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Arterial hypertension

Arterial hypertension is a pathological condition characterized by a long increase in pressure indicators in the arteries of a large circle of blood circulation.A sign of the disease is the increase in diagnostic blood pressure (lower), but in most cases diagnosed, patients have persistent systolic pressure growth (superior).

What pressure is considered increasing

The classification of the blood pressure accepted in 1999 is still valid to this day.The following are considered normal:

  • Optimal: Less than 120/80 mm Hg.Art.;
  • Physiological Standard: Less than 130/85 mm Hg.Art.;
  • Normal increase - in range 130–139/85–89 mm Hg.Art.

An increase in pressure indicates hypertension formation.The internal gradation of the pathology is seen as follows:

  1. Soft (I grade) - 140–159/90–99 mm Hg.Art.
  2. Moderate (II second grade) - 160–179/100–109 mm Hg.Art.
  3. Heavy (III grade) - More than 180/110.

Border guns are diagnosed in case of indicators in 140-149/90 mm Hg.Art.And below.It is accompanied by episodes of pressure growth and its spontaneous stabilization.

Isolated systolic hypertension is diagnosed with 140 and higher / 90 indicators and below mm Hg.Art.This type of pathology is characterized by an increase in the systolic indicator at the physiological level of diastolic.

AG classification (primary, secondary)

The classification of hypertension is based on several signs.When systematizing, doctors took into account:

  • reasons causing the development of pathology;
  • defeated by the objective organs;
  • The current level of blood pressure, etc.

Depending on etiological factors, it is customary to distinguish:

  1. Primary (essential).
  2. Secondary hypertension (symptomatic).

Due to the nature of the passage, benign arterial hypertension (slowly) and malignant (with rapid deterioration of the condition) is distinguished.

Varieties of secondary hypertension (symptomatic)

Secondary (symptomatic) arterial hypertension is a type of disease that develops due to damage to the organs responsible for the regulation of blood pressure.It is characterized by a stubborn course, the absence of a positive reaction to the hypotensive therapy carried out, as well as the changes in the objective organs, in particular, the formation of cardiac, renal insufficiency, etc.

If primary hypertension (essential format) occurs as an independent disease, then secondary forms are always a symptom of the main pathology.Arterial hypertension syndrome accompanies a fairly significant number of diseases.It is diagnosed in 10 % of all identified cases of persistent increase in blood pressure.

The classification of symptomatic hypertension is based on factors that cause the disease.

Distinguish:

  1. Neurogenic hypertension.Development is due to the lesion of the central nervous system and related pathologies, for example, cerebral neoplasia.
  2. Nephrogenic (renal origin).They are divided into interstitial, renewal, renovascular, mixed and rhinopias forms.
  3. ENDOCRINE AG.There are adrenal, thyroid, pituitary and menopause formats.
  4. Hemodynamic: caused by heart pathologies and large arterial channels.
  5. Dosing shape.Its development is due to the use of oral contraceptives, glucocorticosteroid agents, etc.

The size and resistance of the increase in blood pressure, the severity of changes in the state of the left ventricle and the background underlies another classification.Doctors distinguish the following varieties of symptomatic hypertension:

  1. Transient.For pathology, a typically short -term increase in pressure indicators.Changes in the state of the background are completely absent.Hypertrophy of the left ventricle is almost not fixed.
  2. LabyIt is characterized by a moderate and short increase in blood pressure (there is no independent decrease).There is a weak left ventricular hypertrophy, narrowing of the vessels of the eye retina.
  3. Stable.It is accompanied by constantly high blood pressure.Myocardial thickening is diagnosed, serious violations in the bottom vessels.
  4. Malignant (not controlled).It is accompanied by a strong increase in blood pressure.The result is unfavorable.

