Hypertension is a chronic disease that is characterized by a constant increase in blood pressure to high values due to a violation of the regulation of blood circulation in the human body. Also, terms such as arterial hypertension and hypertension are used to denote this condition.
Medical statistics are such that hypertension is one of the most common diseases today. It usually starts to progress in people after the age of 40, but there is a risk of progression at any age. So, more and more often, the disease begins to be detected in patients of working age. It should be noted that the fairer sex suffers several times more often than men. But in men, hypertension is more severe, as they are more prone to developing atherosclerosis of the blood vessels.
Blood pressure can rise with strong mental or physical stress for a short time - this is an absolutely normal phenomenon. A longer increase in blood pressure is observed in a number of diseases of the kidneys, endocrine glands, as well as during pregnancy. But in this case, hypertension is only one of the symptoms that indicates changes in the organs. In hypertension, the increase in blood pressure is an independent, primary, painful process.
The pathogenesis of hypertension is such that, under the influence of exogenous and endogenous factors, the tone of the walls of the arterioles in the body increases. As a result, they gradually narrow and the blood flow in the affected vessels is disturbed. During this pathological process, the blood pressure on the walls of the arteries increases, which leads to additional symptoms.
Etiology
The main reason for the progression of hypertension is the increase in the activity of the sympathetic-adrenal system. The vasomotor center is located in the medulla oblongata of man. From it, certain impulses pass along the nerve fibers to the walls of the vessels, which leads to the expansion or contraction of the vessels. If this center is in a state of irritation, then only impulses will come to the vessels that increase the tone of their walls. As a result, the lumen of the artery narrows.
Arterial hypertension is characterized by a simultaneous increase in systolic and diastolic pressure. This is observed under the influence of various adverse factors.
Exogenous risk factors:
- severe nervous tension is the most common reason for the progression of arterial hypertension;
- hypodynamia;
- irrational eating. Not following the diet and eating large amounts of fatty and fried foods;
- excessive consumption of alcoholic beverages;
- smoking;
- the use of narcotic substances.
Endogenous risk factors:
- burdened heredity;
- obesity;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity (the heart cannot fully distill it through the vessels);
- kidney diseases such as nephritis, glomerulonephritis, pyelonephritis;
- metabolic disorder;
- the presence of endocrine pathologies;
- increased concentration of calcium in the blood;
- the action of adrenaline on the heart during stressful situations;
- increased concentration of sodium in the blood.
Classification
For the entire time of studying the disease, scientists have developed more than one classification of hypertension - according to the appearance of the patient, according to etiology, according to the level of pressure increase, the nature of the course, etc. Some of them have long been outdated, and others, on the contrary, are used more and more often.
Grades of hypertension (by pressure level):
- optimal - indicators 120/80;
- normal - upper from 120 to 129, lower - from 80 to 84;
- elevated normal - upper indicators - from 130 to 139, lower - from 85 to 89;
- hypertension of the 1st degree - SD from 140 to 159, DD - from 90 to 99;
- 2nd degree hypertension - systolic pressure increases to 160-179, and diastolic - to 100-109;
- 3rd degree hypertension - systolic pressure rises above 140, and diastolic pressure rises above 110.
Stages of hypertension according to WHO:
- hypertension 1 stage - the pressure rises, but there are no changes in the internal organs. It is also called transient. The pressure stabilizes after a short period of rest;
- stage 2 or stable. At this stage of hypertension, the pressure rises constantly. The target's major organs are affected. During the examination, damage to the heart, vessels of the fundus, kidneys can be noted;
- Stage 3 or sclerotic. This stage of hypertension is characterized not only by a critical increase in DM and DD, but also by pronounced sclerotic changes in the blood vessels of the kidneys, heart, brain, and fundus. Dangerous complications develop - stroke, coronary artery disease, angioretinopathy, heart attack, etc.
Forms of the disease (depending on the vessels of which organs are affected):
- renal form;
- in the shape of a heart;
- brain shape;
- mixed.
Types of hypertension:
- benign and slow-moving. In this case, the symptoms of the progression of the pathology may gradually appear over 20 years. Both exacerbation and remission phases are observed. The risk of complications is minimal (with timely therapy);
- malignant. The pressure rises sharply. This form of hypertension is practically untreatable. As a rule, the pathology is accompanied by various kidney diseases.
It is worth noting that often with hypertension of 2 degrees and 3, the patient has hypertensive crises. This is an extremely dangerous condition not only for human health, but also for his life. Clinicians distinguish the following types of crises:
- neurovegetative. The patient is hyperactive and highly agitated. Such symptoms of hypertension are manifested: hyperhidrosis, tremor of the upper limbs, tachycardia and copious urination;
- hydropic. In this case, the patient is sleepy and his reactions are suppressed. There is muscle weakness, swelling of the face and hands, reduced diuresis, a constant increase in blood pressure;
- convulsive. This option is the most dangerous, as there is a high risk of developing dangerous complications. It is worth noting that it is the rarest. It is characterized by such symptoms: convulsions and impaired consciousness. Complication - hemorrhage in the brain.
