What is arterial hypertension? This is a disease characterized by readings of blood pressure above 140 mm Hg. Art. in this case the patient is visited by headache, dizziness and nausea. All the symptoms can be removed only with specially selected therapy.
Arterial hypertension can be an independent disease or accompanied by various pathologies, which is their symptom. Hypertension is one of the causes of coronary heart disease and severe kidney damage.
In hypertensive patients, the indicators often return to normal only after taking special medications, and pressure spikes can be noticed regularly and for no reason. The disease is completely impossible to cure, but preventing serious consequences and learning to control your blood pressure is a feasible task.
Do not self-medicate. At the first signs of illness, consult a doctor.
Causes
To date, the exact reasons why essential arterial hypertension may occur are unknown. There are the following risk factors:
- heredity;
- malnutrition;
- bad habits;
- violation of fat metabolism;
- kidney disease;
- diabetes;
- stress;
- inactive lifestyle.
Classification of diseases
During the diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause an increase in pressure. Pathogenesis also has differences taking into account disease variants. There is the following classification of arterial hypertension:
- Pulmonary essential arterial hypertension - is considered one of the varieties of arterial hypertension, it is rare, but it is a great danger to human life. This disease is very difficult to recognize by its symptoms, and even more difficult to treat. Pulmonary arterial hypertension occurs due to increased pulmonary vascular resistance and, as a result, insufficient blood flow.
- Malignant. Symptoms of such arterial hypertension are expressed in the form of elevated blood pressure up to 220/130. there is a radical change in the fundus and swelling of the optic disc. If the diagnosis is made on time, then it is possible to cure this type of arterial hypertension.
- Renovascular arterial hypertension. The reasons for the occurrence of this type of disease are the presence of such pathologies as vasculitis, vascular atherosclerosis and malignant formations in the kidneys. The pathogenesis of the disease is reduced to the formation of characteristic pressure, which can be represented by normal systolic and elevated diastolic blood pressure.
- Labile arterial hypertension. This type of disease is characterized by periodic normalization of pressure. Patients suffering from this form of arterial hypertension are not called patients, because this condition is not a pathology. In some cases, over a period of time, blood pressure returns to normal.
Symptomatic arterial hypertension and its types
Secondary arterial hypertension is a pathological process associated with diseases of organs involved in the normalization of blood pressure. It has the following classification:
- Hemodynamic - associated with violation of hemodynamic states due to organic pathology of large blood vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, aortic coarctation, and aortic valve insufficiency.
- Neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
- Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
- Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
- Medical. This form of symptomatic arterial hypertension is associated with the use of drugs that increase blood pressure.
Symptoms
Before the complications of arterial hypertension occur, it proceeds without certain manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the occurrence of headaches in the back of the head and forehead, dizziness and uncharacteristic sound in the ears.
Damage to the target organ
This type of symptom of arterial hypertension occurs primarily due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. After that, the patient has weakness, flash of black dots in front of the eyes, speech difficulties. Such symptoms upset a person in the late stages of the disease. In addition, complications such as cerebral infarction and bleeding may occur.
Heart Failure
In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory reaction aimed at normalizing the tension of the wall. As a result, increased subsequent load, heart failure. When the heart is damaged, the prognosis is not the most favorable, because such changes in its work are the causes of heart failure, sudden death and the development of ventricular rhythm disorders. Characteristic symptoms are:
- pulmonary edema;
- difficulty breathing during physical activity;
- cardiac asthma.
In some cases, arterial hypertension in children and adults causes pain in the heart area of a certain nature. They can visit a person at rest or emotionally strained without performing physical activity. The main manifestation of the shown chest pains is the impossibility of eliminating them with the help of nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the occurrence of shortness of breath in the early phase of the disease after the application of light loads or at rest. All this indicates characteristic changes in the heart muscle and the occurrence of heart failure. In such a disease, people have swelling of the lower extremities, the cause of which is the retention of sodium and water ions in the body.