The following forms of symptomatic hypertension are found:

  • Pulmonary hypertension (hypertension of a small circle of blood circulation).It is established as a diagnosis when determining blood pressure in the pulmonary artery for 25 mm.Rt. Art.
  • Vasorsenal Ah is a secondary form of pathology due to insufficient blood circulation in the kidneys as a result of deteriorated arterial performance.
  • Portal hypertension is one of the varieties in the symptomatic form of the disease, accompanied by an increase in pressure inside the door vein.
  • VIRSUNGOV duct hypertension.It develops in the context of chronic inflammation of the pancreas.

Consequences and complications

With a long -lasting hypertension, the vessels of the target organs are damaged: heart, brain, kidneys and eyes.The violation of the circulatory process can lead to consequences such as:

  • Angina pectoral attacks,
  • myocardial infarction,
  • Neurological complications, etc.

Important!The formation of acute states at the bottom of a strong increase in blood pressure requires its reduction in the first minutes/hours.

Reasons

Doctors do not know the reasons for the development of the essential form of pathology.Several theories are nominated:

  1. Neurogenic (inheritance).The cause of development is chronic stress, significant emotional shocks and psychological injuries.All this causes a failure in the neural regulation process, accompanied by an increase in sympathetic system activity.The result is the divergence of the signals to all organs and an increase in the tone of the walls of the vessels.
  2. Voluminous saltDue to the deteriorated processes of excess fluid output and certain trace elements.As a result of the excessive content of sodium salts, there is an increase in the total volume of blood.The attempts of the body to maintain the hemostasis process at the physiological level lead to small vessel spasm.The indicators of the thorough volume of the heart stabilize, but the total blood pressure rises.

Important!Doctors argue that the reason for the development of AH is an increase in the activity of the sympathetic system.

The modified risk factors (variables) capable of causing the appearance of arterial hypertension are:

  • Age: The diagnosis of the disease occurs in people in the elderly category;
  • Bad habits: smoking, alcohol intake;
  • a state of chronic stress;
  • insufficient physical activity;
  • overweight;
  • The presence of concomitant pathologies: diabetes is especially unfavorable;
  • Excess salt with lack of potassium.

The reasons for increasing blood pressure can be different.The active work of the adrenal glands, as well as a trend at the genetic level, can act as a provocative factor.

Symptoms

In the initial formation stage, arterial hypertension is asymptomatic.The patient will learn about the presence of a problem only after the development of serious complications.

The only sign of pathology can be called an increase in pressure indicators.There is no complaints at all, or are not specific:

  • headaches located in the forehead and the back of the head;
  • dizziness;
  • noise.

The first complaints are formed at the bottom of the defeat of the objective organs.At this stage, the appearance of the following symptoms is observed:

  • Dizziness, accompanied by headaches, noise arises as a logical result of circulatory disorders;
  • initial problems with information memorization;
  • Hands/legs numb;
  • weakness;
  • Duplication of the visible image;
  • Flashing black points in the field of vision;
  • speech violation (rarely);
  • Nephropathy

The symptoms are typical for the final stages.At the beginning of the formation of pathology, they come.

With damage to the heart, the left ventricle (LV) begins to hypertrophic.The cause of change is the compensatory reaction of the body, which allows stabilizing increased loads in its wall.An increase in ventricle is due to an increase in the number of cardiomiocytes.As the condition worsens, the heart cameras are dilated.

Such damage to the organ can manifest in the form:

  • The formation of heart failure,
  • a sudden cardiac arrest,
  • ischemic disease,
  • Gastric rhythm disorders,
  • asthma of the heart,
  • Strong shortage of breathing during loads.

Important!Cardi pain in the AG context is developed during the absolute rest period or as a result of emotional surge.A characteristic feature is the inability to stop the attack with a glycerol pill.

If the kidneys are damaged, the presence of protein in the urine can be observed.The appearance of blood impurities is not excluded.The probability of renal failure is minimal.

Urine analysis for arterial hypertension

The main clinical sign of arterial hypertension is headache.It appears at any time of the day, but most of the time in the morning.The patient feels it as exploded or pain.The place of location is the back of the head, but the spread to other areas of the head is not excluded.The pain is improved with the inclination and during the cough.It can occur as an answer to stressful situations, physical tension.

