Hypertension 1, 2, 3 and 4 degrees

Man is alive as long as his heart beats. The "pump" of the heart ensures blood circulation in the vessels. In this regard, there is such a thing as 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 arterial hypertension - high blood pressure - consists of a number of factors. Therefore, the more there is, the greater the likelihood that a person will become hypertensive.

Risk factors for the development of hypertension:

  • hereditary predisposition. The risk of getting sick is higher for those who have hypertension in first-degree relatives: father, mother, grandmothers, grandfathers, brothers and sisters. The more relatives suffer from high blood pressure, the greater the risk;
  • age over 35 years;
  • stress (stress hypertension) and mental stress. The stress hormone adrenaline increases your heart rate. It immediately narrows the 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 provoke spasms of blood vessels - involuntary contractions of their walls. This narrows blood circulation;
  • atherosclerosis - blockage of blood vessels with plaques. Total cholesterol should not exceed 6. 5 mmol/l blood;
  • kidney failure (nephrogenic hypertension);
  • endocrinopathy of the adrenal glands, thyroid gland or pituitary gland;
  • excessive salt in food. Table salt provokes arterial spasms and retains fluids in the body;
  • passivity. Physical inactivity is associated with a slow metabolism - metabolism - and gradually weakens the body as a whole;
  • excess body weight. Each additional kilogram increases blood pressure by 2 millimeters of mercury - mmHg;
  • sudden change of weather;
  • chronic lack of sleep and other "provocateurs".

Most of the risk factors for the development of hypertension are closely related. Thus, heavy smokers in most cases develop atherosclerotic plaques, and physically inactive and malnourished people quickly gain excess weight. Such 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 arterial hypertension:

  • low (risk less than 15%);
  • medium (from 15 to 20%);
  • high (more than 20%);
  • very high (more than 30%).

Risk factors for the occurrence of arterial hypertension are also divided into 2 types based on the possibility of their elimination: correctable (correctable) and not. For example, a person can quit smoking, but he is unable to change his background. The amount of risk is summarized by a number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will significantly increase the chance of developing complications.

Hypertension is quite treatable. A lot here depends on the timely diagnosis of the disease, the patient's persistence and his willingness to radically change his lifestyle.

Grade 1 hypertension

first degree hypertension

Arterial hypertension can be primary, d. m. th. develops independently, and secondary - to be a complication of another disease. In the latter case, the treatment is carried out comprehensively, because it is necessary not only to normalize the pressure, but also to cure the accompanying disease-the cause.

A blood pressure reading of 120 per 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 (at maximum contraction of the heart muscle walls). And 80 is the lowest indicator or the so-called diastolic pressure (at their maximum relaxation). Therefore, hypertension is divided into systolic, diastolic and mixed (systolic-diastolic), depending on whether the upper or lower indicators exceed the threshold value.

When the lumen of blood flow is narrowed, the heart spends more effort to push blood into the blood vessels, it wears out faster and begins to work intermittently. An increase in heart rate - heart rate - negatively affects the functioning of the whole body. 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 symptoms of hypertension is preceded by a prehypertensive state - prehypertension.

The degree of severity depends on the stage of development of the disease:

  • "mild" or light;
  • moderate or borderline;
  • very severe or isolated systolic.

Otherwise, stage 1 arterial hypertension is called a mild form of this disease. The upper blood pressure reading ranges from 140 to 159, and the lower one is 90 – 99 mm Hg. Disorders in the functioning of the heart occur spasmodically. 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.

The diagnosis of hypertension is simple: measuring blood pressure using a tonometer. For an accurate diagnosis, the procedure is performed three times a day in a calm environment and in a relaxed state.

Even people at low risk of developing hypertension should have their blood pressure checked regularly. A potentially dangerous factor is enough to monitor the work of your heart more closely. For those who are predisposed to heart disease to a significant extent, it is advisable to buy a cardiovisor - a device for taking an EKG - 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 improves 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 from time to time. If after an intense physical activity your pulse quickens or it is difficult to fall asleep because of the noise of the neighbors, do not panic and consider yourself hypertensive.

During periods of improvement, the patient feels well. Mild hypertension has all the characteristic signs of heart failure. The most severe degrees of the disease differ only in the continuation of symptoms and the appearance of complications.

Complications of grade 1 hypertension

Complications include:

  • kidney sclerosis - nephrosclerosis;
  • hypertrophy of the heart muscle (left ventricle).

Most believe that mild arterial hypertension can be cured without consequences. But the risk of complications with degree 1 is average, d. m. th. about 15%. High pressure in the vessels due to the narrowing of their lumen leads to insufficient blood supply to the tissues. Lack of oxygen and nutrients leads to the death of individual cells and whole organs. Necrosis begins with local, focal lesions. Over time, if left untreated, an ischemic stroke is inevitable.

