary to the verdict, I decided not to give up, began to read various publications on medical topics, apply the recommended methods of treating angina pectoris to myself, and in the end settled on breathing exercises according to the yoga system.

To breathe correctly using this method, you need to, while standing or sitting on a straight-backed chair, relax, think about something pleasant (I always think about the sea), breathe in air through your nose and hold it in your chest so that it is comfortable. Exhale through the mouth and simultaneously with exhalation, it is easy to hit with arms bent at the elbows, like wings, on the left and right on the chest. Perform this breathing for 10 minutes, first once a day, and a week later - in the morning, at lunchtime and in the evening.

I breathed in this way for a month, then I took a 10-day break, and after that I repeated the treatment course. And so, with interruptions, I was treated for six months. With this exercise, at the time of holding the breath, oxygen is directly directed to the heart muscle, relieving tension. Care must first be taken to avoid dizziness. Perform yoga breathing exercises until complete recovery. You yourself should feel when the angina attacks will stop, since each person is different. After that, undergo a medical examination.

In addition to performing breathing exercises for angina pectoris, it is necessary to walk daily in the fresh air near a reservoir, in a forest or park, inhaling fresh air enriched with oxygen.

It is very good to do this with someone in order to have a conversation while walking, getting positive emotions.

After recovery, stress should be avoided, as it can lead to a relapse of the disease. Once, having already recovered, I ran to catch up with the trolleybus (there was such a need) and suddenly felt that I would not reach it. Immediately, according to the yogi system, I breathed in air through my nose, held my breath and thus solved the stressful situation - the trolleybus did not leave without me.

It is very important to learn to forgive everyone, constantly wish people health, good, not remember grievances (mentally burn them in fire). Do not harbor anger in yourself, since most diseases are the result of negative thoughts, deeds and emotions. You can't live in the past, you have to live in the future.

Smile more, laugh, have fun, dance, listen to music and remember that all our organs need to be healed only with good thoughts and that everyone can be a healer for himself. It is possible and necessary to speak with each organ affectionately, as with a particle of oneself.

For example, if your heart aches or tachycardia occurs, immediately put your right palm under the left breast on the heart area, close your eyes, think about this organ with gratitude that it has served you for so many years and thanks to it you live, and mentally to calm the heart , say: “It's okay, calm down. The heart beats rhythmically. I am surrounded by nature, elements: sun, air, water, earth. I live in harmony with my organs, including the most important organ - the heart. Calm down, dear, we will live together for a long time in harmony. " Gently stroke this place, pressing your hand tightly to your chest, with light circular movements so that the palm moves slowly, always clockwise. Say a kind word to your heart, wish it good luck and end your conversation with the words: “So be it. Amen!"

Even the ancients considered the heart to be the focus of reason, love and selflessness. Take care of it!

Ivanova Valentina Nikolaevna

Antihypertensive and antiarrhythmic drugs in the treatment of cardiovascular diseases

Those drugs that affect the blood itself, the blood vessels and the heart muscle, can also be used to treat cardiovascular disease. These drugs alter heart rate and blood pressure, heart pumping, blood clotting and blood flow. Antihypertensive Drugs and Medications Antihypertensive drugs are used to treat high blood pressure. (hypertension). Them. ⇒

Stress creeps in imperceptibly - minor problems, irritation and dissatisfaction with life accumulate little by little and soon overflow. You can continue to be in a state of permanent stress, destroying your health, or you can slightly correct your usual behavior and make life more cloudless! Before you is a whole arsenal of simple but effective ways, how. ⇒

How to stop eating stress

There are people who, because of nervousness, do not eat anything and tirelessly lose weight, and there are those who do not stop eating in such situations and see only this way of dealing with stress. How to get rid of this? As we all know, there are a lot of ways to deal with stress, as well. ⇒

Symptoms and signs of angina pectoris

Angina pectoris is called "angina pectoris". The word "sore throat" means pain, and "pectoris" means chest. Angina pectoris is chest pain or discomfort caused by decreased blood circulation to the heart and heart muscle. This disease is the result of a lack of oxygen and other nutrients in any part of the heart muscle. Signs. ⇒

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Angina pectoris is a clinical form of ischemic disease characterized by attacks of sudden chest pain caused by an acute lack of blood supply to the heart muscle. The pains are localized behind the sternum or to the left of it, spread to the left arm, left shoulder blade, neck, are squeezing, pressing or burning in nature. In most cases, angina pectoris is a consequence of atherosclerosis of the coronary arteries.

