What is hypertension? This is a disease characterized by blood pressure readings above 140 mm Hg. Art. in this case, the patient suffers from headaches, dizziness and nausea. Eliminate all the symptoms that have arisen can only be a specially selected therapy.
Arterial hypertension can be an independent disease or it accompanies various pathologies, being its symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.
In hypertensive patients, the indicators often return to normal only after taking special medications, and pressure increases 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 pressure is a feasible task.
Do not self-medicate. At the first sign of illness, consult a doctor.
Causes
To this day, the exact causes of essential arterial hypertension are unknown. There are the following risk factors:
- inheritance;
- malnutrition;
- bad habits;
- violation of fat metabolism;
- nephropathy;
- diabetes;
- stress;
- inactive lifestyle.
Classification of diseases
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 considering the varieties of the disease. There is the following classification of arterial hypertension:
- Pulmonary essential arterial hypertension - It is considered one of the varieties of arterial hypertension, rare, but which represents a great danger to human life. It is very difficult to identify this ailment by symptoms, and even more difficult to treat. Pulmonary arterial hypertension is formed due to an increase in pulmonary vascular resistance and, as a result, insufficient blood flow.
- Evil one. The symptoms of such arterial hypertension are presented in the form of an increase in blood pressure up to 220/130. there is a radical change in the fundus of the eye and inflammation of the disc of the optic nerve. If the diagnosis was made in time, then it is possible to cure this type of high blood pressure.
- 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 formations in the kidneys. The pathogenesis of the disease is reduced to the formation of a characteristic pressure, which can be represented by normal systolic and elevated diastolic blood pressure.
- Labile arterial hypertension. For this type of disease, periodic normalization of pressure is characteristic. Patients suffering from this form of arterial hypertension are not called patients, since this condition is not a pathology. In some cases, after a period of time, the blood pressure returns to normal.
Symptomatic arterial hypertension and its types.
Secondary hypertension is a pathological process that is associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:
- Hemodynamic - associated with violations 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, insufficiency of the aortic valve.
- neurogenic. This type of symptomatic arterial 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 arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, a rapid and often malignant course. Nephrogenic hypertension is divided into two types: renovascular and parenchymal.
- Medicinal. This form of symptomatic arterial hypertension is associated with the use of drugs that increase blood pressure.
Symptoms
Before there are complications of arterial hypertension, it passes 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 an unusual ringing in the ears.
Target organ damage
These types of high blood pressure symptoms occur first 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, flashes of black dots before his eyes, difficulty speaking. Such symptoms disturb a person at a late stage of the disease. In addition, complications such as cerebral infarction and hemorrhage 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 reaction aimed at normalizing the wall tension. As a result, increased afterload, heart failure. When the heart is damaged, there are not the most favorable forecasts, because such changes in its work are the causes of heart failure, sudden death, and the development of ventricular rhythm disorders. The characteristic symptoms are:
- pulmonary edema;
- shortness of breath at the time of physical activity;
- cardiac asthma.
In some cases, arterial hypertension in children and adults provokes pain in the region of the heart of a certain nature. They can visit a person in a state of rest or emotional overexertion without physical activity. The main manifestation of the presented chest pains is the impossibility of eliminating them with the help of nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath at an early stage of the disease after the application of small loads or at rest. All this indicates characteristic changes in the heart muscle and the formation of heart failure. With such a disease, people have swelling of the lower extremities, the cause of which is the retention of sodium ions and water in the body.
If the injury has affected the kidneys, when passing a urine test, a protein is found in it, and microhematuria and cylindruria are also noted. Very rarely, the pathogenesis of the disease involves the appearance of renal failure.
eye damage
Rarely, this high blood pressure in children and adults affects vision, resulting in decreased sensitivity to light and blindness. If there is visual impairment against the background of high blood pressure, patients have black dots before the eyes, fog or veil. The reasons for such changes are the 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 high blood pressure. She worries the patient at any time of the day or night. It can be explosive in nature and focus on the back of the head, then spread throughout the entire head area. Increased headaches in arterial 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 arterial hypertension, an improvement in the outflow of blood in the veins occurs, and this leads to a decrease in pain until its complete disappearance.
There are cases when headaches against the background of the presented disease are the result of tension of the soft muscles of the head or tendons. The formation of such a pain syndrome occurs after psycho-emotional or physical overexertion. As a rule, such pain is of a squeezing or squeezing nature. A patient suffering from high blood pressure has a feeling of nausea, dizziness. In the presence of prolonged pain, incessant pain is characteristic, irritability occurs in patients, sensitivity to sharp sounds increases, they become short-tempered.
disease stages
For the correct establishment of 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 arterial hypertension, blood pressure indicators return to normal. Due to the fixation of the disease, the pressure inevitably increases. Very often, people do not complain about the formation of any disorders related to their health. But for an easy stage, its own symptoms are characteristic:
- Headaches;
- noise in the ears;
- bad dream;
- mental decline;
- dizziness;
- nosebleed.
As a rule, there are no manifestations of left ventricular hypertrophy, the ECG does not show abnormalities, renal function does not show pathological changes, the background does not change.
Means, medium
This stage is characterized by the presence of a higher and more stable blood pressure level. It can reach 180-105 mm Hg. Art. patients often experience headaches, dizziness, pain in the region of the heart, they have angina pectoris.
