Classification of hypertension

For several years now, doctors have been sounding the alarm: in developed countries that have overcome epidemics, high blood pressure continues to consistently occupy a prominent place among the causes of mortality from cardiovascular diseases.In terms of number of complications and 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 absurd.Lately, such a case will not surprise anyone.

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

What kind of disease is this?

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

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

Standard blood pressure for young people (may vary slightly from person to person) is 120/75 mmHg.Art.For those over forty – 130/80, for those over fifty – 135/84.If the pressure frequently rises to 140/90, doctors talk about hypertension.

Blood pressure is divided into two types:

1. Systolic.The top first number indicates the strength of blood pressure at the moment the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lower number shows blood pressure when the heart muscle (myocardium) relaxes.

High blood pressure (hypertension) is not without reason called the “silent killer”: it can cause the appearance of various pathologies.The heart and brain are especially affected.In advanced cases, it can even cause heart attack and stroke.

Classification of hypertension

The risks of hypertension are impressive, which is why scientists have been studying it since the beginning of the last century.During this period, the classification changed more than once, but two directions were formed:

1. When creating classifications according to the stages of development of the disease, doctors thought about the connection between hypertension and risk factors for the development of hypertension.However, they never reached a full agreement – the debate still continues.
2. Identification of disease variants.The approach investigates the causes of hypertension, the stages and mechanisms of its development.

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

By 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, redness of the face and body is noticeable due to the dilation of the capillaries.Red spots often appear.In the second case, a person suffering from the disease experiences a vascular spasm with increased pressure, becomes cold and pale.

By origin

Doctors have conventionally identified the degrees of hypertension: primary (hypertension) and secondary (symptomatic) hypertension.

The specific reasons for the appearance and development of the primary have not yet been found.It has three degrees.

1st degree arterial hypertension is called “mild”.Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure “jumps,” sometimes rising, then returning to normal.First-degree hypertension has a borderline subgroup with indicators of 140–149 and 90–94 mm Hg.Art.The probability of crises (sudden jumps) is small;if they happen, it is rare.

But for grade 2 (moderate) hypertension the risk is greater.The tonometer shows 160–179 and 100–109 mmHg.Art.Second-degree hypertension is characterized by the fact that the pressure is constantly increased.

Stage 3 (severe) disease can be fatal, especially with concomitant illnesses.This level is characterized by indicators above 180 and above 110 mmHg.Art.

Sometimes a person has problems with just one type of pressure.So hypertension is called isolated and there are two variants of hypertension:

1. systolic.The pressure is greater than 140 and less than 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and less than 90 mmHg.Art.In this case, the “upper” pressure rises to 140 mmHg.Art.and upper, while the “lower” remains normal.So we are talking about an isolated systolic form of hypertension.

Secondary hypertension is less common and is diagnosed in approximately 20% of cases (in young people under 35 years of age - in 25%).This type of disease is caused by a disease of a specific organ.Most often, this symptomatic hypertension appears 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 hypertension

In the recent past, high blood pressure was divided by experts into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects pathologies that appear in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease by grade.There are three of them and each means a series of changes in digital blood pressure values (they were discussed above).

In some classifications you can find the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist notes the 4th degree of the disease, he refers to digital pressure indicators, and not to the patient's condition, since hypertension is at stage 3. It is also considered serious.

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

At first, in stage 1 of the development of hypertension, the organs are still healthy.Often people with hypertension do not go to the hospital first because it feels tolerable and does not particularly interfere with their lives.Hypertensive crises are the exception rather than the rule.Novice hypertensive patients ignore health problems in vain, because at this stage the disease is easier to control.Sometimes treatment for stage 1 hypertension is more about a lifestyle change than taking medication.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to see a specialist.Timely treatment will help 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”.Some, in addition to abnormalities in the functioning of the heart, also develop defects in the retinal blood vessels.A person with hypertension is in stage 2. Attacks happen much more frequently.But the disease is still treatable.If the doctor diagnoses “Stage 2 Hypertension”, his recommendations must be followed with special attention.Because the disease, with greater development, begins to threaten life.

When stage 3 hypertension occurs, all target organs present with a series of complications.Pressure spikes in stage 3 hypertension can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, renal failure and other “gifts” often develop.Often, the third stage of hypertension is observed when the patient already has fundal hemorrhages, heart attack, aneurysms, stroke and other diseases.

