What is hypertension? This is a disease characterized by indications of blood pressure above 140 mm Hg. Art. in this case the patient is visited by headache, dizziness and nausea. Elimination of all symptoms may be only specially selected therapy.
Hypertension can be a disease in itself or accompany various pathologies, being their symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.
In patients with hypertension, the indicators often return to normal only after taking special medications, and pressure surges 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 your blood pressure is a doable task.
Do not self-medicate. At the first signs of illness consult a doctor.
Reasons
To date, the exact causes of essential hypertension are unknown. There are the following risk factors:
- heredity;
- malnutrition;
- bad habits;
- disturbance of fat metabolism;
- kidney disease;
- diabetes;
- stress;
- inactive lifestyle.
Classification of the disease
During a diagnostic examination it is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure. The pathogenesis also has differences, taking into account the varieties of the disease. There is the following classification of arterial hypertension:
- Pulmonary essential arterial hypertension - is considered one of the types of arterial hypertension, rare, but a great danger to human life. It is very difficult to identify this disease by its symptoms and even more difficult to treat. Pulmonary arterial hypertension is caused by an increase in pulmonary vascular resistance and, as a result, insufficient blood flow.
- Malignant. The symptoms of such arterial hypertension are presented in the form of high blood pressure up to 220/130. there is a radical change in the fundus and swelling of the optic disc. If the diagnosis is made in time, then it is possible to cure this type of hypertension.
- Renovascular arterial hypertension. The reasons for the formation of this type of disease are the presence of such pathologies as vasculitis, vascular atherosclerosis and malignant tumors in the kidneys. The pathogenesis of the disease is reduced to the formation of characteristic pressure, which can be represented in normal systolic and elevated diastolic blood pressure.
- Labile arterial hypertension. This type of disease is characterized by periodic normalization of pressure. Patients suffering from this form of arterial hypertension are not called patients, as this condition is not a pathology. In some cases, after a certain period of time, blood pressure returns to normal.
Symptomatic arterial hypertension and its types
Secondary arterial hypertension is a pathological process that is associated with diseases of the organs involved in the normalization of blood pressure. There is the following classification:
- Hemodynamic - associated with disorders of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, coarctation of the aorta, aortic valve insufficiency.
- Neurogenic. This type of symptomatic hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
- Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
- Nephrogenic arterial hypertension. This type of symptomatic hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
- Healing. This form of symptomatic hypertension is associated with the use of drugs that increase blood pressure.
Symptoms
Before there are complications of hypertension, it proceeds without certain manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the formation of headaches in the back of the head and forehead, dizziness and uncharacteristic sound in the ears.
Damage to target organs
These types of symptoms of hypertension appear very early 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 black dots in front of the eyes, difficulty speaking. Such symptoms confuse a person in the late stages of the disease. In addition, complications such as heart attack and bleeding may occur.
Heart failure
In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory response aimed at normalizing the tension on the wall. As a result, increased afterload, heart failure. When the heart is damaged, there are no the most favorable prognosis, as such changes in its work are the causes of heart failure, sudden death and the development of ventricular arrhythmias. The typical symptoms are:
- pulmonary edema;
- difficulty breathing during physical activity;
- cardiac asthma.
In some cases, high blood pressure in children and adults causes pain in the heart of a certain nature. They can visit a person at rest or emotionally strained without performing physical activity. The main manifestation of the presented chest pains is the impossibility to eliminate them with the help of nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath in the early stages of the disease after application of light loads or at rest. All this shows characteristic changes in the heart muscle and the formation of heart failure. In such a disease, people have swelling of the lower extremities, the reason for which is the retention of sodium and water ions in the body.
If the lesion has affected the kidneys, then when passing a urine test, protein is found in it, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.
Eye damage
Less often, this hypertension in children and adults affects vision, which leads to reduced photosensitivity and blindness. If there is visual impairment on the background of high blood pressure, then patients have blackheads in front of the eyes, fog or veil. The reasons for such changes are a 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 hypertension. It worries the patient at any time of the day or night. It can be natural in nature and focus on the back of the head and then spread to the entire head area. Increased headache in hypertension occurs when coughing, tilting the head. This may be accompanied by swelling of the eyelids and face. When performing massage in this case in patients suffering from hypertension, there is an improvement in blood flow in the veins and this leads to a reduction in pain until its complete disappearance.
There are cases when the headache on the background of the presented disease is the result of tense soft muscles of the head or tendons. The formation of such a pain syndrome occurs after psycho-emotional or physical stress. As a rule, such pain has a compressive or astringent nature. A patient suffering from hypertension has a feeling of nausea, dizziness. In the presence of prolonged pain is characterized by constant pain, patients develop irritability, sensitivity to sharp sounds increases, they become hostile.
Stages of the disease
To correctly determine the stage of this pathological process, it is necessary to use the classification. It depends on the damage to the target organ. There are three stages of the disease.
Easy
This stage 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 suffering from hypertension, blood pressure is normalized. Due to the fixation of the disease, the pressure inevitably increases. Very often people do not complain about the formation of any violations in relation to their health. But the easy stage is characterized by its own symptoms:
- headache;
- noise in the ears;
- bad sleep;
- mental decline;
- dizziness;
- nosebleeds.
As a rule, there are no manifestations of left ventricular hypertrophy, ECG has no abnormalities, renal function without pathological changes, the fundus is not changed.
