Classification of hypertension

For several years, doctors have been sounding the alarm: in developed countries that have overcome epidemics, arterial hypertension is still consistently the leading cause of death from cardiovascular diseases.In terms of the number of complications and unfavorable prognosis, it competes with diabetes mellitus.At the same time, the disease is rapidly becoming younger.Decades ago, a 35-year-old stroke patient was considered foolish.Recently, a case like this will not surprise anyone.

According to data from the World Health Organization, about a quarter of the world's population suffers from arterial hypertension.Half of people over the age of 65 have hypertension.

What kind of disease is this?

Hypertension refers to diseases of the cardiovascular system.Its presence causes persistently high blood pressure in the arteries of the systemic circulation.

By itself, pressure on the walls of the blood vessels is a necessary, normal process and necessary for the movement of blood through them.During sleep, the pressure drops slightly, and during stress or physical activity - vice versa.

The standard blood pressure for young people (may vary slightly from person to person) is 120/75 mmHg.Art.For over forty – 130/80, for over fifty – 135/84.If the pressure often rises to 140/90, doctors speak of hypertension.

Blood pressure is divided into two types:

1. Systolic.The first, upper number indicates the strength of blood pressure at the moment when the heart contracts and pushes blood out of the arteries.
2. diastolic.The second, lower number shows the blood pressure when the heart muscle (myocardium) relaxes.

Arterial hypertension (hypertension) is not called the "silent killer" for no reason: it can cause the appearance of various pathologies.The heart and brain are particularly affected.In advanced cases, it can even lead to heart attack and stroke.

Classification of hypertension

The risks of hypertension are impressive, which is why scientists have been studying it since the beginning of the last century.In that period of time, the classification changed several times, but two directions were formed:

1. When creating classifications according to the stages of disease development, doctors thought about the connection between hypertension and risk factors for the development of hypertension.However, they never fully agreed - the debate is still ongoing.
2. Identification of disease variants.The approach deals with the causes of hypertension, stages and mechanisms of its development.

The article will discuss several classifications proposed by scientists.

According to external signs

This is how a German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when the pressure increases, redness of the face and body is noticeable due to capillary expansion.Red spots often appear.In another case, a person suffering from the disease experiences a vascular spasm with an increase in pressure, becomes cold and pale.

By origin

Doctors have conventionally identified the degrees of hypertension: primary (hypertension) and secondary (symptomatic) hypertension.

Concrete reasons for the appearance and development of the primary have not yet been found.It has three degrees.

Arterial hypertension of the 1st degree is called "mild".Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure "jumps", sometimes increases, and then returns to normal.Hypertension of the first degree has a borderline subgroup with indicators of 140–149 and 90–94 mm Hg.Art.The probability of crises (sharp sudden jumps) is small, if they do happen, they are rare.

But for stage 2 (moderate) hypertension, the risk is higher.The tonometer shows 160–179 and 100–109 mmHg.Art.Hypertension of the second degree is characterized by the fact that the pressure is constantly increased.

Stage 3 disease (severe) can be life-threatening, especially with co-morbidities.This level is characterized by indicators greater than 180 and greater than 110 mmHg.Art.

Sometimes a person has problems with only one type of pressure.Then hypertension is called isolated and there are two types of hypertension:

1. systolic.The pressure is greater than 140 and less than 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and less than 90 mmHg.Art.In this case, the "upper" pressure creeps up to 140 mmHg.Art.and higher, while "lower" remains normal.Then it is an isolated systolic form of hypertension.

Secondary hypertension is rarer and is diagnosed in approximately 20% of cases (in young people up to 35 years old - in 25%).This type of disease is caused by a disease of a certain organ.Most often, such symptomatic hypertension occurs due to kidney problems.The division into endocrine, neurogenic, renal and hemodynamic forms was proposed by prof.Doctors still use it today.

Stages of hypertension

In the recent past, arterial hypertension was divided by experts into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects the pathologies that appear in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease by grade.There are three of them and each means a series of changes in the digital blood pressure readings (discussed above).

In some classifications, you can find the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist notes the 4th degree of the disease, he means digital pressure indicators, and not the patient's condition, since hypertension is stage 3. it is also considered severe.

With chronic high blood pressure, the body cannot cope with stress and bad things begin to happen to the organs.Those that are affected earlier than others are called target organs by doctors.Along with the heart and brain, they include the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weak points.

In the beginning, in stage 1 of the development of hypertension, the organs are still healthy.Often, people with hypertension initially do not go to the hospital, because they feel tolerable and do not particularly interfere with their lives.Hypertensive crises are the exception rather than the rule.Beginner hypertensives ignore health problems in vain, because at this stage the disease is the easiest to tame.Sometimes the treatment of stage 1 hypertension comes down to lifestyle changes rather than medication.But it is necessary.Therefore, when the tonometer occasionally shows high levels, it is better to go to a specialist.Timely treatment will help prevent the progression of the "silent killer".

