What is arterial hypertension? It is a disease characterized by blood pressure above 140 mmHg. Art. in this case, the patient suffers from headaches, dizziness, and nausea. Elimination of all symptoms is possible only with specially selected therapy.
Arterial hypertension can be a disease in its own right or can be accompanied by various pathologies. 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 increases in pressure are seen regularly and for no apparent reason. Curing the disease is completely impossible, but preventing severe consequences and learning to control pressure is a feasible task.
Do not self-medicate. See a doctor at the first sign of the disease.
Cause
To date, the exact causes of essential arterial hypertension are unknown. There are the following risk factors:
- heredity;
- malnutrition;
- bad habits;
- violation of fat metabolism;
- kidney disease;
- diabetes;
- tension;
- inactive lifestyle.
Classification of the disease
It is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure during a diagnostic test. Pathogenesis also differs depending on the types of disease. The following classification of arterial hypertension exists:
- Pulmonary essential arterial hypertension - a type of arterial hypertension that is rare but a major threat to human life. This disease is very difficult to identify by symptoms and even more difficult to treat. Pulmonary arterial hypertension is caused by an increase in pulmonary vascular resistance and consequent inadequate blood flow.
- Malicious. Symptoms of such arterial hypertension manifest as increased blood pressure up to 220/130. a radical change occurs in the fundus and swelling of the optic nerve plate. If the diagnosis is made in time, this type of arterial hypertension can be cured.
- Renovascular arterial hypertension. The causes of this type of disease are the presence of pathologies such as vasculitis, vascular atherosclerosis, and malignancies in the kidneys. The pathogenesis of the disease is reduced to the development of characteristic pressure, which can be represented by normal systolic and elevated diastolic blood pressure.
- Labis arterial hypertension. These types of diseases are characterized by periodic normalization of pressure. Patients with this form of arterial hypertension are not referred to as patients because this condition is not a pathology. In some cases, after a while, the blood pressure returns to normal.
Symptoms and types of arterial hypertension
Secondary arterial hypertension is a pathological process associated with diseases of the organs involved in the normalization of blood pressure. It is classified as:
- Hemodynamic - involves a violation of hemodynamic conditions due to the organic pathology of the large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the aortic chamber walls, aortic coarctation, and aortic valve insufficiency.
- Neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
- Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal gland, pituitary gland, and diffuse toxic goiter.
- Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs due to the following causes: nephritis, compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden, rapid, and often malignant course. Nephrogenic arterial hypertension can be divided into two types: renovascular and parenchymal.
- Medical. This form of symptomatic arterial hypertension is associated with the use of drugs that increase blood pressure.
Symptoms
Before the complications of arterial hypertension occur, it progresses without certain manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the development of headache, dizziness, and uncharacteristic ear noise in the back of the head and forehead.
Target organ damage
These symptoms of arterial hypertension are primarily due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the development of headaches and dizziness. After that, the patient has a weakness, black dots flash in front of his eyes, difficulty speaking. Such symptoms bother a person in the late stages of the disease. In addition, complications such as cerebral infarction and bleeding may occur.
Heart failure
In this case, the pathogenesis of the disease to left ventricular growth is reduced due to a compensatory reaction aimed at normalizing the wall tension. As a result, increased afterload, heart failure. There are not the most favorable predictions for heart damage, because such changes in your work cause heart failure, sudden death, and ventricular arrhythmias. Typical symptoms include:
- pulmonary edema;
- difficulty breathing during physical activity;
- cardiac asthma.
In some cases, arterial hypertension in children and adults causes some type of pain in the region of the heart. They can visit a person who is at rest or emotionally overwhelmed without engaging in physical activity. The main manifestation of the presented chest pains is that it is impossible to eliminate them with nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the development of shortness of breath in the early stages of the disease, after performing small loads, or at rest. All this indicates characteristic changes in the heart muscle and the development of heart failure. In such a disease, people cause swelling of the lower extremities due to the retention of sodium and water ions in the body.
