Hypertension is one of the most common cardiovascular diseases. According to WHO, more than 1. 1 billion people suffer from it. Around the world. High blood pressure increases the risk of developing other heart diseases. Hypertension is among the leading causes of death, and the disease is getting younger and younger. It occurs not only in older people, but also in young people. Below you will find out why it appears, how to recognize and control it.
What is hypertension?
This is a chronic condition where the blood pressure is high. It is recorded as two numbers, and the optimal value is 120/80 mmHg. Art. The first number is the systolic pressure, which occurs when blood is ejected from the left ventricle into the aorta during systole (contraction of the heart's ventricles). The second number indicates the diastolic pressure when the heart muscle is relaxed. Blood pressure rises during physical activity and emotional excitement, but its value should be close to normal at rest. If, with multiple measurements at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure exceeds 90 mmHg. Art. , diagnosed with hypertension.
Persistent increases in blood pressure are associated with several factors, including excess weight and lack of physical activity, poor diet, bad habits and high levels of stress.
Causes and risk factors
Hypertension can be primary and secondary:
- primary (essential)hypertension is more common - according to various estimates, in 85-95% of cases. Its appearance is not related to accompanying 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 diseases and abnormalities of large blood vessels.
When the regulation and maintenance of optimal blood pressure is disturbed, primary hypertension occurs. The cause of its occurrence is usually constant nervous overstrain. When establishing a diagnosis, it is important to establish as precisely as possible what causes hypertension, whether it has secondary causes (presence of diseases that cause high 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;
- alcohol consumption and smoking;
- stress, constant emotional tension;
- lack of sleep, its poor quality, insomnia;
- excess salt intake;
- improperly organized sleep and rest patterns (including 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 predisposition to hypertension);
- age over 65 (the disease can also occur in young people; it is worth periodically monitoring blood pressure after the age of 35);
- poor nutrition (lack of vegetables and fruits in the diet, excess of food with a high content of trans fats and saturated fats);
- kidney disease, diabetes mellitus and some other related conditions and diseases.
Many of these factors are interrelated and mutually reinforcing. Some of these can be controlled (for example, nutrition and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is an easy way to reduce your risk of hypertension or improve your well-being if your blood pressure is already high.
Classification
Two approaches are used to classify the disease: by degrees and by stages. The degrees of hypertension differ in the values to which the blood pressure rises, the difference between the stages is in the course of the disease, in the number and severity of accompanying organic lesions.
First degree
Systolic blood pressure - more than 139 and less than 159 mmHg. Art. , and diastolic is at the level of 90-99 mm Hg. Art. With elevated values, blood pressure can be normalized by adjusting lifestyle. To do this, you need to increase physical activity, adjust your diet, give up bad habits and reduce your stress level.
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 greatly. The blood supply to the brain deteriorates, which can cause headaches and dizziness and reduced efficiency. Changes occur on the fundus of the eye. Sclerosis of kidney tissue and blood vessels begins, excretory function is disturbed, kidney 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 value of systolic pressure is above 180 mm Hg. Art. , diastolic - above 110 mm Hg. Art. With hypertension, the workload on the heart becomes too high and causes irreversible changes. Blood pressure must be constantly lowered with medication. Without it, there is a risk of acute heart failure, arrhythmia, angina pectoris, myocardial infarction and other serious conditions. Patients with hypertension of the third stage must be under the constant supervision of a doctor. Continuous use of blood pressure lowering drugs is necessary.
| Arterial pressure | systolic (mm Hg) | diastolic (mm Hg) |
|---|---|---|
| All right | < 130 | < 85 |
| Normal, the so-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 phases in total.
- first stage:moderate hypertension. Blood pressure is unstable and can vary 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 mild.
- second phase:severe hypertension. In the second stage, there is a significant increase in blood pressure, health often deteriorates, and hypertensive crises become severe. In this phase, changes in the internal organs begin due to constantly high blood pressure. Vascular disorders appear and blood flow to the brain worsens. The retinal arteries narrow. Hypertrophy of the left ventricle of the heart develops, and this increases the risk of serious heart pathologies. Signs of kidney dysfunction appear (increased level of albumin in urine, increased level of creatinine in blood serum)
- Third phase:very severe hypertension. Blood pressure becomes critically high - above 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions intensify, heart failure, thrombosis of cerebral vessels, aneurysms, kidney failure and other serious conditions develop. Severe hypertensive crises often occur.
Symptoms
Even with a significant increase in blood pressure, hypertension can be asymptomatic for a long time. For this reason, blood pressure should be measured periodically (monitoring is especially important for people over the age of 35). You can measure blood pressure with an automatic electronic tonometer - such 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 flow 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 (muscle tremors) may occur. Other symptoms include blurred or black spots in front of the eyes, trouble sleeping, palpitations and ringing in the ears.
