Hypertension is one of the most common cardiovascular diseases. According to the WHO, more than 1. 1 billion people suffer from it. global. High blood pressure increases the risk of developing other heart diseases. Hypertension is one of the leading causes of death and the disease is occurring at younger and younger ages. This occurs not only in older people, but also in young people. Below you will find out why it appears, how to recognize it and control it.
What is hypertension?
It is a chronic disease in which blood pressure is high. It is noted as two numbers and the optimal value is 120/80 mmHg. Art. The first number is systolic pressure, which occurs when blood is ejected from the left ventricle of the heart into the aorta at the time of systole (contraction of the ventricles of the heart). The second number indicates 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, with several measurements taken at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure exceeds 90 mmHg. Art. , diagnosed with hypertension.
A persistent increase in blood pressure is associated with several factors, including excess weight and lack of physical activity, poor diet, bad habits and high stress levels.
Causes and risk factors
Hypertension can be primary or secondary:
- primary (essential)hypertension is more common - according to various estimates, in 85-95% of cases. Its occurrence 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 disease and abnormalities of large vessels.
When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its appearance is usually constant nervous overstrain. When making a diagnosis, it is important to establish as accurately as possible the causes of hypertension, if it has secondary causes (the presence of diseases that cause an increase in blood pressure).
There are a number of risk factors that increase the chances of developing primary hypertension:
- excess weight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drinking alcohol and smoking;
- stress, constant emotional tension;
- lack of sleep, poor quality, insomnia;
- excessive salt consumption;
- poorly organized sleep and rest habits (in particular due to irregular or excessively long working hours);
- changes in hormonal levels (in women, 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; blood pressure should be monitored periodically after 35 years);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods rich in trans fats and saturated fats);
- kidney disease, diabetes mellitus and certain other related conditions and illnesses.
Many of these factors are interconnected and mutually reinforcing. Some of them can be controlled (eg, diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). It's a simple way to reduce the risk of hypertension or improve your well-being if your blood pressure is already high.
Classification
To classify the disease, two approaches are used: by degrees and by stages. The degrees of hypertension differ in the values at which blood pressure increases, the difference between the stages lies in the course of the disease, in the number and severity of concomitant organ damage.
First degree
Systolic blood pressure – greater than 139 and less than 159 mmHg. Art. , and diastolic is at the level of 90-99 mm Hg. Art. With high 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 degree
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. With such values, the load on the heart increases significantly. The blood supply to the brain deteriorates, which can cause headaches and dizziness as well as reduced performance. Changes occur in the back of the eye. Sclerosis of tissues and blood vessels of the kidneys begins, excretory function is impaired, and renal 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 systolic pressure value is greater than 180 mm Hg. Art. , diastolic - above 110 mm Hg. Art. With hypertension, the load on the heart becomes too high and causes irreversible changes. Blood pressure must be constantly reduced with medication. Without it, there is a risk of acute heart failure, arrhythmia, angina, myocardial infarction and other serious conditions. Patients with stage 3 hypertension should be constantly monitored by a doctor. Continued use of hypotensive medications is necessary.
| Blood pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| GOOD | < 130 | < 85 |
| Normally, what is called prehypertension | 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 fluctuate throughout the day. At this stage, the condition 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 benign.
- Second step:severe hypertension. In the second stage, there is a significant increase in blood pressure, health often deteriorates and hypertensive crises become severe. At this stage, changes begin in the internal organs due to constantly 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 serious heart pathologies. Signs of renal dysfunction appear (increased albumin level in urine, increased creatinine level in blood serum)
- Third step :very severe hypertension. Blood pressure becomes critical - above 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organ damage intensifies, heart failure, thrombosis of cerebral vessels, aneurysms, kidney failure and other serious ailments develop. Severe hypertensive crises often occur.
Symptoms
Even with a significant increase in blood pressure, hypertension may not have any symptoms for a long time. This is why you should measure your blood pressure periodically (monitoring is especially important for people over 35). You can measure your blood pressure with an automatic electronic tonometer - these 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 blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, cardiac arrhythmias. In severe cases of hypertension, weakness, chest pain, nausea, vomiting, and tremors ("shaky" muscles) may occur. Other symptoms include blurry or black spots before the eyes, trouble sleeping, palpitations and tinnitus.
As the disease progresses, visual acuity gradually decreases, sensitivity in the arms or legs may decrease, and in severe cases, paralysis is possible. During periods of stress, against the background of nervous tension or physical activity, symptoms may increase. They appear more often in middle-aged and elderly people. The disease is more serious if you are overweight, have bad habits, tend to overeat, or are very stressed.
You should see a therapist or cardiologist if you regularly experience headaches, dizziness, or vision problems, or if your blood pressure is often high when you measure your blood pressure yourself.
