A man is alive as long as his heart beats. The heart "pump" provides blood circulation in the vessels. In this connection there is such a thing as blood pressure. Abbreviated AD. Any deviations from normal blood pressure values are deadly.
He specializes in the diagnosis and treatment of respiratory diseases and allergies, has methods for studying the function of external breathing, allergy tests with allergens, autochemotherapy, specific and non-specific immunotherapy.
Risks of developing hypertension
The risk of developing hypertension or arterial hypertension - high blood pressure - consists of a number of factors. Accordingly, the more they are, the greater the probability that a person will become hypertensive.
Risk factors for developing hypertension:
- hereditary predisposition. The risk of the disease is higher in those who have hypertension among first-line relatives: father, mother, grandmother, grandfather, brothers and sisters. The more close relatives with high blood pressure, the greater the risk;
- age over 35 years;
- stress (stress hypertension) and mental stress. The stress hormone adrenaline increases the heart rate. Instantly constricts blood vessels;
- taking certain medications, for example, oral contraceptives and various nutritional supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. The components of tobacco provoke spasms of blood vessels - involuntary contractions of their walls. This narrows the blood flow;
- atherosclerosis - blockage of blood vessels with plaques. Total cholesterol should not exceed 6. 5 mmol/l blood;
- renal failure (nephrogenic hypertension);
- endocrinopathy of the adrenal glands, thyroid gland or pituitary gland;
- excess salt in food. Table salt provokes arterial spasm and retains fluids in the body;
- inactivity. Physical inactivity is accompanied by slow metabolism - metabolism - and gradually weakens the body as a whole;
- overweight. Each additional kilogram increases blood pressure by 2 millimeters of mercury - mmHg;
- sudden change of weather;
- chronic lack of sleep and other "provocateurs".
Most risk factors for the development of hypertension are closely related to each other. Thus, inveterate smokers in most cases develop atherosclerotic plaques, and physically inactive and malnourished people quickly gain excess weight. Such combinations of factors significantly increase the risk of pathological abnormalities in the heart.
Depending on the combination and degree of manifestation of the above factors, as well as the probability of cardiovascular complications in the next decade, there are 4 types of risk of developing arterial hypertension:
- low (risk below 15%);
- medium (from 15 to 20%);
- high (more than 20%);
- very high (over 30%).
Risk factors for the occurrence of arterial hypertension are also divided into 2 types based on the possibility of their removal: correctable (correctable) and not. For example, a person can give up smoking, but he is unable to change his background. The amount of risk is summed up by a number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will significantly increase the percentage chance of developing complications.
Hypertension is quite treatable. Here a lot depends on the timely diagnosis of the disease, the perseverance of the patient and his desire to radically change his lifestyle.
Hypertension 1st degree
Arterial hypertension can be primary, i. e. develop independently, and secondary - be a complication of another disease. In the latter case, the treatment is carried out comprehensively, since it is necessary not only to normalize the pressure, but also to cure the accompanying cause of the disease.
A blood pressure of 120 to 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is the so-called upper blood pressure or systolic pressure (when the walls of the heart muscle are maximally contracted). And 80 is the lower indicator or the so-called diastolic pressure (when they are maximally relaxedAccordingly, hypertension is divided into systolic, diastolic and mixed (systolic-diastolic), depending on whether the upper or lower indicators exceed the threshold value.
When the lumen of the blood flow narrows, the heart spends more effort to push blood into the vessels, it wears out faster and begins to work intermittently. An increase in heart rate - heart rate - negatively affects the functioning of the whole body. Air and nutrients contained in the blood do not have time to enter the cells.
Like any disease, hypertension progresses if left untreated. The appearance of the first hypertensive symptoms is preceded by a prehypertensive state - prehypertension.
The degree of severity depends on the stage of development of the disease:
- "soft" or light;
- moderate or borderline;
- very severe or isolated systolic.
Otherwise, arterial hypertension of the 1st stage is called a mild form of this disease. The upper value of blood pressure ranges from 140 to 159, and the lower value is 90-99 mm Hg. Disturbances in the work of the heart occur spasmodically. Attacks usually pass without consequences. This is a preclinical form of hypertension. Periods of exacerbation alternate with complete disappearance of the symptoms of the disease. During remission, the patient's blood pressure is normal.