Blood circulation disorders inevitably lead to metabolic disorders. This has a detrimental effect on the respiration and nutrition of cells of any kind. Pathological changes are inevitable, for example, sclerosis - replacement by connective tissue. With nephrosclerosis, the kidney walls become pathologically denser and the organ "shrinks". In this regard, the excretory function is disrupted and urea enters the bloodstream.

If the blood vessels narrow, the heart has to work harder to push blood through them. This leads to the pathological expansion of the heart muscle. This hypertrophy is called true or functional. The volume and mass of the left ventricle increases due to the thickening of its walls. This pathology is otherwise called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows it to squeeze harder. It would seem, how can this be dangerous? A "bloated" heart can compress adjacent vessels, and uneven muscle growths can block the left ventricular outflow. Hypertrophy of the heart sometimes leads to sudden death.

Complications from grade 1 hypertension occur extremely rarely. To avoid them, it is enough to minimize the risk of developing arterial hypertension, d. m. th. eliminate its preconditions and causes.

Treatment of stage 1 hypertension

First, the doctor will advise the patient to change his lifestyle. The patient will be advised to have restful sleep, avoid stress, targeted 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 chosen strictly individually, because many patients with hypertension have concomitant diseases. The choice of drugs is influenced by the age of the patient and the medications he uses.

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 - it is to avoid all risk factors for hypertension. Thanks to a healthy lifestyle, you can also prevent the appearance of hereditary pathologies.

Hypertension 2 degrees

hypertension of the second degree

This is hypertension in moderate form. Upper blood pressure is 160 - 179 mm Hg, and lower blood pressure is 100 - 109 mm Hg. At this stage of the disease, 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 are 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 leads to thickening of their walls and an even greater narrowing of the lumen.

Symptoms of stage 2 hypertension

Typical signs of arterial hypertension appear even in mild forms of the disease.

In the second stage, they are accompanied by the following symptoms:

  • 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 tingling of the fingers;
  • fundus pathologies;
  • Hypertensive crises - sudden increases in pressure (sometimes with 59 units at once);
  • the appearance or worsening of signs of target organ damage.

Fatigue, lethargy and swelling appear because the kidneys are involved in the pathological process. A hypertensive attack can be accompanied by vomiting, difficulty urinating and bowel movements, shortness of breath and tears. Sometimes it takes several hours. Complications of a hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.

Forms of hypertensive crisis:

  • neurovegetative (increased heart rate, overexcitement, hand tremors, unmotivated panic, dry mouth);
  • edematous (lethargy, swelling of the eyelids, impaired consciousness);

Symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of high blood pressure. The disease at this stage recedes reluctantly and often returns.

Complications of hypertension 2 degrees

Complications of stage 2 hypertension include the following diseases: aortic aneurysm - a pathological extension of its wall.

To target organs, d. m. th. Internal organs affected by hypertension include:

  • Hemorrhages in various organs occur because the walls of blood vessels thicken more and more, lose their elasticity and become fragile. Increased blood flow easily destroys such vessels. The opposite 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 tear easily.
  • A pathologically narrow lumen increases the possibility of developing atherosclerosis - fat deposits in the walls - and thrombosis - their blockage with a blood clot. Bleeding of brain cells leads to oxygen starvation and their death. This phenomenon is called encephalopathy. Ischemia is starving the heart of oxygen. Angina pectoris is constant chest pain.

Pathological processes related to the underlying disease develop in connection with it. Therefore, if you do not start treatment in time or violate medical prohibitions, there will be more and more target organs and it will become almost impossible to restore health.

Disability from hypertension of the second degree

disability due to hypertension

Patients with hypertension are constantly monitored in the ambulance and periodically examined. In addition to daily blood pressure measurements, they are regularly prescribed an EKG. In some cases, ultrasound may be required - ultrasound examination of the heart, urine tests, blood tests and other diagnostic procedures. Hypertensive patients with a moderate form of the disease are less productive than healthy people.

If there is a persistent impairment of body functions caused by hypertension, the patient is sent to the examination office to receive a medical and social examination report. In rare cases, patients with hypertension are controlled at home, in the hospital or even absent. Sometimes an additional exam program is drawn up. For persons with disabilities, the specialists of the Bureau of Medical and Social Expertise develop a mandatory individual rehabilitation program.

To determine the disability group, the expert committee, along with the degree of hypertension, takes into account the following factors:

  • information from the medical history about hypertensive crises;
  • working conditions of the patient.

The procedure for creating a disability group is necessary for proper employment. Whether it will be easy to find an employer willing to put up with the work of an "inferior" employee is another question. If an applicant for employment 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 for them have been reduced while maintaining full wages (for groups 1 and 2). In addition, they are forced to go on sick leave more often than other employees and their annual leave has been increased. In this regard, most people with disabilities of group 3 hide their illnesses in order to get a well-paid position. Violation of medical instructions regarding working conditions leads to an aggravation of the disease over time.

