What is hypertension? It is a disease characterized by blood pressure readings above 140 mm Hg. Art. in this case the patient is visited by headache, dizziness and nausea. Elimination of all the symptoms that have appeared can only be specially selected therapy.
Hypertension can be an independent disease or accompany various pathologies, being their symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.
In patients with hypertension, the indicators often return to normal only after receiving special medication, and increases in blood pressure 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 your blood pressure is a feasible task.
Do not self-medicate. At the first sign of illness, consult a doctor.
Causes
To date, the exact reasons why essential hypertension can occur are not known. There are the following risk factors:
- inheritance;
- malnutrition;
- bad habits;
- violation of fat metabolism;
- kidney disease;
- diabetes;
- stress;
- inactive lifestyle.
Classification of the disease
During a diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause increased pressure. The pathogenesis also differs depending on the varieties of the disease. There is the following classification of hypertension:
- Essential pulmonary hypertension - is considered one of the varieties of hypertension, rare, but which poses a great risk to human life. It is very difficult to identify this disease by symptoms, even more difficult to treat. Pulmonary arterial hypertension is formed due to increased pulmonary vascular resistance and, as a result, insufficient blood flow.
- Malinje. Symptoms of such hypertension appear in the form of increased blood pressure up to 220/130. there is a radical change in the fundus and swelling of the optic nerve disc. If the diagnosis is made in time, then it is possible to cure this type of hypertension.
- Renovated arterial hypertension. The reasons for the formation of this type of disease are the presence of pathologies such as vasculitis, vascular atherosclerosis and malignant formations in the kidneys. The pathogenesis of the disease is reduced to the formation of characteristic pressure, which may be represented in normal systolic and elevated diastolic blood pressure.
- Unstable arterial hypertension. Periodic normalization of blood pressure is characteristic of this type of disease. Patients suffering from this form of hypertension are not called patients, as this condition is not a pathology. In some cases, over a period of time, blood pressure returns to normal.
Symptomatic hypertension and its types
Secondary hypertension is a pathological process 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 hypertension occurs due to sclerosis of the walls of the aortic chamber, aortic coarctation, aortic valve insufficiency.
- Neurogenic. This type of symptomatic hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
- Endocrinopathy. This form of symptomatic hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
- Nephrogenic hypertension. This type of symptomatic hypertension appears for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic hypertension is associated with a sudden, rapid, and often malignant course. Nephrogenic hypertension is divided into two types: renovascular and parenchymal.
- Medical. This form of symptomatic hypertension is associated with the use of drugs that increase blood pressure.
Symptoms
Before there are complications of hypertension, it proceeds 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 uncharacteristic tinnitus.
Damage to the target organ
Such symptoms of hypertension first appear 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 blackheads in front of the eyes, difficulty in speaking. Such symptoms bother a person in a late stage of the disease. In addition, complications such as cerebral infarction and hemorrhage may occur.
Infrakt
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, the subsequent increase in load, heart failure. When the heart is damaged, there are no more favorable prognoses, because such changes in its work are causes of heart failure, sudden death and the development of ventricular rhythm disorders. Characteristic symptoms are:
- pulmonary edema;
- difficulty breathing at the time of physical activity;
- cardiac asthma.
In some cases, hypertension in children and adults causes pain in the heart region of a certain nature. They can visit a person in a state of rest or emotional stress without performing physical activity. The main manifestation of chest pains is the inability to eliminate 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 shows 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 lesion has affected the kidneys, then when it passes a urine test, a protein is found in it and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the appearance of kidney failure.
Eye damage
Not so often, this hypertension 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, then patients have blackheads in front of the eyes, fog or veil. The reasons for such changes are violations of blood circulation in the retina. Complications can appear as diplopia, visual impairment or complete loss of vision.
Headache
This symptom is considered the most common in hypertension. It bothers the patient at any time of the day or night. It can explode in nature and focus on the back of the head and then spread throughout the head area. Increased headache in hypertension occurs when coughing, tilting the head. This can be accompanied by swelling of the eyelids and face. During the massage in this case, in patients suffering from hypertension, an improvement of blood flow in the veins is observed and this leads to the reduction of pain until its complete disappearance.
There are cases when headaches in the background of the presented disease are the result of straining of the smooth muscles of the head or tendons themselves. The formation of such a pain syndrome occurs after a psycho-emotional or physical overload. As a rule, such pain has a tightening or tightening nature. A patient suffering from hypertension has a mixed feeling, dizziness. In the presence of prolonged pain, incessant pain is characteristic, nervousness appears in patients, sensitivity to sharp sounds increases, they become rapid.
Stages of the disease
For the correct placement 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.
easily
This phase 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 hypertension, blood pressure readings return to normal. Due to the fixation of the disease, the pressure inevitably increases. Too often, people do not complain about the formation of any disorder related to their health. But for a mild stage, its own symptoms are characteristic:
- headache;
- tinnitus;
- poor sleep;
- mental decline;
- dizziness;
- nosebleeds.
As a rule, there are no manifestations of left ventricular hypertrophy, ECG has no abnormalities, renal function without pathological changes, the fundus does not change.
