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Hypertension

Hypertension is a pathological condition characterized by a long increase in pressure indicators in the arteries of a large circle of blood circulation.One sign of the disease is increased (lower) diastolic blood pressure, but in most cases diagnosed, patients have persistent growth in systolic (upper) pressure.

What pressure is considered increased

The classification of blood pressure accepted in 1999 is still valid to this day.The following are considered normal:

  • Ideal - less than 120/80 mm hg.Art.;
  • Physiological norm - less than 130/85 mm Hg.Art.;
  • Normal increase - in the range of 130 to 139/85-89 mm hg.Art.

An increase in pressure indicates hypertension formation.The internal gradation of the pathology seems the following:

  1. SOFT (i grade) - 140–159/90–99 mm hg.Art.
  2. Moderate (II Second Degree) - 160–179/100-109 mm Hg.Art.
  3. Heavy (III Grade) - More than 180/110.

Border weapons are diagnosed in the case of indicators at 140-149/90 mm Hg.Art.And below.It is accompanied by episodes of pressure growth and its spontaneous stabilization.

Isolated systolic hypertension is diagnosed with indicators of 140 and above / 90 and below mm Hg.Art.This type of pathology is characterized by an increase in the systolic indicator at the physiological level of the diastolic.

Ag (primary, secondary) classification

Hypertension classification is based on several signs.In systematizing, doctors took into consideration:

  • reasons causing the development of pathology;
  • defeated by the target organs;
  • The current level of blood pressure, etc.

Depending on etiological factors, it is customary to distinguish:

  1. Primary (essential).
  2. Secondary hypertension (symptomatic).

By the nature of the passage, benign (in slow development) and malignant (with a rapid deterioration of the condition) is distinguished.

Secondary (symptomatic) hypertension varieties

Secondary (symptomatic) arterial hypertension is a type of disease that develops due to damage to the organs responsible for regulating blood pressure.It is characterized by an stubborn course, the absence of a positive reaction to hypotensive therapy performed, as well as changes in target organs, in particular, cardiac formation, renal failure, etc.

If primary hypertension (essential format) occurs as an independent disease, secondary forms are always a symptom of the main pathology.Hypertension syndrome follows a very significant number of diseases.It is diagnosed in 10 % of all identified cases of persistent increase in blood pressure.

The classification of symptomatic hypertension is based on factors that cause the disease.

Distinguish:

  1. Neurogenic hypertension.Development is due to central nervous system injury and related pathologies, for example cerebral neoplasia.
  2. Nephrogenic (renal origin).They are divided into interstitial, renewable, renewing, mixed and rhinopic forms.
  3. Endocrine Ag.There are adrenal, thyroid, pituitary and menopause formats.
  4. Hemodynamic - provoked by heart pathologies and large arterial channels.
  5. Dose form.Its development is due to the use of oral contraceptives, glycocosteroid agents, etc.

The size and resistance of increased blood pressure, the severity of changes in the state of the left ventricle and the bottom underlying the other classification.Doctors distinguish the following varieties of symptomatic hypertension:

  1. Transitional.For pathology, a typically short increase in pressure indicators.Changes in the state of the background are completely absent.Left ventricular hypertrophy is almost not fixed.
  2. Laby.It is characterized by a moderate and short increase in blood pressure (no independent decrease occurs).There is a weak left ventricular hypertrophy, narrowing the vessel of the retina of the eye.
  3. Stable.It is accompanied by constantly high high blood pressure.The thickening of myocardial and severe violations in the back vessels is diagnosed.
  4. Malignant (not controlled).It is accompanied by a marked increase in blood pressure.The result is unfavorable.

The following forms of symptomatic hypertension are found:

  • Pulmonary hypertension (hypertension of a small circle of blood circulation).It is established as a diagnosis in determining blood pressure in the pulmonary artery above 25 mm.RT. Art.
  • The AH vacorsal is a secondary form of pathology due to insufficient blood circulation in the kidneys as a result of impaired arterial performance.
  • Portal hypertension is one of the symptomatic varieties of the disease, accompanied by an increase in pressure inside the door vein.
  • Hypertension of the Varsungov duct.It develops at the bottom of the chronic inflammation of the pancreas.

Consequences and complications

With long hypertension, the vessels of the target organs are damaged: heart, brain, kidneys and eyes.Violation of circulatory process can lead to consequences such as:

  • attacks angina pectoral,
  • myocardial infarction,
  • Neurological complications, etc.

Important!The formation of acute states against the bottom of a sharp increase in blood pressure requires its reduction in the first minutes/hours.

Reasons

The reasons for the development of the essential form of pathology are not known to doctors for sure.Several theories are indicated:

  1. Neurogenic (inheritance).The cause of development is chronic stress, significant emotional shocks and psychological injuries.All of this causes a failure in the neural regulation process, accompanied by an increase in the activity of the sympathetic system.The result is the signs divergence for all organs and an increase in the tone of the walls of the vessels.
  2. Voluminous salt.Due to impaired processes of excess fluid and certain trace elements.As a result of the excessive content of sodium salts, there is an increase in total blood volume.The body's attempts to maintain the process of hemostasis at the physiological level lead to the spasm of small vessels.The indicators of the minute volume of the heart are stabilized, but the total blood pressure is increased.

