Hypertension or arterial hypertension: a condition characterized by stable, that is, detected by repeated measurements, increasing blood pressure. When accompanying many diseases, it is considered a risk factor for the development of dangerous complications of the cardiovascular system, including myocardial stroke and infarction. Hypertonic disease, as the main cause of the pathology in consideration, requires taking medications, normalizing the patient's lifestyle and nutrition.
Blood pressure is a force with which circulating blood acts on the walls of blood vessels. Such pressure at the time of heart contraction is called systolic and during its relaxation: diastolic. The range of normal values for these indicators is quite wide.
In the course of numerous observations, scientists concluded that the risk of cardiovascular complications increases with each additional increase in blood pressure by 10 mm Hg. Art. Already starting with a level of 115/75 mm Rt. Art. However, a decrease in the drug in the pressure only above 140/90 mm proved to be appropriate. Rt. Art. , Therefore, it is precisely a value of this type that is taken as a criterion to determine arterial hypertension.
Reasons
In approximately 90% of cases, hypertension becomes the cause of a stable increase in blood pressure. Such a diagnosis is made to the patient when no other diseases were found accompanied by hypertension during the exam. Among the last:
- Renal pathologies: pyelonephritis, glomerulonephritis, polycystic nephropathy, diabetic, stenosis of renal arteries;
- Endocrine-endocrine disorders of the adrenal gland, pancreas or pituitary gland, thyroid hyperfunction, Izenko cushing syndrome, pheochromocytoma;
- Obstructive apnea syndrome in a dream;
- Valve vices or atherosclerotic damage to the aorta.
Regular use of several medications can also cause an increase in blood pressure. These include oral contraceptives, non -steroid anti -inflammatory drugs, amphetamines, corticosteroids, drugs that contain erythropoetine, cyclosporine, cocaine.
The probability of cardiovascular diseases, including hypertension, is in a close relationship with the following risk factors:
- Inadequate nutrition, which includes an excess of salt of sodium, saturated fats and trans fats, lack of green leafy vegetables, vegetables and fruits in the diet;
- obesity;
- heart pathologies and blood vessels in nearby relatives;
- age over 65;
- sedentary lifestyle;
- chronic stress;
- Harvest habits: smoking, excessive alcohol consumption.
Classification
If it were possible to identify the disease that led to an increase in blood pressure, arterial hypertension is called secondary or symptomatic. In the case of an unidentified cause of hypertension, it is considered primary, caused by hypertension.
The latter has a staging current:
- Stage I. There are no obvious signs of work violations of the objective organs affected by a stable increase in the heart of blood pressure, kidneys, arterial and venous vessels.
- Stage II. There is one of the listed signs or their entirety, such as an increase in the left ventricle of the heart, a decrease pronounced in the filtration rate in the kidneys, the albumin in the urine, an increase in the thickness of the walls of the carotid arteries or the appearance of the atherosclerotic plates in their lumens. In this case, the clinical manifestations of the disease may be absent.
- Stage III Hypertension. There is one or more pathologies associated with atherosclerotic processes in the heart and vessels: myocardial infarction, acute stroke, angina pectoralis, atherosclerosis of the arteries of the lower extremities or severe renal damage, manifested by a decrease pronounced in the filtration and/or significant loss of the urine protein.
Arterial hypertension is divided into several degrees, depending on the maximum indicators of the measured blood pressure:
- The first grade. Systolic blood pressure from 140 to 159 mm. Rt. Art. And/or diastolic: from 90 to 99 mm. Rt. Art.
- The second grade. Systolic blood pressure from 160 to 179 mm. Rt. Art. And/or diastolic: from 100 to 109 mm. Rt. Art.
- The third grade. Systolic blood pressure is more than 180 mm. Rt. Art. and/or diastolic more than 110 mm. Rt. Art.
There is also an isolated form of arterial hypertension, in which only systolic pressure figures in normal diastolic.
Symptoms
Often, an increase in blood pressure is not accompanied by deterioration in the well and can go unnoticed by the patient, so it is very important to regularly measure blood pressure, especially medium and elderly people.
The following symptoms can be the manifestations of hypertension:
- Headache, mainly in the morning after awakening;
- Nose bleeding;
- hemorrhage under the mucous membrane of the eye;
- heart rate violation;
- blurred vision, flashing the flies;
- Tinnitus.