Distinguish between angina pectoris, when pain attacks occur during physical exertion (walking, climbing stairs, carrying heavy loads), and rest angina, in which an attack occurs without connection with physical efforts, for example, during sleep.

There are several variants (forms) of the course of angina pectoris: rare attacks, stable angina pectoris (attacks in the same conditions), unstable angina pectoris (increased frequency of attacks that occur with less stress than before), preinfarction state (increased frequency, intensity and duration seizures, rest angina appears).

In the treatment of angina pectoris, regulation of the motor regimen is important: it is necessary to avoid physical exertion leading to an attack; with unstable and preinfarction angina, the regimen should be limited to bed. In addition, limiting the volume and calorie content of food plays an important role, as well as the use of medications that improve coronary blood circulation and eliminate emotional stress.

The objectives of physical therapy: stimulate neurohumoral regulatory mechanisms to restore normal vascular reactions during muscle work, improve the function of the cardiovascular system, activate metabolism (fight against atherosclerotic processes), improve the emotional and mental state, and ensure adaptation to physical stress.

In the conditions of inpatient treatment with unstable angina pectoris and pre-infarction state, therapeutic exercises are started after the termination of severe attacks on bed rest, with other variants of angina pectoris - on ward mode. As all subsequent modes pass, the motor activity gradually expands. The technique of physical therapy is the same as for myocardial infarction. Transfer from regime to regime is carried out at an earlier date. New starting positions (sitting, standing) are included in the exercises immediately, without preliminary careful adaptation. Walking in ward mode starts from 30-50 m and is brought up to 200-300 m, in free mode - up to 1-1.5 km. Walking pace is slow, with breaks for rest.

At the sanatorium or polyclinic stage of rehabilitation treatment, the motor regimen depends on the functional class to which the patient belongs. The same motor regime and therapeutic physical education are prescribed to patients who have had myocardial infarction more than a year ago, and to patients with atherosclerotic cardiosclerosis.

The role of angina pectoris in ischemic forms of the disease
In what cases the prognosis is unfavorable
Treatment tactics and objectives
How to stop an attack of angina pectoris
Treatment at the ambulance stage
Therapeutic measures in a hospital setting
Outpatient treatment
Other treatments
Massage application
Physiotherapy
Folk remedies

Angina pectoris is a clinical form of coronary heart disease, which has typical manifestations in the form of:

attacks of chest pains of a pressing character with irradiation in left shoulder, scapula, jaw;
pain lasting up to 30 minutes with spontaneous termination or under the influence of nitroglycerin;
connection with physical or emotional stress.

The presence of only two signs indicates atypical angina pectoris, and only one is not associated with the diagnosis at all.

Such rigid settings in diagnostics are necessary to comply with the possibility of treating angina pectoris at all stages according to a single algorithm.

The role of angina pectoris in ischemic forms of the disease

Statistical studies show an increase in the prevalence of angina in the population with aging:

among women in the 45–64 age group, 5–7% have it, and at the age of 65–84 years, 10–12%;
among men, this indicator correspondingly increases from 4 - 7% to 12 - 14%.

In what cases the prognosis is unfavorable

The results do not always depend on how the angina is treated. The factors that negatively affect the course of the disease and lead to worse results have been studied and identified. Among them:

the presence of signs of heart failure and weakness of the left ventricle by ultrasound of the heart;
stenosis of large coronary vessels with a significant spread of the ischemic zone;
severe pain syndrome;
advanced age of patients;
prevalence of depression in the behavior of patients.

Treatment tactics and objectives

pain relief;
reduction of the zone of myocardial ischemia.

Both objectives directly affect the prognosis and life expectancy of patients.

give up smoking, alcoholic beverages, strong coffee;
switch to a diet with restriction of animal fats (fatty meat, sour cream, cream, lard, butter) and easily digestible carbohydrates (sweets, baked goods);
reduce physical activity to moderate, force yourself to move more, do exercises;
at overweight spend low-calorie fasting days;
do auto-training, yoga, suitable soothing procedures to normalize sleep, improve the tolerance of stressful situations.

The patient must draw up a real plan of his actions and clearly adhere to its provisions. Treatment at different stages is carried out by their own methods.