The diagnosis of hypertension is simple: blood pressure measurement using a tonometer. For an accurate diagnosis, the procedure is carried out three times a day in a calm environment and in a relaxed state.
Even people at low risk of developing hypertension should have their blood pressure checked regularly. One potentially dangerous factor is enough to monitor your heart more closely. For those who are significantly predisposed to heart disease, it is advisable to purchase a cardiovisor - a device for making an ECG - electrocardiogram - at home. Any disease is easier to treat at an early stage.
Symptoms of stage 1 hypertension
Symptoms of stage 1 hypertension include:
- headache that progresses with physical exertion;
- stabbing or stabbing pain in left side of chest, radiating to scapula and arm;
- black spots before the eyes.
We must not forget that in mild forms of hypertension all these symptoms appear from time to time. If after intense physical activity your heart rate increases or you have difficulty falling asleep due to noisy neighbors, you should not panic and consider yourself hypertensive.
During periods of improvement, the patient feels excellent. Mild hypertension has all the signs of heart failure. More severe degrees of the disease differ only in the persistence of symptoms and the appearance of complications.
Complications of hypertension 1st degree
Complications include:
- sclerosis of the kidneys - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most believe that mild arterial hypertension can be cured without consequences. But the risk of grade 1 complications is average, i. e. about 15%. High pressure in vessels due to narrowing of their lumen leads to insufficient blood supply to tissues. The lack of oxygen and nutrients leads to the death of individual cells and whole organs. Necrosis begins with local, focal lesions. Over time, if left untreated, an ischemic stroke is inevitable.
Blood circulation disorders inevitably lead to metabolic disorders. This has a detrimental effect on the respiration and nutrition of cells of all types. Pathological changes are inevitable, for example, sclerosis - replacement with connective tissue. In nephrosclerosis, the walls of the kidneys become pathologically thicker and the organ "shrinks". In this regard, the excretory function is impaired and urea enters the blood.
If the blood vessels are narrowed, the heart strains to push blood through them. This leads to pathological enlargement of the heart muscle. This hypertrophy is called true or working. The volume and mass of the left ventricle increases due to thickening of its walls. This pathology is otherwise called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows him to squeeze harder. It seems, how can this be dangerous? A "swollen" heart can press on neighboring vessels, and irregular muscle growths can block the outlet of the left ventricle. Cardiac hypertrophy sometimes leads to sudden death.
Complications of hypertension of the 1st degree occur extremely rarely. To avoid them, it is enough to minimize the risk of developing arterial hypertension, that is, to eliminate its prerequisites and causes.
Treatment of hypertension of the first stage
First, the doctor will advise the patient to change his lifestyle. The patient will be advised about restful sleep, avoiding stress, targeted relaxation exercises, a special diet, exercise, etc. If these measures are not sufficient, drug therapy is used.
The cardiologist prescribes the following drugs: sedatives and other antihypertensive drugs.
Medicines are selected strictly individually, because many patients with hypertension have concomitant diseases. The choice of drugs is influenced by the age of the patient and the drugs he uses.
If it is possible to stop the disease at the initial stage and completely get rid of it, prevention cannot be neglected in the future. Its principle is simple – avoiding all risk factors for hypertension. Thanks to a healthy lifestyle, you can prevent the appearance of even hereditary pathologies.
Hypertension 2 degrees
This is hypertension in a moderate form. Upper blood pressure is 160 - 179 mm Hg and lower blood pressure is 100 - 109 mm Hg. At this stage of the disease, the periods of increased pressure are longer. Blood pressure rarely normalizes.
Depending on the rate of transition of hypertension from one stage to another, benign and malignant arterial hypertension are distinguished. In the second, the disease progresses so rapidly that it is often fatal. Hypertension is dangerous because the increase in the speed of blood movement through the vessels leads to thickening of their walls and even greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Characteristic signs of arterial hypertension appear even in mild forms of the disease.
At the second stage, the following symptoms join them:
- throbbing sensation in the head;
- hyperemia - overflow of blood vessels, for example, redness of the skin;
- microalbuminuria - presence of albumin proteins in the urine;
- numbness and tingling of the fingers;
- pathologies of the fundus;
- hypertensive crises - sudden spikes in pressure (sometimes with 59 units at once);
- appearance or worsening of signs of target organ damage.