If the lesion has affected the kidneys, then during the urine test there is protein in it, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.
Eye damage
Not so often, this arterial hypertension in children and adults affects vision, resulting in decreased sensitivity to light and blindness. If there is visual impairment on the background of high blood pressure, then patients have black spots in front of the eyes, fog or veil. The reasons for such changes are a violation of blood circulation in the retina. Complications can manifest as diplopia, visual impairment, or complete loss of vision.
Headache
This symptom is considered to be the most common in arterial hypertension. It worries the patient at any time of the day or night. It can be spraying in nature and focus on the nape of the neck and then spread over the entire head area. Increased headaches in arterial hypertension occur when coughing, tilting the head. This can be accompanied by swelling of the eyelids and face. When performing massage in this case, in patients suffering from arterial hypertension, there is an improvement in the outflow of blood in the veins, which leads to a reduction in pain until complete disappearance.
There are cases when the headaches on the background of the presented disease are the result of tense soft muscles of the head or tendons. The formation of such a pain syndrome occurs after psycho-emotional or physical overexertion. Such pain is usually constricting or constricting in nature. A patient suffering from arterial hypertension has a feeling of nausea, dizziness. In the presence of prolonged pain, constant pain is characteristic, the patient develops irritability, sensitivity to sharp sounds increases, and they become fast.
Stages of the disease
To correctly set the stage of this pathological process, it is necessary to use classification. It depends on the damage to the target organ. There are three stages of the disease.
Easy
This phase is characterized by a slight increase in blood pressure of 180/100 mm Hg. Art. the pressure level is unstable. During rest in a patient suffering from arterial hypertension, blood pressure indicators return to normal. Due to the fixation of the disease, the pressure inevitably increases. Very often people do not complain of any disorders in their health. But for the mild phase, its symptoms are characteristic:
- headaches;
- noise in the ears;
- bad sleep;
- mental decline;
- dizziness;
- nosebleeds.
As a rule, there are no manifestations of left ventricular hypertrophy, ECG has no abnormalities, renal function without pathological changes, the fundus is not changed.
Medium
This phase is characterized by the presence of higher and more stable blood pressure levels. It can reach 180-105 mm Hg. Art. patients often have headaches, dizziness, pain in the heart area, which have angina pectoris.
This phase is characterized by typical hypertensive crises. The pathogenesis of the disease includes the following signs of damage to target organs:
- left side hypertrophy;
- weakening and tone at the top of the heart;
- accent II tone on the aorta;
- in some patients, ECG symptoms of subendocardial ischemia.
As for the central nervous system, there are various manifestations of vascular insufficiency, strokes, transient cerebral ischemia. For the fundus, in addition to reducing the arterioles, there is compression of the veins, their enlargement, bleeding, exudates. Renal blood flow and glomerular filtration rate for this phase are reduced. But it is impossible to detect these manifestations in the analysis of urine.
difficult
This stage of the disease is characterized by frequent vascular accidents. They occur due to a significant and stable increase in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of larger blood vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In the severe stage, the disease affects the following organs:
- heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
- brain - ischemic and hemorrhagic infarcts are formed, encephalopathy;
- eye fundus;
- kidneys - poor blood flow and glomerular filtration.
Risk factors
Currently, the severity of the described disease directly depends on the risk facts. The risk lies in the creation of cardiovascular complications on the background of high blood pressure. Taking into account the presented complications, the prognosis of the consequences of arterial hypertension is set. There are the following risk factors that worsen the course of the disease and its prognosis:
- age - in men after 50 years, in women after 60 years;
- smoking;
- high cholesterol;
- hereditary factor;
- obesity;
- hypodynamics;
- diabetes.
The presented risk factors can be eliminated (corrected) and cannot be corrected. The first type of risk factor is characterized by the presence of diabetes mellitus, elevated cholesterol, smoking, physical inactivity. Uncorrected risk factors include race, family history, and age.