How to stop an attack of angina pectoris

An attack of angina pectoris can occur at any time and does not depend on the place. The patient, with the help of assistants, must:

sit down (lying down is not necessary);
release the tight collar and belt for free breathing;
put a nitroglycerin tablet under the tongue or spray Isoket from a can;
if the attack happened at home, you can put a mustard plaster on the heart area;
massage the skin over the heart area, this helps to reduce the duration of pain;
alternative treatment recommends drinking a sip of brandy (no more) to dilate blood vessels.

The action of nitroglycerin ends in 5 minutes. You can take the pill again. Some people experience severe headaches and dizziness. This is due to a sharp decrease in blood pressure, especially typical for hypertensive patients. It is recommended to halve the dosage by dividing the tablets in half.

In the absence of effect or intense pain, you should call an ambulance.

Validol remains the drug of choice, it helps to calm down, the strength of the action is much weaker than nitroglycerin. But some patients love this particular drug.

Treatment at the ambulance stage

An ambulance doctor is usually interested in the medications he has taken. In the ambulance arsenal there are more powerful painkillers for stopping an attack:

coronary spasms, relieving spasm of cardiac vessels (Papaverine, Platifillin);
narcotic analgesics (Morphine, Promedol, Omnopon).

They are injected subcutaneously in the absence of the effect of nitroglycerin.

The cardiac team administers droperidol and fentanyl intravenously, possibly short-term inhalation of nitrous oxide.

With a prolonged and severe attack of angina pectoris, the patient is hospitalized in a hospital.

Therapeutic measures in a hospital setting

For the drug treatment of angina pectoris in a hospital setting, drugs are used different groups, in accordance with the standards of therapy. The pharmacological action is aimed at preventing attacks, relieving spasm of coronary vessels, reducing myocardial oxygen demand and normalizing metabolic processes in cells.

There are two groups of basic drugs for angina pectoris.

The first line is a group of β-blockers and agents that cause the closure of calcium channels (Obzidan, Inderal, Anaprilin). Indicated for monotherapy (single drug) or in combination with other drugs.

The second line is added to the first line drugs, but sometimes they themselves become the means of primary treatment. These include:

long-acting nitrates (like nitroglycerin, but last up to 12 hours) Sustak, Nitrosorbide, Nitranol, Erinit;
inhibitors at the enzyme level - Chloracizin, Trimetazine, Nicorandil, Ivabradine;
with stable angina pectoris, patients are prescribed drugs that reduce blood clotting (Thrombus ass, Cardiomagnyl, Clopidogrel).

Outpatient treatment

The therapy continues with one or two drugs (first and second line). Curantil is prescribed to normalize blood viscosity and prevent thrombosis.
A drug from the statin group is selected according to indications.

The combination of angina pectoris with hypertension, diabetes mellitus, heart failure, rhythm and conduction disturbances requires very careful selection of the dosage for the elderly. Don't give them your pills. Even good remedies can be overwhelming.

Mercazolil, Methylthiouracil contain thyroid hormones, delay the development of atherosclerosis and dilate blood vessels, are used in courses in small dosages.
Combined action means include Korontin, Falikor, Intenkordin.
Long-term use of modern aspirin anticoagulants is recommended under the control of a coagulogram.
To normalize metabolic processes in the heart muscle, a course intake of Potassium orotate, Panangin or Asparkam, B vitamins with folic acid is shown, nicotinic acid is prescribed in injections.

Other treatments

In each region there are rehabilitation departments, sanatorium-type centers. In them, treatment is possible at the expense of the compulsory medical insurance fund (for the patient free of charge) and with additional paid services for nutrition and therapy.

The standards include all the necessary drugs, massage, exercise therapy, balneological treatment (baths, showers), the use of auto-training.

Massage application

Massage of the spinal points is applied in the cervicothoracic spine, in the interscapular region, in the region of the left shoulder and sternum.

The procedure lasts 15 - 20 minutes, the course is 10 sessions. The massage can be repeated twice a year.

In cases of a combination of angina pectoris with hypertension, brain lesions, massage of the collar zone and electrophoresis with Euphyllin are combined.

Physiotherapy

The complex of exercise therapy for angina pectoris should be selected individually by the doctor, taking into account the latest analyzes, ECG data and clinical symptoms.

