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Hypertension

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

What pressure is considered adult

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

  • Optimal - less than 120/80 mm Hg.Art;
  • Physiological rate - less than 130/85 mm Hg.Art;
  • Normal growth - in the range of 130–139/85–89 mm Hg.Art.

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

  1. Soft (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 weapons are diagnosed in the case of indicators at 140-149/90 mm Hg.Art.And below.It is associated with episodes of increasing pressure and its spontaneous stabilization.

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

Classification of AG (Primary, Secondary)

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

  • Reasons that provoke the development of pathology;
  • defeated by the target bodies;
  • Current blood pressure level, etc.

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

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

By the nature of the fragment, a benign (slowly developing) and malignant arterial hypertension (with a rapid deterioration of the condition) is distinguished.

Varieties of secondary (symptomatic) hypertension)

Secondary arterial (symptomatic) 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 performed, as well as changes in the target organs, in particular, cardiac formation, kidney failure, etc.

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

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

Distinguish:

  1. Neurogenic hypertension.Development is due to central nervous system lesion and related pathologies, for example, brain neoplasia.
  2. Nephrogenic (renal origin).They are divided into interstitial, renopareenchymal, rhinovascular, mixed and rhinopian forms.
  3. Ag endocrine.It has adrenal, thyroid, pituitary and menopause formats.
  4. Hemodynamic - provoked by pathologies of the heart and large arterial canals.
  5. Dose shape.Its development is due to the use of oral contraceptives, glucocorticosteroid agents, etc.

The size and resistance of increased blood pressure, the severity of the changes in the condition of the left ventricle and fundus support another classification.Doctors distinguish the following types of symptomatic hypertension:

  1. Transient.For pathology, a typical short -term increase in pressure indicators.Changes in the state of the fundus are completely missing.The left ventricular hypertrophy is almost not fixed.
  2. Laby.It is characterized by a moderate, short increase in blood pressure (independent decrease does not occur).There is a weak left ventricular hypertrophy, narrowing the vessels of the retina of the eye.
  3. Consistent.It is associated with high blood pressure continuously.Thickness of the myocardium, severe violations on fundus vessels is diagnosed.
  4. Malignant (uncontrolled).It is associated with a sharp increase in blood pressure.The result is unfavorable.

The following forms of symptomatic hypertension are found:

  • Pulmonary hypertension (hypertension of a small circulatory circulation).It is established as a diagnosis when determining blood pressure in the pulmonary arteries over 25 mm.Rt.Art.
  • Vasorsenal Ah is a secondary form of pathology due to insufficient blood flow to the kidneys as a result of impaired arterial turnover.
  • Portal hypertension is one of the varieties of the symptomatic form of the disease, accompanied by an increase in pressure within the gate vein.
  • Virsungov channel hypertension.It develops against the backdrop of chronic pancreatic inflammation.

Consequences and complications

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

  • Pectoral attacks of angina,
  • myocardial infarction,
  • Neurological complications, etc.

Important!The formation of acute states against the backdrop of a sharp increase in blood pressure requires its decrease in the early minutes/hours.

Reason

The reasons for developing the essential form of pathology are not known to doctors for sure.Named several theories:

  1. Neurogenic (inheritance).The cause of development is chronic stress, significant emotional shocks and psychological damage.All of this provokes a failure in the nervous regulation process, coupled with an increase in the activity of the sympathetic system.The result is the divergence of signals for all organs and an increase in the tone of the ship walls.
  2. Voluminous salt.Due to damaged processes of excess fluid production and certain trace elements.As a result of the excessive content of sodium salts, there is an increase in the overall volume of blood.The body's efforts to maintain the hemostasis process at the physiological level lead to the spasms of small vessels.The indicators of the volume of the heart minute are stabilized, but overall blood pressure has been raised.

