A person lives as long as his heart beats. The heart pump ensures blood circulation in the vessels. In this context there is such a thing as blood pressure. Abbreviated as AD. Any deviation from normal blood pressure is fatal.
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Risks of developing high blood pressure
The risk of developing hypertension or arterial hypertension - high blood pressure - is made up of several factors. Accordingly, the more there are, the greater the likelihood that a person will develop high blood pressure.
Risk factors for developing high blood pressure:
- hereditary predisposition. The risk of getting sick for those with hypertension is higher in first-degree relatives: father, mother, grandmothers, grandfathers, siblings. The more often close relatives suffer from high blood pressure, the greater the risk;
- age over 35 years;
- Stress (stress hypertension) and psychological stress. The stress hormone adrenaline increases your heart rate. It immediately constricts blood vessels;
- Taking certain medications, for example oral contraceptives and various nutritional supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. Components of tobacco trigger spasms of blood vessels - involuntary contractions of their walls. This constricts blood flow;
- Atherosclerosis – blockage of blood vessels by plaques. Total cholesterol should not exceed 6. 5 mmol/l blood;
- kidney failure (nephrogenic hypertension);
- endocrinopathy of the adrenal glands, thyroid or pituitary gland;
- excess salt in food. Table salt causes artery spasms and retains fluid in the body;
- Inactivity. Physical inactivity is accompanied by a slow metabolism - metabolism - and gradually weakens the body as a whole;
- Overweight. Each additional kilogram increases blood pressure by 2 millimeters of mercury – mmHg;
- sudden change in weather;
- chronic lack of sleep and other "provocateurs".
Most risk factors for developing high blood pressure are closely related. In most cases, heavy smokers develop atherosclerotic plaques, and physically passive and undernourished people quickly gain excess weight. Such combinations of factors significantly increase the risk of pathological abnormalities in the heart.
Depending on the combination and degree of expression of the above factors, as well as the likelihood of cardiovascular complications in the next decade, there are 4 types of risk for the development of arterial hypertension:
- low (risk less than 15%);
- average (from 15 to 20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the occurrence of arterial hypertension are also divided into two types based on the possibility of their elimination: correctable (correctable) and not. For example, a person can stop smoking but cannot change their ancestry. The level of risk is summarized using a number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol significantly increases the percentage chance of developing complications.
High blood pressure is easily treatable. Here much depends on the timely diagnosis of the disease, the patient's persistence and his willingness to make a radical change in his lifestyle.
Grade 1 hypertension
Arterial hypertension can be primary, i. e. H. develop independently and be a secondary complication of another disease. In the latter case, treatment is comprehensive, since it is necessary not only to normalize the pressure, but also to cure the accompanying cause of the disease.
A blood pressure value of 120 per 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is the so-called upper blood pressure or systolic pressure (with maximum contraction of the heart muscle walls). And 80 is the lower indicatoror the so-called diastolic pressure (at maximum relaxation). Accordingly, hypertension is divided into systolic, diastolic and mixed (systole-diastole), depending on whether the upper or lower indicators exceed the threshold.
When the lumen of blood flow narrows, the heart makes more effort to push blood into the vessels, it wears out faster and begins to work intermittently. An increase in heart rate - heart rate - negatively affects the functioning of the entire body. The air and nutrients contained in the blood do not have time to penetrate the cells.
Like any disease, high blood pressure will progress if left untreated. The appearance of the first hypertensive symptoms is preceded by a prehypertensive state - prehypertension.
The severity depends on the stage of development of the disease:
- "soft" or light;
- moderate or borderline;
- very severe or isolated systolic course.
Otherwise, stage 1 arterial hypertension is called a mild form of this disease. The upper blood pressure value is between 140 and 159, the lower one is 90 – 99 mm Hg. Disturbances in cardiac function occur in a spasmodic manner. The attacks usually have no consequences. This is a preclinical form of hypertension. Periods of exacerbations alternate with the complete disappearance of the symptoms of the disease. During remission, the patient's blood pressure is normal.
Diagnosing high blood pressure is simple: measuring blood pressure with a tonometer. For an accurate diagnosis, the procedure is carried out three times a day in a quiet environment and a relaxed state.
Even people at low risk of developing high blood pressure need to check their blood pressure regularly. One potentially dangerous factor is enough to more closely monitor the work of your heart. For those who have a significant tendency to heart disease, it is recommended to purchase a cardiovisor - a device for creating an ECG - electrocardiogram - at home. Any disease is easier to treat in its early stages.
