Hypertension or arterial hypertension - a condition characterized by stable, that is, detected by multiple measurements, increased blood pressure. By accompanying many diseases, it is considered a risk factor for the development of dangerous complications from the cardiovascular system, including myocardial stroke and heart attack. Hypertension, as the main cause of the pathology in question, requires medication to be taken, to normalize the patient's lifestyle and nutrition.
Blood pressure is a force by which the circulating blood acts on the walls of the blood vessels. Such pressure at the time of contraction of the heart is called systolic and during its relaxation - diastolic. The range of normal values for these indicators is quite wide.
In the course of many observations, scientists have come to the conclusion that the risk of cardiovascular complications increases with any additional increase in blood pressure by 10 mm Hg. Art. It already starts with a level of 115/75 mm RT. Art. However, a pressure reduction of only over 140/90 mm has proved to be appropriate. RT. Art. , Therefore, it is precisely such a value that is considered a criterion for determining arterial hypertension.
Reasons
In approximately 90% of cases, hypertension causes a steady increase in blood pressure. A similar diagnosis is made to the patient when no other diseases were found during the study, accompanied by hypertension. Among the latter:
- Pathologies of the kidneys - pyelonephritis, glomerulonephritis, polycystic, diabetic nephropathy, stenosis of the renal arteries;
- Endocrine disorders-non-strokes of the adrenal gland, pancreas or pituitary gland, thyroid hyperfunction, syndrome of undercuts, pheochromocytoma;
- Obstructive Apnea Syndrome;
- Valve vices or atherosclerotic aortic damage.
Regular use of a number of medicines can also lead to an increase in blood pressure. These include oral contraceptives, non -steroidal anti -inflammatory drugs, amphetamines, corticosteroids, drugs containing erythropoietin, cyclosporine, cocaine.
The likelihood of cardiovascular disease, including hypertension, is closely related to the following risk factors:
- Improper nutrition, including excess sodium salt, saturated fats and trans fats, lack of leafy greenery, vegetables and fruits in the diet;
- obesity;
- Pathologies of the heart and blood vessels in close relatives;
- age older than 65 years;
- A sedentary lifestyle;
- chronic stress;
- Harvest habits - smoking, excessive alcohol consumption.
Classification
If it is possible to identify the disease, which leads to an increase in blood pressure, arterial hypertension is called secondary or symptomatic. In the case of an unidentified cause of hypertension, it is considered primary caused by hypertension.
The latter has an electricity to place:
- Stage I. There are no obvious signs of disorders of the work of the target organs affected by a stable increase in heart, kidneys, arterial and venous vessels.
- Stage II. There is one of the listed signs or their totality, such as an increase in the left ventricle of the heart, a pronounced decrease in the rate of filtration in the kidneys, albumin in the urine, increase in the thickness of the walls of the carotid arteries, or the appearance of atherosclerotic fruits. In this case, the clinical manifestations of the disease may be absent.
- Stage III hypertension. There are one or more pathologies associated with atherosclerotic processes in the heart and vessels - myocardial infarction, acute cerebrovascular incident, angina pig, atherosclerosis of the lower limb artery or serious damage to the fat.
Arterial hypertension is divided into several degrees, depending on the maximum indicators of the measured blood pressure:
- The first degree. Systolic blood pressure from 140 to 159 mm. RT. Art. And/or diastolic - from 90 to 99 mm. RT. Art.
- The second degree. Systolic blood pressure from 160 to 179 mm. RT. Art. And/or diastolic - from 100 to 109 mm. RT. Art.
- The third degree. Systolic blood pressure is more than 180 mm. RT. Art. and/or diastolic over 110 mm. RT. Art.
There is also an isolated form of arterial hypertension, in which only the figures of systolic pressure in normal diastole.
Symptoms
Often, an increase in blood pressure is not accompanied by a worsening of well -being and may go unnoticed for the patient, so it is so important to regularly measure blood pressure, especially average and elderly.
The following symptoms may be the manifestations of hypertension:
- Headache, mainly in the morning after waking up;
- Nosebleeds;
- hemorrhage under the mucous membrane of the eye;
- heart rate disorder;
- blurred vision, flies flutter;
- Tinite.
The sharp jump in blood pressure to a large number, accompanied by a pronounced deterioration in the well, is called a hypertensive crisis. Most often it happens with an increase in systolic pressure above 180 mm Hg. Art. and/or diastolic above 120 mm Hg. Art. At the same time, the patient has weakness, nausea, vomiting that does not bring relief, impaired consciousness, anxiety and fear, muscle shaking, chest pain.