Breathing exercises "teach" the myocardium to manage with less oxygen, improve ventilation, relieve the hypoxic state. It is recommended to breathe deeply 2 - 3 times a day, observing the following rules:

the room should be well ventilated, it is better to study outside;
inhale with your nose for a count of 1 to 3, then hold your breath for a count of 1, 2 and slowly exhale through your mouth with a count of five;
when exhaling, it is recommended to "beat" yourself on the chest with light movements.

Folk remedies

Treatment of angina pectoris at home is not complete without the use of folk remedies.

Currently, "rational" healers recommend crushing 300 g of garlic and mixing it with three chopped lemons and honey. Insist for at least a week. Take a tablespoon half an hour before meals. The action of phytoncides is combined with vitamin C and natural bioactive substances.

An interesting recipe: add 10 peeled garlic cloves to 2 cups of chicken broth, boil for about 15 minutes. Shortly before finishing add a finely chopped medium bunch of parsley. Strain the broth. Grate the boiled garlic and parsley and put them back in the broth. It is recommended to drink 1/3 cup before meals.

Hawthorn is taken in the form of a tincture of 10 - 15 drops before meals or boiled together with rosehips and drunk as compote.

You can buy ready-made alcoholic tincture from motherwort herb in the pharmacy. Take 10-15 drops.

A mixture of dried apricots, prunes, walnuts with honey and crushed lemon contains essential vitamins and is useful for heart disease.

Treatment of angina pectoris with folk remedies does not exclude prescribed medications. Taking anticoagulants with the recommendations of healers can be dangerous due to the increased action. The appearance of an allergic reaction in the form of a rash, itchy skin is a signal to stop using the prepared product.

When treating angina pectoris, do not get discouraged. Remember that mood affects the prognosis of the disease.

Exercises for Parkinson's Disease Patients Used in Patient Rehabilitation

Parkinson's disease is not very common among older people, but at least 1% of all older people have this disease. This disease is of a neurological nature, and one of its main manifestations is a significant decrease in motor abilities. The same manifestation is the main reason for the disability of patients.

The main cause of the disease is a lack of dopamine, which is responsible for the motor function of the body. As the body ages, dopamine production can decrease, which leads to movement disorders.

Treatment of the disease is carried out in a comprehensive manner, this includes medication, diet and a set of physical exercises.

The Role of Exercise in the Treatment and Rehabilitation of Patients with Parkinson's Disease

The results of many studies conducted unequivocally indicate the fact that certain physical exercises for patients with Parkinson's disease have a positive effect on the restoration of motor functions in patients. Physiotherapy exercises can reduce oxidative stress, increase the transfer of dopamine.

After performing a set of physical exercises, patients notice a decrease in tremor, an increase in postural tissue. Objectively, there is a gradual slowdown in tissue malnutrition in all muscle groups.

In the complex treatment of Parkinson's disease, exercise therapy takes a very important place. Patients acquire new automatic stereotypes of motor functions. In addition, exercise helps restore disorders of the central and autonomic nervous system, strengthens joints and muscles.

In addition, exercise can help reduce the risk of injury from falls. Also, due to the development of new stereotypes of movement, the risk of falling of the patient is reduced.

Basic guidelines for exercise use in patients with first-degree Parkinson's disease

A set of physical exercises designed for patients with Parkinson's disease should be performed by patients every day, at least twice a day. Each lesson should last at least 30 minutes.

The training program should include exercises for the development of complex movements affecting coordination, stage plastic. It is necessary to include movements that allow you to relax the muscles.

Physiotherapy exercises for Parkinson's disease should include relaxation techniques, as well as breathing exercises.

Parkinson's workloads should not be reduced; on the contrary, they should correspond to the recommended loads for healthy people of their age.

Ballroom dancing classes showed themselves very well, especially with the aim of developing coordination of movement and plasticity. Classes with musical instruments develop fine motor skills of movements well.

Recommendations for the use of physical education in the second stage

The second stage of the disease already significantly affects the patient's motor abilities. There is a visible stiffness of movements. At this stage, exhausting physical activity is contraindicated, since they can lead to injuries due to falls, low blood pressure, etc.

The main focus of physical exercise is the development of stability and coordination. It is necessary to pay attention to those types of movements that are aimed at stretching the muscles, increasing the motor function of the joints. Breathing exercises are recommended. The purpose of all exercises is to maintain physical activity and reduce the formation of factors leading to disability.

