Arterial hypertension

Arterial hypertension is a pathological condition characterized by a long increase in pressure indicators in the arteries of a large circle of blood circulation.A recognition of the disease is the increase in diastolic (lower) blood pressure, but in most diagnosed cases, patients have constant growth of systolic (upper) pressure.

What pressure is considered to be increased

The classification of blood pressure, adopted in 1999, is still valid to this day.The following are considered normal:

• Optimal - less than 120/80 mm Hg.Art.;
• Physiological norm - less than 130/85 mm Hg.Art.;
• It is normal - in the range of 130–139/85-89 mm Hg.Art.

The increase in pressure indicates the formation of hypertension.The internal gradation of the pathology looks as follows:

1. Mecca (Grade I) - 140–159/90–99 mm Hg.Art.
2. Moderate (II second degree) - 160–179/100–109 mm Hg.Art.
3. Heavy (grade III) - over 180/110.

Border rifles are diagnosed in the case of indicators in 140-149/90 mm Hg.Art.And below.It is accompanied by episodes of pressure growth and its spontaneous stabilization.

Isolated systolic hypertension has been diagnosed with 140 and above / 90 and below mm Hg indicators.Art.This type of pathology is characterized by an increase in the systolic indicator of the physiological level of the diastolic.

AG classification (primary, secondary)

The classification of hypertension is based on several characters.When systematizes, doctors took into account:

• Causes that provoke the development of pathology;
• defeated by the target bodies;
• The current blood pressure level, etc.

Depending on the etiological factors, it is customary to differ:

1. Primary (essential).
2. Secondary (symptomatic) hypertension.

The nature of the passage distinguishes between benign (slowly developing) and malignant (with rapid deterioration of the condition) arterial hypertension.

Varieties of secondary (symptomatic) hypertension

Secondary (symptomatic) arterial hypertension is a type of disease that develops due to damage to the organs responsible for regulating blood pressure.It is characterized by a stubborn course, the lack of a positive response to the hypotensive therapy, as well as changes in the target organs, more special the formation of cardiac, renal failure, etc.

If primary hypertension (major format) occurs as an independent disease, then secondary forms are always a symptom of the underlying pathology.Arterial hypertension syndrome accompanies a very significant number of diseases.It is diagnosed in 10 % of all identified cases of persistent increase in blood pressure.

The classification of symptomatic hypertension is based on factors that provoke the disease.

Distinguish:

1. Neurogenic hypertension.The development is due to the lesion of the central nervous system and the associated pathologies, for example, brain neoplasia.
2. Nephrogenic (kidney origin).They are divided into interstitial, renoparers, renovid, mixed and rhinopic shape.
3. Endocrine AG.There are formats of adrenal, thyroid, pituitary and menopause.
4. Hemodynamic - provoked by pathologies of the heart and large arterial channels.
5. Dosage form.Its development is due to the use of oral contraceptives, glucocorticosteroid agents, etc.

The size and resistance of the blood pressure increase, the severity of changes in the state of the left ventricle and the funus are the basis of another classification.Doctors distinguish the following varieties of symptomatic hypertension:

1. Transitional.For pathology usually a short -term increase in pressure indicators.Changes in the state of the Fundus are completely absent.The hypertrophy of the left ventricle is hardly fixed.
2. Labes.It is characterized by a moderate, short increase in blood pressure (no independent decrease in).There is low hypertrophy of the left ventricle, narrowing the vessels of the retina of the eye.
3. Stable.It is accompanied by a constant high blood pressure.The thickening of the myocardium, severe disorders in the vessels of the Fundus is diagnosed.
4. Malignant (uncontrolled).It is accompanied by a sharp increase in blood pressure.The result is unfavorable.

The following forms of symptomatic hypertension are detected:

• Pulmonary hypertension (hypertension of a small circular circulation).It is established as a diagnosis in determining blood pressure in the pulmonary artery above 25 mm.RT.Art.
• The AH is a secondary form of pathology due to insufficient blood circulation in the kidney as a result of impaired arterial bandwidth.
• Portal hypertension is one of the varieties of the symptomatic form of the disease, accompanied by an increase in the pressure in the vein of the gate.
• Virsungov hypertension.It develops against the background of chronic inflammation of the pancreas.

Consequences and complications

With a long flowing hypertension, the vessels of the target organs are damaged: heart, brain, kidneys and eyes.Disruption of the blood circulation process can lead to consequences such as:

• angry attacks,
• Myocardial infarction,
• Neurological complications, etc.

Important!The formation of acute conditions against the background of a sharp increase in blood pressure requires its decrease in the first minutes/hours.

Reasons

The reasons for the development of the essential form of pathology are not known to doctors for sure.Several theories have been nominated:

1. Neurogenic (heritage).The cause of development is chronic stress, significant emotional shocks and psychological injuries.All this causes failure in the process of neural regulation, accompanied by an increase in the activity of the sympathetic system.The result is the difference of signals for all organs and increasing the tone of the vessels.
2. Voluminous salt.Due to disturbed processes at the output of excess fluid and certain traces of elements.As a result of excessive sodium salts content, there is an increase in the total volume of blood.The body's attempts to maintain the hemostasis process at the physiological level lead to spasm of small vessels.The indicators for the volume per minute of the heart are stabilized, but the total blood pressure rises.

