A person is alive as long as his heart beats. The cardiac "pump" ensures blood circulation in the vessels. In this regard, there is a blood pressure. Abbreviated as AD. Any deviations from normal blood pressure levels are deadly.
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Risks of developing hypertension
The risk of developing hypertension or high blood pressure – arterial hypertension – consists of a series of factors. Accordingly, the more there are, the more likely a person is to become hypertensive.
Risk factors for developing hypertension:
- hereditary predisposition. The risk of becoming ill is greater for those with hypertension among first-degree relatives: father, mother, grandparents, siblings. The more close relatives suffer from hypertension, the greater the risk;
- age over 35 years;
- stress (stress hypertension) and mental stress. The stress hormone adrenaline increases your heart rate. Instantly contracts blood vessels;
- taking certain medications, for example oral contraceptives and various dietary supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. Tobacco components provoke spasms of blood vessels - involuntary contractions of their walls. This narrows the blood flow;
- atherosclerosis – obstruction of blood vessels with plaques. Total cholesterol should not exceed 6. 5 mmol/l of blood;
- kidney failure (nephrogenic hypertension);
- endocrinopathy of the adrenal glands, thyroid gland or pituitary gland;
- excess salt in food. Table salt causes arterial spasm and retains fluid in the body;
- inactivity. Physical inactivity is accompanied by a slow metabolism - metabolism - and gradually weakens the body as a whole;
- excess body weight. Each extra kilogram increases blood pressure by 2 millimeters of mercury – mmHg;
- sudden change in weather;
- chronic lack of sleep and other "provocateurs".
Most of the risk factors for developing hypertension are closely related. So, heavy smokers in most cases develop atherosclerotic plaques, and physically passive and malnourished people quickly gain excess weight. Such combinations of factors significantly increase the risk of pathological anomalies in the heart.
Depending on the combination and degree of manifestation of the above factors, as well as the likelihood of cardiovascular complications in the next decade, there are 4 types of risk of developing arterial hypertension:
- low (risk less than 15%);
- medium (from 15 to 20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the appearance of arterial hypertension are also divided into 2 types according to the possibility of their elimination: correctable (correctable) and not. For example, a person may very well stop smoking, but cannot change their ancestry. The amount of risk is summarized from several indicators. A patient with stage 1 hypertension who begins abusing alcohol will significantly increase the percentage chance of developing complications.
Hypertension is quite treatable. Much here depends on the timely diagnosis of the disease, the patient's persistence and his willingness to radically change his lifestyle.
1st degree hypertension
Arterial hypertension can be primary, that is, develop independently, and secondary - be a complication of another disease. In the latter case, treatment is carried out comprehensively, since it is necessary not only to normalize the pressure, but also to cure the cause of the concomitant disease.
A blood pressure reading of 120 over 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is the so-called upper blood pressure or systolic pressure (at maximum contraction of the walls of the heart muscle). And 80 is the lowest indicator or the so-called diastolic pressure (at its maximum relaxation). Thus, hypertension is divided into systolic, diastolic and mixed (systole-diastolic), depending on whether the upper or lower indicators exceed the threshold value.
When the blood flow lumen narrows, the heart expends more effort pushing blood into the vessels, wears out more quickly, and begins to work intermittently. An increase in heart rate – heart rate – negatively affects the functioning of the entire body. The air and nutrients contained in the blood do not have time to enter the cells.
Like any disease, hypertension progresses if left untreated. The appearance of the first hypertensive symptoms is preceded by a prehypertensive state - prehypertension.
The degree of severity depends on the stage of development of the disease:
- "soft" or light;
- moderate or borderline;
- very severe or isolated systolic.
Otherwise, stage 1 arterial hypertension is called a mild form of the disease. The upper blood pressure reading ranges from 140 to 159, and the lower is 90 to 99 mm Hg. Disturbances in the functioning of the heart occur spasmodically. Attacks usually pass without consequences. This is a preclinical form of hypertension. Periods of exacerbations alternate with the complete disappearance of the symptoms of the disease. During remission, the patient's blood pressure is normal.
Diagnosing hypertension is simple: measuring blood pressure with a tonometer. For an accurate diagnosis, the procedure is performed three times a day in a calm and relaxed environment.
