Classification of hypertension

Doctors have been sounding the alarm for years: in developed countries that have overcome epidemics, arterial hypertension is still the leading cause of death from cardiovascular diseases.In terms of the number of complications and the unfavorable prognosis, it competes with diabetes mellitus.At the same time, the disease is rapidly rejuvenating.A few decades ago, a 35-year-old stroke patient was considered nonsense.Recently, such a case does not surprise anyone.

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

What disease is this?

Hypertension refers to cardiovascular diseases.Its presence causes persistent high blood pressure in the arteries of the systemic circulation.

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

The standard blood pressure of young people (may vary slightly from person to person) is 120/75 mmHg.Art.For over forty - 130/80, for 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. Systole.The first, upper number indicates the strength of the blood pressure at the moment when the heart contracts and squeezes the blood out of the arteries.
2. Diastole.The second, bottom number shows the blood pressure when the heart muscle (myocardium) relaxes.

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

Classification of hypertension

The risks of high blood pressure are fascinating, which is why scientists have been studying it since the beginning of the last century.During this period, the classification changed several times, but two trends emerged:

1. When creating classifications according to the stages of the development of the disease, doctors thought about the relationship between high blood pressure and risk factors for the development of high blood pressure.However, they never reached a complete agreement - the debate is still ongoing.
2. Identification of variants of the disease.The approach examines the causes, stages and mechanisms of high blood pressure.

The article will discuss several of the classifications proposed by scientists.

With external signs

This is how a German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when the pressure increases, the redness of the face and body is noticeable due to the expansion of the capillaries.Red spots often appear.In the second case, the person suffering from the disease experiences vasospasm with increased pressure, becomes cold and pale.

By origin

Doctors have traditionally identified grades of hypertension: primary (hypertension) and secondary (symptomatic) hypertension.

The specific reasons for its primary appearance and development have not yet been found.It has three grades.

Arterial hypertension of the 1st degree is called "mild".Pressure - 140-159 and 90-99 mm Hg.Art.Blood pressure “spikes”, sometimes increases and then returns to normal.First-degree hypertension has a borderline subgroup with indicators of 140-149 and 90-94 mmHg.Art.The probability of crises (sharp sudden jumps) is small, if they occur, they are rare.

But with stage 2 (moderate) high blood pressure, the risk is higher.The tonometer shows values of 160-179 and 100-109 mmHg.Art.Hypertension of the second degree is characterized by the fact that the pressure is constantly increasing.

Stage 3 disease (severe) can be life-threatening, especially in the case of accompanying diseases.This level is characterized by indicators greater than 180 and greater than 110 mm Hg.Art.

Sometimes a person only has a problem with one type of pressure.Then hypertension is called isolated and there are two types of hypertension:

1. systole.The pressure is more than 140 and less than 90 mm Hg.Art.;
2. subgroup: borderline - 140-149 and less than 90 mm Hg.Art.In this case, the "upper" pressure creeps up to 140 mmHg.Art.and higher, while the "lower" remains normal.We are then talking about the isolated systolic form of hypertension.

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

Stages of high blood pressure

Recently, experts have divided arterial hypertension into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects the pathologies that have appeared in the body over the years.

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

In some classifications, there is a fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When the specialist notes the 4th degree of the disease, he is thinking about digital pressure indicators, and not about the patient's condition, since high blood pressure is 3rd stage, also considered serious.

With chronic high blood pressure, the body cannot cope with stress and bad things start to happen to the organs.Those that are affected earlier than others are called target organs by doctors.In addition to the heart and brain, these include the retina and kidneys.The classification of high blood pressure into stages is based precisely on the effect on these weak points.

At first, in stage 1 of the development of high blood pressure, the organs are still healthy.People with high blood pressure often do not go to the hospital at first, because they feel that it is bearable and does not particularly interfere with their lives.A hypertensive crisis is more the exception than the rule.Patients with initial hypertension ignore health problems in vain, because the disease can be tamed most easily at this stage.Treatment of stage 1 hypertension sometimes depends on lifestyle changes rather than medication.But it is necessary.Therefore, if the tonometer regularly shows a high level, it is better to consult a specialist.Timely treatment helps 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, defects also develop in the blood vessels of the retina.A person with high blood pressure is in stage 2.Crises happen much more often.But the disease is still treatable.If the doctor diagnoses "stage 2 hypertension", his recommendations should be followed especially carefully.Because the disease threatens life with further development.

