A person is alive as long as his heart beats. The "pump" of the heart ensures blood circulation in the vessels. In this sense, there is blood pressure. Abbreviated as AD. Any deviation from normal blood pressure levels is fatal.
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Risks of developing hypertension
The risk of developing hypertension or hypertension (high blood pressure) is due to several factors. Consequently, the more there are, the greater the likelihood that a person will become hypertensive.
Risk factors for developing hypertension:
- hereditary predisposition. The risk of getting sick is greater for those who suffer from hypertension among first-degree relatives: father, mother, grandmothers, grandfathers, siblings. The more close relatives who suffer from high blood pressure, the greater the risk;
- age over 35 years;
- stress (stress hypertension) and mental stress. The stress hormone adrenaline increases heart rate. Instantly constricts blood vessels;
- taking certain medications, for example oral contraceptives and various dietary supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. The components of tobacco cause spasms of blood vessels - involuntary contractions of their walls. This narrows blood flow;
- atherosclerosis: blockage of blood vessels with plaques. Total cholesterol should not exceed 6. 5 mmol/l of blood;
- kidney failure (nephrogenic hypertension);
- endocrinopathy of the adrenal glands, thyroid gland or pituitary gland;
- excess salt in food. Table salt causes arterial spasms and retains fluid in the body;
- inactivity. Physical inactivity is accompanied by a slow metabolism (metabolism) and gradually weakens the body as a whole;
- excess body weight. Each extra kilogram increases blood pressure by 2 millimeters of mercury - mmHg;
- sudden change in weather;
- chronic lack of sleep and other "provocateurs".
Most risk factors for developing hypertension are closely related. Therefore, heavy smokers in most cases develop atherosclerotic plaques, and physically passive and malnourished people quickly gain weight. These 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 likelihood of cardiovascular complications in the next decade, there are 4 types of risk of developing high blood pressure:
- low (risk less than 15%);
- average (15 to 20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the appearance of high blood pressure are also divided into 2 types depending on the possibility of their elimination: correctable (correctable) and not. For example, a person can stop smoking, but they cannot change their ancestry. The amount of risk is summarized from a series of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will significantly increase the percentage of chances of developing complications.
Hypertension is quite treatable. Here much depends on the timely diagnosis of the disease, the patient's perseverance and his willingness to radically change his lifestyle.
1st degree hypertension
High blood pressure can be primary, that is. develop independently and secondarily, be a complication of another disease. In the latter case, treatment is carried out comprehensively, because it is necessary not only to normalize the pressure, but also to cure the concomitant cause of the disease.
A blood pressure reading of 120 by 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 (with maximum contraction of the walls of the heart muscle). And 80 is the lowest indicator or the so-called diastolic pressure (at its maximum relaxation). Accordingly, hypertension is divided into systolic, diastolic and mixed (systole-diastolic), depending on whether the upper or lower indicators exceed the threshold value.
When the lumen of blood flow narrows, the heart spends more effort pushing blood into the vessels, wears out faster and begins to work intermittently. An increase in heart rate (heart rate) negatively affects the functioning of the entire body. The 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, stage 1 high blood pressure is called a mild form of this disease. The upper blood pressure reading ranges from 140 to 159, and the lower is 90 to 99 mm Hg. Alterations in the functioning of the heart occur spasmodically. The attacks usually pass without consequences. This is a preclinical form of hypertension. Periods of exacerbations alternate with the complete disappearance of the symptoms of the disease. During remission, the patient's blood pressure is normal.
Diagnosing hypertension is simple: measuring blood pressure with a tonometer. For accurate diagnosis, the procedure is performed three times a day in a calm and relaxed environment.
Even people at low risk of developing hypertension need to monitor their blood pressure regularly. One potentially dangerous factor is enough to more closely monitor the work of your heart. For those who have a significant predisposition to heart disease, it is advisable to purchase a cardiovisor (a device for conducting 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 exercise;
- aching or stabbing pain in the left side of the chest, radiating to the shoulder blade and arm;
- Black spots before the eyes.
We must not forget that in mild forms of hypertension all these symptoms appear occasionally. If after intense physical activity your pulse accelerates or you have trouble falling asleep due to noisy neighbors, you should not panic and consider yourself hypertensive.
During periods of improvement, the patient feels great. Mild hypertension presents all the characteristic signs of heart failure. The most severe degrees of the disease differ only in the persistence of symptoms and the appearance of complications.
Complications of 1st degree hypertension.
Complications include:
- renal sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most believe that mild high blood pressure can be cured without consequences. But the risk of complications with grade 1 is medium, i. e. approximately 15%. High pressure in the vessels due to the narrowing of their lumen causes insufficient blood supply to the tissues. Lack of oxygen and nutrients causes the death of individual cells and entire organs. Necrosis begins with local focal lesions. Over time, if left untreated, an ischemic stroke is inevitable.
Circulatory disorders inevitably lead to metabolic disorders. This has a detrimental effect on respiration and nutrition of cells of any type. Pathological changes are inevitable, for example, sclerosis - replacement by connective tissue. In nephrosclerosis, the walls of the kidney become pathologically denser and the organ "shrinks". In this sense, the excretory function is disturbed and urea enters the bloodstream.
