High blood pressure belongs to the most common diseases of the heart and blood vessels, affecting around 25% of the adult population.No wonder it is sometimes mentioned as a non -infectious epidemic.Hypertension with its complications considerably affects the mortality of the population.Estimates show that up to 25% of the deaths of people over 40 are directly or indirectly caused by hypertension.The probability of complications determines the stages of hypertension.How many steps has hypertension, how are they classified?Look below.
Important!According to the latest estimates by the World Health Organization of 1993, hypertension in adults is a constant increase in blood pressure to 140/90 mm Hg. Art.
Classification of high blood pressure, determination of the degree of risk of the disease
In WHO, according to etiology, hypertension is classified in primary and secondary.
With primary hypertension (essential) (GB), the main organic cause of the increase in blood pressure (blood pressure) is unknown.A combination of genetic factors, external influences and violations of internal regulation mechanisms is taken into account.
External factors:
- environment;
- Excessive use of calories, development of obesity;
- Increase in salt consumption;
- Lack of potassium, calcium, magnesium;
- excessive alcohol consumption;
- Repeat stressful situations.
Primary hypertension is the most common hypertension, in around 95% of cases.
3 steps of hypertension are separated:
- Stage I - Increase in blood pressure without changes in the organs;
- Stage II - an increase in blood pressure with changes in the organs, but without alteration of their function (hypertrophy of the left ventricle, proteinuria, angiopathy);
- Stage III - Organs accompanied by an altered function (left heart failure, hypertensive encephalopathy, stroke, hypertonic retinopathy, kidney failure).
Secondary hypertension (symptomatic) is an increase in blood pressure as a symptom of the underlying disease with the identified cause.The classification of secondary high blood pressure is as follows:
- Renoparechymal hypertension - occurs due to kidney disease;Reasons: renal parenchymal disease (glomerulonephritis, pyelonephritis), tumors, renal lesions;
- Renovascular hypertension - Renal arteries narrowing with fibromoscular dysplasia or atherosclerosis, renal venous thrombosis;
- Endocrine hypertension - primary hyperaldosteronism (Conn syndrome), hyperthyroidism, pheochromocytoma, kushing syndrome;
- Hypertension caused by drugs;
- Gestational hypertension - high pressure during pregnancy, after childbirth, the condition is often standardized;
- Aorta coarment.
Gestational hypertension can lead to children's congenital illnesses, in particular, retinopathy.2 phases of retinopathy (premature and complete children) are separated ::
- Active - consists of 5 stages of development, can cause vision loss;
- Lying - led to the obstruction of the cornea.
Important!The two stages of the retinopathy of premature and complete children lead to anatomical disorders!
Hypertensive disease according to the international system (according to CIM-10):
- Primary form - i10;
- Secondary form - I15.
Hypertension degrees also determine the degree of dehydration - dehydration.In this case, the classifier is a lack of water in the body.
Share 3 dehydration degrees:
- Degree 1 - Light - Lack of 3.5%;Symptoms - dry mouth, severe thirst;
- Degree 2 - Middle - Security - 3-6%;Symptoms - Similar fluctuations in pressure or reduction in pressure, tachycardia, oliguria;
- Degree 3 - The third degree is the most serious, characterized by a lack of 7 to 14% of water;manifests with hallucinations, delirium;Clinic - Coma, hypovolemic shock.
Depending on the degree and the stage of dehydration, decompensation is carried out by introducing solutions:
- 5% glucose + isotonic naCl (gentle degree);
- 5% NaCl (average degree);
- 4.2% Nahco3(severe degree).
GB steps
Subjective symptoms, in particular with the light and moderate stage of hypertension, are often absent, therefore an increase in blood pressure is often found in the dangerous indicators.The clinical picture is divided into 3 steps.Each step of high blood pressure has typical symptoms, from which the GB classification comes.
Step I
At 1 stage of hypertension, the patient complains of headache, fatigue, rapid heart rate, disorientation, sleep disorders.At 1 GB stage, objective detection on the heart, ECG, the eye fund, in laboratory studies is present in the normal beach.
Stadium II
At the 2nd stages of Ah, subjective complaints are similar, at the same time, there are signs of hypertrophy of the left ventricle, there are signs of hypertensive angiopathy on the retina, microalbuminuria or proteinuria in urine.Sometimes there is a multiplication of red blood cells in the precipitation of urine.At 2 stages of hypertension, symptoms of kidney failure are absent.
Stadium III
With the hypertension of stage III, functional disorders are diagnosed in organs belonging to an increased degree of risk of hypertension:
- Damage to the heart - At first, shortness of breath manifests itself, then - symptoms of cardiac asthma or pulmonary edema;
- Vascular complications - damage to peripheral and coronary arteries, the risk of brain atherosclerosis;
- Changes on the background - have the nature of hypertensive retinopathy, neuroretinopathy;
- Changes in brain blood vessels are manifested by transient ischemic access, thrombotic or typical hemorrhagic strokes;
- In stage III, a stroke, brain damage is diagnosed in almost all patients;
- The benign nephrosclerosis of the kidney vessels - leads to a limitation of glomerular filtration, an increase in proteinuria, red blood cells, hyperuricemia and later to chronic kidney failure.