As the disease progresses, the visual acuity gradually decreases, the sensitivity of 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 occur more often in middle-aged and elderly people. The disease is more severe if you are overweight, have bad habits, tend to overeat or have a high level of stress.
Consult a therapist or cardiologist if you have regular headaches, dizziness or vision problems, or if your blood pressure is often elevated when you measure your blood pressure yourself.
Diagnostics
Diagnosis is usually carried out in three directions:
- blood pressure measurement.It is performed at intervals of several hours or over 2-3 days in order to determine the degree of hypertension and its stage;
- determining the cause of the disease.It is important to determine whether the hypertension is primary or secondary (caused by other diseases). In the second case, special treatment may be required;
- general health monitoring.During the examination, the condition of the heart, cerebral vessels, fundus, and kidneys are monitored. Due to high blood pressure, the functioning of these organs is impaired. When making a diagnosis, it is important to assess their condition.
At the first examination, the doctor will conduct a survey and collect information from the anamnesis related to the disease. Information will be needed on how long the patient has been suffering from hypertension, what is the blood pressure level, whether there are symptoms of heart disease, apnea, severe snoring, whether the person or their close relatives have had a stroke, peripheral artery disease, gout, diabetes, kidneys. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, taking medications.
The following examinations are performed for patients with arterial hypertension:
- blood pressure measurement.It is measured several times at rest (excludes physical activity, caffeine consumption, smoking half an hour before measurement), measurements are made at different times of the day;
- general overview:measurement of height and weight, waist circumference, palpation of the abdomen, assessment of peripheral artery pulsation;
- Urinalysis.Albumin and creatinine levels are important - deviations from the norm indicate kidney dysfunction and require an ultrasound;
- blood analysisKidney ultrasound is prescribed to monitor potassium, creatinine, and lipid levels. Assessment of lipid levels is necessary to control lipid metabolism in order to eliminate the risk of complications on the cardiovascular system;
- EKGit is performed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient to a cardiac or neurological examination or an examination of the respiratory system.
Treatment of hypertension
Arterial hypertension is a disease that cannot be completely cured, but it can be controlled. Therapy and lifestyle changes can stop the development of hypertension, reduce the frequency and severity of crises and eliminate symptoms. But the most important thing is to reduce the risks for the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle adjustments:
- stop smoking;
- refusing to drink alcohol or significantly limiting the amount of alcohol;
- diet: the diet is adjusted, salt intake is reduced (less than 3. 75 g per day), the amount of vegetables and fruits is increased (ideally, 5 portions per day), whole grains, dairy products, low-fat products and calorie intake is limited. If there are no contraindications or kidney disease, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increasing physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is lowered to target values (below 130/80 mmHg) to reduce the risk of complications. With such a reduction, constant monitoring by a doctor is necessary. A tonometer used for home measurements must be calibrated regularly. For patients with diabetes, pregnant women, elderly and debilitated people, the use of antihypertensive drugs requires special caution.
The following can be used to treat hypertension:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and lower blood pressure, but they can cause drowsiness and lethargy, so they are rarely used;
- ACE inhibitors.Reduces peripheral vascular resistance, often prescribed to patients with diabetes;
- 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 severe hypertension;
- diuretics.They reduce the volume of blood plasma, which lowers blood pressure, but can also cause hyperkalemia.
Important!The therapist or cardiologist should prescribe the drugs and their dosages after the examination. Taking medicines without a doctor's prescription can be dangerous.
If your doctor prescribes medication, you will have to undergo periodic check-ups 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 course of hypertension.
Possible complications
Due to increased blood pressure, the walls of the arteries lose their elasticity, and the heart muscle works too much. 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 rise, and this will lead to damage to internal organs and deterioration of overall health and well-being. Smoking, alcohol consumption, overeating, lack of physical activity and a high level of stress accelerate the development of hypertension and make its course more complex.
Consequences
Without treatment, arterial hypertension causes serious consequences. Constant spasm of cerebral vessels leads to ischemia and stroke. They are dangerous with severe disability and even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia and heart failure occur. Without treatment, myocardial infarction is possible.
The severity of hypertensive crises increases, they become complicated, life-threatening and can be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life on the background of hypertension without adequate therapy and restoration of a normal state of health drops sharply, even to the point of severe disability.
Forecast
The prognosis is good if the patient consults a doctor in time and takes measures to control blood pressure and factors that affect hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its more severe course. Even with severe arterial hypertension, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
For the prevention of hypertension, self-monitoring of blood pressure is recommended at 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, eliminate smoking and alcohol consumption, reduce your stress level, devote more time to physical activity: in a word, lead a healthy lifestyle.
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 the level of blood pressure, control weight, lead a healthy lifestyle and undergo preventive examinations by a therapist or cardiologist.