If the lesion has affected the kidney, a protein will be found in the urine and microhaematuria and cylindruria may be observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.
Eye damage
Not very often, this arterial hypertension in children and adults affects vision, resulting in decreased photosensitivity and blindness. If there is visual impairment in the background of high blood pressure, black spots, fog, or a veil may appear in front of the patient's eyes. The reasons for such changes are a violation of the blood flow to the retina. Complications may include diplopia, visual impairment, or complete loss of vision.
Headache
This symptom is most common in arterial hypertension. It worries the patient at any time of the day or night. It can explode in nature and focus in the back of the head and then spread throughout the head. Increased headache in arterial hypertension occurs when the head is coughed. This can be accompanied by swelling of the eyelids and face. In this case, massage in patients with arterial hypertension improves blood flow to the veins, which leads to a reduction in pain until complete disappearance.
There are cases where the headache is the result of tense soft muscles in the head or tendons in the background of the disease presented. The development of such pain syndrome occurs after psycho-emotional or physical overload. Usually, such pain is astringent or astringent nature. A patient with arterial hypertension has nausea and dizziness. In the case of prolonged pain, incessant pain is characteristic, irritability occurs in the patients, the sensitivity to sharp sounds increases, they spin up.
Stages of the disease
Classification should be used to properly determine the stage of the abnormal process. This depends on the damage to the target organ. There are three stages to the disease.
Easy
This stage is characterized by a slight increase in blood pressure of 180/100 mmHg. Art. the pressure level is unstable. During resting time in patients with arterial hypertension, blood pressure levels return to normal. Due to the fixation of the disease, the pressure inevitably increases. Very often, people do not complain about the development of disorders related to their health. But a simple stage is characterized by its own symptoms:
- headache;
- noise in the ear;
- poor sleep;
- mental decline;
- dizziness;
- nose bleeding.
As a general rule, left ventricular hypertrophy has no manifestations, there are no abnormalities on the ECG, renal function without abnormalities, and the fundus does not change.
Medium
This stage is characterized by the presence of higher and more stable blood pressure. It can reach 180-105 mmHg. Art. patients often experience headaches, dizziness, pain in the region of the heart that suffer from angina pectoris.
This stage is characterized by typical hypertensive crises. The pathogenesis of the disease is associated with the following signs of target organ damage:
- left hypertrophy;
- weakening of I-tone at the apex of the heart;
- accent tone II on the aorta;
- ECG symptoms of subendocardial ischemia in some patients.
Regarding the central nervous system, there are various manifestations of vascular insufficiency, cerebral stroke, transient cerebral ischemia. In addition to the reduction of arterioles in the fundus, the veins become compressed, enlarged, bleed and secreted. At this stage, kidney blood flow and glomerular filtration rate decrease. But it is impossible to detect these manifestations in the analysis of urine.
hard
This stage of the disease is characterized by frequent vascular accidents. They are caused by a significant and stable rise in blood pressure and the progression of atherosclerosis and atherosclerosis of the larger blood vessels. At this stage, the blood pressure reaches 230-120 mmHg. Art. no spontaneous blood pressure normalization. In severe stages, the disease affects the following organs:
- heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias;
- cerebral ischemic and haemorrhagic infarctions, encephalopathy;
- fundus;
- kidneys - low blood flow and glomerular filtration.
Risk factors
Currently, the severity of the disease described depends directly on the risk facts. The risk lies in the development of cardiovascular complications underlying the high blood pressure. Prognosis of the consequences of arterial hypertension is diagnosed based on the complications presented. The following risk factors impair the course and prognosis of the disease:
- age - after 50 years for men and 60 years for women;
- smoking;
- high cholesterol;
- hereditary factor;
- obesity;
- hypodynamics;
- diabetes.
The risk factors presented can be eliminated (corrected) and may not be corrected. The first type of risk factors are characterized by the presence of diabetes mellitus, high cholesterol, smoking, and physical inactivity. Uncorrected risk factors include race, family history, and age.
