Classification of hypertension

For several years, doctors have sounded the alarm: in developed countries that have overcome epidemics, arterial hypertension continues to occupy a leading 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 becoming younger.A couple of decades ago, a 35-year-old stroke patient was considered pointless.Recently, such a case will not surprise anyone.

According to the World Health Organization, about a quarter of the world's inhabitants suffer from arterial hypertension.Half of people over 65 have hypertension.

What kind of disease is this?

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

By itself, pressure on the walls of blood vessels is a necessary, normal 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 (may vary slightly from person to person) is 120/75 mmHg.Art.For those over forty – 130/80, for those over fifty – 135/84.If the pressure often rises to 140/90, doctors talk about hypertension.

Blood pressure is divided into two types:

1. Systolic.The first, high number indicates the force of blood pressure at the moment when the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lower number shows the blood pressure when the heart muscle (myocardium) relaxes.

Arterial hypertension (hypertension) is not without reason called the "silent killer": it can cause the appearance of various pathologies.The heart and brain are particularly affected.In advanced cases, it can even lead to heart attack and stroke.

Classification of hypertension

The dangers of hypertension are impressive, which is why scientists have been studying it since the beginning of the last century.During this time period, the classification changed more than once, but two directions were formed:

1. When creating classifications according to the stages of the development of the disease, doctors thought about the relationship between hypertension and risk factors for the development of hypertension.However, they never reached full agreement - the debate is still ongoing.
2. Identification of disease variants.The approach delves into the causes of hypertension, its stages and mechanisms of development.

The article will discuss some of the classifications proposed by scientists.

From external signs

This is how a German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when the pressure increases, the redness of the face and body is visible due to the expansion of the capillaries.Red spots often appear.In the second case, a person suffering from the disease experiences a vascular spasm with an increase in pressure, becomes cold and pale.

From the origin

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

The specific reasons for the appearance and development of the primary have not yet been found.There are three degrees.

Arterial hypertension of the first degree is called "mild".Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure "jumps", sometimes rises, then returns to normal.First-degree hypertension has a borderline subgroup with indicators of 140-149 and 90-94 mm Hg.Art.The possibility of seizures (sudden sharp jumps) is small, if they occur, it is rare.

But for grade 2 (moderate) hypertension, the risk is greater.The tonometer shows 160–179 and 100–109 mmHg.Art.Hypertension of the second degree is characterized by the fact that the pressure increases continuously.

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

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

1. systolic.The pressure is more 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 creeps up to 140 mmHg.Art.and higher, while "low" remains normal.Then 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 - in 25%).This type of disease is caused by a disease of a certain organ.Most often, such symptomatic hypertension occurs due to kidney problems.The division into endocrine, neurogenic, renal and hemodynamic forms was proposed by the professor.Doctors still use it today.

Stages of hypertension

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

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

In some classifications you can find the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist marks the 4th degree of the disease, he means digital pressure indicators, and not the patient's condition, since hypertension is in stage 3. It is also considered severe.

With chronically high blood pressure, the body can't handle the stress and bad things start happening to the organs.Those that are affected earlier than others are called target organs by doctors.Along with the heart and brain, these include the retina and kidneys.The classification of hypertension in stages is based precisely on the impact on these weak points.

In the beginning, 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.Initial patients with hypertension ignore health problems in vain, because at this stage the disease is easier to mitigate.Sometimes treatment for stage 1 hypertension depends more on lifestyle changes than medication.But it is necessary.Therefore, when the tonometer periodically shows high 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 "thick".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 stage 2. seizures occur much more often.But the disease is still curable.If the doctor diagnoses "stage 2 hypertension", his recommendations should be followed especially carefully.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all target organs become known with a host of complications.Pressure increases in hypertension, stage 3. can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is observed when the patient already has bleeding in the bottom, heart attack, aneurysm, stroke and other diseases.

Signs of blood pressure problems

Identifying hypertension at the right time and understanding how long a person has it is the number one problem.Many patients with hypertension learn about the 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, a sedentary lifestyle and old age.

Alarm bells ring if you see:

• occasional headaches;
• the pain "threatens" in the back of the head or knocks in the temples;
• you often feel nauseous and dizzy;
• blinding flickering in the eyes or flying "black flies";
• everything is annoying or covered in apathy;
• tingling or numb fingers;
• swelling of the arms, legs and/or face;
• a rapid heartbeat appears out of the blue.

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

Diagnosis of arterial hypertension

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

The first, the simplest is the measurement of blood pressure.

The second is a complete physical examination.It can only be performed by a specialist.He performs palpation and auscultation (analysis of the sounds that accompany the work of various organs), percussion (tapping different 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 the blood pressure using a special device - a tonometer.By the way, in people who have an easily excitable nervous system, blood pressure numbers can increase even with minor emotional disturbances.When visiting a doctor, such patients experience the "white marrow" syndrome: as soon as the doctor starts measuring blood pressure, it rises.But the reason for these fluctuations is stress and not the disease at all.Although such a reaction to a shock in the long term can provoke interruptions in the normal functioning of the heart and kidneys.In such impressionable patients, the health care provider will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight and body mass index is collected.The specialist requires evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient - nowhere.It is necessary to find out what diseases a person has encountered before and if he has any diseases 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 had hypertension.
• Physical examination.First, the doctor will listen to the heart using a stethoscope.The task is to identify noises, changes in tones or the presence of extraneous sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about its condition against the background of hypertension.
• Biochemical blood test.It is necessary to detect the level of sugar, cholesterol and lipoproteins and to understand how prone a person is to atherosclerosis.
• EKG.An electrocardiogram is an integral element of the diagnostic process.It helps to see irregularities in the 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 for arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see a picture of the changes and defects of the heart, evaluate the function and condition of the valves.
• X-ray examination. Doctors do arteriography and aortography.With their help, specialists study the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.During the diagnosis of arterial hypertension, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while it helps to determine the intensity of blood flow through arteries and veins.
• Ultrasound of the thyroid gland.In addition to 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 become clear whether the thyroid gland plays any role in the development of the disease and what treatment should be prescribed.
• Kidney ultrasound.These organs and their vessels are very sensitive to hypertension.The study helps to assess their condition.

Treatment methods

Today there are many methods for treating hypertension.Some came to us from antiquity;pharmacists and scientists worked to create others for years and years.

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

1. Calcium antagonists are aimed at reducing heart rate.
2. Diuretics, most commonly thiazide diuretics, work to improve urine production and waste.
3. Adrenergic drugs.
4. Vasodilators widen 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 the appearance of signs after the intervention, the entire length of the vein is affected.It is performed under local anesthesia.

A variety of methods derived from the past are classified as alternative medicine.This includes foot soaks, vinegar lotions and much more.

Non-traditional remedies based on sedge, valerian, beetroot, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal decoctions for the treatment of arterial hypertension.Here's an example:

Take 1 tbsp.l.motherwort, sedge root and cumin.Mix it up.Pour a tablespoon of this mixture into a glass of boiling water and leave 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 that aims to help with hypertension and homeopathic remedies.However, it is best to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if not treated.You should monitor your health at any age, because the modern rhythm of life often contributes to the development of the disease.And regardless of the stage and degree of hypertension, without treatment it can lead to fatal consequences.