Diagnosis

The diagnosis of the disease is designed to solve the following problems:

  • Establishment of pathology, determination of the current degree;
  • identification of the origin of hypertension (primary/secondary form);
  • Perform differential diagnosis;
  • Determination of the presence/absence of damage to the objective organs.

During a personal conversation with the patient, the doctor discovers the necessary points:

  1. They have cases of disease in the immediate environment.
  2. How often the pressure is fixed.
  3. Is there a history of chronic diseases in the patient, etc.

The body mass index (BMI) is calculated.Obesity is one of the potential provocatives of hypertension formation.

After completing the inspection, blood pressure is measured.To determine the degree of arterial hypertension, the patient is prescribed by the performance of the blood pressure profile, that is, to measure patients on their own home.It is necessary to take 4 measures: two in the morning and two at night, for several days in a row.

The results should be included in the table.If the indicators exceed 140/90 mm Hg.Art., We can talk about the presence of arterial hypertension.

Sometimes a brush is prescribed (daily blood pressure monitoring).The technique is shown if patient measurements remain normal, but other symptoms of the disease occur.

Important!SMAD are multiple measurements of blood pressure indicators for a full day.The measurements are made by a special device.

To establish the true cause of the development of arterial hypertension and determine the force of damage to the target organs, they are prescribed:

  • Renal system exam.It includes the study of urine: a general test.Realmontal ultrasound of the renal system is prescribed, with the introduction of a radioactive isotope.
  • Heart test.ECG is used (the electrocardiogram shows the growth of the road R), echocardiography (it allows you to see signs of a pathological increase in the left ventricle and other transformations).
  • Ophthalmological examination of the eye.A sign of the disease is the visual impregnation of the blood vessels, sealed.Hemorrhages are not excluded.
  • Ultrasound of the thyroid gland and adrenal glands.
  • The blood test is a general test and an enlarged biochemistry.

When diagnosing the secondary form of hypertension, it is necessary to make differential diagnoses (DIF).She passes in two stages:

  • Analysis of the clinical image, raising complaints, a physical examination of the patient in particular, auscultation, instrumental/laboratory studies;
  • Diagnostic measures that allow it to evaluate the functional status of the organs and existing changes, in particular, it is necessary to eliminate the cardiogram.

The methods considered help to confirm the diagnosis, determine the origin of the disease and choose adequate therapy for the State.

Treatment

Hypertension treatment begins with a lifestyle review and therapy that is not funds.The exception is secondary hypertension.

Pharmacological therapy of arterial hypertension provides the intake of the following drug groups:

  1. DiureticsDrugs have a positive effect on the state of the cardiovascular system.The reception is not accompanied by the development of side effects.The disease therapy begins with diuretics (contraindication - diabetes and gout).At the bottom of the treatment, the volume of urine eliminated by the kidneys and, consequently, excess water and sodium salts increases.Diuretics are prescribed in combination with another hypertension.
  2. ALFA BLOCATORS.Medications are distinguished by good tolerance.They do not affect the level of blood sugars.Provide a decrease in blood pressure with a slight increase in the pulse (heart muscle contraction frequency).The appearance of orthostatic hypotension at the beginning of treatment with medications in this group becomes a side effect.To exclude its development, it is advisable to take medications before bedtime.
  3. Beta blockers.Reduce heart rate, which is accompanied by a decrease in blood pressure.
  4. AS inhibitor.Modern drugs are distinguished by a high therapeutic effect and good tolerance.In the context of taking funds in the patient's body, the form of angiotensin II does not occur: a hormone that causes a narrowing of the light of the blood vessels.Thanks to this, peripheral vessels expand, the heart works in a quieter rhythm.There is a decrease in blood pressure indicators.
  5. Angiotensin-II antagonists.Medications are also blocking angiotensin II.They are designated if it is impossible to receive ACE inhibitors.
  6. Calcium antagonists.The medications expand the gaps of the blood vessels, thus avoiding the development of stroke.Drugs have an excellent therapeutic effect and are well tolerated.Have a small contraindications list.Most of the time prescribed as part of complex therapy.