Standing with your back to the wall, stretch your arms down and touch the wall with your palms. After that, try to squeeze your whole body into the wall as much as possible. Relax on the count of five. Repeat several times.
Raise your arms and touch your palms to your neck. In this position, make turns to the sides, trying to keep the hips motionless. Repeat several times.
In a sitting position, touch the knees with your palms, carry out bends all the way to the knees, then bend back to the maximum. Then sit up straight. Repeat several times.
Tilts the head to each shoulder in turn, do not raise the shoulders.
Movement on motor skills: with the thumb, alternately touch the other fingers. Increase travel speed gradually to maximum.

This is just a brief common complex that can be applied to every patient.

Individual training program physical exercise should be drawn up by a trainer on the recommendation of a doctor, according to the individual needs of the patient.

Recommendations for physiotherapy exercises in the third stage

At the third stage, postural instability begins to appear in patients. All symptoms are significantly aggravated and reduce everyday activity.

Exercise for Parkinson's patients should focus on maintaining motor function, especially walking. This is due to the fact that patients have problems maintaining and increasing the speed of movement, the ability to make turns and change their position relative to external factors.

Therefore, the complex must necessarily include movements that help increase their coordination, make the patient's body more stable in space. Walking training using a wide stride is recommended. Also included are movements for training turns. The patient must often pass through the doors at home with a turn performed by small side steps. In this case, the legs should be wide apart.

It is necessary to perform movements that allow you to stretch the muscles and restore mobility to the joints. Movement gymnastics is recommended.

Exercise therapy for hypertension: a set of exercises and gymnastics

Exercise therapy for hypertension is an indispensable component of complex treatment, which helps to reduce the risk of complications from the cardiovascular system. Sport helps to reduce the dosage of medications taken, normalizes blood pressure indicators.

Hypertension is a common chronic disease. According to statistics, more than 20% of the adult population suffer from the disease. There is a steady upward trend. Pathology occupies a leading position in mortality from heart attack and stroke, and leads to disability.

The onset of hypertension is based on many factors - bad habits, menopause in women, salt abuse, diabetes mellitus, chronic stress, impaired renal function, genetic predisposition.

Consider the indications and contraindications for a set of exercises, we will voice the benefits of physical education for hypertension and the main nuances of performance.

Therapeutic training for hypertension

Rehabilitation for patients is selected in accordance with the history, symptoms, due to certain medical principles. Patients with hypertensive disease of the first stage are recommended to use autogenous exercises, salt-free nutrition, and gymnastics.

Conservative drug treatment is prescribed in cases where the described three methods did not give the required therapeutic effect. At stages 2 and 3, drug therapy is recommended, prevention through exercise.

The set of exercises prescribed to the patient is determined by the state of health, form, degree and stage of the chronic disease. In addition to exercise therapy, Strelnikova's breathing exercises are advised, which helps to reduce DM and DD.

During training, hypertensive patients should refrain from the following actions:

Rhythmic physical activity.
Power loads (lifting loads, etc.).
Trainings taking place against the background of muscle contraction without the participation of the lower and upper extremities.

After a hypertensive attack, the rehabilitation period is different for everyone. In most cases, the patient is recommended to lie down for the first week, that is, to stay in bed, not to be nervous. It is advisable to have a spa treatment according to the profile.

The gymnastic complex with hypertension has a lot of advantages. Exercise strengthens the body, activates the activity of the cardiovascular and central nervous system. They also help restore vascular tone, normalize motor functions, enhance metabolic processes, which together prevent the development of atherosclerotic changes.

Classes are selected individually. As a rule, exercise therapy for hypertension includes general developmental training, in which all muscle groups are involved, as well as special classes for relaxation and relaxation.

Gymnastics is combined with head, neck and shoulder massage. It is carried out after training. Some patients are prescribed exercise therapy even with bed rest.

In the future, workouts are supplemented with aerobics, swimming, hiking, active games, etc.

Classes for hypertension 1 degree

Dr. Shishonin is sure that the jumps in arterial parameters are due to impaired blood circulation in the human body. He invites patients to do exercises aimed at normalizing it.

The Bubnovsky Center accepts patients with hypertension of any degree, vegetative-vascular dystonia and other diseases. On the video of the presentation on the Internet, you can familiarize yourself with the features of the techniques and the effects of them.