Important!Doctors say the reason for the development of AH is an increase in the activity of the sympathetic system.

Modified (variable) risk factors capable of provoking the appearance of arterial hypertension are:

• Age - diagnosis of the disease is found in people of the older age category;
• Bad habits - smoking, alcohol intake;
• a state of chronic stress;
• insufficient physical activity;
• overweight;
• The presence of concomitant pathologies - diabetes is particularly unfavorable;
• Excess salt with lack of potassium.

The reasons for an increase in blood pressure may be different.The active work of the adrenal glands, as well as the tendency of the genetic level, can act as a provocative factor.

Symptoms

In the initial stage of formation, arterial hypertension is asymptomatic.The patient will only learn about having a problem after developing serious complications.

The only sign of pathology may be called an increase in pressure indicators.There are no complaints at all or they are not specific:

• headache localized in the forehead and back of the head;
• dizziness;
• noise.

The first complaints are formed against the background of the defeat of the target organs.At this stage, the following symptoms are noted:

• Dizziness accompanied by headache, noise - occur as a logical result of blood disorders;
• Initial problems with the storage of information;
• Numbness of the arms/legs;
• weakness;
• doubling the visible image;
• flickering black spots in the field of view;
• speech violation (rarely);
• Nephropathy.

The symptoms are typical of the final stages.At the beginning of the formation of pathology, they come.

With damage to the heart left ventricle (LV) begins to hypertrophic.The reason for the change is the compensatory reaction of the body, which allows to stabilize the increased loads on its wall.The increase in ventricular is due to an increase in the number of cardiomyocytes.As the condition worsens, cardiac chambers expand.

Such an organ damage may manifest in the form:

• the formation of heart failure,
• sudden cardiac arrest,
• Ischemic disease,
• stomach rhythmic disorders,
• cardiac asthma,
• Strong shortness of breath during loads.

Important!Cardi pain against the background of the AG develops during the period of absolute rest or as a result of emotional surge.A characteristic characteristic is the inability to stop the attack with a glycerol pill.

If the kidneys are damaged, protein in the urine may be observed.The appearance of blood impurities is not excluded.The likelihood of kidney failure is minimal.

The main clinical sign of arterial hypertension is the headache.It occurs at any time of the day, but most often in the morning.He is felt by the patient as a crack or pain.The location is the back of the head, but the spread in other areas of the head is not excluded.The soreness is improved by tilting and during coughing.This can arise in response to stressful situations, physical tension.

Diagnosis

The diagnosis of the disease is intended to solve the following problems:

• Creating pathology, determination of current degree;
• identification of the origin of hypertension (primary/secondary form);
• making a differential diagnosis;
• Determination of the presence/absence of damage to the target bodies.

During a personal conversation with the patient, the doctor detects the necessary points:

1. Are there any cases of disease in the immediate environment.
2. How often the pressure is fixed.
3. Is there a history of chronic diseases in the patient, etc.

The body mass index (BMI) is calculated.Obesity is one of the potential provocateurs of hypertension formation.

After the inspection is completed, blood pressure is measured.In order to determine the degree of arterial hypertension, the patient is prescribed by the performance of the blood pressure profile, ie.Making measurements of patients alone at home.You need to make 4 measurements: two in the morning and two in the evening, for a few days in a row.

The results must be included in the table.If the indicators exceed 140/90 mm Hg.Art., We can talk about the presence of arterial hypertension.

A brush (daily monitoring of blood pressure) is sometimes prescribed.The technique is indicated if the patient's measurements remain normal, but other symptoms of the disease appear.

Important!SMAD is a multiple measurements of blood pressure indicators for the whole day.The measurements are made by a special device.

In order to determine the true cause of the development of arterial hypertension and to determine the power of damage to the target organs, they are prescribed:

• Renal system examination.Includes urine test - a common test.They are prescribed again, ultrasound of the renal system, renewal with the introduction of a radioactive isotope.
• Heart test.ECG is used (electrocardiogram shows the growth of the road R), echocardiography (allows you to see signs of pathological increase in the left ventricle and other transformations).
• Ophthalmic eye examination.A recognition of the disease is the visual impregnation of blood vessels, compaction.Hemorrhages are not excluded.
• Thyroid ultrasound and adrenal glands.
• Blood testing is a general test and expanded biochemistry.

When diagnosing the secondary form of hypertension, it is necessary to perform a differential diagnosis (DIF).It goes into two stages:

• Clinical picture analysis, complaints, physics examination of the patient in particular, auscultation, instrumental/laboratory tests;
• Diagnostic measures that allow you to evaluate the functional condition of the organs and existing changes, more special, it is necessary to remove the cardiogram.

Methods considered to be assistance in confirming the diagnosis, determining the origin of the disease and the choice of therapy adequate for the condition.

Treatment

Treatment for hypertension begins with a revision of lifestyle and therapy without violation.The exception is secondary hypertension.