Taking into account the degree of arterial hypertension and the factors that contribute to the disease, the occurrence of such complications as heart attack or stroke is predicted for the next 10 years.
With a mild degree of arterial hypertension and the absence of risk factors, the occurrence of complications in the cardiovascular system is minimized in the next 10 years. With one year of non-drug therapy and revision of your lifestyle, it is possible to eliminate this stage of the pathological process. If the pressure readings are greater than 140/90 mm Hg. Art. , then drug treatment was prescribed.
The average degree of risk was accompanied by the creation of complications on the background of arterial hypertension for 10 years in a ratio of 20%. Grade 2 arterial hypertension is treated in the same way as grade 1 hypertension, but here too the dynamics control is adjusted for six months. If there are poor blood pressure results and its stable maintenance, then drug treatment is carried out.
High-risk factors are accompanied by complications within 30%. In this situation, the patient suffering from arterial hypertension is prescribed a complete diagnosis in combination with non-drug therapy.
At very high risk, the patient is prescribed an emergency differential diagnosis of arterial hypertension and medication.
Diagnostic methods
Only after a detailed study can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of arterial hypertension is based on the following types of examinations:
- ECG, glucose analysis and complete blood count;
- Ultrasound of the kidneys, determination of urea levels, creatinine in the blood, general analysis of urine - are performed to exclude the renal nature of the disease;
- Ultrasound of the adrenal glands is recommended if pheochromocytoma is suspected;
- hormone analysis, thyroid ultrasound;
- MRI of the brain;
- Consultations with a neurologist and ophthalmologist.
Effective therapy
Treatment of arterial hypertension should be carried out under the constant supervision of a physician. He is the one who is obliged to make an accurate diagnosis, perform additional diagnostics that include checking:
- fundus;
- renal function;
- heart rate.
After that, the specialist can prescribe antihypertensive therapy, determine various complications. As a rule, patients in whom arterial hypertension syndrome is first detected are hospitalized in order to conduct all necessary studies and choose treatment.
Drug-free treatment
This therapy is recommended for all patients, regardless of the degree of disease from the use of drugs. Such treatment for hypertension includes:
- To quit smoking. It is very important to change the way of life, such changes serve as an excellent prevention of diseases of the cardiovascular system.
- Weight loss. Excess weight is a common cause of high blood pressure, so diet plays an important role in this matter. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
- Reduced salt intake. According to current studies, a reduced amount of salt consumed at 4. 5 g per day helps reduce systolic blood pressure by 4-6 mm Hg. Art.
- Insignificant consumption of strong drinks.
- Specially designed diet. Your diet should include vegetables, fruits, foods rich in magnesium, potassium, potassium, fish, seafood. In addition, the diet includes a limited intake of animal fats.
- Active lifestyle. Here it is very useful to walk fast for 30 minutes 3-4 times a week. When you perform isometric loads, you can cause a rise in blood pressure.
Treatment
Drug therapy should be prescribed taking into account the following recommendations:
- Treatment begins with small doses of medication.
- In the absence of therapeutic effect, it is necessary to replace the use of one drug with another. The interval between stages should be less than 4 weeks, provided that a rapid reduction in blood pressure is not required.
- The use of long-acting drugs to achieve a 24-hour effect with a single dose.
- Application of optimal device combination.
- Therapy should be permanent. It is not allowed to use the drug in courses.
- Effective control of blood pressure throughout the year contributes to a gradual reduction in dose and amount of the drug.
Preventive actions
Prevention of arterial hypertension includes the following recommendations:
- If family members have this disease, and you are older than 30, then you must measure your blood pressure regularly.
- Quit smoking and alcohol.
- A diet low in fat and salt should be followed.
- Exercise outdoors.
- Avoid various stressful situations.
- Maintain a normal body weight.
With arterial hypertension, a person can live a normal full life, but subject to all the recommendations described. Blood pressure control in this case is one of the main components of successful treatment of the disease. Therefore, try not to start the disease and visit the doctor in time to avoid various serious complications.