Constantly high blood pressure has several names in medicine: hypertension, arterial hypertension, essential hypertension.The disease can cause damage to the kidneys, heart, blood vessels, cause stroke, heart attack, bleeding from stomach ulcers and other serious consequences.In order to prevent dangerous health conditions, it is necessary to take timely measures for disease prevention and to know the risk factors that greatly increase the probability of hypertension.
What is hypertension
This is a chronic pathology that develops as a result of dysfunction of vascular regulation, renal and neurohumoral mechanisms.Hypertension (HTN) is a dangerous condition of the body in which there is a persistent increase in blood pressure (BP) with levels above 140/90 mmHg.Art.in patients not taking antihypertensive drugs.
Hypertension accounts for about 40% of all cardiovascular pathologies.The disease occurs more often in men than in the female population.The risk of developing pathology in both sexes increases with age.Hypertension is mostly diagnosed in patients after the age of 40, but recently the disease is more often registered in adolescence and young adulthood.
Stages of headache
Hypertension is a chronic pathology that has three stages of development.In an adult, the optimal blood pressure is 120/80 mmHg.Art.A slight deviation from these indicators up to 139/89 mm Hg.Art.also applies to the norm.A larger number in medical practice is considered pathology.The diagnosis of "hypertension" is made when indicators above 140/90 are repeatedly recorded in different conditions.
Stage 1 hypertension is characterized by sudden changes in pressure.This already indicates a pathological process taking place in the body.The disease in the early stage is almost always asymptomatic.The patient does not pay attention to some signs of hypertension, which explains the large percentage of late requests for qualified help.Symptoms of hypertension of the first stage:
- blood pressure indicators: from 140/90 to 159/99 mm Hg.Art.;
- headaches;
- confusion;
- reduced mental performance;
- dyspnea;
- tachycardia;
- increased swelling;
- fluid retention in the body;
- change in the amount and color of urine.
The second stage of hypertension is arterial hypertension, which occurs in a moderate form.In this stage of the disease, longer periods of elevated blood pressure are observed than at the beginning.Blood pressure readings in stage 2 hypertension rarely return to normal.Patient condition:
- blood pressure indicators: from 160/109 to 179/109 mm Hg.Art.;
- sleep disorder;
- discomfort in the heart area;
- heart failure;
- memory and vision impairment;
- constant irritability;
- dizziness;
- tinnitus;
- aching pain in the back of the head;
- dilated eye vessels;
- facial skin is hyperemic;
- swelling of the face, hands.
Hypertension of the third stage is a severe form of the disease.It is characterized by a patient with a history of myocardial infarction, stroke and other serious pathologies.At this stage, it is possible to completely cure hypertension in very rare cases, only if the high blood pressure lasts for a short time or is secondary.Clinic for severe hypertension:
- blood pressure indicators: from 180/110 mm Hg.Art.and above;
- left ventricular hypertrophy;
- hypertrophy of the interventricular septum;
- impaired movement coordination;
- encephalopathy;
- ischemic or hemorrhagic infarction;
- various kidney lesions;
- permanent visual impairment;
- prolonged hypertensive crises;
- paralysis and paresis due to cerebral circulation disorders;
- limitation of the ability to move independently and take care of oneself.
Risk factors for hypertension
The development, progression and complications of arterial hypertension are directly related to the presence of risk factors for the occurrence of this pathological process.Hypertension is the result of a complex interaction of internal (endogenous) and external (exogenous) causes.The appearance of pathology is facilitated by acquired and innate characteristics of the body, which weaken its resistance to adverse external conditions.
Risk factors for the development of arterial hypertension are classified according to two indicators: variable and non-variable.The former depend on the person's decisions and lifestyle.This includes:
- bad habits;
- physical inactivity;
- smoking;
- drinking alcohol;
- obesity and others.
Immutable risk factors for hypertension are those that a person cannot influence: heredity and physiology (gender, age).In many cases, hypertension is a genetically transmitted disease.If any of your relatives suffered from hypertension, then there is a high probability that the next generation will be affected by the disease.As for physiological factors, according to statistics, middle-aged men are more susceptible to the disease.This is explained by the fact that the female body produces estrogens - hormones that perform a protective function.
