Classification of hypertension

For several years, doctors have been sounding the alarm: in developed countries that have overcome epidemics, arterial hypertension continues to constantly occupy a leading place among the causes of mortality from cardiovascular diseases.In terms of the number of complications and unfavorable prognosis, it competes with diabetes mellitus.At the same time, the disease is rapidly rejuvenating.A couple of decades ago, a 35-year-old stroke patient was considered a fool.Lately, such a case will not surprise anyone.

According to the World Health Organization, about a quarter of the world's inhabitants suffer from high blood pressure.Half of people over the age of 65 are hypertensive.

What kind of disease is this?

Hypertension refers to diseases of the cardiovascular system.Its presence causes persistently high blood pressure in the arteries of the systemic circulation.

By itself, pressure on the walls of blood vessels is a normal and necessary process and is necessary for the movement of blood through them.During sleep, pressure decreases slightly, and during stress or physical activity, vice versa.

Standard blood pressure for young people (may vary slightly from person to person) is 120/75 mmHg.Art.For those over forty – 130/80, for those over fifty – 135/84.If blood pressure often rises to 140/90, doctors speak of hypertension.

Blood pressure is divided into two types:

1. Systolic.The first number at the top indicates the strength of your blood pressure as your heart contracts and pushes blood out of your arteries.
2. Diastolic.The second lowest number shows the blood pressure when the heart muscle (myocardium) relaxes.

It is no coincidence that high blood pressure (hypertension) is called the “silent killer”: it can cause the appearance of various pathologies.The heart and brain are particularly affected.In advanced cases, it can even lead to heart attack and stroke.

Classification of hypertension

The risks of hypertension are staggering, which is why scientists have been studying it since the beginning of the last century.During this period of time, the classification has changed more than once, but two directions have been formed:

1. When creating classifications according to the stages of development of the disease, doctors thought about the connection between hypertension and risk factors for the development of hypertension.However, they never reached a complete agreement: the debate is still ongoing.
2. Identification of disease variants.The approach delves into the causes of hypertension, the stages and mechanisms of its development.

The article will discuss many of the classifications proposed by scientists.

From external signs

This is how a German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when the pressure increases, you notice a redness of the face and body due to the dilation of the capillaries.Red spots often appear.In the second case, a person suffering from the disease experiences a vascular spasm with increased pressure, becomes cold and pale.

By origin

Doctors conventionally identify degrees of hypertension: primary (hypertension) and secondary (symptomatic) hypertension.

The specific reasons for the appearance and development of the primary have not yet been found.It has three degrees.

1st degree arterial hypertension is called "mild".Blood pressure: 140–159 and 90–99 mm Hg.Art.Blood pressure “jumps”, sometimes increases, and then returns to normal.First degree hypertension has a borderline subgroup with indicators of 140–149 and 90–94 mm Hg.Art.The probability of crises (sudden jumps) is small, if they occur, it is rare.

But for grade 2 (moderate) hypertension the risk is greater.The tonometer shows 160–179 and 100–109 mmHg.Art.Second degree hypertension is characterized by the fact that the pressure constantly increases.

Stage 3 (severe) disease can be life-threatening, especially with concomitant illnesses.This level is characterized by indicators above 180 and above 110 mmHg.Art.

Sometimes a person has problems with only one type of pressure.Therefore hypertension is called isolated and there are two variants of hypertension:

1. systolic.The pressure is above 140 and below 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and less than 90 mmHg.Art.In this case, the “upper” pressure rises to 140 mmHg.Art.and upper, while the “lower” remains normal.So we are talking about an isolated form of systolic hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under 35 years old - in 25%).This type of disease is caused by a disease of a specific organ.Most often, such symptomatic hypertension appears due to kidney problems.The division into endocrine, neurogenic, renal and hemodynamic forms was proposed by the professor.Doctors still use it today.

Stages of hypertension

In the recent past, arterial hypertension was divided by experts into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Therefore, the division reflects pathologies that appear in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease by grade.There are three of them, and each indicates a series of changes in digital blood pressure readings (they were discussed above).

In some classifications it is possible to find fourth degree hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist detects the 4th degree of the disease, he means digital pressure indicators, and not the patient's condition, since hypertension is at stage 3. it is also considered heavy.

With chronic hypertension, the body cannot cope with the stress and bad things start to happen to the organs.Those that are affected before the others are called target organs by doctors.Along with the heart and brain, these include the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weak points.

Initially, in stage 1 of the development of hypertension, the organs are still healthy.Often people with hypertension do not go to hospital at first, because they feel tolerable and it does not particularly interfere with their life.Hypertensive crises are the exception rather than the rule.Beginner hypertensive patients ignore health problems in vain, because at this stage the disease is easier to tame.Sometimes treatment for stage 1 hypertension comes down more to lifestyle changes than taking medications.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to turn to a specialist.Prompt treatment will help prevent the “silent killer” from progressing.