A strong blood pressure jump to high numbers, accompanied by a deterioration pronounced in the well, is called hypertensive crisis. Most of the time, it occurs with an increase in systolic pressure of more than 180 mm Hg. Art. and/or diastolic more than 120 mm Hg. Art. At the same time, the patient has weakness, nausea, vomiting, which does not bring relief, deteriorated awareness, anxiety and fear, muscle tremor, chest pain.
Complications
A stable increase in blood pressure with hypertension significantly increases the risk of cardiovascular pathologies, including patient's life. These include:
- acute brain circulation (stroke);
- Angina pectoris, myocardial infarction;
- vascular dementia (dementia);
- Chronic renal and cardiac failure;
- Atherosclerotic lesions of the vessels of the lower extremities.
Diagnosis
The main symptom of hypertension is a stable increase in blood pressure, it revealed at least three dimensions in different days during a quiet environment. In the first measurement of blood pressure in a hospital or clinic for the correction of the results, it is important to comply with the following rules:
- Before examining, the patient needs to sit for several minutes in a quiet room to calm down;
- The size of the tonometer sleeve must correspond to the thickness of the arm and the device itself, which will join the heart level;
- Two measurements are made with an interval of 1-2 minutes in each hand, with a big difference in the numbers obtained, an additional measurement is made;
- In elderly patients, as well as people suffering from diabetes mellitus, or in case of reducing blood pressure in case of change in body position, measurement is carried out in the first and fifth minutes in standing position;
- In addition, heart rate is measured in 30 seconds.
The doctor in an interview with the patient clarifies at what age the pressure began to increase, if there are symptoms such as snoring with breathing stops in a dream, episodes of muscle weakness or sudden palpitations with sweating and headache, and unusual impurities in the urine. It is also important to find out what medications and biodes it takes.
Within the framework of the first stage of the exam, the following tests are carried out for hypertension:
- Clinical blood analysis;
- General urine analysis, microalbumin detection in their daily and daily portions;
- Biochemical blood analysis (cholesterol, lipoproteins to evaluate the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium, as well as glucose and creatinine);
- determination of the gluced hemoglobin level;
- Determination of hormone concentration: thyroxine, triiodyronine and thyroid hormone -Mmer, thyroid antibodies -Butoxidase and thyroidoglobulin, aldosterone.
In case of suspicion of a hereditary predisposition to the disease, it is possible to determine the polymorphisms of the genes associated with the development of arterial hypertension.
To clarify the risk factors for the development and identification of existing cardiovascular pathologies for hypertension, instrumental diagnostic methods are used:
- Daily monitoring of blood pressure;
- Electrocardiographic study;
- echocardiography;
- Holter daily monitoring;
- duplex scan of brachiocephal, kidney or iliac arteries;
- Ultrasound study of the kidneys and adrenal glands;
- Inspection of the bottom of the eye.
With hypertension, control of blood pressure at home is important with the maintenance of a newspaper in which it is necessary to set all the results of time measurements, taking drugs and stress episodes that can cause an increase in blood pressure. At the same time, the measurements must be made in a sitting position, after several minutes of rest, holding the hand to the same level with the heart.
Treatment
With a moderate and low risk of cardiovascular complications, the patient is recommended only to change in the lifestyle, the correction of the diet, the loss of weight, the increase in physical activity and special gymnastics for hypertension, the rejection of bad habits against the background of regular blood pressure. Often these measures are enough to normalize blood pressure.
The diet for hypertension implies the limitation of table salt, caffeine, sharp, salty, smoked and spicy dishes, high fat products, spoils, confectionery with oil cream and alcoholic beverages. It is allowed to use no more than 5 g of salt per day outside the exacerbation of the disease. The recommended daily liquid rate is 1-1. 2 liters.
In the case of non -successful non -flagid treatment for several months, as well as with a high risk of complications, it resorts to hypotensive therapy using drugs for hypertension, whose purpose is a decrease in blood pressure of less than 140/90 mm. Rt. Art. For patients with diabetes or people who already suffer from cardiovascular system pathologies, the objective pressure level is even lower than 130/80 mm. Rt. Art.
Modern hypertension treatment of hypertension includes a combination of two or more drugs from the following groups:
- calcium antagonists;
- angiotencinzinoprodoradores enzyme inhibitors;
- Angiotensin II blockers;
- diuretics (diuretics);
- B-blockers;
- ALFA BLOCATORS.
The vast majority of them occur in the form of hypertension tablets.
Prevention
The prevention of hypertension exacerbations includes timely diagnosis and therapy for diseases of cardiovascular, nervous, urinary and endocrine, implacable systems followed by the doctor's recommendations, including non -union treatment and medication, as well as regular measurement of blood pressure.