Symptoms of stage 1 hypertension
Symptoms of stage 1 hypertension include:
- headaches that progress with exercise;
- aching or stabbing pain on the left side of the chest radiating to the shoulder blade and arm;
- black spots in front of the eyes.
We must not forget that in mild forms of hypertension, all of these symptoms occur occasionally. If your heart rate increases after intense physical activity or you find it difficult to fall asleep due to noisy neighbors, you should not panic and call yourself hypertensive.
During periods of improvement the patient feels great. Mild hypertension has all the signs characteristic of heart failure. More severe degrees of disease differ only in the persistence of symptoms and the occurrence of complications.
Complications of grade 1 hypertension
Complications include:
- Renal sclerosis - nephrosclerosis;
- Hypertrophy of the heart muscle (left ventricle).
Most believe that mild arterial hypertension can be cured without consequences. However, the risk of complications at grade 1 is average, i. e. H. about 15%. High pressure in the vessels due to the narrowing of their lumen leads to insufficient blood supply to the tissues. Lack of oxygen and nutrients leads to the death of individual cells and entire organs. Necrosis begins with local, focal lesions. Over time, an ischemic stroke is inevitable if left untreated.
Circulatory disorders inevitably lead to metabolic disorders. This has a detrimental effect on the respiration and nutrition of cells of all types. Pathological changes are inevitable, for example sclerosis - replacement by connective tissue. In nephrosclerosis, the walls of the kidney become pathologically denser and the organ "shrinks". This causes the excretory function to be disrupted and urea enters the bloodstream.
When blood vessels are narrowed, the heart must try to force blood through them. This leads to a pathological enlargement of the heart muscle. This hypertrophy is called true or functioning hypertrophy. The volume and mass of the left ventricle increase due to the thickening of its walls. This pathology is also called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows for stronger pushing. It would seem, how could this be dangerous? A "swollen" heart can compress adjacent vessels, and uneven muscle growth can block the exit from the left ventricle. Cardiac hypertrophy sometimes leads to sudden death.
Complications from grade 1 hypertension occur extremely rarely. To avoid them, it is enough to minimize the risk of arterial hypertension, i. e. H. eliminate its conditions and causes.
Treatment of stage 1 hypertension
First of all, the doctor will advise the patient to change his lifestyle. The patient is advised to have restful sleep, avoid stress, targeted relaxation exercises, a special diet, exercise, etc. If these measures are not sufficient, drug therapy is used.
The cardiologist prescribes the following medications: sedatives and other antihypertensive medications.
Medicines are selected strictly individually, because many hypertensive patients have concomitant diseases. The choice of medication is influenced by the patient's age and the medications he uses.
If it is possible to stop the disease in the initial stages and completely eliminate it, prevention cannot be neglected in the future. The principle is simple: all risk factors for high blood pressure should be avoided. Thanks to a healthy lifestyle, you can prevent the occurrence of even hereditary diseases.
High blood pressure 2 degrees
This is moderate high blood pressure. The upper blood pressure is 160 - 179 mm Hg, the lower blood pressure is 100 - 109 mm Hg. In this stage of the disease, the periods of elevated pressure are longer. Blood pressure rarely returns to normal.
Depending on the speed of the transition of hypertension from one stage to another, benign and malignant arterial hypertension are distinguished. In the second case, the disease progresses so quickly that it is often fatal. Hypertension is dangerous because an increase in the speed of blood movement through the vessels leads to a thickening of their walls and an even greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Typical signs of arterial hypertension occur even in mild forms.
In the second stage, the following symptoms appear:
- Sensation of pulsation in head;
- Hyperemia – overcrowding of blood vessels, for example redness of the skin;
- Microalbuminuria – the presence of albumin proteins in the urine;
- numbness and chills in the fingers;
- fundus pathologies;
- hypertensive crises – sudden increases in pressure (sometimes by 59 units at once);
- the appearance or worsening of signs of target organ damage.
Fatigue, lethargy and swelling occur because the kidneys are involved in the pathological process. A hypertensive attack may be accompanied by vomiting, difficulty urinating and defecating, shortness of breath, and tearing. Sometimes it takes several hours. Complications of hypertensive crisis include myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, hyperexcitation, hand tremors, unmotivated panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, clouding of consciousness);
The symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of hypertension. The disease is reluctant to go away at this stage and often returns.