If blood vessels narrow, the heart works harder to push blood through them. This leads to pathological enlargement of the heart muscle. This hypertrophy is called true or working hypertrophy. The volume and mass of the left ventricle increase due to the thickening of its walls. This pathology is also called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows you to squeeze harder. It seemed, how could this be dangerous? A "swollen" heart can compress adjacent vessels, and uneven muscle growth can close the outlet of the left ventricle. Cardiac hypertrophy sometimes causes sudden death.
Complications of grade 1 hypertension occur very rarely. To avoid them, it is enough to minimize the risk of developing high blood pressure, that is, eliminate its prerequisites and causes.
Treatment of stage 1 hypertension
First of all, the doctor will advise the patient to change her lifestyle. The patient will be advised to have a restful sleep, avoid stress, perform specific relaxation exercises, a special diet, exercise, etc. If these measures are not sufficient, drug therapy is used.
The cardiologist prescribes the following medications: sedatives and other antihypertensive medications.
Medicines are selected strictly individually, becausemany hypertensive patients have concomitant diseases. The choice of drugs is influenced by the age of the patient and the medications used.
If it is possible to stop the disease at the initial stage and get rid of it completely, prevention cannot be neglected in the future. Its principle is simple: avoid all risk factors for hypertension. Thanks to a healthy lifestyle, it is possible to prevent the appearance of even hereditary pathologies.
Hypertension 2 degrees
This is hypertension in moderate form. The upper blood pressure is 160 to 179 mm Hg and the lower blood pressure is 100 to 109 mm Hg. At this stage of the disease, the periods of increased pressure are longer. Blood pressure rarely returns to normal.
Depending on the speed of transition of hypertension from one stage to another, benign and malignant arterial hypertension is distinguished. In the second, the disease progresses so rapidly that it is often fatal. Hypertension is dangerous because an increase in the speed of blood movement through the vessels causes thickening of their walls and even greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Typical signs of high blood pressure appear even in mild forms of the disease.
In 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 – the presence of albumin proteins in the urine;
- numbness and chills in the fingers;
- fundus pathologies;
- hypertensive crises: sudden increases in pressure (sometimes 59 units at a time);
- the appearance or worsening of signs of damage to target organs.
Fatigue, lethargy and swelling appear because the kidneys are involved in the pathological process. An attack of hypertension may be accompanied by vomiting, difficulty urinating and defecating, difficulty breathing, and tears. Sometimes it lasts several hours. Complications of a hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, overexcitation, hand tremors, unmotivated panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, inhibited consciousness);
The symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of arterial hypertension. The disease at this stage reluctantly recedes and often returns.
Complications of hypertension 2 degrees.
Complications of stage 2 hypertension include the following diseases: aortic aneurysm - a pathological bulge of its wall.
To target organs, that is. Internal organs affected due to hypertension include:
- Bleeding in various organs occurs because the walls of blood vessels become increasingly thickened, lose their elasticity and become brittle. Increased blood flow easily destroys these 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 break easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis (fatty deposits on the walls) and thrombosis (their blockage with a blood clot). Bleeding of brain cells causes lack of oxygen and death. This phenomenon is called encephalopathy. Ischemia is a lack of oxygen to the heart. Angina pectoris is constant pain in the chest.
In connection with it, pathological processes associated with the underlying disease develop. Consequently, if you do not start treatment in a timely manner or violate medical prohibitions, there will be more and more target organs and it will be almost impossible to restore health.
Disability due to 2nd degree hypertension.
Hypertensive patients are constantly monitored in the dispensary and periodically examined. In addition to daily blood pressure measurements, they are periodically prescribed an ECG. In some cases, ultrasound may be required: ultrasound examination of the heart, urine analysis, blood tests and other diagnostic procedures. Hypertensive patients with a moderate form of the disease are less productive than healthy people.
If there is persistent impairment of body functions caused by hypertension, the patient is sent to the office for examination and obtaining a medical and social examination report. In rare cases, hypertensive patients are examined at home, in a hospital, or even in absentia. Sometimes an additional examination program is drawn up. For disabled people, specialists from the Office of Medical and Social Expertise develop a mandatory individual rehabilitation program.
To determine the disability group, the expert commission, along with the degree of hypertension, takes into account the following factors:
- information from the medical history about hypertensive crises;
- Patient working conditions.
The procedure for establishing a disability group is necessary for suitable employment. Another question is whether it will be easy to find an employer willing to put up with the work of an "inferior" employee. If a job applicant presents documents confirming his disability, then, in accordance with federal legislation, he must be provided with the necessary working conditions.
Employers are reluctant to hire people with disabilities because. . . Working hours have been reduced for them while maintaining full salaries (for groups 1 and 2). In addition, they are forced to take sick leave more frequently than other employees and their annual leave has been increased. In this sense, the majority of disabled people in group 3 hide their illnesses to obtain a well-paid position. Violation of medical instructions on working conditions leads to a worsening of the disease over time.
