Classification of hypertension

Doctors have been sounding the alarm for several years: in developed countries that have overcome epidemics, arterial hypertension continues to consistently occupy a leading place among the causes of death from cardiovascular diseases.In terms of the number of complications and the poor prognosis, it competes with diabetes mellitus.At the same time, the disease is rapidly tapering off.A few decades ago, a 35-year-old stroke patient was considered nonsense.Recently, such a case will not surprise anyone.

According to the World Health Organization, about a quarter of the world's population suffers from arterial hypertension.Half of people over 65 suffer from high blood pressure.

What kind of illness is this?

High blood pressure refers to diseases of the cardiovascular system.Its presence causes persistently high blood pressure in the arteries of the systemic circulation.

In itself, pressing on the walls of blood vessels is a necessary, normal process and is necessary for the flow of blood through them.The pressure drops slightly during sleep, and vice versa during stress or physical activity.

The standard blood pressure for young people (may vary slightly from person to person) is 120/75 mmHg.Art.For those over forty – 130/80, for those over fifty – 135/84.If the pressure often rises to 140/90, doctors speak of high blood pressure.

Blood pressure is divided into two types:

1. Systolic.The first, top number indicates the level of blood pressure at the moment the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lower number shows blood pressure when the heart muscle (myocardium) relaxes.

Arterial hypertension (hypertension) is called the “silent killer” for a reason: it can lead to the appearance of various pathologies.The heart and brain are particularly affected.In advanced cases, heart attacks and strokes can even occur.

Classification of hypertension

The risks of high blood pressure are impressive, which is why scientists have been studying it since the beginning of the last century.During this period, the classification changed more than once, but two directions emerged:

1. When classifying the disease according to stages, doctors thought about the connection between high blood pressure and risk factors for the development of high blood pressure.However, full agreement was never reached - the debate is still ongoing.
2. Identification of disease variants.The approach addresses the causes of hypertension, the stages and mechanisms of its development.

The article discusses several of the classifications proposed by scientists.

Through external signs

This is how a German doctor classified the disease.When F. Volgard looked at the patient, he divided the disease into red and pale.In the first case, when the pressure increases, redness on the face and body becomes noticeable due to the expansion of the capillaries.Red spots often appear.In the second case, the sick person feels a vascular spasm with an increase in pressure, becomes cold and turns pale.

By origin

Doctors conventionally identified the severities of hypertension: primary (high blood pressure) and secondary (symptomatic) hypertension.

The specific reasons for the appearance and development of the primary tumor have not yet been found.It has three degrees.

Grade 1 arterial hypertension is described as “mild”.Pressure - 140-159 and 90-99 mm Hg. Art.Art.Blood pressure “jumps,” sometimes rising and then returning to normal.First degree hypertension has a borderline subgroup with indicators of 140-149 and 90-94 mm Hg. Art.The likelihood of crises (strong sudden jumps) is small, if they occur it is rare.

However, the risk is greater for grade 2 (moderate) high blood pressure.The tonometer shows 160-179 and 100-109 mmHg.Art.Second-degree hypertension is characterized by constantly elevated pressure.

Stage 3 (severe) disease can be life-threatening, especially if there are comorbidities.This value is characterized by indicators above 180 and above 110 mmHg.Art.

Sometimes a person only has problems with one type of pressure.Then we speak of isolated high blood pressure and there are two variants of high blood pressure:

1. systolic.The pressure is more than 140 and less than 90 mmHg.Art.;
2. Subgroup: borderline – 140-149 and less than 90 mmHg.Art.In this case, the “upper” pressure increases to 140 mmHg.Art.and higher, while the “lower” remains normal.Then we speak of an isolated systolic form of hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under 35 years old – in 25%).This type of disease is caused by a disease of a specific organ.Most often, such symptomatic hypertension occurs due to kidney problems.The classification into endocrine, neurogenic, renal and hemodynamic forms was suggested by the professor.Doctors still use it today.

Stages of hypertension

In the recent past, arterial hypertension was divided into three stages by experts.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the classification reflects pathologies that occur in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease by degree.There are three of them and each represents a series of changes in digital blood pressure readings (they were discussed above).

In some classifications one finds the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist determines the 4th degree of the disease, he means digital pressure indicators, and not the patient's condition, since hypertension is at stage 3.is also considered difficult.

With chronic high blood pressure, the body cannot cope with the stress and serious damage to the organs occurs.Those that are affected earlier than others are called target organs by doctors.In addition to the heart and brain, this also includes the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weak points.

In the first stage of high blood pressure development, the organs are initially still healthy.Often people with high blood pressure do not initially go to the hospital because they feel tolerable and do not particularly affect their lives.Hypertensive crises are the exception rather than the rule.Initial hypertensives ignore health problems in vain, because at this stage the disease is easiest to control.Sometimes treatment for stage 1 high blood pressure relies on lifestyle changes rather than taking medication.But it is necessary.Therefore, if the tonometer regularly shows high values, it is better to consult a specialist.Timely treatment can help prevent the progression of the “silent killer.”

Stage 2 hypertension is characterized by persistent high blood pressure.The heart is the first to give up - the left ventricle begins to enlarge and “thicken”.In some cases, in addition to cardiac dysfunction, there are also defects in the blood vessels of the retina.A person with high blood pressure is in stage 2. Crises are much more common.But the disease is still treatable.If the doctor makes a diagnosis of “stage 2 hypertension,” his recommendations should be followed especially carefully.As the disease develops further, it begins to become life-threatening.

