Hypertension is a disease of a chronic nature, which is characterized by a persistent increase in blood pressure to high figures due to a violation of the regulation of blood circulation in the human body. Also, terms such as high blood pressure and hypertension are used to refer to this condition.
Medical statistics are such that today hypertension is one of the most common diseases. It usually starts to progress in people after age 40, but there is a risk of progression at any age. So, more and more often the disease began to be detected in patients of working age. It should be noted that the fair sex suffers several times more often than men. But it is in men that hypertension is most severe, since they are more prone to the development of atherosclerosis of 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, an increase in blood pressure is an independent, primary and 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 of the body increases. As a result, they gradually narrow, and the blood flow in the affected vessels is disturbed. During this pathological process, blood pressure increases on the walls of the arteries, which leads to other symptoms.
Etiology
The main reason for the progression of hypertension is an increase in the activity of the sympathetic-adrenal system. The vasomotor center is located in the human medulla oblongata. From there, certain impulses go along the nerve fibers to the walls of the vessels, causing the vessels to expand or contract. If this center is in a state of irritation, only impulses will come to the vessels which 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 cause of progression of high blood pressure;
- hypodynamia;
- irrational eating. Non-compliance with the diet and eating large amounts of fatty and fried foods;
- excessive consumption of alcoholic beverages;
- smoking;
- the use of narcotics.
Endogenous risk factors:
- burdened heredity;
- obesity;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity (the heart cannot completely distill it through the vessels);
- kidney conditions 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 in stressful situations;
- increase in the concentration of sodium in the blood.
Classification
During all the time spent studying the disease, scientists have developed more than one classification of hypertension - according to the appearance of the patient, according to the etiology, according to the level of increased pressure, the nature of theevolution, etc. Some have long been outdated, while others, on the contrary, are increasingly used.
Degrees of hypertension (by pressure level):
- optimal - 120/80 indicators;
- normal - upper from 120 to 129, lower - from 80 to 84;
- normal increase - upper indicators - from 130 to 139, lower - from 85 to 89;
- 1st degree hypertension - SD from 140 to 159, DD - from 90 to 99;
- 2nd degree hypertension - systolic pressure indicators rise to 160-179, and diastolic - up to 100-109;
- 3rd degree hypertension - systolic pressure increases by more than 140, and diastolic - by more than 110.
Stages of hypertension according to the WHO:
- stage 1 hypertension - the pressure increases, 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 is constantly increasing. The main organs of the target are affected. During the examination, it can be noted that damage to the heart, fundus vessels, kidneys;
- Stage 3 or sclera. 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 heart disease, angioretinopathy, heart attack, etc.
Forms of the disease (depending on the vessels whose organs are affected):
- renal form;
- heart shape;
- cerebral form;
- mixed.
Types of hypertension:
- mild and slow flowing. In this case, the symptoms of the progression of the pathology may appear gradually over 20 years. Phases of exacerbation and remission are observed. The risk of complications is minimal (with prompt treatment);
- smart. The pressure rises sharply. This form of hypertension practically does not lend itself to therapy. As a rule, the pathology is accompanied by various kidney diseases.
It should be noted that often with hypertension of 2 and 3 degrees the patient has hypertensive crises. This is an extremely dangerous condition not only for human health, but also for his life. Clinicians distinguish between the following types of seizures:
- neurovegetative. The patient is hyperactive and very agitated. Such symptoms of hypertension are manifested: hyperhidrosis, tremor of the upper extremities, tachycardia and profuse urination;
- dropsical. In this case, the patient is drowsy and his reactions are inhibited. There is muscle weakness, swelling of the face and hands, a decrease in diuresis, a persistent increase in blood pressure;
- convulsive. This option is the most dangerous, since there is a high risk of developing dangerous complications. It should be noted that this is the least common. It is characterized by such symptoms: convulsions and impaired consciousness. Complication - hemorrhage in the brain.
Symptoms
Symptoms of the disease directly depend on the stage of hypertension 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 the presence of pathology. 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 they can easily be normalized.
sclera
The indicated clinical picture is completed by the following symptoms:
- increased headache;
- dizziness;
- feeling of blood rush to the head;
- poor sleep;
- periodic numbness of the fingers on the limbs;
- rapid fatigue;
- "flies" in front of the eyes;
- persistent increase in blood pressure.
