Is it possible to exercise if you have angina? Therapeutic exercises for angina pectoris

13.04.202027.05.2017

Modern medical research has shown that the development of coronary heart disease (CHD+ and angina pectoris) can be facilitated by various factors. As a rule, it is impossible to get rid of the body’s hereditary predisposition 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; stress; disruption of normal metabolism, which caused improper diet;

Terms: Physical inactivity is a weakened state of muscles caused by a sedentary lifestyle.

It is necessary to carry out a competent correction of the lifestyle, to review the canons of life in better side, which will avoid the above factors. First of all, and this applies to any person, even those who have no complaints, it is worth following a daily routine, eating right, being active and healthy image life, do not smoke, do not take drugs and do not drink alcohol.

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

Regular repetition of physical exercises will constantly keep your muscles in good shape;
physical activity leads to an increase in “useful” lipids in the blood and prevents the occurrence of atherosclerosis;
the likelihood of blood clots decreases;
overall well-being and positive attitude improves;
body weight is reduced and diabetes is prevented and much more.

Angina and sports

Many people wonder: is it possible to play sports, run, go to training and do physical exercise with angina pectoris. Here the answer is clear - you can. But there is one condition. Exercise therapy for angina pectoris is selected for the patient by a doctor. This is because during the training physical culture the myocardium will require even more oxygen than before.

And acute oxygen deficiency will lead to pain and discomfort. If exercises for angina are prescribed by your doctor, 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 be beneficial, and not vice versa.

Breathing exercises for angina pectoris

Study physical therapy useful, but it is worth remembering breathing correctly, 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 about something good and positive until you relax. Then take a deep breath in through your nose for 1-2-3, hold your breath for 1-2 and exhale through your mouth for 1-2-3-4-5. At the moment of exhalation, it is recommended to bend your elbows and hit your chest with your “wings” like a bird. Repeat this respiratory complex exercises are worth 10-15 times. Three times a day.
For people suffering from angina pectoris, doctors recommend walking every day in the fresh air, mentally imagining the oxygen saturation of the myocardium.

Therapeutic exercises for angina and heart failure

Preventative treatment and further recovery the body after treatment needs a complex of special therapeutic exercises. For coronary heart disease, the following exercises are recommended:

Sit on a chair and lower your hands to the floor. Inhaling air, raise your arms at an angle of 180 degrees, and exhaling, return them to the starting point. It is recommended to repeat such manipulations during ischemia five times.
Sitting on a chair, fix your hands on your belt. Then, alternately extend one arm after the other and return them to the starting point, repeating the exercise five times.
For ischemia, place your feet shoulder-width apart. Bend your elbows and raise them to chest level. As you inhale, spread your arms and turn your body to the side. When the patient returns to starting position, you can exhale. Repeat the exercise four to six times.
If you have problems with running, then they recommend a moderate walking rhythm for half a minute, and then a fast pace for a minute. During this time, the body will not have time to become very depleted before acute pain appears.

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

Always give preference to those physical activities and exercises that bring pleasure. It is necessary to do such therapeutic exercises, and even play sports, in a good mood and with positive thoughts. Only then will exercise therapy for ischemic heart disease be useful.

If you live in a multi-storey building, then a good start to your physical activities may involve climbing stairs on foot. At the same time, you should not suddenly climb to the ninth floor and lose consciousness. Gradually, with increasing floors, do small “feats”. And without realizing it, you will notice how you go home without an elevator.
To gradually increase physical activity while getting to work, get off at the stop earlier. This is especially important for those people who work in an office sitting at a computer and are susceptible to the development of physical inactivity.
If walking alone only makes you sad, buy a small dog. It’s more fun to walk with her, and to go out fresh air you will regularly. At the same time, no one says that you need to run after your pet around the park at breakneck speed. A calm and easy walk outside is always good.

How much does pressure increase during exercise?

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. Doing exercise stimulates the release of adrenaline, which plays important role in human adaptation to environmental factors. Systematic classes sports help strengthen the vascular wall, stabilize breathing, and also increase the degree of saturation of tissues with useful substances and oxygen.

Causes of increased blood pressure during exercise

An increase in the concentration of adrenaline in the blood is associated with activation of the sympathetic circuit nervous system. During physical exercise, breathing becomes more frequent and fluid circulation in the body improves. This requires additional costs from the body. Blood pressure often increases during everyday life– during heavy lifting, long walking, and also in case of nervous tension.

The following body systems are involved in increasing blood pressure:

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

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

Why does blood pressure increase after exercise?

A physically weak body reacts to new exercises with a short-term increase in blood pressure. Increase by 15–20 mm Hg. Art. within an hour is a variant of the norm. Long-term maintenance of high levels indicates hidden problems of the vascular system. Arterial hypertension at the initial stage is observed only in stressful situations, without manifesting itself in a calm environment.

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

dizziness, accompanied by redness of the eyes, flickering spots in the field of vision, nausea and vomiting;
pain in the heart of an aching, squeezing nature, up to an attack of angina due to spasm of the coronary vessels;
lethargy and lethargy, numbness of the limbs, as well as impaired diction may indicate ischemia of brain tissue;
external signs are facial redness, excessive sweating, constant shortness of breath, sudden coughing attacks.

Dealing with hypertension caused by one of the types of physical labor is more difficult than with the usual increase in blood pressure. Stabilization of hemodynamic parameters depends on the individual characteristics of the body. People prone to vascular diseases should carry a blood pressure-normalizing pill with them and carefully monitor how they feel when performing new exercises.

Reasons for decreased blood pressure during exercise

Regulation of vascular tone is carried out using the sympathetic and parasympathetic parts of the nervous system. In people with sympathicotonia, blood pressure increases 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.

Toward decline blood pressure lead:

vegetative-vascular dystonia of the hypotensive type;
inconsistency of the selected set of exercises with the physical capabilities of a person;
depletion of body resources (vitaminosis, overwork);
heart defects, mitral valve prolapse;
history of angina attacks.

