Hypertension or Arterial Hypertension - A disease characterized by stability, i. e. , by repeated measurements, blood pressure increases. With many diseases, it is considered a risk factor for the development of dangerous complications from the myocardial system, including myocardial stroke and infarction. Hypersonic disease is the main cause of pathology being considered, requiring medication to normalize and nourish the patient's lifestyle.
Blood pressure is a force that circulates blood on the walls of blood vessels. This stress when the heart contracts is called the systolic period, during the relaxation period - the diastolic period. The normal range of these indicators is very wide.
Through numerous observations, scientists concluded that the risk of cardiovascular complications increases with blood pressure increasing by 10 mm Hg. Art. Already started at the level of 115/75mm RT. Art. However, it is appropriate to reduce pressure only above 140/90 mm. RT. Therefore, art is exactly this value, and it is regarded as the standard for determining arterial hypertension.
reason
In about 90% of cases, hypertension is the cause of steady increase in blood pressure. This diagnosis was made to the patient when other diseases were not found during the examination and accompanied by hypertension. the latter:
- Renal Pathology - Pyelonephritis, glomerulonephritis, polycystic, diabetic nephropathy, renal artery stenosis;
- Endocrine diseases of the adrenal gland, pancreas or pituitary gland - neurotumours, hyperthyroid function, izenko-cushing syndrome, Pheochromocytoma;
- Obstructive apnea syndrome in dreams;
- Valve worsens or atherosclerosis damages the aorta.
Regular use of multiple medications may also lead to increased blood pressure. These include oral contraceptives, non-replacement anti-inflammatory drugs, amphetamines, corticosteroids, erythropoietin-containing drugs, cyclosporins, cocaine.
The possibility of cardiovascular disease, including hypertension, is closely related to the following risk factors:
- Improper nutrition, including excessive sodium salt, saturated and trans fats, dietary lack of green leaves, vegetables and fruits;
- Obesity;
- Pathology of in-kind heart and blood vessels;
- Age over 65 years old;
- A sedentary lifestyle;
- Chronic stress;
- Harvest habits - Smoking, drinking too much.
Classification
If a disease that causes an elevated blood pressure can be identified, arterial hypertension is called secondary or symptomatic. In the case of uncertain causes of hypertension, it is believed to be caused by hypertension.
The latter has an installment current:
- The first stage. There are no obvious signs that the work of target organs is violated by the blood pressure, kidneys, arteries and venous blood vessels.
- The second stage. There is one of the listed signs or all of them, such as an increase in the left ventricle of the heart, a significant decrease in the renal filtration rate, albumin in the urine, an increase in the thickness of the carotid artery wall, or the appearance of the intraluminal plaque. In this case, clinical manifestations of the disease may not exist.
- The third stage of hypertension. Pathology related to the atherosclerosis process in the heart and blood vessels - myocardial infarction, acute cerebrovascular accidents, angina, atherosclerosis in the lower limb arteries or severe renal damage, manifested as significant reduction in the filter membrane and/or significant urine loss.
According to the maximum blood pressure measured, arterial hypertension is divided into several degrees:
- First degree. Systolic pressure ranges from 140 to 159 mm. RT. Art. and/or diastolic blood pressure - 90 to 99 mm. RT. Art.
- Second degree. Systolic pressure ranges from 160 to 179 mm. RT. Art. and/or diastolic blood pressure - from 100 to 109 mm. RT. Art.
- The third degree. Systolic pressure exceeds 180 mm. RT. Art. and/or diastolic blood pressure exceeding 110 mm. RT. Art.
There is also an isolated form of arterial hypertension, where there is only a systolic blood pressure chart in normal diastolic blood pressure.
symptom
Generally, an increase in blood pressure is not accompanied by a deterioration of good condition and may not be noticed by the patient, so it is important to measure blood pressure regularly, especially in middle-aged and elderly people.
The following symptoms may be manifestations of hypertension:
- Headache, mainly in the morning after awakening;
- bleeding from the nose;
- bleeding under the mucosa of the eyes;
- Violating the heart rhythm;
- Blurred vision and flickering flies;
- tinnitus.