Signs of blood pressure problems

Identifying hypertension in a timely manner and understanding how long a person has had it is the number one problem.Many hypertensive patients become aware of their diagnosis 3 or more years after the onset of the disease.

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

The alarm bell sounds if you see:

• occasional headache;
• “threats” of pain in the back of the head or blows to the temples;
• often feel nauseous and dizzy;
• shine flashes in the eyes or “black flies” fly;
• everything is irritating or covered in apathy;
• tingling or numb fingers;
• swelling of the arms, legs and/or face;
• out of nowhere, a rapid heartbeat appears.

If you recognize yourself, you should at least systematically measure your blood pressure.But it's better, of course, to go to the hospital.

Diagnosis of high blood pressure

If chronic hypertension is suspected, doctors use three diagnostic methods.

The first and simplest is to measure blood pressure.

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

In the third case, an electrocardiograph helps to draw conclusions.

So, what awaits you when you arrive at the hospital with suspected hypertension?

First, the doctor will check your blood pressure using a special device - a tonometer.By the way, in people who have an easily excitable nervous system, blood pressure numbers can increase even with minor emotional upheavals.When visiting the doctor, these patients experience “white coat” syndrome: as soon as the doctor starts measuring blood pressure, it increases.But the reason for these fluctuations is stress, not illness.Although such a reaction to a long-term shock can provoke disruptions in the normal functioning of the heart and kidneys.In these impressionable patients, the doctor will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight and body mass index is collected.The specialist looks for evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient - nowhere.It is necessary to find out what diseases a person has already faced and whether there are any illnesses at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; it is determined whether there is diabetes), whether the parents were hypertensive.
• Physical examination.First, your doctor will listen to your heart using a stethoscope.The task is to identify noises, changes in tones or the presence of strange sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about its condition against the background of hypertension.
• Biochemical blood test.It is necessary to know the level of sugar, cholesterol and lipoproteins and understand a person's tendency to atherosclerosis.
• ECG.An electrocardiogram is an integral element of the diagnostic process.Helps see irregularities in heart rhythm.With the results in hand, we can assess the presence of hypertrophy of the wall on the left side of the heart, typical of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see a picture of heart changes and defects, assess the functioning and condition of the valves.
• X-ray examination. Doctors do arteriography and aortography.With their help, specialists study the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing high blood pressure, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while it helps to determine the intensity of blood flow in 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 study, it will become clear whether the thyroid gland plays any role in the development of the disease and what treatment to prescribe.
• Kidney ultrasound.These organs and their vessels are very vulnerable to hypertension.The study helps to assess your condition.

Treatment methods

Today there are many methods for treating hypertension.Some have come to us from antiquity;Pharmacists and scientists worked on creating new ones for years and years.

The most common method is drug treatment.Doctors use several types of medications to normalize blood pressure.

1. Calcium antagonists aim to reduce heart rate.
2. Diuretics, most often thiazide diuretics, work to improve urine production and waste.
3. Adrenergic drugs.
4. Vasodilators dilate the blood vessels and thus level the situation.

In some cases, a surgical method called ablation is used.This procedure is not easy.A catheter with a device that creates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.To avoid the appearance of scars after the intervention, the entire length of the vein is affected.Performed under local anesthesia.

A variety of methods that came from the past are classified as alternative medicine.This includes leg parkas, vinegar lotions, and more.

Non-traditional remedies based on valerian, motherwort, beetroot, lemon, honey and horseradish are also effective in treating high blood pressure.

There are many herbal decoctions for the treatment of high blood pressure.Here is an example:

Take 1 tbsp.I.motherwort, valerian root and cumin.Mixture.Pour a tablespoon of this mixture into a glass of boiling water and leave for an hour.Drink the drug three times a day, 1/3 cup.The course lasts one month.

There is also monastic tea intended to help treat hypertension and homeopathic medicines.However, it is best to consult a specialist before treatment.

High blood pressure is a dangerous disease if left untreated.It is necessary to monitor your health at any age, as the modern rhythm of life often contributes to the development of the disease.And whatever the stage and degree of hypertension, without treatment it can lead to fatal consequences.