Stage 2 hypertension is characterized by persistently high blood pressure.The heart gives up first - the left ventricle begins to enlarge and "fatter".Some, in addition to abnormalities in the work of the heart, also develop retinal blood vessel defects.A person with hypertension is stage 2. Crises occur much more often.But the disease is still curable.If the doctor diagnoses "Hypertension of the 2nd stage", his recommendations should be followed especially carefully.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all target organs are affected with a host of complications.An increase in pressure in hypertension, stage 3, can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is noted when the patient already has fundus hemorrhages, heart attacks, aneurysms, strokes and other ailments.

Signs of blood pressure problems

Early recognition of hypertension and understanding how long a person has had the problem is number one.Many hypertensive patients find out about the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, excess weight, smoking, frequent stress, elevated cholesterol levels, sedentary lifestyle and age.

Alarm bells ring if you see:

• occasional headache;
• "threats" of pain in the back of the head or blows to the temples;
• you often feel nauseous and dizzy;
• glare flickers in the eyes or "black flies" fly;
• everything is dull or covered in apathy;
• tingling or numbness in the fingers;
• swelling of hands, feet and/or face;
• a racing heartbeat appears out of the blue.

If you recognize yourself, you should at least measure your blood pressure regularly.But it is better, of course, to go to the hospital.

Diagnosis of arterial hypertension

If chronic hypertension is suspected, doctors use three diagnostic methods.

The first, the simplest, is blood pressure measurement.

The second is a complete physical examination.It can only be performed by a specialist.Performs palpation and auscultation (analysis of sounds accompanying the work of various organs), percussion (tapping various parts of the body and drawing conclusions based on sound), and standard examination.

In the third case, the electrocardiograph helps to draw conclusions.

So what awaits you when you arrive at the hospital with suspected hypertension?

First, the doctor will check your blood pressure using a special device - a tonometer.Otherwise, in people who have an easily excitable nervous system, blood pressure numbers can jump even with minor emotional upheavals.When visiting a doctor, such patients experience the "white coat" syndrome: as soon as the doctor starts measuring blood pressure, it increases.But the reason for these fluctuations is stress, not disease.Although such a reaction to shock can cause disturbances in the normal functioning of the heart and kidneys in the long term.In such impressionable patients, the health care professional will check the pressure multiple times and under different conditions.

• medical examination.Data are collected on the patient's height, weight and body mass index.The specialist looks for evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient - nowhere.It is necessary to find out what diseases the person has encountered before and whether there are any diseases at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; it is determined whether there is diabetes), whether the parents were hypertensive.
• Physical examination.First, the doctor will listen to the heart using a stethoscope.The task is to identify noises, tone changes or the presence of extraneous sounds, if any.After this study, it is possible to rule out heart defects and draw preliminary conclusions about his condition on the background of hypertension.
• Biochemical blood test.It is necessary to find out the level of sugar, cholesterol and lipoproteins, and understand how prone a person is to atherosclerosis.
• EKG.An electrocardiogram is an integral element of the diagnostic process.It helps to detect irregularities in the heart rhythm.Having the results at hand, we can judge the presence of hypertrophy of the wall of the left side of the heart, typical of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see the picture of changes and heart defects, assess the function and condition of the valves.
• x-ray examination.Doctors perform arteriography and aortography.With their help, specialists study the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing arterial hypertension, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, and it helps to determine the intensity of blood flow through arteries and veins.
• Ultrasound of the thyroid gland.In addition to other information, the doctor needs the results of a blood test to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will become clear whether the thyroid gland plays any role in the development of the disease and what treatment should be prescribed.
• Kidney ultrasound.These organs and their vessels are very sensitive to hypertension.The study helps to assess their condition.

Treatment methods

Today, there are many methods for treating hypertension.Some came to us from antiquity;pharmacists and scientists worked for years and years to create others.

The most common method is drug treatment.Doctors use several types of drugs to normalize blood pressure.

1. Calcium antagonists aim to reduce heart rate.
2. Diuretics, most commonly thiazide diuretics, work to improve urine and waste production.
3. Adrenergic drugs.
4. Vasodilators widen the blood vessels and thus equalize the situation.

In some cases, a surgical method called ablation is used.This process is not easy.A catheter with a device that generates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.To prevent scars after the intervention, the entire length of the vein is affected.It is performed under local anesthesia.

Various methods that come from the past are classified as alternative medicine.These include foot soaks, vinegar lotions, and more.

In the treatment of arterial hypertension, non-traditional medicines based on valerian, lemon balm, beetroot, lemon, honey and horseradish are also effective.

There are many herbal decoctions for the treatment of arterial hypertension.Here's an example:

Take 1 tbsp.l.lemon balm, valerian root and cumin.Mix.Pour a spoonful of this mixture over a glass of boiling water and leave it for an hour.Drink the medicine three times a day for 1/3 cup.The course is scheduled for one month.

There is also monastery tea to help with hypertension, and homeopathic medicines.However, it is best to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if not treated.You must monitor your health at any age, because the modern rhythm of life often contributes to the development of diseases.And regardless of the stage and degree of hypertension, without treatment it can lead to fatal consequences.