Diagnostic
Generally, the diagnosis is carried out in three directions:
- blood pressure measurement.Carried out at intervals of several hours or over 2-3 days in order to determine the degree of hypertension and its stage;
- identify the causes of the disease.It is important to determine whether hypertension is primary or secondary (caused by other diseases). In the second case, specific treatment may be necessary;
- monitoring of general health.During the examination, the condition of the heart, cerebral vessels, fundus and kidneys is monitored. Due to high blood pressure, the functioning of these organs is impaired. When making a diagnosis, it is important to assess their condition.
During the first appointment, the doctor will conduct an investigation and collect details of the medical history related to the disease. Information will be needed on how long the patient has had hypertension, what their blood pressure level is, whether they have symptoms of heart disease, apnea, severe snoring, whether the person or their loved ones have hadstroke, peripheral arterial disease, gout, diabetes, kidney disease. The doctor will certainly ask questions about lifestyle: physical activity, bad habits, diet, taking medications.
For patients suffering from high blood pressure, the following examinations are carried out:
- 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 taken at different times of the day;
- general examination:measure height and weight, waist circumference, palpate the abdomen, assess the pulsation of the peripheral arteries;
- Urine analysis.Albumin and creatinine levels are important - deviations from the norm indicate renal dysfunction and require ultrasound;
- blood testTo monitor the levels of potassium, creatinine, lipids, an ultrasound of the kidneys is prescribed. Evaluation of lipid levels is necessary to control lipid metabolism to eliminate the risk of complications of the cardiovascular system;
- ECGperformed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiological or neurological examination or an examination of the respiratory system.
Treatment of hypertension
High blood pressure is a disease that cannot be completely cured, but can be controlled. Therapeutic and lifestyle changes can stop the development of hypertension, reduce the frequency and severity of attacks, and eliminate symptoms. But the most important thing is to reduce the risks to the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle adjustments:
- stop smoking;
- refusal to drink alcohol or significant limitation of the amount of alcohol;
- diet: the diet is adapted, salt consumption is reduced (less than 3. 75 g per day), the quantity of vegetables and fruits is increased (ideally 5 servings per day), whole grains, productsdairy, low-fat products, and caloric intake is limited. If there are no contraindications or kidney diseases, increase the consumption of potassium-containing foods (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increased 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 decrease, constant monitoring by a doctor is necessary. A tonometer used for home measurements should be calibrated regularly. For patients with diabetes, pregnant women, elderly and weakened people, the use of antihypertensive drugs requires special caution.
The following may be used to treat hypertension:
- adrenergic modifiers.They reduce sympathetic nervous system activity and lower blood pressure, but can cause drowsiness and lethargy and are therefore rarely used;
- ACE inhibitors.Reduce peripheral vascular resistance, often prescribed to diabetic patients;
- angiotensin II receptor blockers.They have an effect similar to ACE inhibitors and therefore are not prescribed together with them. Not prescribed during pregnancy;
- beta blockers.Ensure a reduction in blood pressure by slowing the heart rate;
- calcium channel blockers.They reduce total peripheral vascular resistance and can cause reflex tachycardia;
- direct vasodilators.They have a direct effect on blood vessels and are used in cases of severe hypertension;
- diuretics.They reduce blood plasma volume, which reduces blood pressure, but can also cause hyperkalemia.
Important! A therapist or cardiologist must prescribe medications and their dosages after an examination. Taking medications without a doctor's prescription can be dangerous.
If your doctor prescribes medication, you will need to have periodic follow-up 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 minimum amount of medication is needed to control the progression of hypertension.
Possible complications
Due to 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 increase, which will lead to damage to internal organs and a worsening of overall health and well-being. Smoking, alcohol consumption, overeating, lack of physical activity and high stress levels accelerate the development of hypertension and make its course more complex.
Consequences
Without treatment, high blood pressure has serious consequences. Constant spasm of cerebral vessels leads to ischemia and stroke. They are dangerous and cause serious disabilities or even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia and heart failure occur. Without treatment, a myocardial infarction is possible.
The severity of hypertensive crises increases, they become complicated, life-threatening and can be accompanied by strokes, acute coronary syndrome and other serious conditions. The quality of life in the context of hypertension without adequate treatment and without restoration of normal health decreases sharply, even up to serious 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 high blood pressure, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
To prevent hypertension, self-monitoring of blood pressure is recommended over the age of 35 or when symptoms of hypertension appear. It is important to eliminate the effects of factors that cause an increase in blood pressure: control your diet, stop smoking and drinking alcohol, reduce stress levels, devote more time to physical activity: in a word, lead a healthy life.
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 blood pressure, control weight, lead a healthy lifestyle and undergo preventive examinations with a therapist or cardiologist.