If blood pressure decreases only during physical activity and quickly returns to normal levels within an hour after exercise, this may indicate asthenia. Poor nutrition sedentary image life, overweight and a history of lack of exercise make the body especially vulnerable. Thoughtful training with a predominance of the dynamic component will help the body strengthen.

Why does blood pressure drop after exercise?

Many people complain of weakness and dizziness after exercise. If proper rest is provided, 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 values by 10–20 mmHg. Art. characterized by:

dizziness, drowsiness;
severe weakness;
blurred vision, blurred vision;
pain behind the sternum;
feeling of lack of oxygen.

Blood pressure drops to 90 to 60 mmHg. Art. and below can lead to sudden loss of consciousness. To prevent the development of collapse, you need to be careful about your condition during training. Hypotonic people are best suited for walking, exercise therapy and swimming, which help strengthen the vascular system.

Monitoring hemodynamic parameters

Even experienced athletes with high endurance must monitor their condition during training. Before the first lesson, it is recommended to visit a doctor, who should assess the level of blood pressure, pulse intensity, breathing rate and then give recommendations regarding the desired sport.

To improve the condition circulatory system During training you need:

ensure sufficient heat transfer through high-quality clothing (the correct size, appropriate for the season);
measure blood pressure 20 minutes before exercise and 10 minutes after each exercise session;
choose professionally equipped premises with good ventilation and no proximity to production facilities;
drink enough clean water (not less than 2 liters daily).

Those who want to play sports should remember proper nutrition. A love of fatty and fried foods, as well as alcohol abuse, negatively affects the condition of blood vessels. It is worth limiting the amount of coffee and black tea you drink. To improve vascular tone, you need to include more foods containing K and Mg in your diet.

In medical practice for many centuries, the value 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. Indicators that are optimal for a particular person are called “working” indicators. If a person feels well, 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 mmHg. Art. is the limit indicating the development of arterial hypertension.

During intense exercise, the pressure of a previously untrained person during exercise can increase by 15–25 mm Hg. Art. Normally, indicators should return to “working” levels after half an hour. Elevated blood pressure persisting for several hours indicates hypertension. First stage hypertension implies indicators of 140–159/90–99 mmHg. 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 playing sports.

Contraindications for physical activity

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

People suffering from:

frequent sudden changes in pressure in everyday life;
thrombosis of blood vessels of the lower extremities;
cerebrovascular accident.

If the pressure has not returned to normal after half an hour, you should think about other types physical activity. In case of a sharp deterioration of the condition that arose against the background motor activity, sports activities should be stopped for a while.

Medicines for hypertension: what are they?

Hypertension is a sustained increase in blood pressure: systolic “upper” pressure > 140 mm Hg. and/or diastolic “bottom” pressure > 90 mm Hg. The key word here is “sustainable.” The diagnosis of hypertension cannot be made based on a single random blood pressure measurement. Such measurements should be carried out at least 3-4 times different days, and each time the blood pressure turns out to be elevated. If you are nevertheless diagnosed with arterial hypertension, then you will most likely need to take blood pressure pills.

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

Blood pressure pills, which come in 5 main classes, have been proven to significantly improve cardiovascular and renal prognosis. In practice, this means that taking medications delays the development of complications for several years. This effect will only happen if the hypertensive patient takes his pills regularly (every day), even when he has no pain and feels normal. What are the 5 main classes of medications for hypertension are described in detail below.
What is important to know about medications for hypertension:

If the “upper” systolic 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.
A blood pressure of 140/90 or lower is considered more or less safe, and for diabetic patients 130/85 or lower. To reduce blood pressure to this level, you usually have to take not one drug, but several at once.
It is more convenient to take not 2-3 tablets for blood pressure, but one single tablet that contains 2-3 active ingredients. A good doctor is one who understands this and tries to prescribe combined pills rather than individual pills.
Treatment for hypertension should begin with one or more medications 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 to add other drugs. Taking blood pressure pills in maximum doses is a dead end. Study the article “Causes of hypertension and how to eliminate them.” Follow the recommendations outlined in it, and don’t just lower your blood pressure with pills.
It is advisable to be treated with blood pressure pills, which are sufficient to take once a day. Most modern drugs are just like that. These are called long-acting hypertension medications.
Medicines that lower blood pressure prolong life even in older people aged 80 years and older. This has been proven by the results of long-term international studies involving thousands of elderly patients with hypertension. Blood pressure pills definitely do not cause senile dementia, and even slow down its development. Moreover, it is worth taking medications for hypertension in middle age to prevent a sudden heart attack or stroke.
Hypertension medications must be taken continuously, every day. It is prohibited to take unauthorized breaks. Take the antihypertensive pills that are prescribed to you, even on those days when you feel good and your blood pressure is normal.

The pharmacy sells up to a hundred different types blood pressure tablets. They are divided into several large groups, depending on their chemical composition and effect on the patient’s body. Each has its own characteristics. To choose which pills to prescribe, the doctor studies the patient’s test data, as well as the presence of concomitant diseases, in addition to high blood pressure. After this, 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. Read more in the article “What medications for hypertension are prescribed to older people.”

Advertising often promises that your life will be 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 strong. Only natural vitamins and minerals that normalize blood pressure can boast a complete absence of side effects.

Proven effective and cost-effective supplements for normalizing blood pressure:

Magnesium + Vitamin B6 from Source Naturals;
Taurine from Jarrow Formulas;
Fish oil from Now Foods.

Read more about the technique in the article “Treatment of hypertension without drugs“. How to order hypertension supplements from the USA - download instructions. Bring your blood pressure back to normal without the harmful side effects of chemical pills. Improve your heart function. Become calmer, get rid of anxiety, sleep like a baby at night. Magnesium with vitamin B6 works wonders for hypertension. You will have excellent health, the envy of your peers.

Below we will discuss in detail what groups of drugs for hypertension exist and in what cases patients are prescribed drugs from one or another group. After this, you can read separate detailed articles about the specific blood pressure pills you are interested in. You and your doctor may decide that it is better to change your antihypertensive (lowering blood pressure) medication, i.e. start taking a drug of a different class. If you are knowledgeable about what medications are available for hypertension, you will be able to ask intelligent questions to your doctor. In any case, if you have a good understanding of the medications and the reasons why you were prescribed them, you will find it easier to take them.

