Hypertension is one of the most common cardiovascular diseases. According to the WHO, more than 1. 1 billion people suffer from it. worldwide. High blood pressure increases the risk of developing other heart diseases. Hypertension is among the leading causes of death and the disease is rapidly rejuvenating. It occurs not only in the elderly, but also in young people. Below you will find out why it occurs, how to recognize and control it.
What is hypertension?
It is a chronic condition where the blood pressure is high. It is noted as two numbers, with the optimal value being 120/80 mmHg. Art. The first number is the systolic pressure, which occurs when blood is ejected from the left ventricle of the heart into the aorta during systole (contraction of the ventricles of the heart). The second number shows the diastolic pressure when the heart muscle is relaxed. Blood pressure increases during physical activity and emotional excitement, but its value should be close to normal at rest. If in multiple measurements taken at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure exceeds 90 mmHg. Art. , diagnosed with hypertension.
Persistently elevated blood pressure is linked to several factors, including being overweight and lacking in physical activity, poor diet, bad habits and high levels of stress.
Causes and risk factors
Hypertension can be primary and secondary:
- primary (essential)hypertension occurs more often - according to various estimates in 85-95% of cases. Its appearance is not associated with concomitant diseases, the pressure increases under the influence of a complex of factors;
- secondary (symptomatic)hypertension occurs in 5-15%. In this case, high blood pressure is one of the symptoms that can be associated with endocrine disorders, kidney diseases and abnormalities of the great vessels.
When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its occurrence is usually constant nervous overstrain. When diagnosing, it is important to find out as accurately as possible what causes hypertension, whether there are secondary causes (the presence of diseases that cause increased blood pressure).
There are a number of risk factors that increase the chances of developing primary hypertension:
- overweight (obesity);
- insufficient activity, lack of physical activity, lack of physical activity;
- drinking alcohol and smoking;
- stress, constant emotional tension;
- lack of sleep, its low quality, insomnia;
- excessive salt intake;
- improperly organized sleep and rest patterns (including due to irregular or too long working hours);
- changes in hormonal levels (in women, they may be associated with taking oral contraceptives, with the onset of menopause);
- hereditary factors (in total, more than 20 genes have been identified that determine the predisposition to hypertension);
- age over 65 years (the disease can also occur in young people; it is worth periodically monitoring blood pressure after 35 years);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods with a high content of trans-fats and saturated fats);
- kidney disease, diabetes mellitus and some other related conditions and diseases.
Many of these factors are interrelated and mutually reinforcing. Some of these can be controlled (eg diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is an easy way to reduce your risk of hypertension or improve your well-being if your blood pressure is already high.
Classification
Two approaches are used to classify the disease: by degrees and stages. The degrees of hypertension differ in the values to which the blood pressure rises, the difference between the stages is in the course of the disease, in the number, the severity of the accompanying organic lesions.
First degree
Systolic blood pressure - more than 139 and less than 159 mmHg. Art. , and the diastolic is at the level of 90-99 mm Hg. Art. With elevated values, blood pressure can be normalized by adjusting your lifestyle. To do this, you need to increase physical activity, adjust your diet, give up bad habits and reduce stress levels.
Second major
In the second degree, blood pressure values become high and amount to 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastolic. At such values, the load on the heart greatly increases. The blood supply to the brain deteriorates and this can cause headaches and dizziness and reduced performance. Changes occur in the fundus of the eye. Sclerosis of the tissues and blood vessels of the kidneys begins, excretory function is impaired, and kidney failure may develop. The condition of the blood vessels worsens. For treatment, you need to change your lifestyle and start taking medication.
Third degree
The value of systolic pressure is over 180 mm Hg. Art. , diastolic - over 110 mm Hg. Art. In hypertension, the load on the heart becomes too high and provokes irreversible changes. Blood pressure must be constantly lowered with medication. Without it, there is a threat of acute heart failure, arrhythmia, angina pectoris, myocardial infarction and other serious conditions. Patients with hypertension in stage 3 should be constantly monitored by a doctor. Long-term use of drugs to lower blood pressure is necessary.
| Arterial pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| A fine | < 130 | < 85 |
| Usually the so-called narprehypertension | 130–139 | 85–89 |
| 1 - mild hypertension | 140–159 | 90–99 |
| 2 - moderate degree of hypertension | 160–179 | 100–109 |
| 3 - severe hypertension | ≥ 180 | ≥ 110 |
Stages of hypertension
The disease develops gradually. There are three stages in total.
