Classification of hypertension.

For several years now, doctors have been sounding the alarm: in developed countries that have overcome epidemics, high blood pressure continues to consistently occupy a prominent place among the causes of mortality 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 couple of decades ago, a 35-year-old stroke patient was considered foolish.Ultimately, a case like this won't surprise anyone.

According to the World Health Organization, approximately a quarter of the world's inhabitants suffer from high blood pressure.Half of people over 65 years of age are hypertensive.

What kind of disease is this?

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

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

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

Blood pressure is divided into two types:

1. Systolic.The first number, the upper one, indicates the intensity of blood pressure at the moment when the heart contracts and expels blood from the arteries.
2. Diastolic.The second, lower number shows the blood pressure when the heart muscle (myocardium) relaxes.

High blood pressure (hypertension) is not in vain called the "silent killer": it can provoke the appearance of various pathologies.The heart and brain are especially affected.In advanced cases, it can even cause a heart attack and stroke.

Classification of hypertension.

The risks of hypertension are impressive, which is why scientists have been studying it since the beginning of the last century.During this period of time, the ranking 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 connection between hypertension and risk factors for the development of hypertension.However, they never reached a full agreement: the debate still continues.
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.Observing 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 noticeable due to the dilation of the capillaries.Red spots often appear.In the second case, a person suffering from the disease experiences vascular spasm with increased pressure, becomes cold and pale.

By origin

Doctors conventionally identified the degrees of hypertension: primary hypertension (hypertension) and secondary (symptomatic) hypertension.

The specific reasons for the emergence and development of the primary have not yet been found.It has three degrees.

First degree arterial hypertension is called "mild."Pressure: 140–159 and 90–99 mm Hg.Art.Blood pressure “jumps,” sometimes increases, and then returns to normal.First degree hypertension has a borderline subgroup with indicators of 140 to 149 and 90 to 94 mm Hg.Art.The probability of seizures (sudden and sudden jumps) is small;If they occur, it is rare.

But for grade 2 (moderate) hypertension the risk is higher.The tonometer shows 160–179 and 100–109 mmHg.Art.Second degree hypertension is characterized by the fact that the pressure constantly increases.

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

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

1. systolic.The pressure is greater than 140 and less than 90 mmHg.Art.;
2. subgroup: limit: 140-149 and less than 90 mmHg.Art.In this case, the "upper" pressure rises to 140 mmHg.Art.and upper, while the “lower” remains normal.So 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 years of age, in 25%).This type of disease is caused by a disease of a specific organ.Most often, this symptomatic hypertension appears due to kidney problems.The professor proposed the division into endocrine, neurogenic, renal and hemodynamic forms.Doctors still use it today.

Stages of hypertension

In the recent past, experts divided high blood pressure into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects pathologies that appear in the body over the years.

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

In some classifications the fourth degree of hypertension can be found.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist notes the fourth degree of the disease, he refers to the digital pressure indicators, and not to the patient's condition, since stage 3 hypertension is also considered serious.

With chronic high blood pressure, the body cannot handle the stress and bad things start to happen to the organs.Doctors call target organs those that are affected before others.Along with the heart and brain, these include the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weak points.

At first, 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 it does not particularly interfere with their lives.Hypertensive crises are the exception and not the rule.Beginning hypertensive patients ignore health problems in vain, because at this stage the disease is easier to control.Sometimes, treatment for stage 1 hypertension comes down to changing your lifestyle more than taking medications.But it is necessary.Therefore, when the tonometer periodically shows elevated 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 persistent high blood pressure.The heart is the first to give up: 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 in stage 2. Attacks occur much more frequently.But the disease is still treatable.If the doctor diagnoses "Stage 2 Hypertension", his recommendations should be followed with special attention.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all the target organs become known with a lot of complications.Sudden pressure increases in hypertension, stage 3. can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is observed when the patient already has hemorrhages in the fundus, heart attack, aneurysms, stroke and other ailments.

Signs of blood pressure problems

Identifying hypertension early and understanding how long a person has had it is the number one problem.Many hypertensive patients learn of their diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, excess weight, smoking, frequent stress, high cholesterol levels, sedentary lifestyle and old age.

The alarm sounds if you see:

• occasional headache;
• "threats" of pain in the back of the neck or blows to the temples;
• you often feel nauseous and dizzy;
• glare flickers in the eyes or “black flies” fly;
• everything is annoying or covered in apathy;
• tingling or numb fingers;
• swelling of arms, legs and/or face;
• A rapid heartbeat appears out of nowhere.

If recognized, you should at least systematically measure your blood pressure.But of course it is better to go to the hospital.

Diagnosis of high blood pressure.

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

The first and simplest is to measure blood pressure.

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

In the third case, an 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 who have an easily excitable nervous system, blood pressure figures can increase even with minor emotional disorders.When visiting the doctor, these patients experience "white coat" syndrome: as soon as the doctor starts measuring blood pressure, it increases.But the reason for these fluctuations is stress and not illness at all.Although such a reaction to long-term shock can lead to 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 is collected about the patient's height, weight, and body mass index.The specialist looks for evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient, nowhere.It is necessary to know what diseases a person has encountered before and whether he has any ailments at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; it is determined if there is diabetes), if the parents were hypertensive.
• Physical examination.First, the doctor will listen to your heart with a stethoscope.The task is to identify noises, changes in tone or the presence of strange sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about your condition against the background of hypertension.
• Biochemical blood test.It is necessary to know the level of sugar, cholesterol and lipoproteins, and understand how prone a person is to atherosclerosis.
• ECG.An electrocardiogram is an integral element of the diagnostic process.Helps see irregularities in heart rhythm.Having the results in hand, we can judge the presence of hypertrophy of the wall of the left side of the heart, typical of high blood pressure.
• Heart ultrasound.With its help, the doctor can see a picture of heart changes and defects, evaluate the function and condition of the valves.
• X-ray examination. Doctors perform arteriography and aortography.With its help, specialists study the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing high blood pressure, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, at the same time it helps determine the intensity of blood flow through the arteries and veins.
• Ultrasound of the thyroid gland.Along with 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 be 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 study helps evaluate your condition.

Treatment methods

Today there are many methods to treat hypertension.Some came to us from ancient times;Pharmacists and scientists worked on creating others for years and years.

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

1. Calcium antagonists aim to reduce heart rate.
2. Diuretics, most commonly thiazide diuretics, act to improve urine production and waste.
3. Adrenergic drugs.
4. Vasodilators dilate the blood vessels and thus level 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.To prevent scars from appearing after the intervention, the entire length of the vein is affected.Performed under local anesthesia.

A variety of methods that come from the past are classified as alternative medicine.This includes leg parkas, vinegar lotions and much more.

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

There are many herbal decoctions for the treatment of high blood pressure.Here is an example:

Take 1 tablespoon.l.motherwort, valerian root and caraway.Mix.Pour a tablespoon of this mixture into a glass of boiling water and let it sit for an hour.Drink the medicine three times a day, 1/3 cup.The course is designed for one month.

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

High blood pressure is a dangerous disease if it is not treated.It is necessary to monitor your health at any age, because the modern pace of life often contributes to the development of the disease.And whatever the stage and degree of hypertension, without treatment it can have fatal consequences.