Arterial hypertension belongs to the most common heart diseases and blood vessels, which affect about 25% of adult population.No wonder sometimes mentioned as in the non-infectious epidemic.High blood pressure with complications significantly affects the mortality of the population.Assessments show that up to 25% of the death of people older than 40 years of age or indirectly caused by hypertension.The likelihood of complications determines the phases of hypertension.How many phases are there hypertension, how are they classified?See below.
Important!According to the latest estimates of the World Health Organization in 1993. year, hypertension in adults is a constant increase in blood pressure on 140/90 mm Hg.Art.
Classification of arterial hypertension, determining the degree of risk of illness
In who, according to etiology, hypertension is classified in primary and medium.
In addition to the primary (essential) hypertension (GB), the main organic cause of blood pressure increases (blood pressure) is unknown.A combination of genetic factors, external influences and violations of internal regulatory mechanisms is taken into account.
External factors:
- environment;
- Excessive use of calories, the development of obesity;
- Increased salt consumption;
- Lack of potassium, calcium, magnesium;
- Excessive drink;
- Repeating stressful situations.
Primary hypertension is the most common hypertension, in approximately 95% of cases.
3 phases of hypertension are separate:
- Stage and - increased blood pressure without changes in organs;
- Phase II - Increasing blood pressure with bodies changes, but without damaging their function (hypertrophy of the left ventricle, proteinuria, angiopathy);
- Phase III - bodies followed by an impaired function (Left heart failure, hypertensive encephalopathy, stroke, hypertonic retinopathy, kidney failure).
Secondary (symptomatic) hypertension is an increase in blood pressure as a symptom of a fundamental disease with the identified cause.The classification of secondary arterial hypertension is as follows:
- Renoparechymal hypertension - occurs due to kidney disease;Reasons: renal parenchymal disease (glomerulonephritis, pyelonephritis), tumors, kidney damage;
- Renoviscular hypertension - narrowing of renal arteries with fibrosm-mindedness or atherosclerosis, thrombosis of renal veins;
- Endocrine hypertension - primary hyperaldosteronism (conns syndrome), hyperthyroidism, feochromocytoma, compression in Kushing;
- Hypertension caused by medications;
- Gestational hypertension - high pressure during pregnancy, after delivery, the situation is often normalized;
- Koarctation aorta.
Gestational hypertension can lead to innate diseases of the child, especially retinopathy.2 phases of retinopathy (premature and full children) are separate ::
- Active - consists of 5 stages of development, can lead to vision loss;
- Runts - leads to corneal blur.
Important!Both phases of retinopathy premature and full children lead to anatomical disorders!
Hypertensive disease according to the international system (according to ICD-10):
- Primary form - I10;
- Secondary form - I15.
The degrees of hypertension also determine dehydration degree - 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, heavy thirst;
- Degree 2 - Average - Lack - 3-6%;Symptoms - sharp fluctuations in reducing pressure or pressure, tachycardia, oliguria;
- Degree 3 - The third degree is the most difficult, characterized by a lack of 7-14% water;manifests with hallucinations, delirium;Clinic - Coma, hypovolemic shock.
Depending on the degree and phase of dehydration, decompensation is performed by the introduction of a solution:
- 5% glucose + isotonic NACL (mild degree);
- 5% NaCl (average diploma);
- 4.2% nahco3(Heavy degree).
GB phases
Subjective symptoms, especially with a mild and moderate phase of hypertension, are often absent, so increasing blood pressure is often found at the level of dangerous indicators.The clinical picture is divided into 3 phases.Each phase of arterial hypertension has typical symptoms from which GB classification comes.
Phase and
In the 1 phase of hypertension, the patient complains of a headache, fatigue, fast heart repayment, disorientation, sleeping.In the 1st phase of GB, objective heart detection, ECG, eye background, in laboratory studies are present in a normal range.
Phase II
At the other phases of AH, subjective complaints are similar, simultaneously, there are signs of the left ventricular hypertrophy, there are signs of hypertensive angiopathy on the retina, microalbuminuria or urine protein.Sometimes there is a reproduction of red blood cells in urine precipitation.At 2 phases of hypertension, the symptoms of kidney failure are absent.
Phase III
With hypertension III degrees, functional disorders are diagnosed in bodies that belong to an increased risk for hypertension:
- Damage to the heart - in the beginning is manifested, lack of breath - symptoms of heart asthma or pulmonary edema;
- Vascular complications - Damage to peripheral and coronary arteries, risk of brain atherosclerosis;
- Changes to the fundum - have the nature of hypertensive retinopathy, neuroretinopathy;
- Changes in cerebral blood vessels are manifested by transient ischemic colors, typical thrombotic or hemorrhagic vascular moves;
- On III phase, brain brain impact, brain lesions are diagnosed in almost all patients;
- Benign nephrosclerosis Kidney bowl - leads to the limitation of glomerular filtration, increasing proteinuria, red blood cells, hyperikemia, and later chronic renal failure.