Important!Doctors argue that the reason for AH's development is an increase in sympathetic system activity.

Modified risk factors (variables) capable of causing high blood pressure to occur are:

  • Age - The diagnosis of the disease occurs in people in the older age category;
  • Bad habits - smoking, alcohol intake;
  • a state of chronic stress;
  • insufficient physical activity;
  • overweight;
  • The presence of concomitant pathologies - diabetes are especially unfavorable;
  • Excess salt with lack of potassium.

The reasons for increasing blood pressure may be different.Active work of adrenal glands as well as a tendency at the genetic level can act as a provocative factor.

Symptoms

In the initial phase of training, hypertension is asymptomatic.The patient will learn about the presence of a problem only after the development of serious complications.

The only sign of pathology can be called an increase in pressure indicators.There are no complaints, or they are not specific:

  • headaches located in the forehead area and in the back of the head;
  • dizziness;
  • noise.

The first complaints are formed at the bottom of the target organs defeat.At this stage, the appearance of the following symptoms is observed:

  • dizziness, accompanied by headaches, noise - arise as a logical result of circulatory disorders;
  • Initial problems with information memorization;
  • Hands/legs numbness;
  • weakness;
  • Fold the visible image;
  • Black points shake in the field of vision;
  • speech violation (rarely);
  • nephropathy.

Symptoms are typical for the final stages.At the beginning of pathology formation, they are coming.

With damage to the heart, the left ventricle (LV) begins the hypertrophic.The cause of change is the compensatory reaction of the body, which allows you to stabilize increased loads on your wall.An increase in the ventricle is due to an increase in the number of cardiomyocytes.As the condition gets worse, the cardiac chambers are dilated.

This damage to the organ can manifest in the form:

  • the formation of heart failure,
  • a sudden cardiac arrest,
  • ischemic disease,
  • Gastric rhythm disorders,
  • heart asthma,
  • Strong shortness of breath during the loads.

Important!Cardi pain against the background of AG develops during the absolute rest period or as a result of emotional overvoltage.One feature is the inability to stop the attack with a glycerol pill.

If the kidneys are damaged, the presence of protein in the urine can be observed.The appearance of blood impurities is not excluded.The probability of renal failure is minimal.

Urine analysis for arterial hypertension

The main clinical sign of arterial hypertension is headache.It appears at any time of the day, but most of the time in the morning.It is felt by the patient as an explosion or pain.The location place is the back of the head, but spread to other areas of the head is not deleted.The pain is improved by the slope and during cough.It can occur as a response to stressful situations, physical tension.

Diagnosis

The diagnosis of the disease was designed to solve the following problems:

  • Pathology establishment, determination of the current degree;
  • Identification of the origin of hypertension (primary/secondary form);
  • making differential diagnosis;
  • Determination of the presence/absence of damage to the target organs.

During a personal conversation with the patient, the doctor discovers the necessary points:

  1. There are cases of disease in the immediate environment.
  2. How often the pressure is fixed.
  3. There are stories of chronic diseases in the patient, etc.

The body mass index (BMI) is calculated.Obesity is one of the potential causes of hypertension formation.

Upon completion of inspection, blood pressure is measured.To determine the degree of hypertension, the patient is prescribed by the performance of the blood pressure profile, that is, taking measurements to patients on their own at home.It is necessary to make 4 measurements: two in the morning and two of the evening, for several days in a row.

The results should be included in the table.If the indicators exceed 140/90 mm hg.Art., We can talk about the presence of arterial hypertension.

Sometimes a brush is prescribed (daily monitoring of blood pressure).The technique is shown if the patient's measurements remain normal, but other symptoms of the disease occur.

Important!SMAD are several measures of blood pressure indicators for a full day.The measurements are performed by a special device.

To establish the true cause of the development of arterial hypertension and determine the force of damage to the target organs, are prescribed:

  • Examination of the renal system.Includes urine study - a general test.Renal renewal is prescribed, with the introduction of a radioactive isotope.
  • Heart test.ECG is used (electrocardiogram shows the growth of road R), echocardiography (allows you to see signs of a pathological increase in the left ventricular and other transformations).
  • Eye examination of the eye.One sign of the disease is the visual impregnation of blood vessels, the seal.Bleeding are not excluded.
  • Ultrasound of the thyroid gland and suprenal glands.
  • Blood examination is a general test and expanded biochemistry.

By diagnosing the secondary form of hypertension, differential diagnostics (DIF) is required.It passes in two steps:

  • Analysis of the clinical condition, raising complaints, an examination of physics of the patient in particular, auscultation, instrumental/laboratory studies;
  • Diagnostic measures that allow to evaluate the functional status of existing organs and changes, in particular, it is necessary to remove the cardiogram.

The methods considered the help in confirming the diagnosis, determining the origin of the disease and choosing the appropriate therapy.

Treatment

Treatment of hypertension begins with a lifestyle review and non -Drug therapy.The exception is secondary hypertension.

