Arterial hypertension belongs to the most common diseases of the heart and blood vessels, which are approx.25% of them are affected.No wonder it is sometimes mentioned as an infectious epidemic.High blood pressure complications significantly affect population mortality.It is estimated that up to 25% of the death of people under the age of 40 is directly or indirectly caused by hypertension.The likelihood of complications determines the stages of hypertension.How many stages are high blood pressure, how are they classified?Check it out below.
Important!According to the latest estimates of the World Health Organization of 1993, adult hypertension continuously increases blood pressure to 140/90 mm Hg.Art.
Classification of arterial hypertension, determining the risk of disease
In the WHO, according to etiology, hypertension is classified as primary and secondary classes.
In the case of primary (essential) hypertension (GB), the main organic cause of increasing blood pressure (blood pressure) is unknown.We take into account a combination of violations of genetic factors, external influences and internal regulatory mechanisms.
External factors:
- environment;
- excessive use of calories, development of obesity;
- Increased salt consumption;
- Lack of potassium, calcium, magnesium;
- excessive drinking;
- Repetition of stressful situations.
Primary hypertension is the most common hypertension, with approx.95%.
3 sections of hypertension are separated:
- Section I - increased blood pressure without changes in organs;
- II.Section - Increase in blood pressure with changes in organs, but did not reduce their function (left ventricular hypertrophy, proteinuria, angiopathy);
- III.Section - accompanied by impaired functions (left heart failure, hypertonic encephalopathy, stroke, hypertensive retinopathy, kidney failure).
Secondary (symptomatic) hypertension is an increase in blood pressure as a symptom of the disease that is based, with an identified cause.Classification of secondary arterial hypertension is as follows:
- Renoparechyal hypertension - due to kidney disease;Reasons: kidney parenhimal disease (glomerulonephritis, pyelonephritis), tumors, kidney damage;
- Renovascular hypertension - narrowing of kidney arteries with fibromoscular dysplasia or atherosclerosis, kidney venous thrombosis;
- Endocrine hypertension - primary hyperaldosteronism (Conn's syndrome), hyperthyroidism, feochromocytoma, kushing syndrome;
- Hypertension caused by drugs;
- Gestational hypertension - high pressure during pregnancy, after childbirth, the condition is often normalized;
- Coarktation of the aorta.
Pregnancy hypertension can lead to childbirth disease, especially retinopathy.2 Phases of retinopathy (early and full year old) are separated ::
- Active - consists of 5 stages of development and can lead to loss of vision;
- Rubts - leads to clouding of the cornea.
Important!Both stages of retinopathy of early and full year lead to anatomical disorders!
Hypertonic disease according to the international system (according to the ICD-10):
- Primary form - I10;
- Secondary Form - I15.
The degree of hypertension also determines the degree of dehydration - dehydration.In this case, the classifier water scarcity in the body.
Share 3 degrees dehydration:
- Degree 1 - light - 3.5%deficit;Symptoms - dry mouth, severe thirst;
- 2 degrees - average - deficit - 3-6%;Symptoms - sharp fluctuations in pressure or pressure reduction, tachicardia, oliguria;
- Degree -third degree is the most severe, which is characterized by a lack of 7-14% of water;manifested by hallucinations, delirium;Clinic - coma, hypovolemic shock.
Depending on the degree and stage of dehydration, the decompensation is implemented with the introduction of solutions:
- 5% glucose + isotonic NaCl (mild);
- 5% NaCl (average degree);
- 4.2% nahco3(Severe degree).
The sections of GB
Subjective symptoms, especially in the mild and medium stage of hypertension, are often absent, so the increase in blood pressure is often at the level of dangerous indicators.The clinical picture is divided into 3 stages.At every stage of arterial hypertension, there are typical symptoms from which GB classification comes.
Section I
In the 1st stage of hypertension, the patient complains of headache, fatigue, rapid heartbeat, disturbing, sleep disorder.In GB 1, the objective detection is located in the heart, ECG, eye background, laboratory tests in the normal range.
II.Platoon
In Section 2, subjective complaints are similar, but there are signs of the hypertrophy of the left ventricle, there are signs of retinal, microalbuminuria or proteinuria hypertonic angiopathy in the urine.Occasionally, red blood cells are reproduced in the rainfall of the urine.In 2 stages of hypertension, the symptoms of renal failure are missing.
III.
Stage III's hypertension is diagnosed with functional disorders in organs of increased risk of hypertension:
- Heart damage - at the beginning, shortness of breath, then - symptoms of heart asthma or pulmonary edema;
- Vascular complications - damage to peripheral and coronary arteries, the risk of atherosclerosis of the brain;
- Changes in Fundus - Hypertonic Retinopathy, Neuroretinopathy;
- Changes in cerebral blood vessels are shown by temporary ischemic strokes, typical thrombotic or bleeding vascular strokes;
- The III.Brain lesions are diagnosed in almost all patients during the brain;
- The renal vessels lead to benign nephrosclerosis - to restrict glomerular screening, increase proteinuria, red blood cells, hyperuricemia and later chronic renal failure.