Stop treatment even after blood pressure stabilization is strictly prohibited.In this case, the disease will begin to progress again, which will negatively affect the status of the objective organs.In addition, the risk of developing heart attack and stroke increases significantly.

The treatment of the disease is carried out in an outpatient basis: the patient independently takes the selected medications.Hospitalization in the hospital is only recommended in severe cases.

The treatment of pathology, in addition to taking medications, provides massage.Procedures contribute not only to reduce pressure, but also to the general strengthening of the body, improve the activity of the cardiovascular system, etc.Read more about various types of massages in our article: High pressure massage: classic, point and other effective methods.

Nutrition

Compliance with the principles of dietary nutrition is one of the important stages to stabilize blood pressure indicators.With hypertension, diet No. 10 is recommended.

In the initial stage of pathology formation (AH 1 grade), it is necessary to adhere to diet No. 5. Provides a restriction in the use of the salt of the table.With a deterioration in the state and the development of violations in the work of the heart and the vascular system, the transition to diet No. 5 is recommended.

If the disease is complicated by atherosclerosis, diet No. 10 C. The Hippocolesterol diet is prescribed to reduce fats consumed of animal origin, easily digestible carbohydrates.The diet should include foods with a high content of dietary fibers, vegetable fats and proteins.

The list of allowed products is presented by the following positions:

  • Bread - wheat, rye, integral grain, with bran.Baked without love, bake.
  • Soups of seasoned vegetables with cereals.
  • Dietary meat varieties: poultry, rabbit.It is boiled and baking.
  • Be/river fish.Seafood.
  • Seasonal vegetables.You can prepare the stew.
  • Agria milk products and low fat.Sour cream low in fat (placed on a plate).
  • Soft eggs (no more than 3 pieces per week).
  • Dairy and tomato sauces.
  • Croats, pasta.
  • Oil (to add to a finished dish).
  • Fruits/berries (in any form).It can be used for compote preparation, gelatin, gelatin.
  • Jues, milk tea, rose decoction.

It must be completely excluded from the diet:

  • Freshly baked bread, Sdoba, complicated cakes.
  • Favorite broths.
  • Fat meat.
  • Smoked meats, sausages.
  • Fish (salty/smoked), caviar.
  • Fat sauces, cheese, cream.
  • Spring, radish, spinach, spicy radish, fungi.
  • Ice cream, chocolate, confectionery, strong tea, coffee.

Salt consumption must be reduced significantly.

Salt with arterial hypertension

Prevention

Disease prevention is not specific.Standard recommendations:

  1. Adhering to the principles of dietary nutrition, excluding or significantly reducing the volume of certain products.Reduce animal salt and fat consumption.In the cooking process, it is advisable not to suck food.It is necessary to abandon fat/fried fat dishes.
  2. Daily physical activity according to the age group.Performing gymnastics improves well human.It is recommended to participate in running, walking, swimming, visiting the gym, performing breathing exercises.At the beginning of classes, the body must receive a minimal load.It must be gradually increased.
  3. Weight standardization is one of the previous requirements for successful prevention.
  4. It is necessary to learn to control stressful situations, since it is precisely a violation of the work of the central nervous system that doctors call almost the main reason for the development of the disease.Autotorization, meditation, self -hypnosis helps well in this.
  5. A complete rejection of bad habits.Smoking and alcohol are also able to cause a pathology.

Pathophysiology considers arterial hypertension as one of the most serious pathologies, not only a worsening of the patient's quality of life, but capable of causing death.That is why when the episodes of greater blood pressure appear, it is necessary to obtain a specialized consultation and, if necessary, begin the treatment.