Constantly high blood pressure in medicine has several names: hypertension, arterial hypertension, essential hypertension.The disease can cause damage to the kidneys, heart, blood vessels, cause a stroke, heart attack, bleeding from a stomach ulcer and other serious consequences.In order to prevent dangerous health conditions, it is necessary to take timely measures to prevent the disease and to know the risk factors that significantly increase the likelihood of hypertension.
What is hypertension
It is a chronic pathology that develops as a result of dysfunction of vascular regulation, renal and neurohumoral mechanisms.Hypertension (HT) is a dangerous condition of the body in which there is a permanent increase in blood pressure (BP) with levels above 140/90 mmHg.Art.in patients not taking antihypertensive drugs.
Hypertension accounts for approximately 40% of all cardiovascular pathologies.The disease occurs more often in men than in women.The risk of developing pathology in both sexes increases with age.Hypertension is mainly diagnosed in patients after the age of 40, but recently the disease is more often registered in adolescence and young age.
Stages of headache
Hypertension is a chronic pathology that has three stages of development.In an adult, the optimal blood pressure is 120/80 mmHg.Art.A slight deviation from these indicators up to 139/89 mm Hg.Art.also applies to the norm.Higher numbers in medical practice are considered pathology.The diagnosis of "hypertension" is made when indicators above 140/90 are registered repeatedly under different conditions.
Stage 1 hypertension is characterized by sudden changes in pressure.This already indicates a pathological process taking place in the body.The disease in its early stages is almost always asymptomatic.The patient does not pay attention to some signs of hypertension, which explains the high percentage of late requests for qualified help.Symptoms of stage 1 hypertension:
- blood pressure indicators: from 140/90 to 159/99 mm Hg.Art.;
- headache;
- confusion;
- reduced mental efficiency;
- dyspnea;
- tachycardia;
- increased swelling;
- fluid retention in the body;
- change in the amount and color of urine.
The second stage of hypertension is arterial hypertension, which occurs in a moderate form.At this stage of the disease, longer periods of elevated blood pressure are observed than at the beginning.Blood pressure readings in stage 2 hypertension rarely return to normal.Patient condition:
- blood pressure indicators: from 160/109 to 179/109 mm Hg.Art.;
- sleep disorder;
- discomfort in the area of the heart;
- heart failure;
- memory and vision impairment;
- constant irritability;
- vertigo;
- tinnitus;
- aching pain in back of head;
- dilated eye vessels;
- the skin of the face is hyperemic;
- swelling of the face, hands.
The third degree of hypertension is a severe form of the disease.It is characterized by a patient history of myocardial infarction, stroke and other serious pathologies.It is possible to completely cure hypertension at this stage in very rare cases, only if the high blood pressure lasts for a short time or is secondary.Clinic of severe hypertension:
- blood pressure indicators: from 180/110 mm Hg.Art.and above;
- left ventricular hypertrophy;
- hypertrophy of the interventricular septum;
- impaired coordination of movements;
- encephalopathy;
- ischemic or hemorrhagic heart attacks;
- various kidney lesions;
- permanent visual impairment;
- prolonged hypertensive crises;
- paralysis and paresis due to cerebral circulation disorders;
- limiting the ability to move independently and care for oneself.
Risk factors for hypertension
The development, progression and complications of arterial hypertension are directly related to the presence of risk factors for the occurrence of this pathological process.Hypertension is the result of a complex interaction of internal (endogenous) and external (exogenous) causes.The appearance of pathology is facilitated by acquired and congenital characteristics of the body, which weaken its resistance to adverse external conditions.
Risk factors for the development of arterial hypertension are classified according to two indicators: modifiable and non-modifiable.The former depend on a person's decisions and lifestyle.These include:
- bad habits;
- lack of physical activity;
- smoking;
- drinking alcohol;
- obesity and others.
Immutable risk factors for hypertension are those that a person cannot influence: heredity and physiology (gender, age).In many cases, hypertension is a genetically transmitted disease.If any of your relatives suffer from hypertension, then there is a high probability that the next generation will be affected by the disease.As for physiological factors, according to statistics, middle-aged men are more susceptible to the disease.This is explained by the fact that the female body produces estrogens - hormones that perform a protective function.