Indications for prescribing medications for hypertension

The doctor prescribes medications for hypertension to the patient if the risk of complications outweighs 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 accidents, or coronary heart disease, or renal failure, or severe retinopathy (damage to the retina).

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

When prescribing medication for hypertension to a patient, the doctor should give preference to drugs belonging to the groups listed in this note. Anti-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 tablets 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 mellitus	Yes	Yes	Yes	Yes	Yes
Chronic kidney disease			Yes	Yes
Preventing another stroke	Yes		Yes

Indications

Diuretics (diuretics)
Thiazide diuretics	Old age African descent
Loop diuretics	Kidney failure Congestive heart failure
Aldosterone antagonists	Congestive heart failure Previous myocardial infarction
Beta blockers	Angina pectoris Previous myocardial infarction Congestive heart failure (with individual selection of the minimum effective dose) Pregnancy Tachycardia Arrhythmia
Calcium channel blockers	Old age
Dihydroperidine	Angina pectoris Peripheral vascular diseases Atherosclerosis of the carotid artery Pregnancy
Verapamil, Diltiazem	Angina pectoris Atherosclerosis of the carotid artery Cardiac supraventricular tachycardia
ACE inhibitors	Congestive heart failure Left ventricular dysfunction Previous myocardial infarction Nondiabetic nephropathy Nephropathy in type 1 diabetes mellitus
Angiotensin II receptor blockers	Nephropathy in type 2 diabetes mellitus Diabetic microalbuminuria (protein albumin detected in urine) Proteinuria (presence of protein in urine) Left ventricular hypertrophy Cough after taking ACE inhibitors
Alpha blockers	Benign prostatic hyperplasia Hyperlipidemia (problems with blood cholesterol levels)

Additional aspects to consider when choosing medications for hypertension:

Groups of drugs for hypertension

Indications


Thiazide diuretics	Osteoporosis
Beta blockers	Thyrotoxicosis (short courses) Migraine Essential tremor Postoperative arterial hypertension
Calcium antagonists	Raynaud's syndrome Some heart rhythm disorders
Alpha blockers	Prostatic hypertrophy

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

Selection of medications for hypertension for selected concomitant conditions (2013 recommendations)

Associated condition

Suitable medications


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, yet without symptoms of renal failure	ACE inhibitors, sartans

Previous stroke	Any medications to lower blood pressure to safe levels
Previous 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 ventricular rate)	Beta blockers, non-dihydropyridine calcium antagonists
Lots of protein in urine (overt proteinuria), end-stage kidney disease (dialysis)	ACE inhibitors, sartans
Damage to peripheral arteries (leg vessels)	ACE inhibitors, calcium antagonists

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

Notes:

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

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Diuretic medications for hypertension

In the 2014 guidelines, diuretics retain their position as one of the leading classes of medications for hypertension. Because they are the cheapest and enhance the effect of any other blood 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 be a diuretic.

The most commonly prescribed diuretic medications for hypertension are indapamide, as well as good old hydrochlorothiazide (also known as dichlorothiazide and hypothiazide). Manufacturers are trying to get indapamide to displace hydrochlorothiazide, which has been used for about 50 years, from the market. For this purpose, numerous articles are published in medical journals. Indapamide is not expected to have harmful effects on metabolism. It has been shown to reduce the risk of heart attack and stroke in patients with hypertension. But it does not lower blood pressure any more than low-dose hydrochlorothiazide and is probably not much better at reducing the risk of hypertension complications. And it costs much more.

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

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

Calcium antagonists in the treatment of hypertension

Calcium antagonists (calcium channel blockers) are perhaps the most popular medications for hypertension in the world. They are especially indicated if high blood pressure is combined with coronary heart disease, heart rhythm disturbances, and 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, and among them is 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, in chronic kidney disease is considered undesirable. If there is severe (resistant) hypertension, then American experts consider it possible to prescribe combinations of a dihydropyridine and non-dihydropyridine calcium antagonist to patients as a 5-6 “line of defense.”

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

ACE inhibitors

Dozens of rigorous studies have been conducted, the results of which have proven that ACE inhibitors for 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 due to coronary heart disease in acute or chronic form, heart failure, diabetes mellitus, and chronic kidney disease.

Hypertension medications that 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 they would develop a cough less often. In such cases, ACE inhibitors are replaced with sartans, which have the same effect, but do not cause cough.

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

Angiotensin II receptor blockers (sartans)

Since the early 2000s, the indications for the use of angiotensin-II receptor blockers have expanded significantly, including for hypertension as a first-choice drug. These drugs are well tolerated. They are no more likely to cause side effects than placebos. It is believed that in case of hypertension they reduce the risk of heart attack and stroke, and 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, as well as in patients with type 2 diabetes in the presence of diabetic nephropathy (complications of diabetes on the kidneys). In any case, they are prescribed if a patient develops an unpleasant dry cough from taking an ACE inhibitor. The only problem is that angiotensin-II receptor blockers have so far been less studied. A lot of research has been done on them, but still less than on ACE inhibitors.

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

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

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

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

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

Beta blockers

Beta blockers have been attacked in the medical press, but still maintain their position as one of the leading classes of drugs for hypertension. Prescribing these tablets is especially justified for patients who have suffered a myocardial infarction, are diagnosed with angina pectoris, chronic heart failure, heart rhythm disorders or chronic kidney disease. Beta blockers also help against hypertension in young and middle-aged patients who have hyperthyroidism, glaucoma, or increased concentrations of catecholamines in the blood.

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

In elderly patients with hypertension, beta blockers are prescribed if there is concomitant coronary heart disease or chronic heart failure. This is called secondary prevention of cardiovascular complications. But if an elderly person’s hypertension is not complicated, i.e., the risk of a heart attack is low, then treatment with beta blockers is considered not advisable.

