Hypertension is a disease of a chronic nature characterized by a persistent increase in blood pressure to high levels due to disruption of the regulation of blood circulation in the human body. Also, terms such as arterial hypertension and hypertension are used to refer to this condition.
Medical statistics are such that hypertension is one of the most common diseases today. It usually starts to progress in people after the age of 40, but there is a risk of it progressing at any age. Therefore, the disease began to be detected more often in patients of working age. It should be noted that the fairer sex suffers several times more often than men. But in men, hypertension is more difficult, because they are more prone to the development of atherosclerosis of blood vessels.
Blood pressure can rise during severe mental or physical stress for a short time - this is an absolutely normal phenomenon. A prolonged increase in blood pressure is observed in numerous 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, the increase in blood pressure is an independent, primary, painful process.
The pathogenesis of hypertension is such that, under the influence of exogenous and endogenous factors, the tone of the arteriole walls in the body increases. As a result, they gradually narrow and the blood flow in the affected vessels is disrupted. During this pathological process, there is an increase in blood pressure on the walls of the arteries, which entails further 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 it certain impulses go along nerve fibers to the walls of blood vessels, causing the vessels to expand or contract. If this center is in a state of irritation, then only impulses that increase the tone of their walls will reach the blood vessels. 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 unfavorable factors.
Exogenous risk factors:
- severe nervous tension is the most common cause of progression of arterial hypertension;
- hypodynamia;
- irrational diet. Not following a diet and eating large amounts of fatty and fried food;
- excessive consumption of alcoholic beverages;
- smoking;
- the use of narcotic drugs.
Endogenous risk factors:
- burdened heredity;
- obesity;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity (the heart cannot fully distill it through the blood vessels);
- kidney diseases such as nephritis, glomerulonephritis, pyelonephritis;
- metabolic disorder;
- presence of endocrine pathologies;
- increased concentration of calcium in the blood;
- the effect of adrenaline on the heart during stressful situations;
- increased concentration of sodium in the blood.
Classification
Throughout the study of the disease, scientists have developed more than one classification of hypertension - according to the appearance of the patient, according to etiology, according to the level of pressure increase, the nature of the flow, and so on. Some have long been outdated, while others, on the contrary, are used more and more often.
Degrees of hypertension (according to pressure level):
- optimal - indicators 120/80;
- normal - upper from 120 to 129, lower - from 80 to 84;
- increased normal - 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 increase to 160-179, and diastolic - to 100-109;
- 3rd degree hypertension - systolic pressure rises above 140, and diastolic pressure rises above 110.
Stages of hypertension according to WHO:
- 1st stage of 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. In this stage of hypertension, the pressure is constantly rising. The major organs of the target are affected. During the examination, damage to the heart, vessels of the fundus, kidneys can be observed;
- Stage 3 or sclerotic. This phase 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 disease, angioretinopathy, heart attack and so on.
Forms of the disease (depending on which blood vessels are affected):
- renal form;
- heart shape;
- brain shape;
- mixed.
Types of hypertension:
- benign and slow flowing. In this case, symptoms of the progression of the pathology may appear gradually over 20 years. Exacerbation and remission phases are observed. The risk of complications is minimal (with timely therapy);
- malignant. The pressure rises sharply. This form of hypertension is practically not amenable to therapy. As a rule, the pathology is accompanied by various kidney diseases.
It is worth noting that often with hypertension of the 2nd and 3rd degree, 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 crises:
- neurovegetative. The patient is hyperactive and very agitated. Such symptoms of hypertension are manifested: hyperhidrosis, tremor of the upper extremities, tachycardia and copious urination;
- hydropic. In this case, the patient is sleepy and his reactions are inhibited. Weakness of the muscles, swelling of the face and hands, reduced diuresis, persistent increase in blood pressure;
- convulsive. This option is the most dangerous, because there is a high risk of developing dangerous complications. It is worth noting that it is the least common. It is characterized by such symptoms: convulsions and loss of consciousness. Complication - bleeding in the brain.
Symptoms
Symptoms of the disease directly depend on the degree 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 pathology at all. Sometimes patients complain of pain in the heart, irritability, headache, tachycardia, feeling of heaviness in the back of the head. SD and DD indicators are increasing, but can be easily normalized.
sclerotic
The above clinical picture is complemented by the following symptoms:
- increased headache;
- dizziness;
- feeling of a rush of blood to the head;
- bad sleep;
- periodic numbness of the fingers on the limbs;
- fast fatigue;
- "flies" before the eyes;
- persistent increase in blood pressure.
