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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 rise of diastolic blood pressure (lower), but in most cases diagnosed, patients have persistent growth of systolic pressure (superior).

What pressure is considered increased

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

  • Optimal - less than 120/80 mm hg.Art.;
  • Physiological norm - less than 130/85 mm hg.Art.;
  • Normal increase - in the interval 130–139/85–89 mm hg.Art.

An increase in pressure indicates the formation of hypertension.The internal gradation of the pathology seems to follow:

  1. Soft (grade I) - 140–159/90–99 mm hg.Art.
  2. Moderate (second degree) - 160–179/100–109 mm hg.Art.
  3. Heavy (III Grade) - Over 180/110.

The border pistols are diagnosed in the case of indicators in 140-149/90 mm hg.Art.And below.It is accompanied by episodes of pressure growth and its spontaneous stabilization.

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

AG classification (primary, secondary)

The classification of hypertension is based on different signs.During the systematization, doctors took into consideration:

  • reasons that cause the development of the pathology;
  • defeated by the target organs;
  • The current level of blood pressure, etc.

Depending on the etiological factors, it is customary to distinguish:

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

By nature of the passage, benign arterial hypertension (in development slowly) and malignant (with rapid deterioration of the condition) stands out.

Variety of secondary hypertension (symptomatic)

Secondary (symptomatic) arterial hypertension is a type of disease that develops due to damage to the organs responsible for regulating blood pressure.It is characterized by a stubborn path, the absence of a positive reaction to the hypotensive therapy conducted, as well as changes in the target organs, in particular the formation of cardiac, renal failure, etc.

If primary hypertension (essential format) occurs as an independent disease, 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. Neurogen hypertension.The development is due to the injury of the central nervous system and related pathologies, for example cerebral neoplasm.
  2. Nefrogenic (renal origin).They are divided into interstitial forms, renoparenchimals, renewed, mixed and rhinopi.
  3. Endocrino Ag.There are adrenal, thyroid, pituitary and menopause formats.
  4. Hemodynamic - Tested by heart pathologies and large arterial channels.
  5. Form of dosage.Its development is due to the use of oral contraceptives, glucocorticosteroid agents, etc.

The dimensions and resistance of the increase in blood pressure, the severity of changes in the state of the left ventricle and the bottom are the basis of another classification.Doctors distinguish the following varieties of symptomatic hypertension:

  1. Transient.For the pathology, a typically short -term increase in pressure indicators.The changes in the state of the bottom are completely absent.The hypertrophy of the left ventricle is almost not fixed.
  2. Laby.It is characterized by a moderate, short increase in blood pressure (an independent reduction does not occur).There is a weak left ventricular hypertrophy, narrowing of the vases of the retina of the eye.
  3. Stable.It is accompanied by constantly high blood pressure.Myocardial thickening is diagnosed, serious violations in the vases of the bottom.
  4. Evil (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 lung artery for over 25 mm.Rt. Art.
  • The ah vasorsenal is a secondary form of pathology due to insufficient blood circulation in the kidneys following a compromised arterial speed.
  • Portal hypertension is one of the varieties of the symptomatic form of the disease, accompanied by an increase in pressure within the gate vein.
  • Hypertension of the Virstunov's conduit.It develops against the background of chronic pancreas inflammation.

Consequences and complications

With a long flow hypertension, the target vases 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 against the background of a strong increase in blood pressure requires its reduction in the first minutes/hours.

Reasons

The reasons for the development of the essential form of pathology are certainly not for doctors.Several theories are named:

  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 the activity of the sympathetic system.The result is the divergence of the signals for all organs and an increase in the tone of the walls of the ships.
  2. Voluminous salt.Due to the compromise processes of the excess fluid output and some trace elements.As a result of the excessive content of sodium salts, an increase in the total volume of blood occurs.The attempts of the body to maintain the process of hemostasis at the physiological level lead to the spasm of small vessels.The indicators of the minute volume of the heart are stabilized, but total blood pressure is raised.

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 occurrence of arterial hypertension are:

  • Age - The diagnosis of the disease occurs in people of the advanced age category;
  • bad habits - smoking, alcohol intake;
  • a state of chronic stress;
  • insufficient physical activity;
  • overweight;
  • The presence of concomitant pathologies: diabetes is particularly unfavorable;
  • Excess rooms with lack of potassium.