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

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

Second-line hypertension medications

Second-line medications for hypertension, as a rule, lower blood pressure no worse than drugs from the 5 main groups that we discussed above. Why were these drugs given supporting roles? Because they have significant side effects or are simply not well studied, 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 an alpha-1 adrenergic blocker. Methyldopa (dopegyt) is the drug of choice for controlling high blood pressure during pregnancy. Moxonidine (Physiotens) complements the combination treatment of hypertension in persons with concomitant type 2 diabetes, metabolic syndrome, and also if renal function is reduced.

Clonidine (clonidine) powerfully lowers blood pressure, but has severe side effects - dry mouth, lethargy, drowsiness. Do not treat hypertension with clonidine! This drug causes significant increases in blood pressure, “ roller coaster”, which are harmful to blood vessels. When treated with clonidine, heart attack, stroke, or kidney failure will occur much faster.

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

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

Is it worth the patient's time to thoroughly understand how different hypertension pills differ from each other? Of course yes! After all, it depends on how many more years a hypertensive patient will live and how “quality” these years will be. If you switch to a healthy lifestyle and choose the right medications, it is likely that you will be able to 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 persistently researching new, increasingly 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 medications for hypertension in an elderly person

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

Group I includes people with angina pectoris without a history of myocardial infarction.
Group II - people who had a heart attack with acquired cardiosclerosis.
Group III - post-infarction aneurysm of the left ventricle.

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

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

Who can do what?

Patients of the first group, that is, those who have not suffered a myocardial infarction, can do exercises using all muscle groups. Dynamic breathing exercises. The exercises are designed for minutes.

People who have had a myocardial infarction with cardiosclerosis should perform exercises slowly and use 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 exercises is minutes.

Patients from group III are at risk, so physical 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 to rest. Minutes are allotted for the exercises. If the condition worsens, tachycardia, renal-liver failure is observed, shortness of breath or pain in the heart appears, exercise therapy for coronary heart disease should be stopped immediately.

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

Exercises alternate with breathing exercises:

Lying on the floor, arms and legs apart, you should alternately bend your fingers and toes. After several such exercises, move on to simultaneous flexion fingers and toes. 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 apart, the exercise is done with the toes, first they are moved apart in outside, then turn inward. The pace of this exercise is average, breathing is even.
In the same position, raise your shoulders - inhale, lower them - 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 your hand from the elbow and legs from the knee. In the first 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 tempo is a little more intense than slow. Breathing is even.
The body position is the same, legs bent at the knees, tear off hip joint from the floor and inhale, lower - exhale. Repeat 3 times. Breathing is not impaired.
Lying down, bend your legs at the knees and alternately lower them to the right and then to the left. Each tilt is done 2 times. Breathing is slow, the pace of exercise is average.
Lying in the same position, spread in different sides knees - inhale, close - exhale. Repeat 2-3 times, exercise pace is average.

Gymnastics are performed for up to 20 minutes on average 3-4 times a day. If the cardiogram gives good results, then over time it will be possible to increase such classes up to 10 times a day.

After putting on physical therapy, you can move on to next stage when a person can already turn on the right side and climb the stairs independently. The development of motor functions begins. This is done so that it is not violated heart rate, shortness of breath and heart pain did not appear. Light exercises are performed to teach the patient to sit, stand up, climb stairs, etc.

Classes are aimed at working large and medium-sized joints - shoulder and hip. A stick and rubber ball. Exercises are aimed at coordination of movements, balance and attention. Walking should include from 10 to 100 steps. In this case, you should rest often.

Therapeutic exercise is done in sitting position or standing. One breathing exercise is performed every two special exercises. Time: 40 minutes a day, 3-4 times.

After a person begins to move independently, the third period of rehabilitation and physical therapy begins. At this time, the cardiovascular system and breathing are trained. The emphasis is on walking. Initially, it is carried out on a flat surface, later it is worth making descents and 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 take walks of up to 2 km. These classes are conducted in a clinic or sanatorium.

After exercise therapy for coronary artery disease within a medical institution has ended, it is necessary to continue exercising at home. In this case, you should undergo an examination 2 times a month.

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

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

Therapeutic measures in addition to exercise therapy

Medical nutrition. Patients with coronary heart disease are recommended to include honey, nuts, dried apricots, raisins, soy products, fermented milk products, lemons, pumpkin and pumpkin seeds, and rose hips in their diet.

If you are overweight, you should exclude fatty meats, margarine, butter. Replace animal fats with vegetable ones. This is done in order to reduce cholesterol in the blood. Food should be rich in vitamins and microelements.

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

Containing nitroglycerin and its long-acting derivatives. They are needed to relieve spasm in the coronary vessels to facilitate oxygen access to the heart muscle.
Medicines aimed at improving blood composition, reducing blood clotting to prevent the formation of blood clots (for example, aspirin).

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

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

Physiotherapy for ischemic heart disease

Physiotherapeutic 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, such as pain, persistent angina, arrhythmia, and hypertension. If the patient has more severe angina, then a gentle method is used in the form of four-chamber baths.

Electrosleep, galvanic collar, electrophoresis with painkillers and sedatives are also used. Recently, a new method of physiotherapy has appeared - laser treatment.

Rehabilitation should take place gradually and only under the supervision of a doctor. Coronary 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 state of muscles caused by a sedentary lifestyle.

It is necessary to carry out a competent correction of the lifestyle, to revise the canons of life for the better, which will allow us to avoid the above factors. First of all, and this applies to any person, even those who do not have complaints, it is worth following a daily routine, 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 heart disease?

Regular repetition of physical exercises will constantly keep your muscles in good shape;
physical activity leads to an increase in “useful” lipids in the blood and prevents the occurrence of atherosclerosis;
the likelihood of blood clots decreases;
overall well-being and positive attitude improves;
body weight is reduced and diabetes is prevented and much more.

Angina and sports

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

Breathing exercises for angina pectoris

It is useful to engage in physical therapy, but it is also worth remembering about proper breathing, during 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 about something good and positive until you relax. Then take a deep breath in through your nose for 1-2-3, hold your breath for 1-2 and exhale through your mouth for 1-2-3. At the moment of exhalation, it is recommended to bend your elbows and hit your chest with your “wings” like a bird. It’s worth repeating this breathing set of exercises once. Three times a day.
For people suffering from angina pectoris, doctors recommend walking every day in the fresh air, mentally imagining the oxygen saturation of the myocardium.

