Hypertension, or hypertension - a condition characterized by stable, ie, detected by repeated measurements, increased blood pressure. Accompanying many diseases, it is considered a risk factor for the development of hazardous complications of the cardiovascular system, including stroke and myocardial infarction. Hypertonic disease, as the main cause of pathology in mind, requires taking medications, normalizing the patient's lifestyle and nutrition.
Blood pressure is a force with which circulating blood acts on the walls of blood vessels. This pressure at the time of cardiac contraction is called systolic and during its diastolic relaxation. The normal range for these indicators is quite wide.
During numerous observations, scientists have come to the conclusion that the risk of cardiovascular complications increases with each additional increase in blood pressure by 10 mm hg. Art. Already starting with a level of 115/75 mm RT. Art. However, a decrease in pressure drug just above 140/90 mm was eventually appropriate. RT. Art. , Therefore, it is precisely a value that is considered a criterion for determining hypertension.
Reasons
In approximately 90% of cases, hypertension becomes the cause of a stable increase in blood pressure. This diagnosis is made to the patient when other diseases accompanied by hypertension were not found during the exam. Among the last:
- Renal pathologies - pyelonephritis, glomerulonephritis, polycystic and diabetic nephropathy, renal arteries stenosis;
- Endocrine-neoplasm disorders of the adrenal gland, pancreas or pituitary gland, thyroid hyperfunction, Izenko-Cushing syndrome, feochromocytoma;
- Obstructive syndrome of apnea in a dream;
- Valve addictions or atherosclerotic damage to the aorta.
Regular use of various medications can also cause an increase in blood pressure. This includes oral contraceptives, non -steroid anti -inflammatory drugs, amphetamines, corticosteroids, medicines containing erythropoetin, cyclosporine, cocaine.
The likelihood of cardiovascular disease, including hypertension, is in a close relationship with the following risk factors:
- Inadequate nutrition, including excess salt of sodium, saturated fats and trans fats, a lack of leafy vegetables, vegetables and fruits in the diet;
- obesity;
- heart pathologies and blood vessels in close relatives;
- age over 65;
- sedentary lifestyle;
- chronic stress;
- Harvesting habits - smoking, excessive alcohol consumption.
Classification
If it were possible to identify the disease that leads to an increase in blood pressure, hypertension is called secondary or symptomatic. In the case of an unidentified cause of hypertension, it is considered primary, caused by hypertension.
The latter has a preparation chain:
- Step I. There are no obvious signs of violations of target organs affected by a stable increase in the heart of blood pressure, kidneys, arterial and venous vessels.
- Stage II. There are one of the signs listed or its entirety, such as an increase in the left ventricle of the heart, a decrease pronounced in the kidney filtration rate, albumin in the urine, an increase in the thickness of carotid arteries walls or the appearance of atherosclerotic plaques in their lumen. In this case, clinical manifestations of the disease may be absent.
- Stage III Hypertension. There are one or more pathologies associated with atherosclerotic processes in the heart and vessels - myocardial infarction, acute cerebrovascular accident, pectoral angina, atherosclerosis of the lower extremity arteries, or severe kidney damage.
Arterial hypertension is divided into varying degrees, depending on the maximum indicators of measured blood pressure:
- The first degree. Systolic blood pressure from 140 to 159 mm. RT. Art. And/or diastolic - from 90 to 99 mm. RT. Art.
- The second degree. Systolic blood pressure from 160 to 179 mm. RT. Art. And/or diastolic - 100 to 109 mm. RT. Art.
- The third degree. Systolic blood pressure is greater than 180 mm. RT. Art. and/or diastolic above 110 mm. RT. Art.
There is also an isolated form of arterial hypertension, in which only systolic pressure figures in the normal diastolic.
Symptoms
Often an increase in blood pressure is not accompanied by a deterioration in the good -to -be and can go unnoticed for the patient, so it is so important to regularly measure blood pressure, especially the elderly and elderly.
The following symptoms may be the manifestations of hypertension:
- headache, especially in the morning after the awakening;
- Bleeding from the nose;
- bleeding under the mucous membrane of the eye;
- violation of heart rhythm;
- Turvah vision, fly treble;
- tinnitus.