Important!Doctors argue that 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 occurrence of arterial hypertension are:

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

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

Symptoms

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

The only sign of pathology can be called an increase in pressure indicators.No complaints at all, or they are not specific:

  • headaches located in the forehead area and the back of the head;
  • dizziness;
  • noise

The first complaints are formed against the background of loss of target organs.At this stage, the appearance of the following symptoms is observed:

  • Dizziness, accompanied by headaches, noise - arises as a logical result of circulatory disorders;
  • Initial problems with information memorization;
  • The numbness of the hands/feet;
  • weakness;
  • duplication of the visible image;
  • Sliding black dots in the field of viewing;
  • speech violation (rarely);
  • nephropathy.

Symptoms are typical of the final stages.At the beginning of the formation of pathology, they are coming.

With heart damage, the left ventricle (LV) begins to hypertrophic.The cause of the change is the compensatory reaction of the body, which allows to stabilize the increased loads on its wall.An increase in the ventricle is due to an increase in the number of cardiomocytes.As the condition worsens, the heart rooms are diluted.

Such an organ damage can manifest in the form:

  • the formation of heart failure,
  • an unexpected cardiac arrest,
  • ischemic disease,
  • stomach rhythm disorders,
  • heart asthma,
  • Strong shortness of breath during loads.

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

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

Urine analysis for arterial hypertension

The main clinical sign of arterial hypertension is headache.It appears at any time of the day, but more often in the morning.Feels by the patient as an explosion or pain.The site of localization is the back of the head, but the spread to other areas of the head is not excluded.The pain is improved by the slope and during the cough.It can happen as a response to stressful situations, physical strain.

Diagnosis

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

  • Creating pathology, determining the current scale;
  • Identification of the origin of hypertension (primary/secondary form);
  • performing differential diagnosis;
  • Determining the presence/absence of damage to the target organs.

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

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

Calculate the body mass index (BMI).Obesity is one of the potential provocations of hypertension formation.

After the inspection is completed, blood pressure is measured.To determine the degree of arterial hypertension, the patient is described by the performance of the blood pressure profile, ie.making measurements for patients themselves at home.It is necessary to make 4 measurements: two in the morning and two in the evening, for a few days.

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

Sometimes a brush is described (daily monitoring of blood pressure).The technique is indicated if the patient's measurements remain normal, but another symptom of the disease occurs.

Important!SMAD is a multiple measurement of blood pressure indicators for a full day.Measurements are performed by a special device.

To establish the true cause of the development of arterial hypertension and to determine the strength of damage to the target organs, are defined:

  • Examination of the renal system.Includes urine study - a general test.Re -rial, renal system treatment, renography with the introduction of a radioactive isotope is prescribed.
  • Heart test.ECG is used (electrocardiogram indicates route Rusha), echocardiography (allows you to see signs of a pathological growth in the left ventricle and other transformations).
  • Ophthalological examination of the eye.One sign of the disease is the visual impregnation of blood vessels by signing.Hemorrhages are not excluded.
  • Ultrasound of the thyroid gland and adrenal glands.
  • Blood examination is a general test and enlarged biochemistry.

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

  • Analysis of the clinical figure, raising complaints, an examination of patient physics in particular, auscultation, instrumental/laboratory studies;
  • Diagnostic measures that allow you to evaluate the functional state of the organs and existing changes, in particular, it is necessary to remove the cardiogram.

The methods considered help to confirm the diagnosis, determine the origin of the disease and to choose adequate therapy for the state.

Treatment

Hypertension treatment begins with a lifestyle and non -Drug therapy review.The exception is secondary hypertension.

Arterial hypertension therapy provides for the taking of the following groups of medication:

  1. Diuretics.The drug has a positive effect on the condition of the cardiovascular system.Reception is not associated with the development of side effects.Disease therapy begins with diuretics (contraindication - diabetes and gout).Against the backdrop of treatment, the volume of urine removed from the kidneys and, accordingly, increases excess salts of water and sodium.Diuretics are described in combination with other hypertension.
  2. Alpha-blocker.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 pulse (frequency of heart muscle contraction).The occurrence of orthostatic hypotension at the beginning of treatment with the drugs of this group becomes a side effect.To rule out its development, it is advisable to take medicines before bedtime.
  3. Beta-blocker.Reduce heart rate, which is associated with a lowering blood pressure.
  4. ACE inhibitory.Modern drugs are distinguished by a high therapeutic effect and good tolerance.Despite the origin of funding in the patient's body, the form of angiotensin II does not occur - a hormone that provokes a narrowing of the lumen of blood vessels.Thanks to this, peripheral vessels expand, the heart functions at a quieter pace.There is a decrease in blood pressure indicators.
  5. Angiotensin-II antagonists.Medicines are also blocking angiotensin II.They are named if it is impossible to obtain ACE inhibitors.
  6. Calcium antagonists.The medication expands the vascular gaps, thereby preventing the development of stroke.The drugs have an excellent therapeutic effect and are well tolerated.Have a small list of contraindications.Most often described as part of complex therapy.