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

Symptoms

In the initial formation phase, arterial hypertension is asymptomatic.The patient will learn 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 are no complaints at all or are not specific:

  • Headache located in the front area and in the back of the head;
  • dizziness;
  • noise.

The first complaints are formed against the background of the defeat of the target organs.At this stage, the appearance of the following symptoms is noted:

  • The dizziness, accompanied by headaches, noise - present themselves as a logical result of circulatory disorders;
  • start problems with the storage of information;
  • Hands/legs numbness;
  • weakness;
  • doubling of the visible image;
  • Shaking blackheads in the visual field;
  • violation of language (rarely);
  • nephropathy.

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

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 to stabilize an increase in loads on the wall.An increase in ventricle is due to an increase in the number of cardiomyocytes.As the condition worsens, the rooms of the heart are dilated.

This damage to the organ can manifest itself in the form:

  • the formation of heart failure,
  • a sudden cardiac arrest,
  • ischemic disease,
  • gastric rhythmic disorders,
  • cardiac asthma,
  • Strong lack of breath during loads.

Important!Cardi pain against the background of AG develops during the period of absolute rest or due to emotional overvoltage.A feature feature is the inability to stop the attack with a glycerol pill.

If the kidneys are damaged, the presence of proteins 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.It is felt by the patient as a burst or pain.The place of location is the back of the head, but the diffusion in other areas of the head is not excluded.The pain has improved from inclination and during cough.It can occur as a response 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 the differential diagnosis;
  • Determination of the presence/absence of damage to the target organs.

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

  1. There are cases of illness in the immediate environment.
  2. How many times the pressure is fixed.
  3. There are a story of chronic diseases in the patient, etc.

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

After the completion of the inspection, blood pressure is measured.To determine the degree of arterial hypertension, the patient is prescribed by the performance of the profile of blood pressure, that is to say measures to patients alone at home.It is necessary to make 4 measurements: two in the morning and two in the evening, for several days in a row.

The results must be included in the table.If the indicators exceed 140/90 mm hg.Art., We can speak of the presence of arterial hypertension.

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

Important!Smad are multiple measurements of blood pressure indicators for a whole day.Measurements are performed by a special device.

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

  • Renal system examination.Includes the study of the urine - a general test.A king -rial and ultrasound of the kidney system are prescribed, the Renography with the introduction of a radioactive isotope.
  • Heart test.ECG is used (the electrocardiogram shows the growth of the road R), the echocardiography (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, the sealing.Hemorrhages are not excluded.
  • Ultrasound of the thyroid gland and adrenal glands.
  • Blood examination is a general test and an enlarged biochemistry.

When diagnosing the secondary form of hypertension, it is necessary to perform differential diagnostics (DIF).Passes in two phases:

  • Analysis of the clinical picture, lift complaints, a patient's physics exam in particular, auscultation, instrumental/laboratory studies;
  • Diagnostic measures that allow to evaluate the functional state of the organs and the existing changes, in particular, it is necessary to remove the cardiogram.

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

Treatment

The treatment of hypertension begins with a revision of lifestyle and non -pharmacological therapy.The exception is secondary hypertension.

Drug therapy of arterial hypertension involves taking the following groups of drugs:

  1. Diuretics.The drugs have a positive effect on the state of the cardiovascular system.Reception is not accompanied by the development of side effects.The therapy of the disease begins with diuretics (contraindication - diabetes and gout).Against the background of the treatment, the volume of urine removed from the kidneys and, consequently, increases excess water and sodium salts.The diuretics are prescribed in combination with other hypertension.
  2. Alpha-blockers.The drugs are distinguished by good tolerance.They do not affect the level of sugar in the blood.Provide a decrease in blood pressure with a slight increase in the impulse (frequency of contraction of the heart muscle).The occurrence of orthostatic hypotension at the beginning of the treatment with the drugs of this group becomes a side effect.To exclude its development, it is advisable to take medicines before bedtime.
  3. Beta-blockers.Reduce heart rate, which is accompanied by a decrease in blood pressure.
  4. ACE inhibitor.Modern drugs are distinguished by a high therapeutic effect and good tolerance.Against the background of the intake of funds in the patient's body, the form of angiotensin II does not occur - a hormone that causes a narrowing of the lumen of blood vessels.Thanks to this, peripheral ships expand, the heart works in a more calm rhythm.There is a decrease in blood pressure indicators.
  5. ANGIOTENSINA-II antagonists.Medicines are also blocking Angiotensin II.They are appointed if it is impossible to receive ACE inhibitors.
  6. Calcium antagonists.The drugs expand the gaps of the blood vessels, thus preventing the development of stroke.The drugs have an excellent therapeutic effect and are well tolerated.Have a small list of contraindications.More often prescribed as part of complex therapy.