Endogenous
Intrinsic risk factors for hypertension are the presence of diseases or conditions that cause high blood pressure.Among them:
- diabetes mellitus;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity;
- metabolic disorder;
- kidney disease (pyelonephritis, nephritis, glomerulonephritis);
- increased concentration of sodium or calcium in the blood;
- the effect of adrenaline during stress;
- dyslipidemia (fat metabolism disorder);
- increased uric acid content;
- neurocirculatory dystonia;
- pregnancy;
- the menopause.
Related to lifestyle and environmental influences
Exogenous risk factors for hypertension are related to the patient's lifestyle.The number of acquired causes that can be successfully combated is considerable, but each point can be easily corrected if one wishes.The main exogenous risk factors for hypertension:
- Insufficient physical activity.Constant work in the office, traveling exclusively by vehicle, lack of time to visit the gym leads to a weakening of the respiratory system, impaired muscle function and deterioration of blood circulation.All these factors provoke an increase in blood pressure.
- Uncontrolled salt intake.Sodium chloride in large quantities causes thirst and slows the removal of fluids from the body.Water causes an increase in the volume of circulating blood, as a result of which myocardial contractions become more frequent, which leads to an increase in blood pressure.The consumption rate of table salt is no more than 5 g/day.
- Magnesium and/or potassium deficiency.The body needs these trace elements for the proper functioning of the blood vessels and the heart muscle.With their deficiency, there is a risk of developing hypertension.
Diagnosis
Hypertension is determined by various methods - the blood pressure level is measured several times using a tonometer and phonendoscope, the clinical picture of the disease is examined, clinical, physical and instrumental tests are prescribed.Main diagnostic approaches:
- Biochemical blood test.The level of high/low density lipoproteins and cholesterol is detected and the sugar level is determined.These indicators are important in determining the cause of high blood pressure.
- EKG.The electrocardiogram has long been a reliable aid in the diagnosis of hypertension.The ECG reveals interruptions in the work of the heart, determines the presence of angina pectoris and provides data on the displacement of the heart from the electrical axis and the condition of the myocardium.
- Ultrasound of the heart.The main vessels (carotid arteries) that lead to the brain are illuminated to detect atherosclerotic plaques, to assess the condition of the vessel walls and the risk of stroke.
- Arteriography.X-ray method for studying the walls of arteries and their lumen.
- Dopplerography.Ultrasound technique for diagnosis of blood flow in veins, arteries and vessels.
- Ultrasound of the kidneys.It helps to identify large tumors in the adrenal glands and lesions of the kidney tissue leading to the appearance of renoparenchymal hypertension.
- Ultrasound of the thyroid gland.It helps to identify or exclude the influence of the thyroid gland on the development of hypertension in a patient.
Treatment
Treatment of hypertension depends on the cause of the disease.The first thing the patient should do is to eliminate all the risks associated with hypertension.Then drug therapy is used in combination with non-drug methods: following an anti-cholesterol diet, physical activity, quitting smoking and drinking alcoholic beverages.Drug treatment is carried out according to different schemes:
- Patients at low to moderate risk of developing hypertension are prescribed one drug to lower their blood pressure.
- Patients at high risk of cardiovascular pathologies are prescribed two or more drugs in individual doses.
The choice of drugs and dosage is made by the doctor, taking into account the patient's age, concomitant pathologies and risk factors.Several groups of drugs are used to treat hypertension:
- Thiazide diuretics.They inhibit the absorption of chlorides and sodium in the renal tubules, so that they do not enter the blood, but are excreted from the body with urine.
- Calcium channel blockers.They reduce calcium intake, as a result of which the workload of the myocardium decreases and blood pressure decreases.
- ACE inhibitors.They reduce the concentration of the hormone angiotensin in the blood, which has the ability to narrow the lumen of blood vessels, which increases blood pressure.
- Angiotensin II receptor antagonists.Reduces blood pressure in the first stage of hypertension.
- Beta blockers.They relax the vascular walls, which leads to improved blood circulation and normalization of blood pressure.
- Central alpha-2 agonists.The heart rate is reduced, which is manifested by a decrease in blood pressure.
- Direct vasodilators.It relaxes the smooth muscles of the arterioles, which provokes a decrease in blood pressure.
- Renin inhibitors.They promote the expansion of arteries and inhibit the activity of renin, an enzyme with a vasoconstrictor effect.