Complications
A stable increase in blood pressure with hypertension significantly increases the risk of cardiovascular pathologies, including the patient's life. These include:
- Acute cerebral circulation (stroke);
- Angina pectoris, myocardial infarction;
- vascular dementia (dementia);
- chronic renal and heart failure;
- Atherosclerotic lesions of the vessels of the lower limbs.
Diagnostics
The main symptom of hypertension is a steady increase in blood pressure, revealing at least three dimensions in different days during a calm environment. In the first measurement of blood pressure in a hospital or clinic for the correctness of the results, it is important to follow the following rules:
- Before examining, the patient should sit for a few minutes in a quiet room to calm down;
- The size of the Tonometer cuff must correspond to the thickness of the arm and the device itself - to be attached to the level of the heart;
- Two measurements are made at an interval of 1-2 minutes of each hand, with a large difference in the resulting numbers, additional measurement is carried out;
- In adult patients, as well as people suffering from diabetes mellitus, or in case of suspicion of reducing blood pressure in the event of a change in body position, the measurement is carried out in the first and fifth minute in a permanent position;
- In addition, the heart rate is measured within 30 seconds.
In an interview with the patient, it clarifies at what age the pressure first began to increase if there are symptoms such as snoring with breathing in the dream, attacks of muscle weakness, or sudden palpitations with sweating and headache and unusual urine impurities. It is also important to find out what medicines and biodites are taking.
Within the first stage of the study, the following hypertension tests are carried out:
- Clinical blood test;
- General urine analysis, detection of microalbumin in its disposable and daily parts;
- Biochemical blood test (cholesterol, lipoproteins to assess the risk of atherosclerosis, electrolytes in the blood - potassium, sodium, chlorine, calcium, as well as glucose and creatinine);
- Determining the level of glycated hemoglobin;
- Determination of the concentration of hormones -citizin, triiodothyronine and thyroid hormone, antibodies to the thyroid gland -polyoxidase and thyroidoglobulin, aldosterone.
In the case of suspicion of hereditary predisposition to the disease, it is possible to determine the polymorphisms of genes related to the development of arterial hypertension.
In order to clarify the risk factors for the development and identification of existing cardiovascular pathologies for hypertension, instrumental diagnostic methods are used:
- Daily monitoring of blood pressure;
- electrocardiographic examination;
- echocardiography;
- Daily Daily Monitoring;
- duplex scanning of brachiocephalus, renal or iliac arteries;
- Ultrasound examination of the kidneys and adrenal glands;
- Checking the bottom of the eyes.
With hypertension, blood pressure control at home is important for maintaining a diary in which it is necessary to determine all the results of time measurements by taking episodes of drugs and stress that can cause an increase in blood pressure. At the same time, the measurements should be taken in a sitting position, after a few minutes of rest, holding the hand at the same level with the heart.
Treatment
With a moderate and low risk of cardiovascular complications, the patient is recommended only for lifestyle change, diet correction, weight loss, increase in physical activity and special gymnastics for hypertension, rejection of bad blood pressure background. Often these measures are sufficient to normalize blood pressure.
The hypertension diet includes restriction of table salt, caffeine, sharp, salty, smoked and spicy dishes, high fat products, offal, butter cream and alcoholic beverages. It is permissible to use no more than 5 g of salt a day beyond the exacerbation of the disease. The recommended daily fluid speed is 1-1, 2 liters.
In the case of unsuccessful treatment without RDRUG for several months, as well as with a high risk of complications, they resort to hypotensive therapy using medicines for hypertension, the purpose of which is to reduce blood pressure below 140/90 mm. RT. Art. For patients with diabetes or persons who already suffer from pathologies of the cardiovascular system, the level of target pressure is even lower-130/80 mm. RT. Art.
Modern drug treatment for hypertension involves a combination of two or more medicines from the following groups:
- calcium antagonists;
- Angiotensin -producing enzyme inhibitors;
- angiotensin II blockers;
- diuretics (diuretics);
- B-blockers;
- Alpha-blockers.
The greater part of them are produced in the form of hypertension tablets.
Prevention
Prevention of exacerbation of hypertension involves timely diagnosis and therapy for diseases of the cardiovascular, nervous, urinary and endocrine systems, ruthlessly, followed by the doctor's recommendations, including treatment and treatment of the Union, as well as regular measurement of blood pressure.