Fatigue, lethargy and swelling appear because the kidneys are involved in the pathological process. A hypertensive attack can be accompanied by vomiting, difficulty urinating and bowel movements, shortness of breath and tears. Sometimes it lasts several hours. Complications of hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (rapid heart rate, overexcitement, trembling hands, unmotivated panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, depressed consciousness);
Symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of high blood pressure. The disease at this stage retreats reluctantly and often returns.
Complications of hypertension 2 degrees
Complications of stage 2 hypertension include the following diseases: aortic aneurysm - pathological protrusion of its wall.
Target organs, i. e. internal organs, affected due to hypertension include:
- Hemorrhages appear in various organs because the walls of the blood vessels thicken more and more, lose their elasticity and become brittle. Increased blood flow easily destroys such vessels. The reverse process occurs with the development of aneurysms. Here the walls are stretched and thinned due to increased blood circulation. They are so weakened that they tear easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis - fatty deposits on the walls - and thrombosis - blocking them with a blood clot. Bleeding of brain cells leads to oxygen starvation and their death. This phenomenon is called encephalopathy. Ischemia is oxygen starvation of the heart. Angina pectoris is constant chest pain.
In connection with it, pathological processes related to the main disease develop. Accordingly, if you do not start timely treatment or violate medical prohibitions, there will be more and more target organs and it will become almost impossible to restore health.
Hypertensive disability 2nd degree
Hypertensive patients are under constant dispensary monitoring and are periodically reviewed. In addition to daily blood measurements, an ECG is regularly prescribed. In some cases, an ultrasound may be necessary - an ultrasound examination of the heart, urine tests, blood tests and other diagnostic procedures. Hypertensive patients with a moderate form of the disease are less productive than healthy people.
If there is permanent damage to body functions caused by hypertension, the patient is sent to the examination office to receive a medical and social examination. In rare cases, patients with hypertension are examined at home, in a hospital or even in absentia. Sometimes an additional exam syllabus is prepared. For people with disabilities, specialists from BMSP develop a mandatory individual program for rehabilitation.
To determine the disability group, the expert commission, together with the degree of hypertension, takes into account the following factors:
- information from the medical history about hypertensive crises;
- working conditions of the patient.
The procedure for establishing a disability group is necessary for proper employment. Whether it will be easy to find an employer willing to tolerate the work of a "poor" employee is another matter. If the job applicant presents documents confirming his disability, then in accordance with federal law he must be provided with the necessary working conditions.
Employers are reluctant to hire people with disabilities because. . . working hours for them are reduced while maintaining full wages (for groups 1 and 2). In addition, they are forced to take sick leave more often than other employees, and their annual leave has been increased. In this regard, most people with group 3 disabilities hide their illnesses in order to get a well-paid position. Violation of medical instructions regarding working conditions leads to worsening of the disease over time.
People with disabilities of group 3 receive cash benefits and have the right to engage in professional activities with some restrictions:
- strong vibrations and noise are contraindicated;
- You cannot work overtime, weekends or night shifts without the employee's consent;
- Constant physical or psycho-emotional stress is not allowed;
- prohibition of work at high altitude, in hot shops, near dangerous mechanisms;
- reducing the duration of work involving high concentration of attention;
- seven-hour day.
A special case is malignant arterial hypertension in stage 2. Its development is so rapid, and the patient's condition is severe, that the commission assigns him a 2 group of disability. This is no longer a task force. For 2nd and 3rd degrees of disability, a medico-social examination is carried out annually. People with disabilities of the following categories are exempt from re-examination:
- men over 60;
- women over 55;
- people with irreversible anatomical defects.
The definition of a disability group is due to the need for social protection of patients with hypertension. His ability to work is limited.
Treatment of stage 2 hypertension
At this stage of the disease, there is no way to do without medication. The tablets are taken regularly, preferably at the same time of the day. The patient should not think that in order to get rid of the disease, it will be enough just to take medicine. If he does this while indulging, for example, in fatty foods and alcohol, then the positive effect of the therapy will quickly disappear. The disease will progress to the next stage where any treatment is no longer effective.
Hypertension 3 degrees
Why are doctors concerned about deviations in blood pressure readings from the norm, even by one? The fact is that when the pressure increases by several units, the risk of developing cardiovascular complications increases by the same percentage. For example, if a person has mild hypertension and the blood pressure deviates from normal from 120 to 80 mm Hg. with 39 units, then there is a very high probability of the occurrence of pathological abnormalities in various organs (39%). What then can be said about the 3rd degree of the disease, in which the deviation is at least 60 units?