Considering the extent of arterial hypertension and the triggers of the disease, a prognosis is observed with the development of complications such as heart attack or stroke for the next 10 years.
In the absence of mild arterial hypertension and risk factors, the development of cardiovascular complications will be minimized over the next 10 years. With a year of non-drug therapy and a lifestyle review, this level of cessation can be eliminated. If the pressure values are greater than 140/90 mmHg. Art. , They prescribe medication.
The average risk is accompanied by a 10-year complication of arterial hypertension lasting 10 years. Grade 2 arterial hypertension is treated in the same way as grade 1, but here the regulation of the dynamics is adjusted for six months. If blood pressure and its maintenance are stable, medication should be given.
High risk factors are associated with complications within 30%. In this situation, a patient with arterial hypertension is prescribed a full diagnosis in combination with non-drug treatment.
In a very high risk, the patient is prescribed an emergency differential diagnosis of arterial hypertension and is taking medication.
Diagnostic methods
Only after a thorough examination can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of arterial hypertension is based on the following types of tests:
- ECG, glucose analysis and complete blood count;
- Kidney ultrasound, determination of urea levels, blood creatinine levels, general urine tests are performed to rule out the kidney nature of the disease;
- If pheochromocytoma is suspected, ultrasound examination of the adrenal glands should be performed;
- analysis of hormones, ultrasound of the thyroid gland;
- MRI of the brain;
- Neurologist and ophthalmologist consultation.
Effective therapy
Treatment of arterial hypertension should be performed under the constant supervision of a physician. He is obliged to make an accurate diagnosis, to carry out additional diagnostics, which includes checking:
- fundus;
- renal function;
- the work of the heart.
Thereafter, one skilled in the art may prescribe antihypertensive therapy and identify various complications. Generally, patients who are first diagnosed with arterial hypertension syndrome should be hospitalized to perform all necessary examinations and select treatment.
Non-pharmacological treatment
Such therapy is recommended for all patients, regardless of the degree of illness of the drug. Such treatments for high blood pressure include:
- Give up smoking. Lifestyle changes are very important, such changes are an excellent prevention of cardiovascular disease.
- Removing the extra pounds. Overweight is a common cause of high blood pressure, so diet plays an important role in this issue. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
- Reduced salt intake. Ongoing studies have shown that reducing the amount of salt reduced to 4. 5 g per day reduces systolic blood pressure by 4-6 mmHg. Art.
- Insignificant consumption of strong drinks.
- Specially designed diet. The diet should include vegetables, fruits, foods high in magnesium, potassium, potassium, fish, seafood. In addition, the diet includes limited intake of animal fats.
- Active lifestyle. It is very useful to walk 30 minutes a minute 3-4 times a week. It can cause an increase in blood pressure when performing isometric loads.
Medical treatment
Pharmacotherapy should be prescribed taking into account the following recommendations:
- Treatment begins with a small dose of medication.
- In the absence of a therapeutic effect, the use of one drug should be replaced by another. The interval between stages should be less than 4 weeks, provided that no rapid reduction in blood pressure is required.
- Use of long-acting drugs to achieve a 24-hour effect with a single dose.
- Using the optimal combination of tools.
- Therapy should be constant. The use of the drug in courses is prohibited.
- Effective control of blood pressure throughout the year will help to gradually reduce the dose and amount of medicine.
Preventive measures
The prevention of arterial hypertension includes the following recommendations:
- If your family members suffer from this disease and you are over 30, you should measure your pressure regularly.
- Quit smoking and alcohol.
- A low fat and low salt diet should be followed.
- Practice outdoors.
- Avoid various stressful situations.
- Maintain a normal body weight.
With arterial hypertension, a person can live a normal, full life, but following all the recommendations described. The regulation of blood pressure in this case is a major component of successful treatment of the disease. Therefore, try not to start the disease and see a doctor in time to avoid various serious complications.