Even people at low risk of developing high blood pressure need to check their blood pressure regularly. A potentially dangerous factor is enough to more closely monitor the work of your heart. For those who have a significant predisposition to heart disease, it is advisable to purchase a cardiovisor - a device for carrying out an ECG - electrocardiogram - at home. Any disease is easier to treat at an early stage.
Symptoms of Stage 1 Hypertension
Symptoms of stage 1 hypertension include:
- headache that progresses with exercise;
- aching or stabbing pain in the left side of the chest, radiating to the shoulder blade and arm;
- black spots before the eyes.
We must not forget that in mild forms of hypertension all these symptoms appear occasionally. If after intense physical activity your pulse quickens or it is difficult to fall asleep due to noise from neighbors, do not panic and consider yourself hypertensive.
During periods of improvement, the patient feels great. Mild hypertension has all the characteristic signs of heart failure. The most serious degrees of the disease differ only in the persistence of symptoms and the occurrence of complications.
Complications of 1st degree hypertension
Complications include:
- renal sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most believe that mild hypertension can be cured without consequences. But the risk of complications with grade 1 is average, i. e. About 15%. High pressure in the vessels due to the narrowing of their lumen leads to insufficient blood supply to the tissues. Lack of oxygen and nutrients leads to the death of individual cells and entire organs. Necrosis begins with local and focal lesions. Over time, if left untreated, an ischemic stroke is inevitable.
Circulatory disorders inevitably lead to metabolic disorders. This has a detrimental effect on the respiration and nutrition of cells of any type. Pathological changes are inevitable, for example, sclerosis - replacement by connective tissue. In nephrosclerosis, the walls of the kidney become pathologically denser and the organ "shrinks". In this regard, the excretory function is disturbed and urea enters the bloodstream.
If the blood vessels are narrowed, the heart struggles to push blood through them. This leads to pathological enlargement of the heart muscle. This hypertrophy is called true or functional. The volume and mass of the left ventricle increase due to the thickening of its walls. This pathology is also called cardiomyopathy. The heart adapts its structure to the body's needs. The extra muscle tissue allows it to squeeze harder. It would seem, how could this be dangerous? A "swollen" heart can compress adjacent vessels, and irregular muscle growths can close the left ventricular outlet. Cardiac hypertrophy sometimes leads to sudden death.
Complications of grade 1 hypertension occur extremely rarely. To avoid them, simply minimize the risk of developing arterial hypertension, that is, eliminate its prerequisites and causes.
Treatment of stage 1 hypertension
First, the doctor will advise the patient to change their lifestyle. The patient will be advised to have restful sleep, avoid stress, targeted relaxation exercises, special diet, exercise, etc. If these measures are not sufficient, drug therapy is used.
The cardiologist prescribes the following medications: sedatives and other antihypertensives.
Medicines are selected strictly individually, becauseMany hypertensive patients have concomitant diseases. The choice of medications is influenced by the patient's age and the medications they use.
If it is possible to stop the disease at the initial stage and get rid of it completely, prevention cannot be neglected in the future. Its principle is simple: avoid all risk factors for hypertension. Thanks to a healthy lifestyle, it is possible to prevent the occurrence of even hereditary pathologies.
Hypertension 2 degrees
This is hypertension in moderate form. The upper blood pressure is 160 to 179 mm Hg and the lower blood pressure is 100 to 109 mm Hg. At this stage of the disease, periods of increased pressure are longer. Blood pressure rarely returns to normal.
Depending on the speed of transition of hypertension from one stage to another, benign and malignant arterial hypertension are distinguished. In the second, the disease progresses so quickly that it is often fatal. Hypertension is dangerous because an increase in the speed of blood movement through the vessels leads to thickening of the walls and an even greater narrowing of the lumen.
Symptoms of Stage 2 Hypertension
Typical signs of high blood pressure appear even in mild forms of the disease.
In the second stage, they are accompanied by the following symptoms:
- sensation of pulsation in the head;
- hyperemia - overflow of blood vessels, for example, redness of the skin;
- microalbuminuria – presence of albumin proteins in the urine;
- numbness and chills in the fingers;
- fundus pathologies;
- hypertensive crises - sudden pressure surges (sometimes 59 units at once);
- the appearance or worsening of signs of target organ damage.