An accentuated blood pressure leap to high numbers, accompanied by a deterioration pronounced in the well -being, is called the hypertensive crisis. Most of the time, it occurs with an increase in systolic pressure of over 180 mm hg. Art. and/or diastolic above 120 mm hg. Art. At the same time, the patient has weakness, nausea, vomiting, which does not bring relief, impaired consciousness, anxiety and fear, muscle trensions, chest pain.
Complications
A stable increase in blood pressure with hypertension significantly increases the risk of cardiovascular pathologies, including the patient's life. These include:
- Acute brain circulation (stroke);
- Angina Pectoris, myocardial infarction;
- Vascular dementia (dementia);
- Chronic renal and heart failure;
- Atherosclerotic lesions of the lower extremities vessels.
Diagnosis
The main symptom of hypertension is a stable increase in blood pressure, has revealed at least three dimensions on different days during a calm environment. In the first measurement of blood pressure in a hospital or clinical for the correction of results, it is important to comply with the following rules:
- Before examining, the patient needs to sit for several minutes in a silent room to calm down;
- The size of the tonometro cuff must correspond to the thickness of the arm and the device itself - to be attached to the heart level;
- Two measurements are performed with a 1-2 minute interval in each hand, with a big difference in the numbers obtained, additional measurement is made;
- In elderly patients, as well as people suffering from diabetes mellitus, or if suspected of reducing blood pressure in case of change in body position, the measurement is performed in the first and fifth minutes in standing position;
- In addition, heart rate is measured in 30 seconds.
The doctor in an interview with the patient clarifies how age the pressure began to increase, if there are symptoms such as snoring with breath stopped in a dream, crises of muscle weakness or sudden palpitations with sweat and headache and unusual impurities in the urine. It is also important to find out which medications and bullies it takes.
Within the structure of the first stage of the exam, the following tests are performed for hypertension:
- Clinical blood test;
- General urine analysis, microalbumin detection in its time and diary portions;
- Biochemical blood examination (cholesterol, lipoproteins to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium and glucose and creatinine);
- Determination of the level of glycated hemoglobin;
- Determination of hormone concentration -tyroxine, triiodothyronine and thyroid hormone -mer, thyroid antibodies -peroxidase and thyroidoglobulin, aldosterone.
In case of suspected hereditary predisposition to the disease, it is possible to determine the polymorphisms of genes associated with the development of hypertension.
To clarify risk factors for the development and identification of existing cardiovascular pathologies for hypertension, instrumental diagnostic methods are used:
- daily monitoring of blood pressure;
- Electrocardiographic study;
- echocardiography;
- Holter's daily monitoring;
- Duplex scan of brachiocephalous, kidney or iliac arteries;
- Ultrasound study of adrenal kidneys and glands;
- Eye bottom inspection.
With hypertension, blood pressure control at home is important to maintain a diary in which it is necessary to correct all the results of time measurements, taking medications and stress episodes that can cause an increase in blood pressure. At the same time, measurements should be performed in a sitting position after several minutes of rest, keeping your hand on the same level with the heart.
Treatment
With a moderate and low risk of cardiovascular complications, the patient is recommended only to change lifestyle, diet correction, weight loss, increased physical activity and special gymnastics for hypertension, rejection of bad habits against the bottom of regular blood pressure. Often, these measures are sufficient to normalize blood pressure.
The hypertension diet involves the limitation of table salt, caffeine, clear dishes, salty, smoked and spicy, high fat products, offal, oil cream and alcoholic beverages. It is allowed to use no more than 5 g of salt a day outside the exacerbation of the disease. The recommended daily fluid rate is 1-1, 2 liters.
In the case of unsuccessful non -deprived treatment for several months, as well as with a high risk of complications, it uses hypotensive therapy using hypertension medications, whose goal is a decrease in blood pressure less than 140/90 mm. RT. Art. For patients with diabetes or people who already suffer from pathologies of the cardiovascular system, the target pressure level is even lower than 130/80 mm. RT. Art.
Modern drug treatment of hypertension includes a combination of two or more medications from the following groups:
- Calcium antagonists;
- Angiotenzinzinproding enzyme inhibitors;
- Angiotensin II blockers;
- diuretics (diuretics);
- B blockers;
- Alpha-blockers.
The vast majority of them are produced in the form of hypertension tablets.
Prevention
The prevention of hypertension exacerbations includes diagnosis and timely therapy for diseases of cardiovascular, nervous, urinary and endocrine systems, relentless followed by the doctor's recommendations, including treatment and non -union medicines, as well as regular blood pressure measurement.