Hypertension

What is high blood pressure? This is a disease characterized by blood pressure readings above 140 mm Hg. Art. in this case, the patient is visited by headache, dizziness and a feeling of nausea. Eliminating all the symptoms that have arisen can only be specially selected therapy.

Arterial hypertension can be an independent disease or accompany various pathologies, being their symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.

In hypertensive patients, the indicators often return to normal only after taking special medications, and pressure changes can be observed regularly and for no apparent reason. It is completely impossible to cure the disease, but preventing serious consequences and learning to control blood pressure is a feasible task.

Do not self-medicate. At the first sign of illness, consult a doctor.

Causes

To date, the exact reasons why essential arterial hypertension could occur are unknown. There are the following risk factors:

• heredity;
• malnutrition;
• bad habits;
• violation of fat metabolism;
• kidney disease;
• diabetes;
• fatigue;
• inactive lifestyle.

Disease classification

During a diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure. Pathogenesis also has differences taking into account the varieties of the disease. There is the following classification of arterial hypertension:

1. Pulmonary essential arterial hypertension - is considered one of the varieties of arterial hypertension, rare, but represents a great danger to human life. It is very difficult to identify this disorder from symptoms and even more difficult to treat. Pulmonary arterial hypertension is formed due to an increase in pulmonary vascular resistance and, as a result, insufficient blood flow.
2. Malignant. Symptoms of such arterial hypertension occur in the form of an increase in blood pressure up to 220/130. there is a radical change in the bottom and swelling of the optic nerve disc. If the diagnosis was made in time, it is possible to cure this type of arterial hypertension.
3. Renovascular arterial hypertension. The reasons for the formation of this type of disease are the presence of pathologies such as vasculitis, vascular atherosclerosis and malignant formations in the kidneys. The pathogenesis of the disease is reduced to the formation of characteristic pressure, which can be represented in the normal high systolic and diastolic blood pressure.
4. Labile arterial hypertension. For this type of disease, periodic normalization of pressure is characteristic. Patients suffering from this form of arterial hypertension are not called patients, as this condition is not a pathology. In some cases, blood pressure returns to normal over a period of time.

Symptomatic arterial hypertension and its types

Secondary arterial hypertension is a pathological process associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:

1. Hemodynamic: associated with violations of hemodynamic conditions due to the organic pathology of the great vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, coarctation of the aorta, insufficiency of the aortic valve.
2. Neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
3. Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
4. Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
5. Medicinal. This form of symptomatic arterial hypertension is associated with the use of drugs that increase blood pressure.

Symptoms

Before there are complications of arterial hypertension, it proceeds without certain manifestations. The only symptom of this disease is hypertension. The pathogenesis of hypertension is reduced to the formation of headaches in the back of the head and forehead, dizziness and unusual ringing in the ears.

Target organ damage

This type of high blood pressure symptoms occur much earlier due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. Subsequently, the patient has weakness, blinking of black dots in front of his eyes, difficulty speaking. Such symptoms disturb a person in an advanced stage of the disease. Additionally, complications such as cerebral infarction and hemorrhage can occur.

Heart failure

In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory reaction aimed at normalizing the tension of the wall. As a result, increased afterload, heart failure. When the heart is damaged, there are no more favorable predictions, because such changes in its work are the causes of heart failure, sudden death and the development of ventricular rhythm disturbances. The characteristic symptoms are:

• pulmonary edema;
• difficulty in breathing at the time of physical activity;
• cardiac asthma.

In some cases, arterial hypertension in children and adults causes pain in the heart region of a certain nature. They can visit a person in a state of rest or emotional overload without engaging in physical activity. The main manifestation of the presented chest pains is the impossibility of their elimination with the help of nitroglycerin.

The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath at an early stage of the disease after the implementation of small loads or at rest. All this indicates characteristic changes in the heart muscle and the formation of heart failure. With such a disease, people have swelling of the lower extremities, the cause of which is the retention of sodium ions and water in the body.