Fatigue, lethargy and swelling appear because the kidneys are involved in the pathological process. A hypertensive attack may be accompanied by vomiting, difficulty urinating and evacuating, shortness of breath and tears. Sometimes it lasts several hours. Complications of a hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, overexcitation, hand tremors, unmotivated panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, inhibition of consciousness);
The symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of hypertension. The disease at this stage regresses reluctantly and often returns.
Complications of hypertension 2 degrees
Complications of stage 2 hypertension include the following diseases: aortic aneurysm - a pathological protrusion of its wall.
To target organs i. e. Internal organs affected due to hypertension include:
- Bleeding in various organs occurs because the walls of blood vessels become increasingly thick, lose their elasticity and become brittle. Increased blood flow easily destroys these vessels. The reverse process occurs with the development of aneurysms. Here the walls become stretched and thinned due to increased blood circulation. They are so weakened that they tear easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis - fatty deposits in the walls - and thrombosis - blockage of them with a blood clot. Bleeding of brain cells leads to lack of oxygen and their death. This phenomenon is called encephalopathy. Ischemia is the lack of oxygen in the heart. Angina pectoris is constant pain in the chest.
Pathological processes associated with the underlying disease develop in connection with it. Consequently, if you do not start treatment in a timely manner or violate medical prohibitions, there will be more and more target organs and it will be almost impossible to restore health.
2nd degree hypertension disability
Hypertensive patients are constantly monitored in the dispensary and periodically examined. In addition to daily blood pressure measurements, an ECG is regularly prescribed. In some cases, an ultrasound may be necessary - ultrasound examination of the heart, urine tests, blood tests and other diagnostic procedures. Hypertensive patients with a moderate form of the disease are less productive than healthy people.
If there is persistent impairment of bodily functions caused by hypertension, the patient is referred to the agency for examination to obtain a medical and social examination report. In rare cases, hypertensive patients are examined at home, in the hospital or even in absentia. Sometimes an additional examination program is drawn up. For people with disabilities, specialists from the Office of Medical and Social Expertise develop a mandatory individual rehabilitation program.
To determine the disability group, the expert commission, along with the degree of hypertension, takes into account the following factors:
- medical history information about hypertensive crises;
- patient's working conditions.
The procedure for establishing a disability group is necessary for adequate employment. Whether it will be easy to find an employer willing to tolerate the work of an "inferior" employee is another question. If a job seeker presents documents confirming his disability, then, in accordance with federal law, he must be provided with the necessary working conditions.
Employers are reluctant to hire people with disabilities because. . . working hours for them were reduced, maintaining full salary (for groups 1 and 2). Furthermore, they are required to take sick leave more frequently than other employees, and their annual leave has been increased. In this sense, the majority of people with group 3 disabilities hide their illnesses to get a well-paid job. Violation of medical instructions regarding working conditions leads to the worsening of the disease over time.
People with group 3 disabilities receive monetary benefits and can carry out professional activities with some restrictions:
- strong vibrations and noise are contraindicated;
- It is not possible to work overtime, on weekends or on night shifts without the employee's consent;
- Constant physical or psycho-emotional stress is not allowed;
- prohibition of working at high altitudes, in hot workshops, near dangerous mechanisms;
- reducing the duration of work that involves high concentration of attention;
- seven-hour working day.
A special case is stage 2 malignant arterial hypertension. Its development is so rapid and the patient's condition is serious that the commission assigns him a disability of group 2. This is no longer a working group. For degrees 2 and 3 of disability, a medical and social examination is carried out annually. Persons with disabilities of the following categories are exempt from re-examination:
- men over 60;
- women over 55;
- people with irreversible anatomical defects.
The assignment of a disability group is motivated by the need for social protection of hypertensive patients. Your ability to engage in work activities is limited.
Treatment of stage 2 hypertension
At this stage of the disease there is no way to go without medication. The tablets are taken regularly, if possible at the same time of day. The patient should not think that just taking medication will be enough to get rid of the disease. If he does this and at the same time gets carried away, for example, with fatty foods and alcohol, the positive effect of therapy will quickly disappear. The disease will move to the next stage, in which any treatment will no longer be effective.
Hypertension 3 degrees
Why are doctors alarmed by deviations in blood pressure readings from the norm, even if it is one? The fact is that when the pressure increases by several units, the risk of developing cardiovascular complications increases at the same rate. For example, if a person has mild hypertension and blood pressure deviates from normal by 120 to 80 mm Hg. in 39 units, then there is a very high probability of pathological abnormalities occurring in various organs (39%). What can then be said about the 3rd degree of the disease, in which the deviation is at least 60 units?
