Arterial hypertension

arterial hypertension

What is high blood pressure? This is a disease characterized by blood pressure readings above 140 mm Hg. Art. in this case, the patient is visited by headaches, dizziness and feeling of nausea. Eliminating all the symptoms that have arisen can only be a specially selected therapy.

Hypertension can be an independent disease or accompany several pathologies, being its symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.

In hypertensive patients, indicators usually return to normal only after the use of special drugs, and pressure spikes can be observed regularly and for no apparent reason. It is completely impossible to cure the disease, but preventing serious consequences and learning to control your blood pressure is a viable task.

Don't self-medicate. At the first sign of illness, see a doctor.

Causes

To this day, the exact reasons why essential arterial hypertension can occur are unknown. There are the following risk factors:

  • heredity;
  • malnutrition;
  • bad habits;
  • violation of fat metabolism;
  • kidney disease;
  • diabetes;
  • stress;
  • inactive lifestyle.

Disease classification

During a diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure. The pathogenesis also presents differences taking into account the varieties of the disease. There is the following classification of high blood pressure:

  1. Essential pulmonary arterial hypertension - is considered one of the varieties of arterial hypertension, rare, but representing a great danger to human life. It is very difficult to identify this disease by the symptoms and even more difficult to treat. Pulmonary arterial hypertension is formed due to increased pulmonary vascular resistance and, as a result, insufficient blood flow.
  2. Malignant. Symptoms of such high blood pressure are presented in the form of increased blood pressure up to 220/130. there is a radical change in the background and swelling of the optic nerve disc. If the diagnosis was made in time, it is possible to cure this type of high blood pressure.
  3. Renovascular arterial hypertension. The reasons for the formation of this type of disease are the presence of pathologies such as vasculitis, vascular atherosclerosis and malignant formations in the kidneys. The pathogenesis of the disease is reduced to the characteristic pressure formation, which can be represented in normal systolic and elevated diastolic blood pressure.
  4. Labile arterial hypertension. For this type of disease, periodic normalization of pressure is characteristic. Patients suffering from this form of high blood pressure are not called patients as this condition is not a pathology. In some cases, over a period of time, blood pressure returns to normal.

Symptomatic arterial hypertension and its types

Secondary arterial hypertension is a pathological process that is associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:

  1. Hemodynamics - associated with violations of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, coarctation of the aorta, insufficiency of the aortic valve.
  2. Neurogenic. This type of symptomatic high blood pressure occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
  3. Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
  4. Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
  5. Medicinal. This form of symptomatic high blood pressure is associated with the use of drugs that increase blood pressure.

Symptoms

Before there are complications from high blood pressure, it proceeds without certain manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the formation of headaches in the back of the head and forehead, dizziness and unusual sound in the ears.

target organ injury

This type of high blood pressure symptoms occur first due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. Subsequently, the patient has weakness, flashes of black dots in front of his eyes, difficulty speaking. Such symptoms disturb a person at an advanced stage of the disease. In addition, complications such as cerebral infarction and hemorrhage can occur.

Cardiac insufficiency

In this case, the pathogenesis of the disease is reduced to an enlargement of the left ventricle due to a compensatory reaction aimed at normalizing wall tension. As a result, increased afterload, heart failure. When the heart is damaged, there are not the most favorable predictions, because such changes in its work are the causes of heart failure, sudden death and the development of ventricular rhythm disorders. The characteristic symptoms are:

  • pulmonary edema;
  • difficulty breathing during physical activity;
  • cardiac asthma.

In some cases, high blood pressure in children and adults causes pain in the heart region of a certain nature. They may visit a person in a state of rest or emotional overload without performing physical activity. The main manifestation of the presented chest pain is the impossibility of its elimination with the help of nitroglycerin.

The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath at an early stage of the disease after the implementation of small loads or at rest. All this indicates characteristic changes in the heart muscle and the formation of heart failure. With this disease, people have swelling of the lower extremities, the cause of which is retention of sodium ions and water in the body.