If the lesion has affected the kidneys, then when passing a urinalysis, a protein is found, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.

Eye damage

Not so often, this high blood pressure in children and adults affects vision, resulting in decreased sensitivity to light and blindness. If there is a visual impairment on the background of hypertension, then patients have black dots in front of the eyes, fog or veil. The reasons for such changes are the violation of blood circulation in the retina. Complications can manifest as diplopia, visual impairment, or complete loss of vision.

Headache

This symptom is considered the most common in arterial hypertension. It worries the patient at any time of the day or night. It can explode in nature and concentrate in the back of the head, then spread throughout the head area. The increase in headache in high blood pressure occurs when coughing, tilting the head. This can be accompanied by swelling of the eyelids and face. When performing massage in this case, in patients suffering from arterial hypertension, there is an improvement in the outflow of blood in the veins and this leads to a decrease in pain until its complete disappearance.

There are cases when the headache against the background of the presented disease is the result of tense soft muscles of the head itself or tendons. The formation of such a pain syndrome occurs after psycho-emotional or physical overload. As a rule, such pain is tightening or tightening in nature. A patient suffering from arterial hypertension has a feeling of nausea, dizziness. In the presence of prolonged pain, incessant pain is characteristic, in patients irritability occurs, sensitivity to high-pitched sounds increases, they become short-tempered.

Stages of the disease

For the correct setting of the stage of this pathological process, it is necessary to use the classification. It depends on the target organ damage. There are three stages of the disease.

Easy

This phase is characterized by a slight increase in blood pressure of 180/100 mm Hg. Art. the pressure level is unstable. During rest in a patient with arterial hypertension, blood pressure indicators return to normal. Due to the fixation of the disease, the pressure inevitably increases. Most often, people do not complain about the formation of ailments affecting their health. But for an easy stage, its symptoms are characteristic:

• headache;
• noise in the ears;
• sleep badly;
• mental decline;
• dizziness;
• nosebleeds.

As a rule, there are no manifestations of left ventricular hypertrophy, the ECG has no abnormalities, renal function without pathological changes, the ocular fundus has not changed.

medium

This phase is characterized by having a higher and more stable blood pressure level. It can reach 180–105 mm Hg. Art. patients often experience headache, dizziness, pain in the region of the heart, which has angina pectoris.

This phase is characterized by the typical hypertensive crises. The pathogenesis of the disease involves the following signs of damage to target organs:

• hypertrophy of the left;
• weakening of the I tone at the apex of the heart;
• accent II tone on the aorta;
• in some patients, ECG symptoms of subendocardial ischaemia.

As for the central nervous system, there are various manifestations of vascular insufficiency, cerebral stroke, transient cerebral ischemia. For the fundus, in addition to reducing the arterioles, there is compression of the veins, their increase, hemorrhages, exudates. Blood flow to the kidneys and glomerular filtration rate for this phase are reduced. But it is impossible to detect these manifestations in urinalysis.

heavy

This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and stable increase in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of the largest vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In a severe stage, the disease affects the following organs:

• heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
• brain - ischemic and hemorrhagic infarcts are formed, encephalopathies are formed;
• fundus;
• kidneys - low blood flow and glomerular filtration.

Risk factors

At present, the severity of the described disease directly depends on the risk facts. The risk lies in the formation of cardiovascular complications against the background of hypertension. Taking into account the presented complications, the prognosis of the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and its prognosis:

• age - in men after 50, in women after 60;
• to smoke;
• high cholesterol;
• hereditary factor;
• obesity;
• hypodynamy;
• diabetes.

The risk factors presented may be eliminated (correctable) and may not be correctable. The first type of risk factors is characterized by the presence of diabetes mellitus, high cholesterol, smoking, physical inactivity. Uncorrected risk factors include race, family history, and age.

