Arterial hypertension

What is arterial hypertension? This is a disease characterized by blood pressure readings above 140 mmHg. Art. In this case, the patient is visited by headaches, dizziness and nausea. Eliminating all the symptoms that have arisen can only be specially selected therapy.

Arterial hypertension can be an independent disease or accompany various pathologies that are its symptom. High blood pressure is one of the causes of coronary heart disease and severe kidney damage.

In hypertensive patients, the indicators often return to normal only after taking special medications, and pressure surges can be observed periodically and for no apparent reason. It is completely impossible to cure the disease, but avoiding serious consequences and learning to control your pressure is a doable task.

Don't treat yourself. At the first sign of illness, consult a doctor.

causes

To date, the exact reasons for the occurrence of essential arterial hypertension are unknown. The risk factors are:

• heredity;
• malnutrition;
• Bad habits;
• violation of lipid metabolism;
• kidney disease;
• diabetes mellitus;
• emphasize;
• inactive lifestyle.

classification of the disease

During a diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure. The pathogenesis also shows differences considering the types of the disease. There is the following classification of arterial hypertension:

1. Pulmonary essential arterial hypertension - is considered one of the rare types of arterial hypertension, but it poses a great threat to human life. It is very difficult to identify this disease by symptoms, and even more difficult to treat. Pulmonary arterial hypertension arises due to an increase in pulmonary vascular resistance and, as a result, insufficient blood flow.
2. Malignant. Symptoms of such arterial hypertension are presented in the form of increased blood pressure up to 220/130. there is a radical change in the fundus and swelling of the optic disc. If the diagnosis was made in time, then it is possible to cure this type of arterial hypertension.
3. Renovascular arterial hypertension. The reasons for the development of this type of disease are the presence of such pathologies as vasculitis, vascular atherosclerosis, malignant formations in the kidneys. The pathogenesis of the disease is reduced to the formation of a characteristic pressure, which can be represented by normal systolic and increased diastolic blood pressure.
4. Labile arterial hypertension. Periodic normalization of pressure is characteristic of this type of disease. Patients suffering from this form of arterial hypertension are not called patients, since this condition is not a pathology. In some cases, blood pressure returns to normal after some time.

Symptomatic arterial hypertension and its types

Secondary arterial hypertension is a pathological process associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:

1. Hemodynamic - associated with violations of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, aortic stenosis, aortic valve insufficiency.
2. neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
3. endocrinopathy. This form of symptomatic arterial hypertension is observed with hormonally active tumors of the adrenal glands, pituitary gland and diffuse toxic goiter.
4. Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is associated with a sudden onset, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
5. Medical. This form of symptomatic arterial hypertension is associated with taking medications that increase blood pressure.

symptoms

Before complications of arterial hypertension appear, it proceeds without specific manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the formation of headaches in the back of the head and in the forehead, dizziness and uncharacteristic sounds in the ears.

target organ damage

These types of symptoms of arterial hypertension first appear due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. Subsequently, the patient has weakness, the flashing of black dots in front of his eyes, difficulty speaking. Such symptoms bother a person at a late stage of the disease. In addition, complications such as cerebral infarction and bleeding can occur.

heart failure

In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory reaction to the normalization of wall tension. As a result, increased afterload, heart failure. When the heart is damaged, there are not the most favorable forecasts, since such changes in its work are the causes of heart failure, sudden death and the development of ventricular arrhythmia. The characteristic symptoms are:

• pulmonary edema;
• Difficulty breathing during physical activity;
• cardiac asthma.

In some cases, arterial hypertension in children and adults causes pain in the region of the heart of a certain kind. You can visit a person in a state of calm or emotional overstrain, without engaging in physical activity. The main manifestation of the presented chest pains is the impossibility of eliminating them with the help of nitroglycerin.

The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath at an early stage of the disease after performing low loads or at rest. All this indicates characteristic changes in the heart muscle and the development of heart failure. With such a disease there is swelling of the lower extremities, the cause of which is the retention of sodium and water ions in the body.