This stage is characterized by typical hypertensive crises. The pathogenesis of the disease involves the following signs of damage to target organs:
- left hypertrophy;
- weakening of tone I at the apex of the heart;
- accent II tone on the aorta;
- in some patients, ECG symptoms of subendocardial ischemia.
As for the central nervous system, there are various manifestations of vascular insufficiency, cerebral cerebrovascular accidents, transient cerebral ischemia. For the bottom, in addition to reducing the arterioles, there is compression of the veins, their increase, hemorrhages, exudates occur. The blood flow in the kidneys and the glomerular filtration rate for this stage are reduced. But it is impossible to detect these manifestations in urinalysis.
heavy
This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and stable increase in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of the largest vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In a severe stage, the disease affects the following organs:
- heart: angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
- brain: ischemic and hemorrhagic infarctions are formed, encephalopathy;
- eye fundus;
- kidneys: low blood flow and glomerular filtration.
Risk factor's
Currently, the severity of the described disease directly depends on the risk factors. The risk lies in the formation of cardiovascular complications against the background of high blood pressure. Taking into account the complications presented, the prognosis of the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and its prognosis:
- age: in men after 50 years, in women after 60 years;
- of smoking;
- high cholesterol;
- hereditary factor;
- obesity;
- hypodynamia;
- diabetes.
The risk factors presented can be eliminated (correctable) and may not be correctable. The first type of risk factors is characterized by the presence of diabetes mellitus, high cholesterol, smoking, sedentary lifestyle. Uncorrected risk factors include race, family history, and age.
Taking into account the degree of arterial hypertension and the factors contributing to the disease, a prognosis is observed with the formation of such complications as a heart attack or stroke for the next 10 years.
With a mild degree of arterial hypertension and the absence of risk factors, the formation of complications from the cardiovascular system is minimized for the next 10 years. With non-pharmacological therapy for a year and a review of your lifestyle, it is possible to eliminate this degree of the pathological process. If the pressure readings are greater than 140/90 mm Hg. Art. , then drug treatment is prescribed.
The average degree of risk is accompanied by the formation of complications against the background of arterial hypertension for 10 years in the ratio of 20%. Arterial hypertension of the second degree is treated in the same way as the first degree, but here too the control of dynamics for six months is adjusted. If there are poor results of blood pressure and its stable maintenance, drug treatment is carried out.
High-grade risk factors are accompanied by the formation of complications within 30%. In this situation, a patient suffering from arterial hypertension is prescribed a comprehensive diagnosis in combination with non-drug treatment.
With very high risk, the patient is prescribed an urgent differential diagnosis of arterial hypertension and taking medication.
Diagnostic methods
Only after a thorough study can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of high blood pressure is based on the following types of tests:
- ECG, glucose analysis and complete blood count;
- Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general urinalysis are carried out in order to exclude the renal nature of the formation of the disease;
- Ultrasonography of the adrenal glands is recommended if pheochromocytoma is suspected;
- hormone analysis, ultrasound of the thyroid gland;
- MRI of the brain;
- Consult with a neurologist and an ophthalmologist.
effective therapy
Treatment of high blood pressure should be carried out under the constant supervision of a doctor. It is he who is obliged to make an accurate diagnosis, to carry out additional diagnostics, which include checking:
- bottom;
- kidney function;
- the work of the heart.
After that, the specialist can prescribe antihypertensive treatment, determine various complications. As a rule, patients in whom the syndrome of arterial hypertension was detected for the first time are hospitalized to carry out all the necessary studies and the choice of treatment.
Non-pharmacological treatment
Such therapy is recommended for all patients, regardless of the degree of disease from the use of drugs. Such treatment for hypertension includes:
- Give up smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
- Elimination of extra kilos. A common cause of high blood pressure is excess weight, so diet plays an important role in this matter. In addition, a balanced and adequate diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
- Reducing the amount of salt intake. According to ongoing studies, a reduced amount of salt consumed at 4. 5 g/day helps reduce systolic blood pressure by 4-6 mm Hg. Art.
- Insignificant consumption of strong drinks.
- Specially designed diet. Your diet should include vegetables, fruits, foods rich in magnesium, potassium, potassium, fish, shellfish. In addition, the diet involves a limited intake of animal fats.
- Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very helpful. When performing isometric loads, it can lead to an increase in blood pressure.
Medical treatment
Drug therapy should be prescribed taking into account the following recommendations:
- Treatment begins with small doses of medication.
- In the absence of a therapeutic effect, it is necessary to replace the use of one drug with another. The interval between grades should be less than 4 weeks, as long as a rapid drop in blood pressure is not required.
- The use of long-acting drugs to obtain a 24-hour effect with a single dose.
- Application of the optimal combination of devices.
- The therapy must be permanent. It is not allowed to use the drug in the courses.
- Effective control of blood pressure throughout the year contributes to a gradual reduction in the dose and amount of medication.
Preventive actions
The prevention of arterial hypertension includes the following recommendations:
- If family members have this disease, and you are over 30 years old, then you need to measure your pressure regularly.
- Quit smoking and alcohol.
- A low-fat, low-salt diet should be followed.
- Exercise outdoors.
- Avoid various stressful situations.
- Maintain normal body weight.
With arterial hypertension, a person may well lead a normal and full life, but subject to all the described recommendations. Control of blood pressure 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 a timely manner in order to avoid various serious complications.