Medium
This stage is characterized by the presence of a higher and more stable level of blood pressure. It can reach 180-105 mm Hg. Art. patients often experience headaches, dizziness, pain in the heart, who have angina pectoris.
This stage is characterized by typical hypertensive crises. The pathogenesis of the disease includes the following signs of damage to target organs:
- left hypertrophy;
- weakening of the I tone at the top of the heart;
- accent II tone on the aorta;
- in some patients ECG symptoms of subendocardial ischemia.
With regard to the central nervous system, there are various manifestations of vascular insufficiency, strokes, transient cerebral ischemia. For the fundus, in addition to the reduction of arterioles, there is compression of the veins, their increase, there are hemorrhages, exudates. Renal blood flow and glomerular filtration rate are reduced for this stage. But it is impossible to detect these manifestations in the analysis of urine.
heavy
This stage of the disease is characterized by frequent vascular accidents. They occur due to a significant and stable increase in blood pressure, as well as the progression of atherosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In severe stages, the disease affects the following organs:
- heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias;
- brain - ischemic and hemorrhagic heart attacks, encephalopathy;
- Eye bottom;
- kidneys - low blood flow and glomerular filtration.
Risk factors
Currently, 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 high blood pressure. Given the presented complications, the prognosis for the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and its prognosis:
- age - for men after 50 years, for women after 60 years;
- smoking;
- high cholesterol;
- hereditary factor;
- obesity;
- hypodynamia;
- diabetes.
The presented risk factors can be eliminated (corrected) and cannot be corrected. The first type of risk factors are characterized by the presence of diabetes, high cholesterol, smoking, lack of physical activity. Uncorrected risk factors include race, family history, and age.
Given the degree of arterial hypertension and the factors contributing to the disease, there is a prognosis with the formation of such complications as heart attack or stroke over the next 10 years.
With mild hypertension and no risk factors, the development of complications of the cardiovascular system is minimized over the next 10 years. With non-drug therapy for a year and reconsideration of your lifestyle it is possible to eliminate this stage of the pathological process. If the pressure reading is greater than 140/90 mm Hg. Art. , then drug treatment is prescribed.
The average degree of risk is accompanied by the formation of complications on the background of hypertension for 10 years in a ratio of 20%. Grade 2 hypertension is treated in the same way as grade 1 hypertension, but here the dynamics control is also adjusted for six months. If there are poor results from blood pressure and its stable maintenance, then medical treatment is carried out.
High risk factors are accompanied by the formation of complications within 30%. In this situation, a patient suffering from hypertension is prescribed a complete diagnosis in combination with non-drug treatment.
At very high risk, the patient is prescribed an emergency differential diagnosis of hypertension and medication.
Diagnostic methods
Only after a thorough study can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of hypertension is based on the following types of tests:
- ECG, glucose analysis and complete blood count;
- Ultrasound of the kidneys, determination of urea, creatinine in the blood, general analysis of urine - are performed to exclude the renal nature of the formation of the disease;
- An ultrasound of the adrenal glands is recommended if pheochromocytoma is suspected;
- hormone analysis, thyroid ultrasound;
- MRI of the brain;
- Consultation with a neurologist and ophthalmologist.
Effective therapy
Treatment of hypertension should be carried out under the constant supervision of a physician. He is obliged to make an accurate diagnosis, to perform additional diagnostics, which includes inspection:
- fundus;
- renal function;
- the work of the heart.
The specialist can then prescribe antihypertensive treatment to determine various complications. As a rule, patients who are diagnosed with hypertension for the first time are hospitalized to perform all necessary tests and choose treatment.
Non-drug treatment
Such therapy is recommended for all patients, regardless of the degree of the disease the use of drugs. Such treatment of hypertension includes:
- Quit smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
- Eliminate extra pounds. A common cause of high blood pressure is being overweight, so diet plays an important role in this. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes, myocardial hypertrophy.
- Reduced salt intake. According to current studies, reduced salt intake to 4, 5 g / day, helps reduce systolic blood pressure by 4-6 mm Hg. Art.
- Insignificant consumption of strong drinks.
- Specially developed diet. Your diet should include vegetables, fruits, foods high in magnesium, potassium, potassium, fish, seafood. In addition, the diet includes a limited intake of animal fats.
- Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very useful. When performing isometric loads, you can provoke an increase in blood pressure.
Medical treatment
Drug therapy should be prescribed taking into account the following recommendations:
- Treatment begins with small doses of drugs.
- In the absence of 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 no rapid reduction in blood pressure is required.
- The use of long-acting drugs to obtain a 24-hour effect with a single dose.
- Apply the optimal combination of devices.
- Therapy should be constant. It is not allowed to use the drug in courses.
- Effective control of blood pressure throughout the year contributes to a gradual reduction in the dose and amount of drugs.
Preventive actions
Prevention of hypertension includes the following recommendations:
- If family members have this disease and you are over 30 years old, then you should measure your blood pressure regularly.
- Quit smoking and alcohol.
- A low-fat, low-salt diet should be followed.
- Outdoor exercise.
- Avoid various stressful situations.
- Maintain a normal body weight.
With arterial hypertension a person can live a normal full life, but in compliance with all the described recommendations. Blood pressure control in this case is one of the main components of successful treatment of the disease. Therefore, try not to start the disease and visit a doctor in time to avoid various serious complications.