If the lesion has affected the kidneys, then when passing a urine test, a protein is found in it, and microscopic hematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.

eye damage

Not so often, this arterial hypertension in children and adults affects vision, which leads to a decrease in photosensitivity and blindness. With impaired vision against the background of hypertension, patients have black dots in front of the eyes, fog or haze. The reasons for such changes are the violation of blood circulation in the retina. Complications can manifest as diplopia, visual impairment, or complete vision loss.

headache

This symptom is considered the most common in arterial hypertension. She takes care of the patient at any time of the day or night. It can burst in nature and concentrate in the back of the head, and then spread throughout the head area. Increased headache in arterial hypertension occurs when coughing and tilting the head. This may be accompanied by swelling of the eyelids and face. When performing a massage in this case, in patients with arterial hypertension, there is an improvement in blood outflow in the veins, which leads to a decrease in pain up to its complete disappearance.

There are cases when headaches against the background of the present disease are due to strained soft muscles of the head itself or tendons. The development of such a pain syndrome occurs after a psycho-emotional or physical overload. As a rule, such pains are squeezing or tightening in nature. A patient suffering from arterial hypertension has a feeling of nausea and dizziness. With persistent pain, incessant pain is characteristic, irritability occurs in patients, sensitivity to sharp sounds increases, they become short-tempered.

stages of the disease

For the correct setting of the stage of this pathological process, it is necessary to use classification. It depends on the target organ damage. There are three stages of the disease.

Easy

This stage is characterized by a slight increase in blood pressure of 180/100 mmHg. Art. Pressure level is unstable. During rest in a patient suffering from arterial hypertension, blood pressure indicators return to normal. Fixing the disease inevitably increases the pressure. Very often people do not complain about the formation of disorders related to their health. But for a light stage, its own symptoms are characteristic:

• Headache;
• noise in the ears;
• poor sleep;
• mental decline;
• Dizziness;
• nosebleeds.

As a rule, there are no manifestations of left ventricular hypertrophy, the ECG does not show any abnormalities, the kidney function is without pathological changes, the fundus is not changed.

Middle

This stage is characterized by the presence of a higher and more stable level of blood pressure. It can reach 180-105 mmHg. Art. Patients often have headaches, dizziness, pain in the heart area, who have angina.

This stage is characterized by typical hypertensive crises. The pathogenesis of the disease includes the following signs of damage to the target organs:

• hypertrophy of the left;
• weakening of the I sound at the apex of the heart;
• accent II tone on the aorta;
• in some patients, ECG symptoms of subendocardial ischemia.

In relation to the central nervous system, there are various manifestations of vascular insufficiency, stroke, transient cerebral ischemia. For the fundus, in addition to the reduction in arterioles, there is compression of the veins, their increase, bleeding, exudates occur. Blood flow in the kidneys and glomerular filtration rate are reduced for this stage. However, it is impossible to detect these manifestations in urinalysis.

difficult

This stage of the disease is characterized by frequent vascular accidents. They arise as a result of a significant and stable increase in blood pressure, as well as the progression of atherosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230–120 mmHg. Art. there is no spontaneous normalization of blood pressure. In a severe stage, the disease affects the following organs:

• heart - angina, circulatory failure, myocardial infarction, arrhythmias are formed;
• brain - ischemic and hemorrhagic infarctions, encephalopathy are formed;
• fundus;
• Kidneys - low blood flow and glomerular filtration.

risk factors

Currently, the severity of the described disease directly depends on the risk facts. The risk lies in the formation of cardiovascular complications against the background of hypertension. Taking into account the presented complications, the prognosis of the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and the prognosis:

• age - in men after 50 years, in women after 60 years;
• Smoking;
• high cholesterol;
• hereditary factor;
• Obesity;
• hypodynamia;
• diabetes mellitus.

The risk factors presented may be eliminated (correctable) and may not be correctable. The first type of risk factors is characterized by the presence of diabetes mellitus, high cholesterol, smoking and physical inactivity. Uncorrected risk factors include race, family history, and age.

Taking into account the degree of arterial hypertension and the contributing factors of the disease, a prognosis is observed with the formation of such complications as myocardial infarction or stroke for the next 10 years.