Complications of grade 2 hypertension
Complications of stage 2 hypertension include the following diseases: Aortic aneurysm – a pathological protrusion of its wall.
To target organs, i. e. H. Internal organs affected by high blood pressure include:
- Bleeding in various organs occurs because the walls of the blood vessels become increasingly thicker, lose their elasticity and become brittle. Increased blood flow easily destroys such vessels. The reverse process occurs when aneurysms form. Here the walls become stretched and thinner due to increased blood circulation. They are so weakened that they tear easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis - fatty deposits on the walls - and thrombosis - their blockage by a blood clot. Bleeding of brain cells leads to oxygen starvation and their death. This phenomenon is called encephalopathy. Ischemia is a lack of oxygen to the heart. Angina pectoris is constant chest pain.
In connection with this, pathological processes associated with the underlying disease develop. Accordingly, if you do not start treatment on time or violate medical prohibitions, the target organs will become larger and larger and restoring health will become almost impossible.
2nd degree hypertension disability
Hypertension patients are constantly monitored in the pharmacy and examined regularly. In addition to the daily blood pressure measurement, you will be regularly prescribed an ECG. In some cases, an ultrasound scan may be required – ultrasound of the heart, urine tests, blood tests and other diagnostic procedures. Hypertensive people with a moderate form of the disease are less productive than healthy people.
If there is persistent impairment of physical functions due to high blood pressure, the patient is sent to the practice for an examination in order to receive a medical and social examination report. In rare cases, hypertensive patients are examined at home, in the hospital or even in absentia. Sometimes an additional testing program is created. Specialists from the Bureau of Medical and Social Expertise develop a mandatory individual rehabilitation program for disabled people.
To determine the disability group, the expert commission takes into account the following factors in addition to the degree of hypertension:
- information from medical history about hypertensive crises;
- Patient working conditions.
The procedure for establishing a disability group is necessary for proper employment. Whether it will be easy to find an employer willing to put up with the work of a "substandard" employee is another question. If a job applicant submits documents proving his disability, he is provided with the necessary working conditions in accordance with federal lawTo provide.
Employers are reluctant to hire people with disabilities because. . . Their working hours were reduced while maintaining full wages (for groups 1 and 2). In addition, they are required to take sick leave more often than other employees and their annual leave has been increased. Most disabled people in group 3 hide their illnesses in order to get a well-paid job. Violations of medical instructions regarding working conditions lead to worsening of the disease over time.
People with disabilities in group 3 receive cash benefits and are allowed to engage in professional activity with some restrictions:
- strong vibrations and noise are contraindicated;
- You may not work overtime, weekends or night shifts without the employee's consent;
- Constant physical or psycho-emotional stress is not allowed;
- Prohibition of work at heights, in hot workshops, near dangerous mechanisms;
- Reducing the duration of work that requires high concentration;
- seven-hour working day.
A special case is malignant arterial hypertension in stage 2. Its development is so rapid and the patient's condition is serious that the commission assigns him group 2 disability. This is no longer a working group. For disability levels 2 and 3, a medical and social examination is carried out annually. Disabled people in the following categories are exempt from the re-examination:
- men over 60 years old;
- women over 55 years old;
- People with irreversible anatomical defects.
The assignment of a disabled group results from the need for social security for high blood pressure patients. His ability to work is limited.
Treatment of stage 2 hypertension
At this stage of the disease there is no alternative to medication. The tablets are taken regularly, if possible at the same time of day. The patient should not think that it is enough just to take medication to get rid of the disease. If he does this and at the same time indulges in fatty foods and alcohol, for example, the positive effect of the therapy quickly wears off. The disease progresses to the next stage, where any treatment is no longer effective.
High blood pressure 3 degrees
Why are doctors alarmed if blood pressure values deviate even slightly from the norm? The fact is that with an increase in pressure by several units, the risk of cardiovascular complications increases by the same percentage. For example, if a person suffers from mild hypertension and the blood pressure deviates from the normal 120 to 80 mm Hg. by 39 units, then there is a very high probability that pathological abnormalities will occur in various organs (39%). What can then be said about the 3rd degree of the disease, in which the deviation is at least 60 units?