- First stage:moderate hypertension. Blood pressure is unstable and can vary throughout the day. At this stage, the state of the internal organs and the central nervous system remains normal, there are no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
- Second stage: severe hypertension. In the second stage, a significant increase in blood pressure is observed, health often deteriorates and hypertensive crises become severe. At this stage, changes in the internal organs begin due to constant high blood pressure. Vascular disorders appear and the blood supply to the brain deteriorates. The retinal arteries narrow. Hypertrophy of the left ventricle of the heart develops, which increases the risk of severe cardiac pathologies. Signs of kidney dysfunction appear (increased levels of albumin in the urine, increased levels of creatinine in the blood serum)
- Third stage:very severe hypertension. Blood pressure becomes critically high - over 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions intensify, heart failure, thrombosis of cerebral vessels, aneurysms, kidney failure and other serious conditions develop. Severe hypertensive crises often occur.
Symptoms
Even with a significant increase in blood pressure, hypertension may have no symptoms for a long time. For this reason, you should periodically measure your blood pressure (monitoring is especially important for those over 35). You can measure your blood pressure with an automatic electronic tonometer - such devices are sold in pharmacies.
The main symptoms of hypertension are headache, dizziness and heaviness in the head. These manifestations are associated with vasospasm and deterioration of the blood supply to the brain. Possible nosebleeds, tinnitus, decreased vision, cardiac arrhythmias. In severe cases of hypertension, weakness, chest pain, nausea, vomiting and tremors (muscle tremors) may occur. Other symptoms include blurred or black spots before the eyes, trouble sleeping, palpitations and ringing in the ears.
As the disease progresses, visual acuity gradually decreases, the sensitivity of the hands or feet may decrease, and in severe cases, paralysis is possible. During periods of stress, against the background of nervous tension or physical activity, the symptoms may increase. They appear more often in middle-aged and elderly people. The disease is more severe if you are overweight, have bad habits, tend to overeat or have a high level of stress.
You should consult a therapist or cardiologist if you have regular headaches, dizziness or vision problems, or if your blood pressure often rises when you measure your blood pressure yourself.
Diagnosis
Diagnosis is usually carried out in three directions:
- blood pressure measurement.It is carried out at intervals of several hours or for 2-3 days to determine the degree of hypertension and its stage;
- identifying the causes of the disease.It is important to determine whether the hypertension is primary or secondary (caused by other diseases). In the second case, specific treatment may be required;
- general health monitoring.During the examination, the condition of the heart, cerebral vessels, fundus of the eyes and kidneys is monitored. Due to high blood pressure, the functioning of these organs is impaired. When diagnosing, it is important to assess their condition.
At the first appointment, the doctor will conduct an examination and collect medical history details related to the disease. Information is needed, how long the patient has been suffering from hypertension, what is the blood pressure level, whether there are symptoms of heart disease, apnea, loud snoring, whether the person or his close relatives have had strokes, peripheral arterial disease, gout, diabetes, kidney disease. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, medication intake.
The following tests are performed in patients with arterial hypertension:
- blood pressure measurement.It is measured several times at rest (physical activity, caffeine consumption, smoking are excluded half an hour before the measurement), measurements are made at different times of the day;
- overview:measurement of height and weight, waist circumference, palpation of the abdomen, assessment of peripheral arterial pulsation;
- Urinalysis.Albumin and creatinine levels are important - deviations from the norm indicate renal dysfunction and require ultrasound;
- blood analysisTo monitor the levels of potassium, creatinine, lipids, an ultrasound of the kidneys is prescribed. Assessment of lipid levels is necessary to control lipid metabolism in order to eliminate the risk of complications from the cardiovascular system;
- EKGperformed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiac or neurological examination or an examination of the respiratory system.