With a slight degree of arterial hypertension and the absence of risk factors, the development of complications from the cardiovascular system is minimized for the next 10 years. With a year of non-drug therapy and a lifestyle overhaul, it is possible to get rid of this degree of the pathological process. If the pressure readings are above 140/90 mm Hg. Art. , then drug treatment is prescribed.

The average risk is associated with the formation of complications against the background of arterial hypertension for 10 years in a ratio of 20%. Grade 2 arterial hypertension is treated like grade 1, but dynamic control is adjusted for 6 months. With poor results of blood pressure and its stable maintenance, drug treatment is carried out.

High-grade risk factors are accompanied by the formation of complications within 30%. In this situation, a patient suffering from arterial hypertension is prescribed a full diagnosis in combination with non-drug treatment.

With a very high risk, the patient is prescribed an urgent differential diagnosis of arterial hypertension and taking medication.

diagnostic methods

Only after a thorough examination can you prescribe effective therapy and get rid of all the manifestations of this disease. The diagnosis of arterial hypertension is based on the following types of examinations:

• ECG, glucose analysis and complete blood count;
• Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general analysis of urine - are carried out to exclude the renal nature of the formation of the disease;
• If a pheochromocytoma is suspected, an ultrasound examination of the adrenal glands is advisable;
• hormone analysis, ultrasound of the thyroid gland;
• MRI of the brain;
• Consultation with a neurologist and an ophthalmologist.

Effective therapy

Treatment of arterial hypertension should be carried out under constant medical supervision. He is obliged to make an accurate diagnosis and carry out additional diagnostics, including checking:

• fundus;
• kidney function;
• the work of the heart.

After that, the specialist can prescribe antihypertensive treatment and identify various complications. As a rule, patients in whom the syndrome of arterial hypertension was first detected are hospitalized for all the necessary studies and the choice of treatment.

Non-drug treatment

Such therapy is recommended for all patients, regardless of the degree of the disease or medication intake. Such treatment of hypertension includes:

1. Stop smoking. It is very important to change your lifestyle, because such changes are an excellent prevention of diseases of the cardiovascular system.
2. Elimination of extra pounds. A common cause of hypertension is obesity, so diet plays an important role in this matter. In addition, a balanced and species-appropriate diet has a beneficial effect on risk factors such as diabetes mellitus and myocardial hypertrophy.
3. Reduced amount of salt intake. According to ongoing studies, reducing salt intake to 4. 5 g/day helps reduce systolic blood pressure by 4-6 mm Hg. Art.
4. Insignificant consumption of strong drinks.
5. Specially designed diet. Your diet should include vegetables, fruits, foods high in magnesium, potassium, potassium, fish and seafood. In addition, the diet includes a limited intake of animal fats.
6. Active Lifestyle. It makes a lot of sense to walk briskly for 30 minutes 3-4 times a week. With isometric loads, you can provoke an increase in blood pressure.

Medical treatment

Therapy with drugs should be prescribed taking into account the following recommendations:

1. Treatment begins with small doses of medication.
2. In the absence of a therapeutic effect, the use of one drug must be replaced with another. The interval between degrees should be less than 4 weeks, provided that a rapid reduction in blood pressure is not required.
3. The use of long-acting drugs to achieve a 24-hour effect with a single dose.
4. Application of the optimal combination of devices.
5. Therapy should be permanent. It is not allowed to use the drug in courses.
6. Effective control of blood pressure throughout the year contributes to a gradual reduction in the dose and amount of medication.

preventive measures

Prevention of arterial hypertension includes the following recommendations:

1. If family members have this disease and you are over 30 years old, you need to measure your pressure regularly.
2. Quit smoking and alcohol.
3. A low-fat and low-salt diet should be followed.
4. train outside.
5. Avoid various stressful situations.
6. Maintain a normal body weight.

With arterial hypertension, a person can quite lead a normal, full life, but subject to all the recommendations described. Control of blood pressure in this case is one of the main components of successful treatment of the disease. Therefore, try not to start the disease and consult a doctor in time to avoid various serious complications.