Stage 2 hypertension is characterized by persistent high blood pressure.The heart is the first to give up: the left ventricle begins to enlarge and "thicken".Some, in addition to abnormalities in the functioning of the heart, also develop defects in the blood vessels of the retina.A person with hypertension is stage 2. Seizures occur much more often.But the disease is still treatable.If the doctor diagnoses “Stage 2 Hypertension”, his recommendations should be followed with particular attention.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all target organs manifest with a variety of complications.Pressure spikes in hypertension, stage 3. can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, renal failure and other "gifts" often develop.Often, the third stage of hypertension is noticed when the patient already has hemorrhages in the fundus, heart attack, aneurysms, strokes and other ailments.

Signs of blood pressure problems

Identifying hypertension early and understanding how long a person has had it is the number one problem.Many hypertensive patients learn of the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, excess weight, smoking, frequent stress, high cholesterol levels, sedentary lifestyle and old age.

Alarm bells ring if you see:

• occasional headache;
• “threats” of pain in the back of the neck or blows to the temples;
• you often feel nausea and dizziness;
• glare flashes in the eyes or "black flies" fly;
• everything is annoying or covered by apathy;
• tingling or numbness in the fingers;
• swelling of the arms, legs and/or face;
• suddenly a rapid heartbeat appears.

If you recognize yourself, you should at least systematically measure your blood pressure.But it is better, of course, to go to the hospital.

Diagnosis of arterial hypertension

If chronic hypertension is suspected, doctors use three diagnostic methods.

The first, and simplest, is to measure blood pressure.

The second is a complete physical exam.It can only be performed by a specialist.Performs palpation and auscultation (analysis of sounds accompanying the work of various organs), percussion (touching various parts of the body and drawing conclusions based on the sound) and a standard examination.

In the third case, an electrocardiograph helps to draw conclusions.

So, what awaits you when you arrive at the hospital with suspected hypertension?

First, the doctor will check your blood pressure using a special device - a tonometer.By the way, in people who have an easily excitable nervous system, blood pressure values can increase even in case of minor emotional upheavals.When they go to the doctor, these patients experience “white coat syndrome”: as soon as the doctor starts measuring their blood pressure, it increases.But the reason for these fluctuations is stress and not illness.Although such a reaction to long-term shock can provoke disruptions in the normal functioning of the heart and kidneys.In such impressionable patients, the healthcare provider will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight, and body mass index is collected.The specialist looks for evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient, anywhere.It is necessary to find out what diseases a person has already encountered and whether there are any ailments at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; it checks whether there is diabetes), whether the parents were hypertensive.
• Physical exam.First, your doctor will listen to your heart using a stethoscope.The task is to identify noises, changes in tone or the presence of extraneous sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about his condition against the background of hypertension.
• Biochemical blood test.It is necessary to find out the level of sugar, cholesterol and lipoproteins and understand how prone a person is to atherosclerosis.
• ECG.The electrocardiogram is an integral part of the diagnostic process.Helps see irregularities in the heart rhythm.Having the results in hand we can judge the presence of hypertrophy of the wall of the left side of the heart, typical of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see a picture of heart changes and defects, evaluate the function and condition of the valves.
• Radiographic examination.Doctors perform arteriography and aortography.With their help, specialists study the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing arterial hypertension, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while it helps determine the intensity of blood flow through the arteries and veins.
• Ultrasound of the thyroid.Along with other data, the doctor needs the results of a blood test to determine the level of hormones produced by the thyroid.Based on the results of the study, it will be clear whether the thyroid gland plays a role in the development of the disease and what treatment to prescribe.
• Ultrasound of the kidneys.These organs and their vessels are very vulnerable to hypertension.The study helps evaluate their condition.

Treatment methods

Today, there are many methods to treat hypertension.Some have come to us from antiquity;pharmacists and scientists have been working on creating others for years and years.

The most common method is drug treatment.Doctors use different types of drugs to normalize blood pressure.

1. Calcium antagonists are intended to reduce heart rate.
2. Diuretics, most often thiazide diuretics, work to improve urine production and waste.
3. Adrenergic drugs.
4. Vasodilators dilate the blood vessels and thus level the situation.

In some cases, a surgical method called ablation is used.This procedure is not easy.A catheter with a device that creates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.To avoid the appearance of scars after surgery, the entire length of the vein is affected.Performed under local anesthesia.

A variety of methods that come from the past are classified as alternative medicine.This includes leg parkas, vinegar lotions and much more.

Non-traditional remedies based on valerian, motherwort, beetroot, lemon, honey and horseradish are also effective in treating high blood pressure.

There are many herbal decoctions for the treatment of arterial hypertension.Here is an example:

Take 1 tbsp.the.motherwort, valerian root and cumin.Mix.Pour a spoonful of this mixture into a glass of boiling water and leave for an hour.Drink the drug three times a day, 1/3 cup.The course is designed for one month.

There is also monastery tea intended to help with hypertension and homeopathic medicines.However, it is better to consult a specialist before treatment.

High blood pressure is a dangerous disease if left untreated.It is necessary to monitor your health at any age, because the pace of modern life often contributes to the development of the disease.And whatever the stage and degree of hypertension, without treatment it can lead to fatal consequences.