It should be noted that this stage can evolve over several years and at the same time the patients will be active and mobile. But a violation of the blood supply to certain organs leads to a violation of their functioning.
ultimate
Usually at this stage, doctors detect kidney and heart failure, as well as a violation of blood circulation in the brain. The outcome of the disease, as well as the development of complications, is determined by the form of hypertension. Seizures often occur.
With a cardiac form, the patient gradually progresses to heart failure. Appears shortness of breath, pain in the projection of the heart, hepatomegaly, edema. With the cerebral form of a person, severe headaches, visual impairment disturb.
Hypertension and maternity
Hypertension during pregnancy is the most common cause of premature birth or perinatal death of the fetus. Usually, a woman's hypertension already exists before the onset of pregnancy and simply activates, because bearing a child is a kind of stress for the body.
In view of the high risk for the mother and the unborn child, in the event of a diagnosis of a disease, it is important to determine exactly the degree of this risk in order to solve the problem of the continuation of gestation ortermination of pregnancy. Doctors distinguish between three degrees of risk (depending on the stage of high blood pressure):
- 1 degree of risk - complications of pregnancy are minimal, seizures rarely develop. Possible angina pectoris. Pregnancy in this case is allowed;
- 2 degree of risk - expressed. 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. Complications of pregnancy occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Perhaps placental abruption, uremia, impaired blood circulation in the brain. Pregnancy poses a danger to the life of the mother, so it is terminated.
Patients who are kept pregnant should make sure to visit the 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;
- ganglioblockers;
- beta-blockers.
Also, in order to treat the disease during pregnancy, doctors resort to physiotherapy.
Diagnostic
When the first signs of a disease appear, it is important to immediately contact a medical institution to confirm or refute the diagnosis. The earlier 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 on both hands. If the patient is elderly, measurements are also taken while standing. When diagnosing, it is important to clarify the true cause of the progression of the pathology.
A comprehensive hypertension diagnostic plan includes:
- history taking;
- SMAD;
- Urine analysis;
- blood biochemistry;
- determination of the level of bad cholesterol in the blood;
- x-ray;
- ECG;
- fundus examination;
- ultrasound.
Treatment
Hypertension treatment 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 daily routine of the patient, correct his weight, limit the use of table salt and completely abandon bad habits.
To correct the pressure, the following drugs are prescribed:
- alpha-blockers;
- beta-blockers ;
- calcium channel blockers;
- diuretics. This group of drugs is especially important because it helps reduce the level of sodium in the blood, thereby reducing swelling in the walls of blood vessels.
All these drugs should be taken only as prescribed by the attending physician. Uncontrolled consumption of such funds can only aggravate the patient's condition. These drugs are taken according to a certain scheme.
Diet
During the treatment of hypertension, in addition to taking medication, it is important to follow a special diet. With hypertension, the patient is assigned table number 10. The principles of such a diet:
- add seafood to the diet;
- limit salt intake;
- fractional nutrition;
- limit carbohydrates and animal fats in the diet.
The diet of this pathology involves a restriction:
- Sahara;
- in bread;
- potatoes;
- Pasta;
- cereal-based dishes;
- eggs;
- animal fats;
- ghee;
- sour cream and more.
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;
- the vinegar;
- Jam;
- cranberries
- lemon.
The diet is indicated not only during treatment, but also after it, so as not to cause deterioration of the condition. It should be noted that the diet is developed strictly individually for each patient, taking into account the characteristics of his body. An important point - during the diet you should not consume more than 1. 5 liters of fluid per day.
Prevention
Preventing hypertension is quite simple. The first thing to do is to normalize your diet and 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 per day. You can take vitamin preparations. Also, the prevention of hypertension involves the exclusion of smoking and the consumption of alcoholic beverages.
If possible, stress should be avoided, as it is one of the factors causing disease. Prevention of hypertension should be addressed as early as possible to minimize the risk of developing the disease.