Therapeutic exercises for angina and heart failure

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

Sit on a chair and lower your hands to the floor. Inhaling air, raise your arms at an angle of 180 degrees, and exhaling, return them to the starting point. It is recommended to repeat such manipulations during ischemia five times.
Sitting on a chair, fix your hands on your belt. Then, alternately extend one arm after the other and return them to the starting point, repeating the exercise five times.
For ischemia, place your feet shoulder-width apart. Bend your elbows and raise them to chest level. As you inhale, spread your arms and turn your body to the side. When the patient returns to the starting position, you can exhale. Repeat the exercise four to six times.
If you have problems with running, then they recommend a moderate walking rhythm for half a minute, and then a fast pace for a minute. During this time, the body will not have time to become very depleted before acute pain appears.

Exercises for coronary heart disease

Gymnastic exercises for coronary heart disease

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

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

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

The second functional type includes patients with rare attacks of angina pectoris (that is, appearing during muscle work), arising, for example, when too brisk walking, going up to the 2nd-3rd floor. 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 in walking at a leisurely pace twice a day for minutes.

The third functional type includes people with coronary heart disease with frequent attacks of angina pectoris that occur with small muscle tension, for example, climbing 1 floor, walking at a moderate pace on level ground, etc. Their tolerance for physical activity is less than 50 W. They tolerate walking at a slow pace well and can do it for minutes.

Representatives of the fourth functional type are characterized by frequent attacks of angina at rest and stress. So, pain can occur even with minor loads, say, walking. They can be recommended for long walks, but with mandatory rest periods.

Let us recall that among a number of risk factors for “angina pectoris” is limitation of physical activity. Adequate physical exercise will help expand 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 approximate complex exercises available for patients with the first or second functional type. If during class you suddenly feel pain or discomfort in the heart area, you should reduce the load or even interrupt the activity.

A set of exercises for coronary heart disease

Sitting on a chair, hands down. Stretch your arms to the sides to shoulder level, take a deep breath, lower them down and exhale. Repeat 3-5 times.
While sitting, keep your hands on your waist. Right hand lift over the side to shoulder level, inhale, return to the starting position, exhale. Same thing for the left hand. Repeat 3-5 times.
Standing, spread your legs, bend your arms horizontally at the elbows and hover in front of your chest. Rotate the body with arms raised - inhale, return to the starting position, exhale. Repeat 4-6 times.
Normal walking (30 seconds), 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 your shoulders. Repeat 5-7 times forward and backward.
Standing, hands on the back of the head in a lock. Place your left foot to the side on your toe, tilt your body to the left, straighten up and take the starting position. Same thing 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 waist. Spinning the head with full amplitude to the right, then to the left. Perform 3-5 times in each direction.
Walking is simple, alternating with acceleration (3 minutes).
Walking is simple (30 sec), then with a high hip lift (30 sec).
While standing, alternately bend the body to the right, then to the left while bending the arm of the opposite side (the so-called “pump” exercise), the amplitude is maximum. Repeat 4-6 times in each direction.
While standing, we hold our hands in front of us and spread them slightly. Raise your left leg and touch your right palm, returning to the starting position. Same thing 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 clasp our hands in a “lock” and hold them on our knees. Turn your palms out, raising your arms 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 resting on the seat. Changing the position of the legs. Perform 8-10 times.

Physical activity for coronary heart disease

According to modern medical data, the development of IHD (coronary heart disease) can be facilitated by large number factors. Among the most common and “aggressive” ones are poor heredity, alcohol abuse, smoking, chronic stress, metabolic disorders due to poor nutrition, chronic fatigue, and physical inactivity. Of course, it is almost impossible to get rid of a hereditary predisposition to IHD, and you cannot completely protect yourself from stress. But you can adjust your lifestyle so as to avoid the other factors mentioned above. First of all, you should quit smoking, optimize your diet and ensure proper physical activity on the body.

The benefits of physical activity:

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

Regular physical activity is beneficial for everyone, as it allows you to protect yourself from the development of many unpleasant diseases. But, unfortunately, it is only the illness itself that often pushes us to change our lifestyle and regular exercise.

Only certain types of physical activity are suitable for patients with coronary heart disease.

IHD develops as a result of acid starvation, which leads to the formation of atherosclerotic plaque. The plaque causes the artery that supplies blood to the heart to narrow, causing less oxygen-rich blood to reach the heart muscle. In this case, the intense work of the heart becomes difficult and, under heavy loads, angina pectoris develops - a painful attack of the heart muscle.

Naturally, angina attacks require limited physical activity. Often, in order to get rid of angina, it is necessary to resort to medication, or even surgical treatment. In the case of a severe heart attack - a heart attack, patients begin to be completely afraid of physical activity and, in an effort to “protect” the heart, often limit movement to the point of giving up walking.

For patients with angina and those who have had a heart attack, physical activity can have 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) are very beneficial.

Moderate physical activity helps increase 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 normalize the functioning of collateral blood flow - an interarterial connection that serves to redistribute blood flow, which helps to increase the amount of oxygen-rich blood reaching the heart muscle.

Medical studies show that physical activity in patients who have had a heart attack reduces the risk of a second heart attack by 7 times and reduces mortality by 6 times, compared with patients who prefer to reduce physical activity as much as possible.

Therefore, for patients who have had a heart attack, performing normal household activities (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 easiest option for physical activity in this case is daily walking. At the same time, you should not overload yourself: the walk should take place at a slow or moderate pace (depending on how you feel), for half an hour - an hour, but not less than 5 days a week. If during a walk you feel weak or tired, you need to take a break - sit down on a bench or return home at a slow pace. Don't be upset - during the rehabilitation process you will be able to go through more and more. However, an increase in physical activity, just like the beginning of physical exercise, after hospitalization must be agreed upon with a physical therapy specialist or the treating cardiologist.