Disabled people of group 3 receive cash benefits and are allowed to engage in professional activities with certain restrictions:

  • vibrations and loud noises are contraindicated;
  • You cannot work overtime, weekends or night shifts without the consent of the employee;
  • Continuous physical or psycho-emotional stress is not allowed;
  • prohibition of work at high altitudes, in hot shops, near dangerous mechanisms;
  • reducing the duration of work that involves high concentration of attention;
  • seven hour work day.

A special case is malignant arterial hypertension of stage 2. Its development is so rapid and the patient's condition is severe that the commission assigns him a disability of group 2. This is no longer a working group. For degrees 2 and 3 of disability, a medical and social examination is carried out every year. Persons with disabilities of the following categories are excluded from re-examination:

  • men over 60 years old;
  • women over 55;
  • persons with irreversible anatomical defects.

The assignment of a disability group is caused by the need for social protection of patients with hypertension. His ability to engage in work activity is limited.

Treatment of stage 2 hypertension

At this stage of the disease, there is no way to do without medication. 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 just to take medications. If he does this while being cheated at the same time, for example, by fatty foods and alcohol, then the positive effect of the therapy will quickly disappear. The disease will move to the next stage, in which any treatment is no longer effective.

Hypertension 3 degrees

hypertension of the third degree

Why are doctors alarmed by deviations in blood pressure measurements from the norm, 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 the blood pressure deviates from the normal 120 to 80 mm Hg. with 39 units, then there is a very high probability of the occurrence of pathological abnormalities in various organs (39%). What then can be said 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 falls to the normal 120/80. Pathological changes are now irreversible.

Symptoms of stage 3 hypertension

Symptoms of stage 3 hypertension include:

  • impaired coordination of movements;
  • permanent visual impairment;
  • paresis and paralysis due to cerebral circulation disorders;
  • prolonged hypertensive crises with speech disorders, blurred consciousness and sharp pain in the heart;
  • significant limitation of the ability to move independently, communicate and take care of oneself.

In severe cases, patients with hypertension can no longer cope without external help; they require constant attention and care. The above signs of hypertension indicate that the patient's well-being is gradually deteriorating, the disease is spreading to new organ systems and there are more and more complications.

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;
  • damage to peripheral arteries;
  • 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 otherwise called associated clinical conditions. When the cerebral circulation is damaged, a stroke develops, accompanied by loss of sensation in the limbs and fainting. Heart failure is a whole complex of heart 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, the more terrible and severe its consequences. The circulatory system is so important to the life of the body that the slightest deviation in its functioning has a powerful destructive effect.

Disability from hypertension of the third degree

In severe cases of illness, disability group 1 is created. At this stage, patients are practically unable to work. Sometimes they are recognized as partially able to work 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 condition, this is necessary to prevent death.

Treatment of stage 3 hypertension

As the course of the disease worsens, more and more powerful drugs are prescribed or their list remains the same, but the dose increases. At this stage of hypertension, the effect of drug therapy is minimal. Patients with chronic hypertension are condemned to take pills for life.

When the disease becomes severe, surgery may be required. The operation is indicated for some blood vessel and heart pathologies. The method of stem cell therapy for stage 3 arterial hypertension is considered innovative.

Hypertension 4 degrees

Some experts also identify stage 4 of the disease, which is very severe. In most cases, death is imminent. They try to ease the patient's suffering as much as possible and provide first aid with every hypertensive crisis. The patient is lying down, raising his head. He is urgently given medication that significantly lowers his blood pressure.

Without treatment, new complications appear. Some of them provoke others, and diseases increasingly defeat a person. To stop this destructive process in time, you just need to monitor the dynamics of changes in your blood pressure, at least using a regular tonometer.

Example of risk calculation depending on the stage of hypertension

Stages of hypertension Other risk factors, POM or disease BP (mmHg)

High normal Level 1 Level 2 Level 3
GARDEN 130-139
DBP 85-89
GARDEN 140-159
DBP 90-99
GARDEN 160-179
DBP 100-109
SBP ≥180
DBP ≥ 110
Phase I No other FRs The risk is reduced
(risk 1)
Low risk (risk 1) Moderate risk
(risk 2)
High risk
(risk 3)
1-2 FR The risk is reduced
(risk 1)
Moderate risk
(risk 1)
moderate /
High risk
High risk
(hazard 3)
≥3 FR Short /
moderate risk
(risk 1)
moderate /
High risk
High risk
(risk 3)
High risk
(risk 3)
Phase II POM, CKD stage 3 or DM without
organ damage
moderate /
High risk
High risk
(risk 3)
High risk
(risk 3)
high /
very tall
Phase 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 factors that can be influenced to reduce it. Among these modifiable features:

  • Obesity (with BMI over 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 disorders such as atrial fibrillation, and others may also increase the risk.