Stage 3 hypertension is a severe chronic form of the disease. Blood pressure rises above 180/110 mm Hg, never drops to normal 120/80. The pathological changes are already irreversible.
Symptoms of Stage 3 Hypertension
Symptoms of stage 3 hypertension include:
- impaired coordination of movements;
- persistent visual impairment;
- paresis and paralysis due to cerebral circulation disorders;
- prolonged hypertensive crises with speech disorders, blurred consciousness and sharp pains in the heart;
- significant limitation of the ability to move independently, communicate and care for oneself.
In severe cases, hypertensive patients can no longer survive without external help and require constant attention and care. The above signs of hypertension show that the patient's well-being is gradually deteriorating, the disease is spreading to new organ systems, and there are more and more complications.
Complications of grade 3 hypertension
Complications of grade 3 hypertension include the following diseases:
- myocardial infarction – the middle muscular layer of the heart;
- cardiac asthma - choking attacks;
- peripheral arterial damage;
- hypertensive retinopathy affects the retina of the eyes;
- Scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of grade 3 arterial hypertension are also called associated clinical conditions. When cerebral circulation is impaired, a stroke occurs, accompanied by loss of sensitivity in the limbs and fainting. Heart failure is a whole complex of heart pathologies. The kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes mellitus, nephropathy is inevitable.
The more advanced the disease, the more terrible and serious its consequences. The circulatory system is so important for the life of the body that the slightest deviation in its functioning has a powerful destructive effect.
3rd degree hypertension disability
In severe cases of the disease, disability group 1 is established. At this stage, patients are practically unable to work. Sometimes they are recognized as partially capable of working and continue to work, but only at home or under special conditions.
But even with the most severe degree of disability, the patient must undergo rehabilitation procedures. In this state of affairs, this is necessary to avoid death.
Treatment of stage 3 hypertension
As the course of the disease worsens, more and more potent medications are prescribed, or the list remains the same but the dosage increases. At this stage of hypertension, the effect of drug therapy is minimal. Chronic hypertensive patients are doomed to take pills for the rest of their lives.
When the disease becomes severe, surgery may be necessary. The operation is indicated for certain pathologies of blood vessels and the heart. The stem cell therapy method for stage 3 arterial hypertension is considered innovative.
Hypertension 4 degrees
Some experts also identify stage 4 of the disease, which is very serious. In most cases, death is near. They try to alleviate the patient's suffering as much as possible and, at each hypertensive crisis, they provide first aid. The patient lies down, raising his head. He is urgently given medication that drastically reduces his blood pressure.
Without treatment, new complications arise. Some of them cause others, and diseases increasingly affect people. To stop this destructive process in time, it is enough to monitor the dynamics of changes in blood pressure, at least using an ordinary tonometer.
Example of calculating risk depending on the stage of hypertension
Stages of hypertension Other risk factors, POM or BP disease (mmHg)
| High normal | Grade 1 | Grade 2 | Grade 3 | ||
| GARDEN 130-139 PAD 85-89 |
GARDEN 140-159 PAD 90-99 |
GARDEN 160-179 PAD 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FR | Low risk (risk 1) |
Low risk (risk 1) | Moderate risk (risk 2) |
High risk (risk 3) |
| 1-2 France | Low risk (risk 1) |
Moderate risk (risk 1) |
Moderate / high risk |
High risk (risk 3) |
|
| ≥3 French francs | Short / moderate risk (risk 1) |
Moderate / high risk |
High risk (risk 3) |
High risk (risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without organ damage |
Moderate / high risk |
High risk (risk 3) |
High risk (risk 3) |
High / very high risk |
| Stage III | Established CVD, CKD stage ≥4 or diabetes with organ damage |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
EN - hypertension
SBP - systolic blood pressure
DBP - diastolic blood pressure
RF is a risk factor
CVD - cardiovascular disease
CKD – chronic kidney disease
DM - diabetes mellitus
POM - target organ damage
Once the risk category has been determined, the doctor can identify factors that can be influenced to reduce it. Among these modifiable characteristics:
- Obesity (with a BMI greater than 30), as well as central or visceral obesity, which is determined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, serious heart rhythm disorders such as atrial fibrillation and others may also increase the risk.