Classification of hypertension

For several years, doctors have been sounding the alarm: in developed countries that have overcome epidemics, arterial hypertension continues to occupy a leading place among the causes of death 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 few decades ago, a 35-year-old stroke patient was considered foolish.Recently, such a case will not surprise anyone.

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

What kind of disease is this?

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

In itself, the pressure on the walls of the blood vessels is a necessary, normal process and is necessary for the movement of blood through them.During sleep, the pressure drops slightly, and during stress or physical activity - the opposite.

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

Blood pressure is divided into two types:

1. Systolic.The first, upper number shows the force of blood pressure at the moment when the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lower number shows the blood pressure when the heart muscle (myocardium) relaxes.

Arterial hypertension (hypertension) is not without reason 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 impressive, so scientists have been studying it since the beginning of the last century.During this period of time, the classification changed more than once, but two directions were formed:

1. When creating classifications according to the stages of development of the disease, doctors thought about the relationship between hypertension and risk factors for the development of hypertension.However, they never reached full 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 several of the classifications proposed by scientists.

By 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, redness of the face and body is noticed due to the expansion of capillaries.Red spots often appear.In the second case, a person suffering from the disease experiences a vascular spasm with a surge in pressure, becomes cold and pale.

By origin

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

The specific reasons for the appearance and development of the primary have not yet been discovered.There are three degrees.

Arterial hypertension of the 1st degree is called "mild".Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure "jumps", sometimes rises, then returns to normal.Hypertension of the first degree has a borderline subgroup with indicators of 140–149 and 90–94 mm Hg.Art.The probability of crises (sudden sudden jumps) is small, if they happen, it is rare.

But for grade 2 (moderate) hypertension, the risk is greater.The tonometer shows 160–179 and 100–109 mmHg.Art.Hypertension of the second degree is characterized by a constant increase in pressure.

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

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

1. systolic.The pressure is more than 140 and less than 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and below 90 mmHg.Art.In this case, the "upper" pressure creeps up to 140 mmHg.Art.and higher while the "lower" remains normal.Then we are talking about an isolated systolic form of hypertension.

Secondary hypertension is less common and is diagnosed in approximately 20% of cases (in young people under 35 - in 25%).This type of disease is caused by a disease of a certain organ.Most often, such symptomatic hypertension occurs 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 specialists into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.In this way, the division reflects the pathologies that appear in the body over the years.

In 1999, scientists decided it was more accurate to classify the disease by grade.There are three of them, and each means a set of changes in the digital values of blood pressure (they were discussed above).

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

With chronic high blood pressure, the body cannot cope with the stress and bad things start to happen to the organs.Those that are affected earlier than others are called target organs by doctors.Along with the heart and brain, these include the retina and kidneys.The classification of hypertension by degrees is based precisely on the effect 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 the hospital at first, because they feel tolerable and do not interfere with their lives much.Hypertensive crises are the exception rather than the rule.Beginning hypertensives ignore health problems in vain, since at this stage the disease is the easiest to tame.Sometimes treating stage 1 hypertension is more about changing your lifestyle than taking medication.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to go to a specialist.Timely treatment will help prevent the progression of the "silent killer".

Stage 2 hypertension is characterized by persistently high blood pressure.The heart first fails - 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. Crises occur much more often.But the disease is still treatable.If the doctor diagnoses "hypertension stage 2", his recommendations should be followed especially carefully.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all target organs present with a host of complications.Pressure spikes in hypertension, stage 3. can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, kidney failure and other "gifts" often develop.Often the third stage of hypertension is noted when the patient already has hemorrhages in the fundus, heart attack, aneurysm, stroke and other diseases.

Signs of blood pressure problems

Timely identification of hypertension and understanding how long a person has had it is the number one problem.Many hypertensives learn about the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, being overweight, smoking, frequent stress, elevated cholesterol levels, a sedentary lifestyle and advanced age.

Alarm bells ring if you see:

• periodic headache;
• pain "threats" in the back of the head or blows in the temples;
• often feel nausea and dizziness;
• glare flickers in the eyes or "black flies" fly;
• everything is boring or covered in apathy;
• numbness or tingling in the fingers;
• swelling of the hands, feet and/or face;
• a rapid heart rate suddenly 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

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

The first, the simplest, is to measure your blood pressure.

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

In the third case, the 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 with an easily excitable nervous system, blood pressure values can jump even with mild emotional shocks.When visiting a doctor, such patients experience the "white coat" syndrome: as soon as the doctor starts measuring blood pressure, it rises.But the cause of these fluctuations is stress, not disease.Although such a shock reaction in the long term can cause disturbances in the normal functioning of the heart and kidneys.In such impressionable patients, the doctor will check the pressure more than once and under different conditions.

• Medical examination.Information on the patient's height, weight and body mass index is collected.The specialist is looking for data on symptomatic hypertension.
• Medical history.No interview with the patient - nowhere.It is necessary to find out what diseases a person had before and whether he has any diseases at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; it is established whether there is diabetes), whether the parents were hypertensive.
• Physical examination.First, the doctor will listen to the heart using a stethoscope.The task is to identify noises, changes in tones or the presence of extraneous sounds, if any.After this examination, it is possible to rule out heart defects and make preliminary conclusions about his condition against the background of hypertension.
• Biochemical blood test.It is necessary to establish the level of sugar, cholesterol and lipoproteins and to understand how prone a person is to atherosclerosis.
• EKG.The electrocardiogram is an integral part of the diagnostic process.It helps to see heart rhythm irregularities.Having the results in hand, we can judge the presence of hypertrophy of the wall of the left side of the heart, characteristic of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see a picture of changes and heart defects, evaluate the function and condition of the valves.
• x-ray examination.Doctors do arteriography and aortography.With their help, specialists examine 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 helping to determine the intensity of blood flow through the arteries and veins.
• Ultrasound of the thyroid gland.Among other data, the doctor needs the results of a blood test to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will become clear whether the thyroid gland plays any 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 survey helps to assess their condition.

Methods of treatment

Today there are many methods of treating hypertension.Some have come to us from antiquity;pharmacists and scientists have worked on creating others for years and years.

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

1. Calcium antagonists are aimed at reducing the heart rate.
2. Diuretics, most commonly thiazide diuretics, work to improve urine production and excretion.
3. Adrenergic drugs.
4. Vasodilators widen the blood vessels and thus equalize 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.In order for scars not to appear after the intervention, the entire length of the vein is affected.It is performed under local anesthesia.

A variety of methods that have come from the past are classified as alternative medicine.This includes foot parks, vinegar lotions, and more.

Non-traditional remedies based on valerian, motherwort, beetroot, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

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

Take 1 tbsp.l. motherwort, valerian root and cumin.Mix it up.One tablespoon of this mixture is poured with a glass of boiling water and left for an hour.Drink the medicine three times a day, 1/3 cup.The course is designed for one month.

There is also a monastery tea designed to help with hypertension and homeopathic remedies.However, it is best to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if left untreated.You should monitor your health at any age, as the modern rhythm of life often contributes to the development of the disease.And regardless of the stage and degree of hypertension, without treatment it can lead to fatal consequences.