What is the phase or degree of hypertension the most dangerous?Despite various symptoms, all phases and degree arterial hypertension are dangerous, they require appropriate systemic or symptomatic treatment.
Degree
In accordance with blood pressure indicators (blood), determined during diagnosis, 3 degrees of hypertension are different:
- light;
- average;
- tough.
There is also a fourth concept - determination of resistant hypertension, in which even the appropriate choice of antihypertensive drugs, blood pressure indicators are not reduced below 140/90 mm Hg.Art.
The table presented a clearer overview of the degrees of arterial hypertension.
Classification of AG and stratification of normal blood pressure according to ESH / ESC guidelines 2007.
| Category | Systolic pressure, mm Hg.Art. | Diastolic pressure, mm Hg.Art. |
|---|---|---|
| Optimal | <120 | <80 |
| Normal | 120-129 | 80-84 |
| Increased 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 hypertension in degrees.The selection of disease treatment regimes depends on the degree determination.
Diplomas
The disease can only be detected by regular measurement of blood pressure.Measurements should be carried out in a relaxed environment, at least 3 times in a certain period.
This is the only way to assess the presence or absence of hypertension.Depending on the degree of blood pressure increases, the clinical picture of the disease is different.
II degree
The second degree of hypertension is characterized by periods of increased pressure alternately with reducing indicators or increasing only diastolic values.In this measure, hypertension, cases of growing pressure in certain circumstances are typical, especially in patients with an unstable nervous system.
III degree
III The degree of AG is characterized by a critical increase in blood pressure.
The GB III is characterized by severe complications that arise as a result of harmful effects of high blood pressure on all bodies and systems.First of all, the heart, kidneys, eyes, the brain is affected.With the hypertension III degree, symptoms and treatment are closely related - with insufficient or irregular treatment, the disease can lead to serious effects: stroke, encephalopathy, eye lesions, blood vessels.Lack of treatment for III degree Hypertension increases the risk of isolated systolic hypertension.
At this stage of the arterial hypertension of the degree of risk, it increases significantly!Memory disorders, mental activities, frequent loss of consciousness is manifested.
The hypertonic crisis arises as a complication of the III century and is considered IV Art.GB.
Risks
In accordance with the classification of hypertension due to phases and degrees, patients are divided into risk groups, depending on the weight of AG.4 categories vary (that is, there is as many as more as degrees hypertension), which determine the principle of the probability of damage to internal organs in the future.
Risks to the disease degree:
- Risk less than 15%;
- risk up to 20%;
- Risk 20-30%;
- The risk is above 30%.
Low, insignificant
The low-risk group includes men for up to 55 years and women up to 65 years from and Art.arterial hypertension.In this group, the risk of cardiovascular pathology in the period of up to 10 years is less than 15%.People belonging to low-risk group recommend changes in lifestyle.If the unsupported efficiency is not showing efficiency within 6-12 months.
Average
The average risk group includes people from I - II Art.Hypertension, provided that there are 1-2 risk factors.The risk increases with high body weight, smoking, cholesterol increases, glucose tolerance, lack of movement.Hereditary factors are also important.The risk of cardiovascular complications in these people is higher, and 15-20% is 10 years.People relating to this group are recommended to adhere to a healthy lifestyle.If pressure reduction does not occur within 6 months, pharmacotherapy is prescribed.
High
High -rk Group includes people from I - II centuries.Hypertension, susceptible to the presence of at least 3 risk factors, which include:
- Diabetes;
- Defeat of targeted organ;
- atherosclerotic vascular diseases;
- Left ventricular hypertrophy;
- Increased creatinine;
- Changes in eye vessels.
This group includes hypertension 3. century, which do not have risky factors (the risk of cardiovascular diseases is 20-30% 10 years).Representatives of this group are under the supervision of the cardiologist.
Very high
A group of hypertension with very high risk of cardiovascular disease (more than 30% in 10 years) includes people with III Art.Hypertension, provided there is at least 1 risk factor.In addition, this group includes patients with AH I - II Art.In the presence of creeping cerebral circulation, ischemia, nephropathy.This group control cardiologists, requires active therapy.
Conclusion
The problem of arterial hypertension is that the disease has no typical symptoms, characterized by various clinical images.Therefore, often a person does not know about the presence of the disease.Therefore, high pressure was detected by accident, during inspection or in the event of complications.When diagnosing hypertension, it is important to inform the patient correctly that it can greatly affect the course of his illness, after a healthy lifestyle.