The drug therapy of hypertension provides for ingestion of the following groups of medicines:

  1. Diuretics.Medicines have a positive effect on the state of the cardiovascular system.The reception is not accompanied by the development of side effects.The therapy of the disease begins with diuretics (against -indication - diabetes and gout).In the context of treatment, the volume of urine removed by the kidneys and therefore excess water and sodium salts increases.Diuretics are prescribed in combination with another hypertension.
  2. Alpha-blocker.Medicines are distinguished by good tolerance.They do not affect the blood sugar level.Provide a decrease in blood pressure with a slight increase in the pulse (cardiac muscle contraction frequency).The occurrence of orthostatic hypotension at the beginning of treatment with the medicines of this group becomes a side effect.To exclude its development, it is advisable to take medicine before bed.
  3. Betabloquers.Reduce heart rate, which is accompanied by a decrease in blood pressure.
  4. ECA inhibitor.Modern medications are distinguished by a high therapeutic effect and good tolerance.In the context of receiving backgrounds in the patient's body, the form of angiotensin II - a hormone causing a narrowing of the lumen of the blood vessels not to occur.Thanks to this, peripheral vessels expand, the heart works at a calmer pace.There is a decrease in blood pressure indicators.
  5. Angiotensin-II antagonists.The medications are also blocking angiotensin II.They are named if it is impossible to receive ECA inhibitors.
  6. Calcium antagonists.Drugs expand the gaps in blood vessels, thus preventing the development of stroke.The medications have an excellent therapeutic effect and are well tolerated.Have a small list of contrasts.Most often prescribed as part of complex therapy.

Stopping treatment even after stabilization of blood pressure is strictly prohibited.In this case, the disease will begin to progress, which will negatively affect the state of the alive organs.In addition, the risk of developing heart attacks and strokes increases significantly.

Treatment of the disease is performed on an outpatient patient: the patient independently takes selected medications.Hospital hospitalization is recommended only in severe cases.

Pathology treatment, besides taking medications, provides massage.The procedures contribute not only to reducing pressure, but also to the overall strengthening of the body, improving cardiovascular system activity, etc.Read more about various types of massage in our article: high pressure massage - classic, points and other effective methods.

Nutrition

Compliance with the principles of food nutrition is one of the important stages for stabilizing blood pressure indicators.With hypertension, diet nº 10 is recommended.

In the early stage of pathology formation (ah 1 degree), it is necessary to adhere to diet No. 5. It provides a restriction on table salt use.With a deterioration in the state and the development of violations in the work of the heart and the vascular system, the transition to diet No. 5 A.

If the disease is complicated by atherosclerosis, diet No. 10 C. The hipocolesterol diet is prescribed to reduce the fats consumed of animal origin, easily digestible carbohydrates.The diet should include high food fiber foods, vegetable fats and proteins.

The list of allowed products is presented by the following positions:

  • Bread - wheat, rye, whole grain, with bran.Bakation does not go up, roasted.
  • Vegetable soups seasoned with cereals.
  • Varieties of meat in the diet: birds, rabbit.It is allowed to boil and bake.
  • Sea/river fish.Seafood.
  • Seasonal vegetables.From them, you can prepare the stew.
  • Sour products and low fat cottage cheese.Low -content sour cream (placed on a plate).
  • Soft eggs (no more than 3 pieces a week).
  • Dairy and tomato sauces.
  • Croats, pasta.
  • Oil (to add to a finished plate).
  • Fruits/berries (anyway).It can be used for the preparation of compounds, jam, jam.
  • Juices, tea with milk, roseiph decoction.

Should be completely excluded from the diet:

  • Newly bread, sdoba, complicated sweets.
  • Favorite broth.
  • Great meat.
  • Smoked meat, sausages.
  • Fish (salty/smoked), caviar.
  • Fat sauces, cheese, cream.
  • Spring, radish, spinach, rabben, mushrooms.
  • Ice cream, chocolate, confectionery, strong tea, coffee.

Salt consumption should be significantly reduced.

Salt with hypertension

Prevention

The prevention of the disease is not specific.Standard Recommendations:

  1. Add to the principles of food nutrition, excluding or significantly reducing the volume of certain products.Reduce the consumption of salt and animal fats.In the cooking process, it is advisable not to suck food.It is necessary to abandon fat/sharp/fried dishes.
  2. Daily physical activity according to the age group.Gymnastics improves the human well.It is recommended to get involved in running, walking, swimming, visiting the gym, performing breathing exercises.At the beginning of classes, the body should receive a minimum load.Must be increased gradually.
  3. Weight standardization is one of the prerequisites for successful prevention.
  4. It is necessary to learn to control stressful situations, as it is precisely a violation of the work of the central nervous system that doctors call almost the main reason for the development of the disease.Autotoring, meditation, self -hypnosis helps well in this.
  5. A complete rejection of bad habits.Smoking and alcohol are also able to cause a pathology.

Pathophysiology considers hypertension as one of the most serious pathologies, not just a worsening of the patient's quality of life, but capable of causing death.This is why when episodes of increased blood pressure appear, it is necessary to obtain a specialized consultation and, if necessary, start treatment.