Symptoms
Symptoms of the disease directly depend on which stage of hypertension is observed in the patient.
neurogenic
An increase in blood pressure is usually observed against the background of severe psycho-emotional stress or due to increased physical exertion. At this stage, there may be no signs of pathology at all. Sometimes patients begin to complain of pain in the heart, irritability, headache, tachycardia, a feeling of heaviness in the back of the head. Indicators of SD and DD increase, but can easily be normalized.
sclerotic
The indicated clinical picture is complemented by the following symptoms:
- increased headache;
- vertigo;
- feeling of a rush of blood to the head;
- bad sleep;
- periodic numbness of the fingers of the limbs;
- rapid fatigue;
- "flies" before the eyes;
- constant increase in blood pressure.
It is worth noting that this stage can progress for several years and at the same time patients will be active and mobile. But the violation of the blood supply to certain organs leads to a violation of their functioning.
final
Usually, at this stage, doctors detect kidney and heart failure, as well as impaired blood circulation in the brain. The outcome of the disease, as well as the development of complications, are determined by the form of hypertension. Crises often happen.
In the cardiac form, the patient gradually progresses to heart failure. There is shortness of breath, pain in the projection of the heart, hepatomegaly, edema. With the brain shape of a person, severe headache, visual impairment disturb.
Hypertension and childbirth
Hypertension during pregnancy is the most common cause of premature birth or perinatal fetal death. Usually, female hypertension already exists before the beginning of pregnancy and then it is simply activated, since the birth of a child is a kind of stress for the body.
Considering the high risk for the mother and the unborn child, in case of diagnosis of a disease, it is important to accurately determine the degree of this risk in order to decide the question of further pregnancy or termination of pregnancy. Doctors distinguish three degrees of risk (depending on the stage of arterial hypertension):
- 1 degree of risk - pregnancy complications are minimal, crises develop rarely. Possible angina. Pregnancy in this case is permissible;
- 2 degree of risk - pronounced. Complications develop in 20-50% of cases. A pregnant woman has hypertensive crises, insufficiency of the coronary vessels of the heart, high blood pressure. Termination of pregnancy is indicated;
- 3 degree of risk. Pregnancy complications occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Perhaps detachment of the placenta, uremia, impaired blood circulation in the brain. The pregnancy poses a danger to the mother's life, so it is terminated.
Patients who maintain a pregnancy should visit a doctor once a week so that he can monitor their condition. Compulsory treatment of hypertension. It is allowed to use such antihypertensive drugs:
- antispasmodics;
- saluretics;
- sympatholytics;
- clonidine derivatives;
- Rauwolfia preparations;
- ganglion blockers;
- beta blockers.
Also, to treat the disease during pregnancy, doctors resort to physiotherapy.
Diagnosis
When the first signs of illness appear, it is important to immediately contact a medical institution to confirm or refute the diagnosis. The sooner this is done, the lower the risk of progression of dangerous complications (damage to the heart, kidneys, brain). During the initial examination, the doctor necessarily measures the pressure in both arms. If the patient is elderly, then measurements are also taken in a standing position. During the diagnosis, it is important to clarify the real reason for the progression of the pathology.
A comprehensive plan for diagnosing hypertension includes:
- history taking;
- SMADs;
- Urinalysis;
- blood biochemistry;
- determining the level of bad cholesterol in the blood;
- Roentgen;
- ECG;
- fundus examination;
- ultrasound.
Treatment
Treatment of hypertension is carried out in a hospital, so doctors can constantly monitor the patient's condition and, if necessary, adjust the treatment plan. It is important to normalize the patient's daily life, correct his weight, limit the use of table salt and completely give up bad habits.
To correct the pressure, the following drugs are prescribed:
- alpha-blockers;
- beta-blockers;
- calcium channel blockers;
- diuretics. This group of drugs is particularly important because it helps to reduce the level of sodium in the blood, thus reducing the swelling of the blood vessel walls.
All these drugs should be taken only according to the prescription of the attending physician. Uncontrolled intake of such means can only worsen the patient's condition. These drugs are taken according to a certain schedule.
Diet
During the treatment of hypertension, in addition to taking medication, it is important to adhere to a special diet. With hypertension, the patient is prescribed table number 10. The principles of such a diet:
- add seafood to the diet;
- limiting salt intake;
- fractional feeding;
- limiting carbohydrates and animal fats in the diet.
The diet for this pathology implies a restriction:
- Sahara;
- of bread;
- potatoes;
- pasta;
- cereal dishes;
- eggs;
- animal fats;
- ghee;
- sour cream, etc.
Diet number 10 is complete and can be followed for a long time. To improve the taste of dishes, you can add to them:
- honey;
- prunes;
- vinegar;
- jam;
- blueberries
- lemon.
The diet is indicated not only during the treatment, but also after it, so as not to provoke a worsening of the condition. It is worth noting that the diet is developed strictly individually for each patient, taking into account the characteristics of his body. Important point - during the diet, you should consume no more than 1. 5 liters of liquid per day.
Prevention
Prevention of hypertension is quite simple. The first thing you need to do is normalize your diet, as well as lead an active lifestyle. In order for the vessels to be elastic, you need to eat more vegetables and fruits, drink up to 2 liters of water a day. You can take vitamin preparations. Also, the prevention of hypertension includes the exclusion of smoking and drinking alcoholic beverages.
If possible, stress should be avoided, as it is one of the provoking factors of the disease. Prevention of hypertension should be undertaken as early as possible to minimize the risk of developing the disease.