It is strictly forbidden to stop the treatment even after stabilization of blood pressure.In this case, the disease will begin to progress again, which will negatively influence the state of the target organs.In addition, the risk of developing heart attack and stroke increases significantly.

The treatment of the disease is carried out on an outpatient basis: the patient takes on selected drugs independently.Hospitalization in hospital is recommended only in more serious cases.

In addition to taking drugs, the treatment of pathology involves a massage.The procedures contribute not only to the reduction of pressure, but also to the overall strengthening of the body, improve the activity of the cardiovascular system, etc.Read more about various types of massage in our article: massage with high pressure: classic, point and other effective methods.

Nutrition

Respect for the principles of dietary nutrition is one of the important stages to stabilize blood pressure indicators.With hypertension, diet n.10.

In the initial phase of the formation of pathology (Ah 1 degree), it is necessary to adhere to diet no.5. It provides for a restriction in the use of table salt.With a deterioration of the state and the development of violations in the work of the heart and the vascular system, the transition to diet no.5 A.

If the disease is complicated by atherosclerosis, diet n.10 C. The diet for iPocolesterol is prescribed to reduce the fatty fats of animal origin, easily digestible carbohydrates.The diet should include foods with a high content of food fibers, vegetable fats and proteins.

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

  • Bread: wheat, rye, whole wheat, with bran.Baking not -love, cooking.
  • Vegetable soups seasoned with cereals.
  • Dietary varieties of meat: poultry, rabbit.Bold and cook is allowed.
  • Seafish/river.Seafood.
  • Seasonal vegetables.From them you can prepare the stew.
  • Acid products -Milk and low -fat cottage.Low fatty cream (positioned on a plate).
  • Soft eggs (no more than 3 pieces per week).
  • Lattiero -Casearies and tomato sauces.
  • Croatians, pasta.
  • Oil (for the addition of a finished dish).
  • Fruits/berries (in any shape).It can be used for the preparation of compounds, jelly, jelly.
  • Juice juices, milk tea, pink decoction.

It must be completely excluded from the diet:

  • Bailed bread, slaughter, complicated perfumes.
  • Favaro broths.
  • Fatty meat.
  • Smoked meats, sausages.
  • Fish (salty/smoked), caviar.
  • Fat sauces, cheeses, cream.
  • Spring, radishes, spinach, horseradish, mushrooms.
  • Ice cream, chocolate, pastry, strong tea, coffee.

The consumption of salt must be significantly reduced.

Salt with arterial hypertension

Prevention

The prevention of the disease is not specific.Standard recommendations:

  1. Adhere to the principles of dietary nutrition, excluding or significantly reducing the volume of certain products.Reduce the consumption of animal and fatty salt.In the cooking process, it is advisable not to suck food at all.It is necessary to abandon fat/sharp/fried dishes.
  2. Daily physical activity in accordance with the age group.The execution of gymnastics improves human well -being.It is recommended to engage in the race, walk, swim, visit the gym, perform breathing exercises.At the beginning of the lessons, the body should receive a minimum load.It must be gradually increased.
  3. The normalization of weight is one of the prerequisites for a 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 almost call the main reason for the development of the disease.Autotoring, meditation, car -ipnosis helps well in this.
  5. A complete refusal of bad habits.Smoking and alcohol are also able to cause a pathology.

Pathopathology considers arterial hypertension as one of the most serious pathologies, not only a worsening of the patient's quality of life, but able to cause death.That's why when the episodes of increased blood pressure increase, it is necessary to obtain specialized advice and, if necessary, start treatment.