Drug therapy for arterial hypertension provides the following groups of medicines:

1. Diuretics.Medicines have a positive effect on the condition of the cardiovascular system.Admission is not accompanied by the development of side effects.The treatment of the disease begins with diuretics (contraindication - diabetes and gout).Against the background of treatment, the volume of urine removed from the kidneys and, accordingly, excess water and sodium salts increases.Diuretics are prescribed in combination with other hypertension.
2. Alpha-blockers.Medicines are distinguished by good tolerance.They do not affect the level of blood sugars.Provide a decrease in blood pressure with a slight increase in heart rate (frequency of contraction of the heart muscle).The appearance of orthostatic hypotension at the beginning of treatment with this group's drugs becomes a side effect.In order to rule out its development, it is advisable to take medicines before going to bed.
3. Beta-blockers.Reduce your heart rate, which is accompanied by a decrease in blood pressure.
4. ACE inhibitor.Modern drugs are characterized by a high therapeutic effect and good tolerance.Against the background of taking agents in the patient's body, the form of angiotensin II - a hormone that provokes narrowing of the lumen of the blood vessels does not occur.Thanks to this, the peripheral vessels expand, the heart works in a more peaceful rhythm.Reduces blood pressure indicators.
5. Antagonists angiotensin-II.Medicines also block angiotensin II.They are appointed if it is impossible to obtain ACE inhibitors.
6. Calcium antagonists.Medicines extend the gaps of blood vessels, thus preventing the development of stroke.Medicines have an excellent therapeutic effect and are well tolerated.They have a small list of contraindications.It is most often prescribed as part of complex therapy.

Stop treatment even after stabilizing blood pressure is strictly forbidden.In this case, the disease will start to progress again, which will adversely affect the condition of the target organs.In addition, the risk of developing heart attack and stroke increases significantly.

The treatment of the disease is performed on an outpatient basis: the patient independently taking selected medicines.Hospitalization at the hospital is recommended only in severe cases.

Treatment of pathology in addition to taking medication provides massage.The procedures contribute not only to reducing pressure, but also to the overall strengthening of the body, improving the activity of the cardiovascular system, etc.Read more about different types of massage in our article: High pressure massage - classic, points and other effective methods.

Meal

Compliance with the principles of nutritional nutrition is one of the important stages of stabilizing blood pressure indicators.With hypertension, diet # 10 is recommended.

At the initial stage of the formation of pathology (AH 1 degree) it is necessary to adhere to diet # 5. It provides a restriction on the use of dining salt.With the deterioration of the state and the development of disorders in the work of the heart and vascular system, the transition to diet No. 5 A is recommended.

If the disease is complicated by atherosclerosis, diet 10 C. Hypoholesterol diet is prescribed to reduce the fat consumed fat, easily digestible carbohydrates.The diet should include foods high in dietary fibers, vegetable fats and proteins.

The list of authorized products is presented from the following positions:

• Bread - wheat, rye, whole grains, with bran.Baking without love, baking.
• Vegetable soups seasoned with cereals.
• Dietary varieties of meat: poultry, rabbit.It is allowed to cook and bake.
• Sea/river fish.Seafood.
• Seasonal vegetables.You can prepare the stew from them.
• Acid products and cottage cheese cheese with low fat.Low sour cream (placed on a plate).
• Soft eggs (no more than 3 pieces a week).
• Dairy and tomato sauces.
• Croats, pasta.
• Oil (for adding to a finished dish).
• Fruits/fruits (in any form).It can be used to prepare compotes, jelly, jelly.
• Juices, tea with milk, decoction of the study.

It should be completely excluded from the diet:

• Freshly baked bread, sdoba, complex sweets.
• Phavari forces.
• Fatty meat.
• Smoked meats, sausages.
• Fish (salt/smoked), caviar.
• Fatty sauces, cheeses, cream.
• Spring, radishes, spinach, horseradish, mushrooms.
• Ice cream, chocolate, confectionery, strong tea, coffee.

Salt consumption should be significantly reduced.

Prevention

Prevention of the disease is nonspecific.Standard recommendations:

1. Adhere to the principles of nutritional nutrition, except for a significant reduction in the volume of certain products.Reduce the consumption of animal salt and fat.In the process of cooking, it is advisable not to suck the food at all.You need to abandon fat/sharp/fried dishes.
2. Daily physical activity in accordance with the age group.Gymnastics improves the human well.It is recommended that you participate in running, walking, swimming, visiting the gym, performing breathing exercises.At the beginning of the hours, the body should get a minimum load.It must be increased gradually.
3. Normalization of weight is one of the prerequisites for successful prevention.
4. You need to learn how to control stressful situations, as this is precisely a violation of the work of the central nervous system, which doctors call almost the main cause of the disease.Automation, meditation, only -hypnosis helps well with this.
5. Complete rejection of bad habits.Smoking and alcohol are also capable of provoking pathology.

Pathophysiology considers arterial hypertension as one of the most serious pathologies, not only a deteriorating quality of life of the patient, but also capable of causing death.Therefore, when the episodes of high blood pressure occur, it is necessary to obtain specialized consultation and, if necessary, to start treatment.