Medium
This stage is characterized by the presence of a higher and more stable level of blood pressure. It can reach 180-105 mm Hg. Art. patients often experience headaches, dizziness, pain in the heart region, which have angina pectoris.
This stage is characterized by the typical hypertensive crisis. The pathogenesis of the disease includes the following signs of target organ damage:
- left hypertrophy;
- weakening of tone I at the apex of the heart;
- accent tone II in the aorta;
- in some patients, ECG symptoms of subendocardial ischemia.
Regarding the central nervous system, various manifestations of vascular insufficiency, strokes, transient cerebral ischemia are observed. For the fundus, in addition to the reduction of arterioles, there is compression of the veins, their enlargement, hemorrhages occur, exudates. Kidney blood flow and glomerular filtration rate for this stage are reduced. But it is impossible to detect these manifestations in urine analysis.
heavy
This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and sustained increase in blood pressure, as well as by the progression of arteriosclerosis and atherosclerosis of larger 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 infarcts are formed, encephalopathy;
- ocular fundus;
- kidneys - low blood flow and glomerular filtration.
Risk factors
Currently, the severity of the disease described depends directly on the facts of the risk. The risk lies in the formation of cardiovascular complications against the background of high blood pressure. Considering the presented complications, the prognosis of the consequences of 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;
- smoking;
- high cholesterol;
- hereditary factor;
- obesity;
- hypodynamics;
- 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, physical inactivity. Unadjusted risk factors include race, family history and age.
Considering the degree of hypertension and the contributing factors of the disease, a prognosis is observed with the formation of complications such as heart attack or stroke for the next 10 years.
With a mild degree of hypertension and lack of risk factors, the formation of complications of the cardiovascular system is minimized for the next 10 years. With non-drug therapy for a year and a review of your lifestyle, it is possible to eliminate this degree of pathological process. If pressure readings are greater than 140/90 mm Hg. Art. , then drug treatment is prescribed.
The average degree of risk is associated with the formation of complications on the background of hypertension for 10 years in a ratio of 20%. Second-degree arterial hypertension is treated in the same way as first-degree, but here the dynamics control for six months is also regulated. If there are poor results of blood pressure and its maintenance is stable, then drug treatment is performed.
High-risk factors are associated with the formation of complications within 30%. In this situation, a patient suffering from hypertension is prescribed a complete diagnosis in combination with non-drug treatment.
At a very high risk, the patient is prescribed an urgent differential diagnosis of hypertension and medication.
Diagnostic methods
Only after a thorough study can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of hypertension is based on the following types of examination:
- ECG, glucose analysis and complete blood count;
- Kidney ultrasound, determination of the level of urea, creatinine in the blood, general analysis of urine - are performed to exclude the renal nature of the formation of the disease;
- It is advisable to perform an ultrasound of the adrenal glands if pheochromocytoma is suspected;
- hormone tests, thyroid gland ultrasound;
- MRI of the brain;
- Consultation with a neurologist and an ophthalmologist.
Effective therapy
Treatment of hypertension should be carried out under the constant supervision of a physician. It is he who is obliged to make an accurate diagnosis, to perform additional diagnosis, which includes control:
- fundus;
- kidney function;
- the work of the heart.
After that, the specialist may prescribe antihypertensive treatment, determine various complications. As a rule, patients who were first diagnosed with hypertension syndrome are hospitalized to perform all necessary studies and choose treatment.
Non-drug treatment
Such therapy is recommended for all patients, regardless of the degree of disease drug use. Such treatment for hypertension includes:
- To quit smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
- Eliminate excess pounds. A common cause of high blood pressure is excess weight, so diet plays an important role in this matter. In addition, a balanced and proper diet has a beneficial effect on risk factors like diabetes mellitus, myocardial hypertrophy.
- Reduced amount of salt intake. According to ongoing studies, a reduced amount of salt consumed at 4. 5 g / day helps lower systolic blood pressure by 4-6 mm Hg. Art.
- Insignificant consumption of strong drinks.
- Specially created diet. Your diet should include vegetables, fruits, foods rich in magnesium, potassium, potassium, fish, seafood. In addition, the diet includes a limited intake of animal fats.
- An active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very helpful. When performing isometric loads, you may provoke 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 degrees should be less than 4 weeks, provided that a rapid reduction in blood pressure is not required.
- Use of long-acting drugs to get a 24-hour effect with a single dose.
- Implement the optimal combination of equipment.
- Therapy should be permanent. The use of drugs in courses is not allowed.
- Effective year-round blood pressure control contributes to a gradual reduction in the dose and amount of medication.
Preventive actions
Prevention of hypertension includes the following recommendations:
- If family members have this disease and you are over 30 years old, then you should measure your blood pressure regularly.
- Quit smoking and alcohol.
- A diet low in fat and salt should be followed.
- Exercise outside.
- Avoid various stressful situations.
- Maintain a normal body weight.
With hypertension, a person can live a full normal life, but subject to all the recommendations described. Blood pressure control in this case is one of the key components of successful treatment of the disease. Therefore, try not to start the disease and visit the doctor at the right time to avoid various serious complications.