When stage 3 hypertension occurs, all target organs become noticeable with a variety of complications.Pressure surges in hypertension, stage 3. can be accompanied by attacks of heart failure and cardiac asthma.Arteriosclerosis, angina pectoris, kidney failure and other “gifts” often occur.The third stage of hypertension is often detected when the patient already suffers from fundal hemorrhage, heart attack, aneurysms, stroke and other ailments.

Signs of blood pressure problems

The number one problem is detecting high blood pressure in a timely manner and understanding how long a person has been suffering from it.Many high blood pressure patients do not learn of the diagnosis until three or more years after the onset of the disease.

Factors that increase the risk of developing high blood pressure include heredity, obesity, smoking, frequent stress, high cholesterol, lack of exercise and age.

The alarm bell rings when you see:

• occasional headaches;
• Pain “threatens” at the back of the head or shocks in the temples;
• often feel nausea and dizziness;
• Glare flickers in the eyes or “black flies” fly;
• everything is annoying or obscured by apathy;
• tingling or numbness of fingers;
• swelling of the arms, legs and/or face;
• A rapid heartbeat appears out of the blue.

If you recognize yourself, you should at least systematically measure your blood pressure.But of course it's better to go to the hospital.

Diagnosis of arterial hypertension

If chronic high blood pressure is suspected, doctors use three diagnostic methods.

The first and easiest option is to measure your blood pressure.

The second is a complete physical examination.It can only be carried out by a specialist.He carries out palpation and auscultation (analysis of sounds accompanying the work of various organs), percussion (tapping on various parts of the body and drawing conclusions from sounds), as well as a standard examination.

In the third case, an electrocardiograph helps to draw conclusions.

So what can you expect if you come to the hospital with suspected high blood pressure?

First, the doctor checks your blood pressure using a special device - a tonometer.By the way: In people with an easily excitable nervous system, blood pressure levels can skyrocket even during minor emotional upheavals.Such patients experience “white coat syndrome” when they visit the doctor: As soon as the doctor starts measuring their blood pressure, it rises.However, the reason for these fluctuations is stress and not illness.Although such a reaction to shock can lead to disruptions in the normal functioning of the heart and kidneys in the long term.In such easily influenced patients, the doctor will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight and body mass index is recorded.The specialist looks for evidence of symptomatic hypertension.
• Medical history.Without questioning the patient – nowhere.It is important to find out which illnesses a person has previously suffered from and whether any symptoms are currently present.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol levels; it is determined whether there is diabetes), whether the parents were hypertensive.
• Physical examination.First, the doctor listens to the heart with a phonendoscope.The task is to detect noises, changes in tone or the presence of extraneous noise, if necessary.After this study, it is possible to exclude heart defects and make preliminary conclusions about its condition against the background of hypertension.
• Biochemical blood test.It is necessary to find out the levels of sugar, cholesterol and lipoproteins and understand how susceptible a person is to atherosclerosis.
• ECG.An electrocardiogram is an integral part of the diagnostic process.It helps detect irregularities in the heart rhythm.Based on the results, we can assess the presence of hypertrophy of the wall of the left side of the heart, which is typical of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can get an idea of changes and heart defects and assess the function and condition of the valves.
• X-ray examination.Doctors perform arteriography and aortography.With their help, specialists examine the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing arterial hypertension, the doctor examines the condition of the brain and carotid arteries.Ultrasound is harmless and does not cause complications and helps determine the intensity of blood flow through the arteries and veins.
• Ultrasound of the thyroid.Among other data, the doctor will need the results of a blood test to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it becomes clear whether the thyroid gland plays a role in the development of the disease and what treatment should be prescribed.
• Ultrasound of the kidneys.These organs and their vessels are very susceptible to high blood pressure.The study helps to assess their condition.

Treatment methods

Today there are many methods for treating high blood pressure.Some came to us from ancient times;Pharmacists and scientists worked for years to create others.

The most common method is drug treatment.Doctors use different types of drugs to normalize blood pressure.

1. Calcium antagonists aim to reduce heart rate.
2. Diuretics, most commonly thiazide diuretics, improve urine production and excretion.
3. Adrenergic medications.
4. Vasodilators expand the blood vessels and thereby balance the situation.

In some cases, a surgical method called ablation is used.This procedure is not easy.A catheter with a device that produces radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.To prevent scars from occurring after the procedure, the entire length of the vein is affected.Performed under local anesthesia.

A variety of methods that come from the past are classified as alternative medicine.These include leg parkas, vinegar lotions and much more.

Unconventional remedies based on valerian, motherwort, beets, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal decoctions for the treatment of arterial hypertension.Here is an example:

Take 1 tbsp.l.Motherwort, valerian root and caraway.Mix.Pour a tablespoon of this mixture into a glass of boiling water and let it stand for an hour.Drink the drug three times a day, 1/3 cup.The course is designed to last one month.

There is also monastery tea, which is said to help with high blood pressure, and homeopathic medicines.However, it is best to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if left untreated.You need to monitor your health at any age, as the modern rhythm of life often contributes to the development of the disease.And regardless of the stage and degree of high blood pressure, it can have fatal consequences if left untreated.