Physical activity should never lead to another attack of angina. During exercise, severe shortness of breath or rapid heartbeat is unacceptable. During physical activity, you need to monitor your pulse - its frequency should increase in accordance with the increase in load. In this case, the optimal increase in heart rate should be determined by the attending physician on an individual basis, according to the severity of coronary artery disease and associated pathologies.

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

Leading Russian specialist 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, one can define permissible load in each specific case.

Remember that, depending on the severity of the manifestation, angina is divided into four functional classes, where I is mild angina, in which attacks occur only during very intense physical activity, and IV is the most severe angina, in which an attack occurs at the slightest physical activity and even at rest. Prohibited loads are marked with a “-” sign, while permitted loads are marked with a “+„ sign. 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 ensures the movement of blood through the vessels. But the force of contraction of the left ventricle alone is not enough to ensure normal functioning of the heart. Extracardiac factors play a major role in blood circulation. For diseases of the cardiovascular system, along with drug treatment, therapeutic exercises are recommended. Exercises allow you to maximize the effect of extracardiac (non-cardiac) circulatory factors and contribute to the normalization of impaired functions. Therapeutic exercise is often used for diseases of the circulatory system in acute period, as well as during recovery, it is used in the future as maintenance therapy.

To the main contraindications to physical therapy exercises should include: acute phase of rheumatism, endo-, myocardium; serious disturbances of the cardiac conduction system and rhythm; circulatory failure in the third stage, acute heart failure.

Methods of influence

The method of exercise therapy 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 amount of load are selected based on the motor mode assigned to the patient.

The effect of exercise therapy in diseases of the cardiovascular system

Myocardial infarction is focal or multiple necrosis of the heart muscles, which is caused by acute coronary insufficiency. The tissue susceptible to necrosis is replaced by a scar after some time. A heart attack is characterized by severe pain in the heart area, increased heart rate, decreased blood pressure, drowsiness, and suffocation. An ECG allows you to determine the location of the infarction and its severity. The first three days are characterized by an increase in body temperature, 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 physical therapy.

The main form of physical therapy at the first stage is massage, walking up the stairs, and measured walking. If the patient’s course of a heart attack is not complicated, then classes can begin on the 2-3rd day, by which time the acute signs of a heart attack have subsided. The timing of the start of classes, as well as the load, is determined strictly individually and directly depends on the nature of the stage and the severity of post-infarction angina.

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

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

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

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

The objectives 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, therapeutic exercises, general exercise equipment, therapeutic swimming and physical exercises in the pool, massage.

Heart defects: exercise therapy

Therapeutic exercise for heart defects is a combination of active and breathing exercises. Classes are held at a slow pace, without intensification, lasting days. In the next 2-3 weeks, patients are prescribed therapeutic exercises.

Coronary heart disease: exercise therapy

Means of physical therapy for coronary heart disease: therapeutic exercises, physical exercises in water, swimming, dosed walking.

Doing exercises

A set of exercises for coronary heart disease:

Starting position – hands on the belt, standing above the seat of the chair. We move 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 and exhale.
Starting position: standing by a chair. Sit down - exhale, stand up - inhale.
Starting position - sitting, bend your right leg - clap, return to the starting position. Do the same with the left leg.
Starting position – sitting on a chair. Do not hold your breath, squat in front of the chair, then return to the starting position.
The starting position is the same, legs straight, arms forward. Bend your legs at the knees, place your hands on your belt, then return to the starting position.
Starting position – standing. We move our right leg back, arms up – inhale, starting position – exhale. Repeat for the left leg.
Starting position – standing, hands on waist. Perform tilts to the right and left.
Starting position – standing, hands in front of the chest. We move our arms to the sides - inhale, starting position - exhale.
Starting position – standing. We move our right leg and arm forward. The same with the left leg.
Starting position – standing, arms up. We sat down, then returned to the starting position.
The starting position is the same, arms up, hands in the lock. We rotate the body.
Starting position – standing. Take a step forward with your left foot - arms up, return to the standing position. Repeat for the right leg.
Starting position – standing, hands in front of the chest. Make turns left and right with arms outstretched.
Starting position – standing, hands to shoulders. Perform alternate straightening of arms.
Walking in place.

Breathing exercises for angina pectoris

breathing exercises for angina

I suffered greatly from angina pectoris (angina pectoris), the most common form of coronary heart disease. Its main manifestation is attacks of squeezing, pressing pain in the chest. Angina occurs suddenly, lasts from several minutes to half an hour, has varying intensity, and can be severe. left hand, shoulder blade, shoulder or neck. An angina attack is often accompanied by a feeling of fear. Do not give in to it and try to immediately relieve the heartache. To do this, always have validol on hand. If an angina attack occurs while walking, and 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 won’t be able to live without nitroglycerin.”

But despite the verdict, I decided not to give up, began to read various publications on medical topics, apply the recommended methods for treating angina pectoris, and eventually settled on breathing exercises according to the yoga system.

To breathe correctly using this method, you need to stand or sit on a chair with a straight back, relax, think about something pleasant (I always think about the sea), inhale air through your nose and hold it in your chest so that it feels comfortable. Exhale through your mouth and at the same time as you exhale, lightly hit your chest with your arms bent at the elbows, like wings, to the left and right. Perform this breathing for 10 minutes, first once a day, and after a week - in the morning, lunch and evening.

I breathed this way for a month, then took a 10-day break, and after that I repeated the treatment course. And so she was treated intermittently for six months. During this exercise, when you hold your breath, oxygen is directly sent to the heart muscle, relieving tension. You need to be careful at first to avoid dizziness. Perform yoga breathing exercises until complete recovery. You yourself must feel when the angina attacks stop, since each person is individual. After this, 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 pond, in a forest or park, inhaling fresh air enriched with oxygen.

It’s very good to do this with someone so that while walking you can have a conversation and get positive emotions.

After recovery, stress should be avoided, as it can lead to relapse of the disease. One day, having already recovered, I ran to catch up with the trolleybus (there was such a need) and suddenly I felt that I wouldn’t make it. Immediately, according to the yogi system, I inhaled 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, goodness, and not remember grievances (mentally burn them in fire). Do not harbor anger, 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 treated only with good thoughts and that everyone can be their own healer. You can and should talk to each organ affectionately, as if you were talking to a part of yourself.