If the lesion has affected the kidneys, when passing a urine test, a protein is found in it, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.

eye damage

Not so often, this high blood pressure in children and adults affects vision, resulting in decreased sensitivity to light and blindness. If there is visual impairment in the context of high blood pressure, patients will have black dots before the eyes, fog or veil. The reasons for such changes are the violation of blood circulation in the retina. Complications can manifest as diplopia, visual impairment, or complete loss of vision.

Headache

This symptom is considered the most common in arterial hypertension. It worries the patient at any time of the day or night. It may be exploding in nature and focusing on the back of the head and then spreading over the entire head area. The increase in headaches in high blood pressure occurs when coughing, tilting the head. This can be accompanied by swelling of the eyelids and face. When performing massage in this case, in patients suffering from high blood pressure, there is an improvement in the output of blood in the veins, and this leads to a decrease in pain until its complete disappearance.

There are cases when headaches in the context of the presented disease are the result of tense soft muscles of the head itself or tendons. The formation of such a pain syndrome occurs after a psycho-emotional or physical overload. As a rule, this pain is squeezed or squeezed in nature. A patient suffering from high blood pressure has a feeling of nausea, dizziness. In the presence of prolonged pain, incessant pain is characteristic, irritability occurs in patients, sensitivity to high-pitched sounds increases, they become irascible.

stages of the disease

For the correct definition of the stage of this pathological process, it is necessary to use the classification. Depends on target organ damage. There are three stages of the disease.

Easy

This phase is characterized by a slight increase in blood pressure of 180/100 mm Hg. Art. the pressure level is unstable. During rest in a patient suffering from high blood pressure, blood pressure indicators return to normal. Due to the fixation of the disease, the pressure inevitably increases. Often, people do not complain about the formation of any disorders in relation to their health. But for an easy stage, its own symptoms are characteristic:

  • headaches;
  • noise in the ears;
  • bad sleep;
  • mental decline;
  • dizziness;
  • nosebleed.

As a rule, there are no manifestations of left ventricular hypertrophy, ECG has no abnormalities, renal function has no pathological changes, the background is not changed.

Medium

This phase is characterized by the presence of a higher and more stable blood pressure level. It can reach 180-105 mm Hg. Art. Patients often experience headaches, dizziness, pain in the heart region, who have angina pectoris.

This phase is characterized by typical hypertensive crises. The pathogenesis of the disease involves the following signs of target organ damage:

  • left hypertrophy;
  • weakening of the I tone at the apex of the heart;
  • accent tone II in the aorta;
  • in some patients, ECG symptoms of subendocardial ischemia.

Regarding the central nervous system, there are several manifestations of vascular insufficiency, strokes, transient cerebral ischemia. Towards the bottom, in addition to the reduction of arterioles, there is compression of the veins, their enlargement, hemorrhages, exudates. Blood flow to the kidneys and glomerular filtration rate for this stage are reduced. But it is impossible to detect these manifestations in the analysis of urine.

heavy

This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and stable increase in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In a severe stage, the disease affects the following organs:

  • heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
  • brain - ischemic and hemorrhagic infarctions, encephalopathy are formed;
  • eye 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 formation of cardiovascular complications against the background of high blood pressure. Taking into account the complications presented, the prognosis of the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and its prognosis:

  • age - in men after 50 years, in women after 60 years;
  • smoke;
  • high cholesterol;
  • hereditary factor;
  • obesity;
  • hypodynamia;
  • diabetes.

The risk factors presented may be eliminated (correctable) and may not be correctable. The first type of risk factors is characterized by the presence of diabetes mellitus, high cholesterol, smoking, physical inactivity. Uncorrected risk factors include race, family history, and age.

Taking into account the degree of arterial hypertension and the contributing factors of the disease, there is a prediction with the formation of complications such as heart attack or stroke in the next 10 years.