Blood pressure rose sharply to high numbers, accompanied by a significant deterioration of the well, which is known as a hypertension crisis. In most cases, it occurs with an increase in systolic blood pressure of more than 180 mm Hg. Art. and/or diastolic blood pressure exceeding 120 mm Hg. Art. At the same time, the patient's weaknesses, nausea, vomiting will not bring relief, consciousness, anxiety and fear, muscle tremor, and chest pain.
complication
Stable elevation of blood pressure and hypertension greatly increase the risk of cardiovascular pathology, including the patient's life. These include:
- Acute cerebral circulation (stroke);
- Angina, myocardial infarction;
- Vascular dementia (dementia);
- Chronic renal and heart failure;
- Atherosclerotic lesions of lower limb blood vessels.
diagnosis
The main symptom of hypertension is a steady increase in blood pressure, with at least three dimensions on different days in a calm environment. When measuring blood pressure in a hospital or clinic for the first time to achieve correctness of results, it is important to follow the following rules:
- Before the examination, the patient needs to sit in a quiet room for several minutes before calming down.
- The size of the cuff sleeve should correspond to the thickness of the arm and the device itself - will attach to the heart level;
- The intervals of each hand were 1-2 minutes, and two measurements were performed, with a large difference in the obtained numbers, and additional measurements were performed.
- In elderly patients and patients with diabetes, or in cases where blood pressure is suspected to be reduced when the body position changes, the measurement is performed within the first and fifth minutes of the standing position;
- In addition, the heart rate is measured within 30 seconds.
In an interview with the patient, the doctor explained at what age to start to increase, if there were symptoms such as breathing in a dream, breathing stop, muscle weakness or sudden palpation of sudden sweating and headaches, and abnormal impurities in the urine. It is also important to find out which medicines and biological plants he takes.
Within the framework of the first phase of the examination, the following tests were performed for hypertension:
- Clinical blood test;
- General urine analysis, detecting microalbumin in its period and daily parts;
- Biochemical blood tests (cholesterol, lipoprotein is used to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium, and glucose and creatinine);
- Determine glycated hemoglobin levels;
- Determine the concentration of hormones - thyroxine, triiodomethyl alcohol and thyroid-odextrin, antibodies against thyroid-peroxygenase and thyroglobulin, aldosterone.
If genetic susceptibility disease is suspected, polymorphisms of genes associated with the development of arterial hypertension can be determined.
To elucidate the risk factors for developing and identifying existing cardiovascular pathology for hypertension, an instrumental diagnostic method was used:
- Monitor blood pressure every day;
- Electrocardiogram study;
- echocardiography;
- Holter Daily Monitoring;
- Duplex scans the brain arm, kidney or arterioles;
- Ultrasound study of kidneys and adrenal glands;
- Check the fundus.
Using hypertension, controlling blood pressure at home is important for maintaining a diary where all the results measured at a fixed time are necessary, taking medications that may cause elevated blood pressure and onset of stress. At the same time, measurements must be made in the sitting position after sitting for a few minutes and holding hands at the same level.
treat
Due to the moderate and low risk of cardiovascular complications, it is recommended that patients only adapt to lifestyle changes, diet correction, weight loss, increased physical exercise and special gymnastics to provide high blood pressure and reject bad habits on the background of routine blood pressure. These measures are usually sufficient to normalize blood pressure.
A high-pressure diet involves table salt, caffeine, sharp, salty, smoky and spicy dishes, high in fat content, crusts, candy, paired with oil cream and alcoholic beverages. No more than 5 grams of salt per day is allowed in addition to aggravation of the disease. The recommended daily fluid rate is 1-1. 2 liters.
In the high risk of non-pharmacological treatments that have not been successful within a few months, as well as for the high risk of complications, the use of drugs for the purpose of lowering blood pressure by less than 140/90 mm. RT. Art. For patients with diabetes or who already have cardiovascular pathology, the target pressure level is even lower than 130/80 mm. RT. Art.
Modern drug treatment for hypertension includes a combination of two or more drugs in the following two groups:
- calcium antagonists;
- Angiotenzinzinzinoproding enzyme inhibitor;
- angiotensin II blockers;
- diuretics (diuretics);
- Block B;
- alpha receptor blocker.
The vast majority of them are produced in tablet form with high blood pressure.
prevention
Preventing aggravated hypertension includes timely diagnosis and treatment of cardiovascular, neurological, urinary and endocrine system diseases, continuously, followed by doctors’ recommendations, including non-union treatments and medications, as well as regular blood pressure measurements.