To stop treatment even after stabilization of blood pressure is strictly prohibited.In this case, the disease will again begin to progress, which will adversely affect the condition of the target organs.Moreover, the risk of developing heart attack and stroke increases significantly.

The treatment of the disease is performed on outpatient basis: the patient receives independently selected medicines.Hospital hospitalization is recommended only in severe cases.

The treatment of pathology in addition to taking medication provides massage.Procedures contribute not only to reducing pressure but also to 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.

Food

Compliance with the principles of dietary food is one of the important stages to stabilize blood pressure indicators.With hypertension, diet no.10.

In the initial phase of the formation of pathology (ah 1 degree), it is necessary to adhere to diet no.5. It provides a restriction on the use of table salt.With a deterioration in the state and the development of violations in the work of the heart and the vascular system, the transition to Diet no.5 A.

If the disease is complicated by atherosclerosis, diet no.10 C. Hypolesterol diet is prescribed to reduce fats consumed of animal origin, easily soluble carbohydrates.The diet should include foods with a high content of dietary fibers, vegetable fats and proteins.

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

  • Bread - wheat, rye, whole grain, with bran.Baking not -love, baking.
  • Cereal -past vegetable soups.
  • Dietary varieties of meat: bird, rabbit.Allowed to boil and bake.
  • Sea/river fish.Seafood.
  • Seasonal vegetables.From them you can prepare the worry.
  • Products with sour shirt and low -fat cottage cheese.Secer with low yogurt (placed on a plate).
  • Soft eggs (no more than 3 pieces per week).
  • Milk and tomato sauces.
  • Croats, pasta.
  • Oil (for adding a finished dish).
  • Fruits/berries (in any form).It can be used for the preparation of compounds, jelly, jelly.
  • Juices, milk tea, rose decoction.

Should be completely excluded from the diet:

  • Breeze bread, sdoba, intricate pastries.
  • Favorable soups.
  • Fatty meat.
  • Smoked meat, sausages.
  • Fish (salty/smoked), caviar.
  • Fat sauces, cheeses, cream.
  • Spring, radishes, spinach, horseradish, mushrooms.
  • Ice cream, chocolate, cakes, strong tea, coffee.

Salt consumption should be significantly reduced.

Salt with arterial hypertension

PREVENTION

Prevention of the disease is not specific.Standard recommendations:

  1. Respect the principles of dietary food, excluding or significantly reducing the volume of certain products.Reduce the consumption of animal salt and fats.In the cooking process, it is advisable not to absorb food at all.It is necessary to abandon the fat/sharp/fried dishes.
  2. Daily physical activity in accordance with the age group.Performing gymnastics improves human well -being.It is recommended to engage in running, walking, swimming, visiting the gym, to perform breathing exercises.At the beginning of the classes, the body should get a minimal load.Should gradually increase.
  3. Weight normalization is one of the prerequisites for successful prevention.
  4. It is necessary to learn how to control stressful situations, as it is precisely a violation of the work of the central nervous system that doctors call almost the main reason for the development of the disease.Autotorization, meditation, self -hypnosis helps well in this.
  5. A complete rejection of bad habits.Smoking and alcohol are also capable of provoking a pathology.

Pathophysiology considers arterial hypertension as one of the most serious pathologies, not just a worsening quality of the patient's life, but capable of causing death.This is why when episodes of blood pressure growth appear, it is necessary to get a specialized consultation and, if necessary, begin treatment.