Stage 3 hypertension is a severe, chronic form of the disease. Blood pressure rises above 180/110 mm Hg, it never drops to the normal 120/80. Pathological changes are already irreversible.
Symptoms of stage 3 hypertension
Symptoms of stage 3 hypertension include:
- impaired coordination of movements;
- persistent visual impairment;
- Paresis and paralysis due to cerebral circulatory disorders;
- persistent hypertensive crises with speech disorders, clouding of consciousness and stabbing pain in the heart;
- significant limitation of the ability to move independently, communicate and care for oneself.
In severe cases, high blood pressure patients can no longer cope without outside help and require constant attention and care. The above signs of hypertension indicate that the patient's well-being is gradually deteriorating, the disease is spreading to new organ systems, and complications are increasing.
Complications of grade 3 hypertension
Complications of grade 3 hypertension include the following diseases:
- Myocardial infarction – the middle muscular layer of the heart;
- cardiac asthma - attacks of suffocation;
- peripheral artery damage;
- hypertensive retinopathy affects the retina of the eyes;
- Scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of grade 3 arterial hypertension are also called associated clinical conditions. When cerebral circulation is impaired, a stroke occurs, which is accompanied by loss of feeling in the limbs and fainting. Heart failure is a whole complex of heart diseases. The kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes mellitus, nephropathy is inevitable.
The more advanced the disease, the more terrible and serious its consequences are. The circulatory system is so important for the life of the body that the slightest deviation in its functioning has a powerful destructive effect.
3rd degree hypertension disability
If the course of the disease is severe, disability group 1 is determined. At this stage, patients are practically unable to work. Sometimes they are recognized as partially able to work and continue to work, but only at home or under special conditions.
But even with the most severe disability, the patient must undergo rehabilitation. In this situation, this is necessary to prevent death.
Treatment of stage 3 hypertension
As the course of the disease worsens, more and more powerful drugs are prescribed or their list remains the same, but the dosage increases. At this stage of hypertension, the effect of drug therapy is minimal. Chronic hypertensive patients are doomed to take pills for the rest of their lives.
If the condition becomes severe, surgery may be necessary. The operation is indicated for certain diseases of the blood vessels and heart. The method of stem cell therapy for stage 3 arterial hypertension is considered innovative.
High blood pressure 4 degrees
Some experts also identify stage 4 of the disease, which is very serious. In most cases, death is near. They try to alleviate the patient's suffering as much as possible and provide first aid in any hypertensive crisis. The patient is laid down and raises his head. He is urgently given medication to significantly lower his blood pressure.
Without treatment, new complications arise. Some of them provoke others, and diseases increasingly overwhelm a person. To stop this destructive process in a timely manner, you just need to monitor the dynamics of changes in your blood pressure, at least using a regular tonometer.
Example of a risk calculation depending on the stage of hypertension
Stages of hypertension Other risk factors, POM or disease Blood pressure (mmHg)
| High normal | Graduation 1 | Conclusion 2 | Conclusion 3 | ||
| GARDEN 130-139 DBP 85-89 |
GARDEN 140-159 DBP 90-99 |
GARDEN 160-179 DBP 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FRs | Low risk (Risk 1) |
Low risk (Risk 1) | Moderate risk (Risk 2) |
High risk (Risk 3) |
| 1-2 FR | Low risk (Risk 1) |
Moderate risk (Risk 1) |
Moderate / high risk |
High risk (Risk 3) |
|
| ≥3 FR | Short / moderate risk (Risk 1) |
Moderate / high risk |
High risk (Risk 3) |
High risk (Risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without Organ damage |
Moderate / high risk |
High risk (Risk 3) |
High risk (Risk 3) |
High / very large risk |
| Stage III | Detected CVD, CKD stage ≥4 or diabetes with organ damage |
Very high risk (Risk 4) |
Very high risk (Risk 4) |
Very high risk (Risk 4) |
Very high risk (Risk 4) |
GB – High blood pressure
SBP – systolic blood pressure
DBP – diastolic blood pressure
RF is a risk factor
CVD – cardiovascular disease
CKD – chronic kidney disease
DM – diabetes mellitus
POM – target organ damage
Once the risk category is determined, the doctor can identify influencing factors to reduce it. These changeable characteristics include:
- Obesity (with a BMI over 30), as well as central or visceral obesity, which is determined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, severe cardiac arrhythmias such as atrial fibrillation and others can also increase the risk.