Against the background of the first degree of the disease, the complex includes training aimed at relaxing the muscles in a standing or sitting position. In addition, balls, gymnastics sticks, light weight barbells are used.

Classes begin with an elementary load. The patient needs to walk in a regular step in a circle, then move to toes, then to heels, back forward. Every 5-8 steps the design options change. The duration of the entire exercise is up to 5 minutes. Easy to carry out at home.

The first exercise therapy exercises must be carried out under the guidance of an experienced instructor, who will correct it in a timely manner if there are errors. The main task of the patient is to adhere to all recommendations.

For quick recovery and prevention of exacerbation, exercises are recommended:

Sit on a chair, lower your hands down, raise your shoulders while inhaling. Then they make a backward movement, as if they were "describing" a circle. Lower, repeat 5-6 times.
IP - the patient sits on a chair, hands rest on the belt, free breathing - 1 minute. Stretch your arms forward, straighten your right knee while inhaling. Fasten your hands with a “lock” under the knee, perform swaying movements. Repeat 5 times on each leg.

The hypotensive effect of physiotherapy exercises is manifested when the frequency of classes is at least three times a week.

When training more than 3 times, the normalization and stabilization of blood pressure at the target level is noted.

Gymnastics for hypertension grade 2

With arterial hypertension of the second degree, they begin with a minimal load to give the body time to get used to it. As a rule, the picture is complicated by the excess weight of the patient, which aggravates the situation.

The exercise scheme is compiled individually. Depends on the condition and ability of the patient to perform the exercises. Includes a variety of activities that target all muscle groups.

In addition, physiotherapy is prescribed for hypertension - warm baths, magnetotherapy, electrophoresis, etc., focused on improving blood circulation and vascular condition, which helps to reduce the systolic and diastolic rate.

Approximate polyclinic complex for hypertension of the 2nd degree:

Lie on your back, arms along the body. Bend your legs at the knees, pull your feet to the buttocks, clench your hands into fists. Deep breath - tension of all muscles. As you exhale, the knees are straightened, the fingers are unclenched. Relaxation - 1 minute. Repeat 7 times.
The starting position is the same. The hands are placed on the shoulders, then the hands are pulled up and back. After the stage of relaxation on the exhale. Repeat 5 times.
Lie on the floor, all muscles tense while inhaling. The body is "pressed" as much as possible to a flat surface, rest against it with your heels. Make 3-4 approaches.

Medical gymnastics for the neck is recommended for the combination of hypertension and cervical osteochondrosis, as well as other problems associated with the vertebrae in this department. The exercises are performed correctly and under the supervision of an instructor. One wrong move is pain and the risk of complications.

If during training the patient does not feel well - the head hurts and is dizzy, the face turns pale or reddened, it is necessary to stop exercising.

Contraindications and training features

Exercise therapy for hypertension is a useful set of exercises, but patients can get "relief" from it due to medical contraindications. People should be "isolated" from any physical activity if their blood pressure is above 220/120 mm Hg, even if they feel well.

Exercise should not be performed with high intracranial pressure, against the background of progressive malignant hypertension. In this case, only medication is prescribed, it is permissible to use folk remedies. Practice shows that the latter are ineffective.

Contraindications to exercise therapy:

Shortness of breath, swelling.
Pulse over 100 beats or less than 50 beats per minute.
Frequent attacks of atrial fibrillation or tachycardia.
If the ECG shows signs of ischemia.
Frequent and complicated hypertensive crises.
A large number of leukocytes in the blood.

When treating arterial hypertension, a number of rules are followed. They allow the heart and blood vessels to adapt to changing conditions, respectively, complications of a different nature are prevented.

The increase in load occurs gradually. Do not start with abrupt and unusual activity for a person. The intensity increases with each session. Gymnastics for hypertension always begins with breathing exercises and warm-ups.

Be sure to monitor your blood pressure and heart rate before and after exercise. Compliance with the drinking regime, especially in the hot season, in order to prevent dehydration of the body.

The exercises are performed freely, without undue effort. If you experience discomfort, pain in the heart, you must stop immediately or slow down the pace of exercise.

Physiotherapy for arterial hypertension is part of complex therapy that helps the body recover faster after a hypertensive attack. Correct performance is the key to a full and long life with normal blood pressure.

The best modern remedy for hypertension and high blood pressure. 100% pressure control guarantee and excellent prevention!

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