Treatment of hypertension
Arterial hypertension is a disease that cannot be completely cured, but it can be controlled. Therapy and lifestyle changes can stop the development of hypertension, reduce the frequency and severity of crises, and eliminate symptoms. But the most important thing is to reduce the risks to the cardiovascular system, the brain and the kidneys.
Treatment begins with lifestyle adjustments:
- to give up smoking;
- refusing to drink alcohol or significantly limiting the amount of alcohol;
- diet: the diet is adjusted, salt intake is reduced (less than 3. 75 g per day), the amount of vegetables and fruits is increased (ideally you need 5 portions per day), whole grains, dairy products, low-fatproducts and calorie intake is limited. If there are no contraindications or kidney diseases, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increasing physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is reduced to target values (below 130/80 mmHg) to reduce the risk of complications. With such a reduction, constant monitoring by a doctor is necessary. The tonometer used for home measurements should be calibrated regularly. In patients with diabetes, pregnant women, the elderly and exhausted people, the use of antihypertensive drugs requires special attention.
The following can be used to treat hypertension:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and lower blood pressure, but they can cause drowsiness and lethargy, so they are rarely used;
- ACE inhibitors.Reduction of peripheral vascular resistance, often prescribed to patients with diabetes;
- angiotensin II receptor blockers.They have an effect similar to ACE inhibitors, which is why they are not prescribed together with them. Not prescribed during pregnancy;
- beta blockers.Provide a lowering of blood pressure by slowing the heart rate;
- calcium channel blockers.They reduce the total peripheral vascular resistance and can provoke reflex tachycardia;
- direct vasodilators.They have a direct effect on blood vessels and are used in severe hypertension;
- diuretics.They reduce the volume of blood plasma, which reduces blood pressure, but can also provoke hyperkalemia.
important!A therapist or cardiologist should prescribe drugs and their dosages after an examination. Taking medicines without a doctor's prescription can be dangerous.
If the doctor prescribes medication, you will have to undergo periodic control examinations to assess the effectiveness of the treatment and adjust it. It is important to adjust your lifestyle and restore normal health so that a minimal amount of medication is required to control the course of hypertension.
Possible complications
Due to the increased blood pressure, the walls of the arteries lose their elasticity and the heart muscle works too hard. This increases the risk of angina, acute heart failure and heart attack. Due to impaired blood supply to the brain, transient ischemic attacks and strokes are possible. The severity of hypertension will increase without treatment and lifestyle correction: the pressure will continue to rise and this will lead to damage to internal organs and worsen general health and well-being. Smoking, drinking alcohol, overeating, lack of physical activity and high levels of stress accelerate the development of hypertension and complicate its course.
Consequences
Without treatment, arterial hypertension leads to serious consequences. Constant spasm of cerebral vessels leads to ischemia and stroke. They are dangerous with severe disability and even death. When the workload on the heart muscle becomes too high, tachycardia, arrhythmia and heart failure occur. Without treatment, myocardial infarction is possible.
The severity of hypertensive crises increases, they become complex, life-threatening and can be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life on the background of hypertension without adequate therapy and restoration of the normal state of health sharply decreases, even to severe disability.
Forecast
The prognosis is good if the patient consults a doctor in time and takes measures to control blood pressure and factors affecting hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its severe course. Even with severe arterial hypertension, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
To prevent hypertension, self-monitoring of blood pressure is recommended for those over 35 years of age or when symptoms of hypertension appear. It is important to eliminate the effects of the factors that provoke an increase in blood pressure: control your diet, exclude smoking and drinking alcohol, reduce stress levels, devote more time to physical activity: in a word, lead a healthy lifestyle.
Conclusion
Hypertension is a dangerous disease, but it can be controlled by maintaining normal health and reducing the risk of complications. To do this, it is important to monitor your blood pressure levels, control your weight, lead a healthy lifestyle and undergo preventive examinations with a therapist or cardiologist.