Stage 3 hypertension is a severe, chronic form of the disease. Blood pressure rises above 180/110 mm Hg, never falling to the normal 120/80. Pathological changes are now irreversible.
Symptoms of stage 3 hypertension
Symptoms of stage 3 hypertension include:
- impaired coordination of movements;
- permanent visual impairment;
- paresis and paralysis due to cerebral circulation disorders;
- prolonged hypertensive crises with speech disorders, blurred consciousness and acute pain in the heart;
- significantly limiting the ability to move independently, communicate and care for oneself.
In severe cases, patients with hypertension can no longer manage without external help, they require constant attention and care. The above signs of hypertension indicate that the patient's well-being gradually deteriorates, the disease spreads to new organs and systems, and there are more and more complications.
Complications of hypertension grade 3
Complications of hypertension of degree 3 include the following diseases:
- myocardial infarction - the middle muscle layer of the heart;
- cardiac asthma - attacks of suffocation;
- peripheral artery damage;
- hypertensive retinopathy affects the retina of the eyes;
- scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of arterial hypertension grade 3 are otherwise called associated clinical conditions. With impaired cerebral blood circulation, a stroke develops, accompanied by loss of sensitivity in the limbs and fainting. Heart failure is a whole complex of cardiac pathologies. The kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes mellitus, then nephropathy is inevitable.
The more advanced the disease, the more terrible and severe its consequences. The circulatory system is so important to the life of the body that the slightest deviation in its functioning has a powerful destructive effect.
Hypertensive disability 3rd degree
In severe cases of the disease, 1 group of disability is established. At this stage, patients are practically unable to work. Sometimes they are recognized as partially able to work and continue to work, but only at home or under special conditions.
But even with the most severe degree of disability, the patient must go through rehabilitation procedures. In this state of affairs it is necessary to prevent death.
Treatment of stage 3 hypertension
As the course of the disease worsens, more and more powerful drugs are prescribed or their list remains the same, but the dose increases. At this stage of hypertension, the effect of drug therapy is minimal. Chronic hypertensives are doomed to take pills for life.
When the disease becomes severe, surgery may be necessary. The operation is indicated for certain pathologies of the blood vessels and the heart. The method of stem cell treatment of arterial hypertension in stage 3 is considered innovative.
Hypertension 4 degrees
Some experts also identify the 4th stage of the disease, which is very severe. In most cases, death is near. They try to relieve the patient's suffering as much as possible and provide first aid in every hypertensive crisis. The patient is lying down, raising his head. He is urgently given drugs that sharply lower blood pressure.
Without treatment, new complications appear. Some of them provoke others and the diseases defeat a person more and more. To stop this destructive process in time, you just need to monitor the dynamics of changes in your blood pressure, at least with the help of a simple tonometer.
An example of risk calculation depending on the stage of hypertension
Stages of hypertension Other risk factors, POM or disease BP (mmHg)
| High normal | Grade 1 | Grade 2 | Grade 3 | ||
| GARDEN 130-139 DBP 85-89 |
GARDEN 140-159 DBP 90-99 |
GARDEN 160-179 DBP 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FRs | Little risk (risk 1) |
Low risk (risk 1) | Moderate risk (risk 2) |
High risk (risk 3) |
| 1-2 FR | Little risk (risk 1) |
Moderate risk (risk 1) |
moderately / high risk |
High risk (risk 3) |
|
| ≥3 FR | short / moderate risk (risk 1) |
moderately / high risk |
High risk (risk 3) |
High risk (risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without organ damage |
moderately / high risk |
High risk (risk 3) |
High risk (risk 3) |
high / very tall risk |
| Stage III | Established CVD, CKD stage ≥4 or diabetes with organ damage |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
GB - hypertension
SBP - systolic blood pressure
DBP - diastolic blood pressure
RF is a risk factor
CVD - cardiovascular diseases
CKD - chronic kidney disease
DM - diabetes mellitus
POM - target organ damage
Once the risk category is determined, the doctor can identify factors that can be influenced to reduce it. Among these modifiable characteristics:
- Obesity (with a BMI over 30), as well as central or visceral obesity, which is defined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, severe heart rhythm disorders such as atrial fibrillation, and others can also increase the risk.