Endogenous
Intrinsic risk factors for hypertension are the presence of diseases or conditions that cause high blood pressure.among them:
- diabetes mellitus;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity;
- metabolic disorder;
- kidney diseases (pyelonephritis, nephritis, glomerulonephritis);
- increased concentration of sodium or calcium in the blood;
- effect of adrenaline during stress;
- dyslipidemia (disorder of fat metabolism);
- increased uric acid content;
- neurocirculatory dystonia;
- pregnancy;
- menopause.
Related to lifestyle and environmental influences
Exogenous risk factors for hypertension are related to the patient's lifestyle.The number of acquired causes that can be successfully countered is significant, but each point can be easily adjusted if a person wishes.Main exogenous risk factors for hypertension:
- Insufficient physical activity.Constant work in the office, traveling exclusively by vehicle, lack of time to visit the gym lead to a weakening of the respiratory system, damage to muscle function and deterioration of blood circulation.All these factors cause an increase in blood pressure.
- Uncontrolled salt intake.Sodium chloride in large quantities causes thirst and delays the removal of fluids from the body.Water causes an increase in the volume of circulating blood, as a result of which myocardial contractions are more frequent, which leads to an increase in blood pressure.The consumption rate of table salt is not higher than 5 g per day.
- Lack of magnesium and/or potassium.The body needs these microelements for the proper functioning of blood vessels and heart muscle.If they are deficient, there is a risk of developing hypertension.
Diagnostics
Hypertension is determined by various methods - the blood pressure level is measured several times with a tonometer and phonendoscope, the clinical picture of the disease is studied, and clinical, physical and instrumental studies are prescribed.Main diagnostic approaches:
- Biochemical blood test.High/low density lipoprotein and cholesterol levels are detected and sugar levels are determined.These indicators are important for determining the cause of high blood pressure.
- EKG.The electrocardiogram has long been a reliable assistant in diagnosing hypertension.The EKG detects disturbances in the work of the heart, determines the presence of angina and provides data on the displacement of the heart from the electrical axis and the condition of the myocardium.
- Ultrasound of the heart.The main vessels (carotid arteries) leading to the brain are illuminated to detect atherosclerotic plaques, assess the condition of the vascular walls and the risk of stroke.
- Arteriography.X-ray method for studying the walls of arteries and their lumen.
- Dopplerography.Ultrasound technique for diagnosing blood flow in veins, arteries and vessels.
- Kidney ultrasound.It helps to identify large tumors in the adrenal glands and lesions of the kidney tissue, which leads to the appearance of renoparenchymal hypertension.
- Ultrasound of the thyroid gland.It helps to recognize or rule out the influence of the thyroid gland on the development of hypertension in the patient.
Treatment
Treatment of hypertension depends on the cause of the disease.The first thing a patient should do is eliminate all the risks associated with hypertension.Then drug therapy is used in combination with non-drug methods: following a diet against cholesterol, physical activity, stopping smoking and drinking alcoholic beverages.Drug treatment is carried out according to different schemes:
- Patients with a low to moderate risk of developing hypertension are prescribed one blood pressure lowering drug.
- Patients with a high risk of cardiovascular pathologies are prescribed two or more drugs in individual doses.
Medicines are selected and dosed by the doctor, taking into account the patient's age, accompanying pathologies and risk factors.Several groups of drugs are used to treat hypertension:
- Thiazide diuretics.They inhibit the absorption of chloride and sodium in the renal tubules so that they do not enter the blood, but are excreted from the body in the urine.
- Calcium channel blockers.It reduces calcium intake, which reduces the load on the myocardium and lowers blood pressure.
- ACE inhibitors.They reduce the concentration of the hormone angiotensin in the blood, which has the ability to narrow the lumen of blood vessels, which increases blood pressure.
- Angiotensin II receptor antagonists.It reduces blood pressure in the first stage of hypertension.
- Beta blockers.They relax the vascular walls, which leads to improved blood circulation and normalization of blood pressure.
- Central alpha-2 agonists.The heart rate decreases, which is manifested by a decrease in blood pressure.
- Direct vasodilators.It relaxes the smooth muscles of the arterioles, which causes a decrease in blood pressure.
- Renin inhibitors.They promote the expansion of arteries and inhibit the activity of renin, an enzyme with vasoconstrictor action.