It is worth noting that this stage can progress for several years, and at the same time patients will be active and mobile. But violation of blood supply to certain organs implies 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. Crises often occur.
In the cardiac form, the patient gradually progresses to heart failure. Difficulty breathing, pain in the projection of the heart, hepatomegaly, edema appear. With the cerebral form of a person, severe headaches, visual impairment are disturbed.
Hypertension and childbirth
Hypertension in pregnancy is the most common cause of premature birth or perinatal death of the fetus. Usually, hypertension in a woman already exists before the beginning of pregnancy and then it is simply activated, because giving birth to a child is a kind of stress for the body.
Considering the high risk for the mother and the unborn child, in the case of diagnosing the disease, it is important to accurately determine the degree of this risk in order to resolve the issue of further gestation or termination of pregnancy. Doctors distinguish three degrees of risk (based on the stage of arterial hypertension):
- 1 degree of risk - complications in pregnancy are minimal, crises rarely develop. Possible angina. Pregnancy is allowed in this case;
- 2 degree of risk - pronounced. Complications develop in 20-50% of cases. The pregnant woman has hypertensive crises, insufficiency of the coronary vessels of the heart, high blood pressure. Termination of pregnancy is shown;
- 3 degree of risk. Pregnancy complications occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Perhaps separation of the placenta, uremia, impaired blood circulation in the brain. The pregnancy poses a threat to the mother's life, so it is terminated.
Patients who remain in the second state should 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 diseases during pregnancy, doctors resort to physiotherapy.
Diagnostics
When the first signs of the disease appear, it is important to immediately contact a medical institution to confirm or refute the diagnosis. The sooner this is done, the lower the risk of developing dangerous complications (heart, kidney, brain damage). During the initial examination, the doctor must measure the pressure on both arms. If the patient is older, measurements are also taken in a standing position. During the diagnosis, it is important to clarify the true cause of the progression of the pathology.
A comprehensive plan for the diagnosis of hypertension includes:
- collection of anamnesis;
- SMAD;
- Urinalysis;
- blood biochemistry;
- determining the level of bad cholesterol in the blood;
- x-ray;
- EKG;
- fund review;
- ultrasound.
Treatment
Treatment of hypertension is carried out in the hospital, so doctors can constantly monitor the patient's condition and adjust the treatment plan if necessary. It is important to normalize the patient's daily routine, correct his weight, limit the use of table salt and completely abandon bad habits.
The following drugs are prescribed for pressure correction:
- alpha-blockers;
- beta-blockers;
- calcium channel blockers;
- diuretics. This group of drugs is particularly important, as it helps to reduce the level of sodium in the blood, thereby reducing the swelling of the walls of blood vessels.
All these medicines should be taken only according to the doctor's prescription. Uncontrolled intake of such agents can only worsen the patient's condition. These drugs are taken according to a specific schedule.
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 your diet;
- limit salt intake;
- fractional nutrition;
- limit the intake of carbohydrates and animal fats in the diet.
The diet for this pathology implies a restriction:
- Sahara;
- bread;
- potato;
- pasta;
- cereal dishes;
- eggs;
- animal fats;
- ghee;
- sour cream and much more.
Diet number 10 is complete and can be followed for a long time. To improve the taste of the dish, you can add:
- honey;
- prunes;
- vinegar;
- jam;
- cranberries
- lemon.
A diet is indicated not only during the treatment, but also after it, so as not to cause the condition to worsen. It is worth noting that the diet is developed strictly individually for each patient, taking into account the characteristics of his body. Important thing - during the diet, you should not consume more than 1. 5 liters of liquid per day.
Prevention
Prevention of hypertension is quite simple. The first thing to do is to normalize the diet, as well as lead an active lifestyle. In order for the blood vessels to be elastic, it is necessary to eat more vegetables and fruits, drink up to 2 liters of water a day. You can take vitamin preparations. Also, the prevention of hypertension implies the exclusion of smoking and drinking alcoholic beverages.
If possible, stress should be avoided, which is one of the provoking factors of the disease. Prevention of hypertension should be addressed as soon as possible to reduce the risk of developing the disease.