For example, if your heart hurts or tachycardia occurs, immediately place your right palm under your left chest on the heart area, close your eyes, think about this organ with gratitude that it has selflessly served you for so many years and thanks to it you live, and mentally to calm your heart , say: “Everything is fine, calm down. The heart beats rhythmically. I am surrounded by nature, the 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 in harmony for a long time.” Gently stroke the area, pressing your hand tightly to your chest, with your lungs. in a circular motion so that the palm moves slowly, always clockwise. Say a kind word to your heart, wish it good luck and end your communication with the words: “So be it.” Amen!"

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

Ivanova Valentina Nikolaevna

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Those drugs that affect the blood itself, the blood vessels and heart muscle, can also be used to treat cardiovascular diseases. These drugs change heart rate and blood pressure, the pumping function of the heart, and blood clotting and flow. Antihypertensive drugs and medications Antihypertensive drugs are used to treat high blood pressure. (hypertension). Their. ⇒

Stress creeps up unnoticed - 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 adjust your usual behavior and make life more cloudless! Before you is a whole arsenal of simple but effective ways how. ⇒

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Symptoms and signs of angina

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

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I suffered greatly from angina pectoris (angina pectoris), the most common form of coronary heart disease. Its main manifestation is attacks of squeezing, pressing pain in the chest. Angina 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. An angina attack is often accompanied by a feeling of fear. Do not give in to it and try to immediately relieve the heartache. To do this, always have validol on hand. If an angina attack occurs while walking, and 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 won’t be able to live without nitroglycerin.”

To breathe correctly using this method, you need to stand or sit on a chair with a straight back, relax, think about something pleasant (I always think about the sea), inhale air through your nose and hold it in your chest so that it feels comfortable. Exhale through your mouth and at the same time as you exhale, lightly hit your chest with your arms bent at the elbows, like wings, to the left and right. Perform this breathing for 10 minutes, first once a day, and after a week - in the morning, at lunch and in the evening.

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

It’s very good to do this with someone so that while walking you can have a conversation and get positive emotions.

For example, if your heart hurts or tachycardia occurs, immediately place your right palm under your left chest on the heart area, close your eyes, think about this organ with gratitude that it has selflessly served you for so many years and thanks to it you live, and mentally to calm your heart , say: “Everything is fine, calm down. The heart beats rhythmically. I am surrounded by nature, the 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 in harmony for a long time.” Gently stroke the area, pressing your hand tightly to your chest, using light circular movements so that your palm moves slowly, always in a clockwise direction. Say a kind word to your heart, wish it good luck and end your communication with the words: “So be it.” Amen!"

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

Ivanova Valentina Nikolaevna

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Dosed loads have a good effect on the condition cardiovascular system. Exercise helps relieve shortness of breath and normalizes heart rate. With progressive exertional angina, walking, swimming, skiing, and special exercises. Physical education treatment should be carried out under the supervision of a doctor or exercise therapy trainer with a medical education. The doctor individually selects a suitable set of exercises, adjusts them if necessary, and monitors the patient’s well-being.

Treatment of progressive angina pectoris using non-traditional methods is practiced. These include breathing exercises, which reduce the number of attacks.

Gymnastics for angina pectoris

Set of exercises

1. Walking. Walk calmly around the room for 1-2 minutes. The tempo is slow at first, then gradually increases to medium.

2. Crossing your arms. Place your feet shoulder-width apart and spread your arms to the sides. Crossing your arms in front of your chest, touch your shoulders with your palms and exhale. Raising your arms to the sides, inhale. The pace is slow. Repeat 10-15 times.

3. Tilts to the sides. Place your feet shoulder-width apart and hold your hands behind your head. Tilt your torso left and right, without bending your legs. Breathe freely. The pace is slow. Repeat 5-8 times in each direction.

4. Half squat. Place your feet together. Do half squats while holding the back of a chair. Squatting, exhale. The pace is slow. Repeat 8-10 times.

5. Deep breathing. Place your feet together, arms down. Take a deep breath, rising onto your toes, slightly arching your back and placing your hands on your waist. Then exhale and return to the starting position. Repeat 4-6 times.

6. Alternately raising your arms forward. Place your feet shoulder-width apart, arms down, fingers clenched into a fist, alternately raise your right and left hand forward. Breathe freely. The pace is average. Repeat 8-10 times.

7. Side turns. Place your feet shoulder-width apart, feet parallel, arms down. Turn your torso to the left, moving your arms to the sides with your palms up - inhale; return to the starting position - exhale. The pace is average. Repeat 3-6 times in each direction.

8. Leg curl. Standing with your feet together, sideways to the back of the chair, one hand rests on the back and the other on your belt. Slowly bend one leg, raising the knee forward, then, straightening it, move it to the side; then return to the starting position. Do the same with the other leg. Breathe freely. Repeat 4-5 times with each leg.

9. Breathing with hand movements. Place your feet shoulder-width apart and bend your arms toward your shoulders. Slowly, with a deep breath, extend your arms upward wider, slightly arching your back and moving your head back; exhale and return to the starting position. Repeat 4-6 times.

10. Slow walking. Walk slowly around the room for 1-2 minutes.

11. Rest while sitting with complete muscle relaxation for 1-2 minutes.

Attacks of angina pectoris are treated, including with the help of special gymnastics, which is also a good preventive measure. Therapeutic exercise or exercise therapy helps the body gradually get used to physical activity, resulting in improved blood circulation and metabolism.

Is it possible to do physical exercise?

For angina pectoris, physical therapy is one of the methods of therapy, since it promotes the following processes:

normalization of vascular reactions during muscle work;
eliminating spasms in cardiovascular system;
improving the functioning of the excretory system.