Disabled people of group 3 receive cash benefits and can carry out professional activities with some restrictions:
- strong vibrations and noises are contraindicated;
- Overtime, weekend or night shifts cannot be worked without the employee's consent;
- Constant physical or psycho-emotional stress is not allowed;
- prohibition of working at high altitudes, in hot workshops, near dangerous mechanisms;
- reduce the duration of work that involves high concentration of attention;
- Seven-hour work day.
A special case is stage 2 malignant arterial hypertension. Its development is so rapid and the patient's condition is serious that the commission assigns group 2 disability. This is no longer a working group. For degrees 2 and 3 of disability, a medical and social examination is carried out annually. Disabled people of the following categories are exempt from reexamination:
- men over 60 years of age;
- women over 55 years of age;
- people with irreversible anatomical defects.
The assignment of a disability group is due to the need for social protection of hypertensive patients. Your ability to carry out work activities is limited.
Treatment of stage 2 hypertension
At this stage of the disease, it is not possible to do without medication. The tablets are taken regularly, if possible at the same time of day. The patient should not think that to get rid of the disease it will be enough to take medication. If you do this and at the same time indulge in, for example, fatty foods and alcohol, the positive effect of the therapy will quickly disappear. The disease will move to the next stage, in which any treatment will no longer be effective.
Hypertension 3 degrees
Why are doctors alarmed by deviations from the norm in blood pressure readings, 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 blood pressure deviates from normal by 120 to 80 mm Hg. in 39 units, then there is a very high probability of pathological abnormalities in various organs (39%). What can we say then about the third 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 drops to the normal level of 120/80. The pathological changes are already irreversible.
Symptoms of stage 3 hypertension
Symptoms of stage 3 hypertension include:
- impaired coordination of movements;
- persistent visual impairment;
- paresis and paralysis due to disorders of cerebral circulation;
- prolonged hypertensive crises with speech disturbances, clouded consciousness and acute pain in the heart;
- significant limitation of the ability to move independently, communicate and care for oneself.
In severe cases, hypertensive patients can no longer manage without outside help; They need constant attention and care. The above signs of hypertension show that the patient's well-being gradually deteriorates, the disease spreads to new organ systems, and more and more complications arise.
Complications of grade 3 hypertension.
Complications of grade 3 hypertension include the following diseases:
- myocardial infarction – the middle muscular layer of the heart;
- cardiac asthma: suffocation attacks;
- 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 grade 3 arterial hypertension are also called associated clinical conditions. When cerebral circulation is disturbed, a stroke develops, accompanied by loss of sensitivity in the extremities 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 is, the more terrible and serious its consequences are. The circulatory system is so important for the life of the body that the slightest deviation in its functioning has a powerful destructive effect.
Disability due to 3rd degree hypertension.
In severe cases of the disease, disability group 1 is established. At this stage, patients are practically unable to work. Sometimes they are recognized as partially capable of working and continue to work, but only at home or under special conditions.
But even with the most severe degree of disability, the patient must undergo rehabilitation procedures. In this situation, this is necessary to prevent death.
Stage 3 Hypertension Treatment
As the course of the disease worsens, more and more powerful medications are prescribed or their list remains the same, but the dosage increases. At this stage of hypertension, the effect of drug therapy is minimal. Chronic hypertensive patients are condemned to take pills for life.
When the disease becomes severe, surgery may be required. The operation is indicated for certain pathologies of the blood vessels and heart. The stem cell therapy method for stage 3 high blood pressure is considered innovative.
Hypertension 4 degrees
Some experts also identify stage 4 of the disease, which is very serious. In most cases, death is near. They try to alleviate the patient's suffering as much as possible and provide first aid in each hypertensive crisis. The patient lies down, raising his head. He is urgently given medications that drastically reduce his blood pressure.
Without treatment, new complications appear. Some provoke others and diseases increasingly overtake a person. To stop this destructive process in time, it is enough to monitor the dynamics of changes in blood pressure, at least using a regular tonometer.
Example of risk calculation according to the stage of hypertension.
Stages of hypertension Other risk factors, POM or disease BP (mmHg)
| high normality | Grade 1 | Grade 2 | 3rd grade | ||
| GARDEN 130-139 PAD 85-89 |
GARDEN 140-159 PAD 90-99 |
GARDEN 160-179 PAD 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FR | Low risk (risk 1) |
Low risk (risk 1) | Moderate risk (risk 2) |
High risk (risk 3) |
| 1-2 FR | Low risk (risk 1) |
Moderate risk (risk 1) |
Moderate / high risk |
High risk (risk 3) |
|
| ≥3 FR | Short / moderate risk (risk 1) |
Moderate / high risk |
High risk (risk 3) |
High risk (risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without organ damage |
Moderate / high risk |
High risk (risk 3) |
High risk (risk 3) |
High / very high 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 disease
CKD - chronic kidney disease
DM - diabetes mellitus
POM: target organ damage
Once the risk category is determined, the doctor can identify the factors that can influence reducing it. Among these modifiable features:
- Obesity (with a BMI greater than 30), as well as central or visceral obesity, which is determined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, severe heart rhythm disturbances such as atrial fibrillation, and others may also increase the risk.