With a mild degree of arterial hypertension and the absence of risk factors, the formation of complications of the cardiovascular system is minimized for the next 10 years. With non-drug therapy for a year and a review of your lifestyle, it is possible to eliminate this degree of the pathological process. If pressure readings are greater than 140/90 mm Hg. Art. , then drug treatment is prescribed.

The average degree of risk is accompanied by the formation of complications in the context of arterial hypertension for 10 years in a proportion of 20%. 2nd degree arterial hypertension is treated in the same way as 1st degree, but here the dynamics control is also adjusted for six months. If there are poor blood pressure results and its stable maintenance, drug treatment is carried out.

High-grade risk factors are accompanied by the formation of complications by 30%. In this situation, a patient suffering from high blood pressure is prescribed a full diagnosis in combination with a non-drug treatment.

At a very high risk, the patient is prescribed an urgent differential diagnosis of high blood pressure and medication use.

diagnostic methods

MRI as a way to diagnose hypertension

Only after a thorough study can you prescribe an effective therapy and eliminate all manifestations of this disease. The diagnosis of high blood pressure is based on the following types of tests:

  • ECG, glucose analysis and complete blood count;
  • Ultrasound of the kidneys, determination of the level of urea, blood creatinine, general urinalysis - are carried out to exclude the renal nature of the formation of the disease;
  • Ultrasound of the adrenal glands is advisable if pheochromocytoma is suspected;
  • hormone analysis, ultrasound of the thyroid gland;
  • MRI of the brain;
  • Consultation with neurologist and ophthalmologist.

effective therapy

The treatment of high blood pressure should be carried out under the constant supervision of a doctor. It is he who is obliged to make an accurate diagnosis, to carry out additional diagnoses, which include checking:

  • bottom;
  • kidney function;
  • the work of the heart.

After that, the specialist can prescribe antihypertensive treatment, determine various complications. As a rule, patients in whom the arterial hypertension syndrome was detected for the first time are hospitalized to carry out all the necessary studies and the choice of treatment.

non-drug treatment

Such therapy is recommended for all patients, regardless of the degree of illness from drug use. Such treatment for hypertension includes:

  1. To quit smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
  2. Shedding extra pounds. A common cause of high blood pressure is being overweight, so diet plays an important role in this matter. In addition, a balanced and adequate diet has a beneficial effect on risk factors such as diabetes mellitus and myocardial hypertrophy.
  3. Reduced amount of salt intake. According to ongoing studies, a reduced amount of salt consumed to 4. 5 g/day helps to reduce systolic blood pressure by 4-6 mm Hg. Art.
  4. Insignificant consumption of strong drinks.
  5. Specially designed diet. Your diet should include vegetables, fruits, foods rich in magnesium, potassium, potassium, fish, seafood. In addition, the diet involves a limited intake of animal fats.
  6. Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very helpful. When performing isometric loads, you can provoke an increase in blood pressure.

Medical treatment

Drug therapy should be prescribed taking into account the following recommendations:

  1. Treatment starts with small doses of medication.
  2. In the absence of a therapeutic effect, it is necessary to replace the use of one drug with another. The interval between grades should be less than 4 weeks, as long as a rapid drop in blood pressure is not required.
  3. The use of long-acting drugs to achieve a 24-hour effect with a single dose.
  4. Application of the ideal combination of devices.
  5. Therapy must be permanent. It is not allowed to use the drug in courses.
  6. Effective blood pressure control throughout the year contributes to a gradual reduction in the dose and amount of medication.

Preventive actions

The prevention of high blood pressure includes the following recommendations:

  1. If family members have this condition and you are over 30, you will need to have your blood pressure checked regularly.
  2. Give up smoking and alcohol.
  3. A low-fat, low-salt diet should be followed.
  4. Exercise outdoors.
  5. Avoid various stressful situations.
  6. Maintain normal body weight.

With high blood pressure, a person can live a normal and full life, but subject to all the recommendations described. Blood pressure control in this case is one of the main components of successful treatment of the disease. So, try not to start the disease and visit a doctor in a timely manner to avoid various serious complications.