Taking into account the degree of arterial hypertension and factors contributing to the disease, a forecast is observed with the formation of complications such as heart attack or stroke for the next 10 years.

With a mild degree of arterial hypertension and the absence of risk factors, the formation of complications of the cardiovascular system is minimized for the next 10 years. With non-drug therapy for a year and a revision of your lifestyle, it is possible to eliminate this degree of the pathological process. If the pressure readings are greater than 140/90 mm Hg. Art. , Then a drug treatment is prescribed.

The average degree of risk is accompanied by the formation of complications against the background of arterial hypertension for 10 years in a ratio of 20%. Arterial hypertension of the 2nd degree is treated in the same way as the 1st degree, but here too the control of the dynamics is regulated for six months. If there are poor results of blood pressure and its stable maintenance, drug treatment is carried out.

High-grade risk factors are accompanied by the formation of complications within 30%. In this situation, a patient suffering from arterial hypertension is prescribed a complete diagnosis in combination with non-drug treatment.

At a very high risk, the patient is prescribed an urgent differential diagnosis of arterial hypertension and taking medications.

Diagnostic methods

Only after a thorough study can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of arterial hypertension is based on the following types of tests:

• ECG, glucose analysis and complete blood count;
• Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general urinalysis - are performed to exclude the renal nature of the formation of the disease;
• Ultrasound of the adrenal glands is recommended if pheochromocytoma is suspected;
• analysis for hormones, ultrasound of the thyroid gland;
• MRI of the brain;
• Consultation with a neurologist and an ophthalmologist.

Effective therapy

Treatment of arterial hypertension should be carried out under the constant supervision of a physician. It is he who is obliged to make an accurate diagnosis, to carry out additional diagnostics, which includes checking:

• bottom;
• kidney function;
• the work of the heart.

Subsequently, the specialist can prescribe antihypertensive treatment, determine various complications. As a rule, patients in whom the syndrome of arterial hypertension was first detected are hospitalized to carry out all the necessary studies and the choice of treatment.

Non-drug treatment

Such therapy is recommended for all patients, regardless of the degree of disease from the use of drugs. Such treatment for hypertension includes:

1. To quit smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
2. Elimination of extra pounds. A common cause of hypertension is excess weight, so diet plays an important role in this matter. In addition, a balanced and correct diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
3. Reduced salt intake. According to ongoing studies, a reduced amount of salt consumed at 4. 5g / day helps reduce systolic blood pressure by 4-6mm Hg. Art.
4. Insignificant consumption of strong drinks.
5. Specially designed diet. Your diet should include vegetables, fruits, foods rich in magnesium, potassium, potassium, fish, seafood. In addition, the diet includes a limited intake of animal fats.
6. Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very helpful. When performing isometric loads, it is possible to provoke an increase in blood pressure.

Medical treatment

Drug therapy should be prescribed taking into account the following recommendations:

1. Treatment begins with small doses of drugs.
2. In the absence of a therapeutic effect, it is necessary to replace the use of one drug with another. The interval between degrees should be less than 4 weeks, provided that a rapid decrease in blood pressure is not required.
3. The use of long-acting drugs to achieve a 24-hour effect with a single dose.
4. Application of the optimal combination of devices.
5. Therapy should be permanent. It is not allowed to use the drug in courses.
6. Effective control of blood pressure throughout the year contributes to a gradual reduction in the dose and quantity of drugs.

Preventive actions

Prevention of arterial hypertension includes the following recommendations:

1. If family members have this disease and you are over 30, then you need to measure your blood pressure regularly.
2. Stop smoking and alcohol.
3. A low-fat, low-salt diet should be followed.
4. Exercise outdoors.
5. Avoid various stressful situations.
6. Maintain normal body weight.

With high blood pressure, a person can live a normal and full life, but subject to all the recommendations described. Control of blood pressure in this case is one of the main components of the successful treatment of the disease. Therefore, try not to start the disease and visit a doctor in a timely manner in order to avoid various serious complications.