What step or degree of hypertension is the most dangerous?Despite various symptoms, all stages and degrees of high blood pressure are dangerous, they require appropriate systemic or symptomatic treatment.
Degree
In accordance with the indicators of blood pressure (blood), determined at the time of diagnosis, 3 degrees of hypertension are distinguished:
- light;
- average;
- heavy.
There is also a 4th concept - the determination of resistant hypertension (persistent), in which even with the appropriate choice of an antihypertensive drug combination, blood pressure indicators are not reduced below 140/90 mm Hg. Art.
A clearer overview of high blood pressure degrees is presented in the table.
AG classification and stratification of normal blood pressure according to ESH / ESC 2007 directives.
| Category | Systolic pressure, MM Hg. Art. | Diastolic pressure, MM Hg. Art. |
|---|---|---|
| Optimal | <120 | <80 |
| Normal | 120–129 | 80–84 |
| Increase in normal | 130–139 | 85–89 |
| 1 degree | 140–159 | 90–99 |
| 2 degrees | 160–179 | 100–109 |
| 3 degrees | more than 180 | more than 110 |
| Isolated systolic hypertension | more than 140 | Less than 90 |
The patient's difficulties vary in accordance with the separation of degrees hypertension.The choice of the disease for treatment of the disease depends on the determination of the degree.
I degree
The disease can only be detected with a regular measurement of blood pressure.Measures must be carried out in a relaxed environment, at least 3 times in a certain period.
It is the only way to assess the presence or absence of hypertension.Depending on the degree of increased blood pressure, the clinical image of the disease differs.
II Diploma
The 2nd degree of hypertension is characterized by increased pressure periods alternating with a decrease in indicators, or an increase in diastolic value only.In this extent, hypertension, cases of increasing pressure in certain circumstances are typical, especially in patients with an unstable nervous system.
III Diploma
III degree of AG is characterized by a critical increase in blood pressure.
GB degree III is characterized by serious complications that result from the harmful effects of high blood pressure on all organs and systems.First of all, the heart, the kidneys, the eyes, the brain are affected.With the hypertension of degree III, the symptoms and treatment are closely associated - with insufficient or inappropriate treatment, the disease can have serious consequences: stroke, encephalopathy, renal failure, irreversible ocular lesions, blood vessels.The absence of treatment for the degree of hypertension III increases the risk of isolated systolic hypertension.
At this stage of high blood pressure, the degree of risk increases considerably!Memory disorders, mental activity, frequent loss of consciousness are manifested.
The hypertonic crisis occurs as a complication of the III Century and is considered as IV art.GB.
Risks
In accordance with the classification of hypertension due to stages and degrees, patients are divided into risk groups, depending on the severity of the GA.4 categories are distinguished (that is to say that there are as much as degrees of hypertension), which are determined by the principle of the probability of damage to internal organs in the future.
Risks on the degree of disease:
- risk less than 15%;
- risk up to 20%;
- risk of 20 to 30%;
- The risk is greater than 30%.
Low, insignificant
A low -risk group includes men up to 55 years and women at 65 years of art.High blood pressure.In this group, the risk of cardiovascular pathology during the period up to 10 years is less than 15%.People belonging to a low -risk group are recommended to change the lifestyle.If within 6 to 12 months, non -drug therapy does not show effectiveness, it is advisable to prescribe drugs.
Average
The average risk group includes I-II art.Hypertension, provided that there are 1 to 2 risk factors.The risk increases with high body weight, smoking, an increase in cholesterol, a violation of glucose tolerance, a lack of movement.Hereditary factors are also important.The risk of cardiovascular complications in these people is higher and is 15 to 20% for 10 years.People related to this group are recommended to comply with a healthy lifestyle.If a reduction in pressure does not occur within 6 months, pharmacotherapy is prescribed.
High
The high risk group includes people from II Century.Hypertension, subject to the presence of at least 3 risky factors, in particular:
- diabetes;
- Defeat of the target organs;
- atherosclerotic vascular diseases;
- left ventricular hypertrophy;
- Creatinine increase;
- Changes in ships for the eyes.
This group also includes hypertension of the 3rd century, which has no risk factor (the risk of cardiovascular disease is 20 to 30% for 10 years).Representatives of this group are under the supervision of a cardiologist.
Very high
A hypertension group with a very high risk of cardiovascular disease (more than 30% for 10 years) includes people with art III.Hypertension, provided there are at least 1 risky factor.In addition, this group includes patients with art Ah i - II.In the presence of a violation of brain traffic, ischemia, nephropathy.This group is controlled by cardiologists, requires active therapy.
Conclusion
The problem of high blood pressure is that the disease has no typical symptoms, is characterized by a variety of clinical images.Therefore, often a person does not know the presence of the disease.Consequently, high pressure is detected by accident, during the inspection or in the manifestation of complications.When diagnosing hypertension, it is important to properly inform the patient that he can largely affect the course of his illness, after a healthy lifestyle.