At the same time, it is important to choose the right physical activity so as not to worsen your well-being. It depends on the stage of the disease, which can be:

Initial. The person experiences only slight discomfort, attacks occur very rarely and do not last long. It is recommended to exercise for no more than 30 minutes. The exercises can be quite intense. They help improve functions internal organs, develop all muscle groups.
Typical. The patient experiences attacks during various physical activities. Pain can occur when climbing stairs, walking for a long time, as well as during stress and emotional overstrain. His general condition worsens, shortness of breath appears, and his heart rate increases. You can train for up to 20 minutes, but you must strictly monitor your heart rate. Perform exercises in a less strenuous mode, be sure to take breaks between them, during which to restore breathing and pulse.

If during exercise your heart rate changes by 15% or more, stop exercising or take a break and slow down.

Pronounced. A person experiences pain even in a state of complete rest. Should be abandoned active activities and long-term loads. However, even at this stage it is allowed to perform physical therapy exercises. Classes last no longer than 15 minutes (they also include 5 minutes for a break between exercises). Do the exercises at a calm pace. If an attack develops, dizziness or shortness of breath occurs, you should immediately stop exercising and consult a doctor.

Basic rules of exercise therapy

When practicing physical therapy, it is important to adhere to the basic rules, which are as follows:

conduct classes 2–8 days after the attack, depending on its severity;
start training with minimal load and duration;
when exercising, listen carefully to the body and, if your health condition worsens, interrupt the complex, and if necessary, consult a doctor to adjust physical therapy;
active exercises combine with breathing exercises.

Exercise sets

Cardiologists have developed special complexes, which can be found below. Before performing them, you need to consult with your doctor, who can supplement or replace some exercises, increase or decrease the duration of exercises.

Warm-up

The lesson always begins with a warm-up. Its task is to prepare the body for further stress and “warm up” the muscles. Repeat each exercise 3-4 times:

Stand straight, feet shoulder-width apart. Tilt the body left and right, back and forth at a calm pace. Look straight ahead.
Raise your arms above your head to your sides. Stand on your toes and reach for the sky, and then return to the starting position.
Starting position - lying on your back, legs and arms spread apart, but without much tension. Bend and straighten your fingers alternately on the lower and upper limbs.
Lie on your back. Move your toes forward and backward.

Complex No. 1

Perform the exercises 4-5 times, and the starting position does not change - lying on your back:

Pull your shoulders up, trying to reach the tips of your ears with them. Perform the exercise slowly without effort, monitoring your breathing.
Bend your legs at the knees and bend your arms at the elbows. Take turns to carefully describe a circle with them.
Extend your arms along your body, palms down, and bend your legs at the knees. Leaning on your legs, raise your buttocks and stomach as much as possible, forming a triangle. The main load falls on the legs and arms.
Bend your legs at the knees and spread them in different directions, connecting your feet.
Finally, walk in place. For the first time, the walking duration should not exceed 1 minute. Then, with the doctor's permission, it can be gradually increased.

Complex No. 2

Suitable for those who suffer from stable angina. Consists of the following exercises:

Starting position - sitting on a chair, arms down and relaxed. Stretch your arms to the sides to shoulder level, take a deep breath and exhale. Repeat 5 times.
The starting position is similar, but the hands are located at the waist. Raise one arm over the side to shoulder level, inhale, return to the starting position and exhale. Do the same with the other hand. Repeat 3 times for each hand.
Starting position - standing, feet shoulder-width apart, arms bent horizontally elbow joint and fixed in front of the chest. Make body turns with arms raised - inhale, return to the starting position - exhale. Repeat 4 times.
Finish by walking in place for 60 seconds.

In tandem with physical therapy, breathing exercises give good results, because when performed, the organs are enriched with oxygen, the heartbeat and metabolism are stabilized, the diaphragm is strengthened, and the emotional state and well-being improve.

For angina pectoris, it is recommended to do breathing exercises using the Buteyko method. The Soviet physiologist and clinician believed that with this disease a person breathes shallowly and with difficulty. Such unusual breathing for the body leads to the fact that the lungs quickly contract and the blood vessels narrow. As a result, there is an excessive accumulation of carbon dioxide in the blood, and the body experiences oxygen starvation.

Thanks to Buteyko’s breathing exercises, normalization occurs respiratory system Therefore, all organs are provided with oxygen.

The breathing pattern is as follows:

inhale - 5 seconds;
exhale - 5 seconds;
pause with maximum relaxation - 5 seconds.

How can you tell if you're breathing correctly? Place one hand on your stomach and the other on your chest. If, when inhaling, the stomach first retracts, and then - rib cage, then the exercise is performed correctly. It should be remembered that you inhale through your nose and exhale through your mouth.

Contraindications to breathing exercises:

pregnancy and lactation;
chronic diseases;
inflammatory diseases of the small and large pelvis;
adenomyosis.

So, regular classes physical exercise and breathing exercises help get rid of the symptoms of the disease and improve general condition and human well-being, and also normalize the functions of all internal systems of the body. But that's it medical complexes done under the strict supervision and control of a specialist!

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

Angina and sports

Breathing exercises for angina pectoris

Therapeutic exercises for angina and heart failure

How much does pressure increase during exercise?

Causes of increased blood pressure during exercise

Why does blood pressure increase after exercise?

Reasons for decreased blood pressure during exercise

Why does blood pressure drop after exercise?

Monitoring hemodynamic parameters

Contraindications for physical activity

Medicines for hypertension: what are they?

Indications for prescribing medications for hypertension

Diuretic medications for hypertension

Calcium antagonists in the treatment of hypertension

ACE inhibitors

Angiotensin II receptor blockers (sartans)

Beta blockers

Second-line hypertension medications

Who can do what?

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

Therapeutic measures in addition to exercise therapy

Physiotherapy for ischemic heart disease

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

Angina and sports

Breathing exercises for angina pectoris

Therapeutic exercises for angina and heart failure

Exercises for coronary heart disease

Gymnastic exercises for coronary heart disease

Physical activity for coronary heart disease

The benefits of physical activity:

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

Daily physical activity

Exercise therapy for diseases of the cardiovascular system

Methods of influence

The effect of exercise therapy in diseases of the cardiovascular system

Doing exercises

Breathing exercises for angina pectoris

Antihypertensive and antiarrhythmic drugs in the treatment of cardiovascular diseases

How to stop stress eating

Symptoms and signs of angina

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