When stage 3 hypertension occurs, all target organs present with a host of complications.In stage 3 hypertension, the increase in pressure can be associated with heart failure and asthma attacks.Arteriosclerosis, angina pectoris, kidney failure and other "gifts" often develop.It often happens that the third stage of hypertension is observed when the patient already has hemorrhages in the fundus, heart attack, aneurysm, stroke and other diseases.

Signs of blood pressure problems

The number one problem is identifying hypertension in time and understanding how long a person suffers.Many hypertensive patients learn about the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing high blood pressure are heredity, being overweight, smoking, frequent stress, elevated cholesterol levels, a sedentary lifestyle and old age.

Alarm bells ring when you see:

• occasional headache;
• pain "threatens" in the back of the head or knocks in the temple;
• you often feel nauseous and dizzy;
• blinding light flashes in the eyes or "black flies" fly;
• covered by everything annoying or apathetic;
• fingers tingling or numb;
• 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

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

The first, simplest, is to measure blood pressure.

The second is a complete physical examination.It can only be done by a specialist.He performs palpation and auscultation (analysis of sounds accompanying the work of various organs), percussion instruments (tapping different parts of the body and drawing conclusions based on sound), and standard examination.

In the third case, the electrocardiograph helps in drawing conclusions.

So what awaits you if you arrive at the hospital with suspected high blood pressure?

First, the doctor will check your blood pressure with a special device - a tonometer.In people with an easily excitable nervous system, the blood pressure numbers can jump even in case of minor emotional shocks.During a doctor's visit, such patients experience the "white coat" syndrome: as soon as the doctor starts measuring the blood pressure, it rises.But the cause of these fluctuations is stress, and not disease at all.Although such a shock effect can cause disturbances in the normal functioning of the heart and kidneys in the long term.In such susceptible patients, the health care provider checks the pressure several times and under different conditions.

• Medical examination.Information is collected on the patient's height, weight and body mass index.The specialist looks for evidence of symptomatic high blood pressure.
• Medical history.Without asking the patient - nowhere.It is necessary to find out what diseases a person has encountered before and whether he currently has any diseases.We analyze risk factors and lifestyle (presence/absence of bad habits, diet, cholesterol level; they determine whether there is diabetes), whether the parents were hypertensive.
• Physical examination.First, the doctor listens to the sound of the heart using a stethoscope.The task is to identify the presence of noises, voice changes or extraneous sounds, if any.After this examination, it is possible to rule out heart defects and draw preliminary conclusions on the background of high blood pressure.
• Biochemical blood test.It is necessary to determine the level of sugar, cholesterol and lipoproteins, as well as to understand how prone a person is to atherosclerosis.
• EKG.The electrocardiogram is an integral part of the diagnostic process.It helps to detect cardiac arrhythmias.With the results, we can assess the hypertrophy of the left side of the heart wall, which is characteristic of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can get an idea of changes and heart defects, assess the function and condition of the valves.
• X-ray examination.Doctors perform arteriography and aortography.With their help, specialists examine the wall and lumen of the arteries to rule out congenital narrowing of the aorta (coarctation) and the presence of atherosclerotic plaques.
• Dopplerography.When diagnosing arterial hypertension, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while helping to determine the intensity of blood flow through arteries and veins.
• Ultrasound of the thyroid gland.Along with other data, the doctor needs the results of a blood test to determine the level of hormones produced by the thyroid gland.Based on the results of the examination, 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 blood vessels are very sensitive to high blood pressure.The study helps to assess their condition.

Treatment methods

Today, there are many ways to treat high blood pressure.Some have come to us from ancient times;pharmacists and scientists have worked for years to create others.

The most common method is drug treatment.Doctors use several drugs to normalize blood pressure.

1. The purpose of calcium antagonists is to reduce the heart rate.
2. Diuretics, most commonly thiazide diuretics, improve urine production and urination.
3. Adrenergic drugs.
4. Vasodilators dilate 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 equipped with a device that generates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.In order to avoid the appearance of scars after the procedure, the entire length of the vein is affected.It is performed under local anesthesia.

Many methods from the past are part of alternative medicine.This includes leg rubs, vinegar creams, and more.

Non-traditional remedies based on valerian, motherwort, beetroot, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal concoctions to treat high blood pressure.Here is an example:

Take 1 tbsp.l.motherwort, valerian and cumin.Mix.Pour a tablespoon of this mixture into a glass of boiling water and leave for an hour.Drink the medicine three times a day, 1/3 cup.The course is planned for one month.

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

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