Which stage or degree of hypertension is the most dangerous?Despite the various symptoms, all stages and degrees of arterial hypertension require dangerous systemic or symptomatic treatment.
Degree
In accordance with the blood pressure (blood) indicators determined at the time of diagnosis, 3 degrees of hypertension are different:
- light;
- average;
- difficult.
There is also a definition of a 4th concept of resistant (lasting) hypertension in which, even if blood pressure indicators are properly chosen, blood pressure scores do not decrease below 140/90 mm Hg.Art.
A clearer overview of the degree of arterial hypertension is shown in the table.
Classification AG and normal blood pressure stratification in accordance with the ESH/ESC guidelines, 2007.
| Category | Systolic pressure, mm hg.Art. | Diastolic pressure, mm hg.Art. |
|---|---|---|
| Optimal | <120 | <80 |
| Normal | 120-129 | 80-84 |
| Increased normal | 130-139 | 85-89 |
| 1 grade | 140-159 | 90-99 |
| 2 degrees | 160-179 | 100-109 |
| 3 degrees | more than 180 | more than 110 |
| Isolated systolic hypertension | more than 140 | less than 90 |
The patient's difficulties change based on the separation of hypertension.The choice of the treatment of the disease depends on the determination of the degree.
I diploma
The disease can only be detected by regular measurement of blood pressure.Measurements should be made at least three times at least three times during a period of time.
This is the only way to assess the presence or absence of hypertension.Depending on the degree of blood pressure increase, the clinical image of the disease differs.
II.
The second degree of hypertension is characterized by periods of increased pressure, alternating with the decrease of indicators or only with the increase in diastolic value.In this sense, hypertension, under certain circumstances, is characterized by increasing pressure, especially in patients with unstable nervous system.
III.
The III.AG is characterized by a critical increase in blood pressure.
The III.The degree of GB is characterized by serious complications that arise as a result of the harmful effects of high blood pressure on all organs and systems.Above all, it affects the heart, the kidneys, the eyes, the brain.The III.Grade high blood pressure The symptoms and treatment are closely related - with inadequate or inadequate treatment, the disease can have serious consequences: stroke, encephalopathy, kidney failure, irreversible eye lesions, blood vessels.The III.The lack of gradual treatment of hypertension increases the risk of isolated systolic hypertension.
At this stage of arterial hypertension, the risk of risk is increasing significantly!Memory disorders, mental activity, and loss of frequent awareness are manifested.
The hypertonic crisis is in the III.It is a complication of the 20th century and is seen as IV art.Gb.
Risks
Patients are divided into risk groups in accordance with the classification of hypertension and degrees, depending on the severity of the AG.4 categories are distinguished (that is, as much as the degree of hypertension), which will be determined in the future with the principle of the likelihood of damage to internal organs.
Risks to the extent of the disease:
- The risk is less than 15%;
- 20%risk;
- 20-30%risk;
- The risk exceeds 30%.
Low, insignificant
The low -risk group belongs to the age of 55 and women up to 65.Arterial hypertension.In this group, the risk of cardiovascular pathology is less than 15%in the period of 10 years.People belonging to a low -risk group are recommended to change their lifestyle.If non -medical treatment does not show efficiency within 6-12 months, it is advisable to write medications.
Average
The average risk group includes Hypertension I - II, provided there are 1-2 risk factors.The risk increases with the increase of high body weight, smoking, cholesterol, violation of glucose tolerance and lack of movement.Hereditary factors are also important.In these people, the risk of cardiovascular complications is higher and 15-20%for 10 years.It is recommended for people -related people to adhere to a healthy lifestyle.If the pressure drop does not occur within 6 months, medication is prescribed.
High
The high -risk group includes I - II.People of the 20th century.High blood pressure, depending on the presence of at least 3 risk factors that include:
- diabetes;
- Defeat of the target organs;
- atherosclerotic vascular disease;
- Left ventricular hypertrophy;
- increased creatinine;
- Changes in the eye vessels.
This group also includes the 3rd century hypertension, which has no risky factor (the risk of cardiovascular disease for 10 years 20-30%).The representatives of this group are under the supervision of cardiologist.
Very high
A group of hypertension with very high risk of cardiovascular disease (more than 30% for 10 years) includes people with III Art.Hypertension, provided there is at least 1 risky factor.In addition, this group includes patients with AH I - II Art.In the presence of violations of cerebral circulation, ischemia, nephropathy.This group is controlled by cardiologists and requires active therapy.
Conclusion
The problem of arterial hypertension is that the disease has no typical symptom, characterized by a variety of clinical images.Therefore, often a person is not aware of the presence of the disease.Therefore, high pressure is detected during accidents, controls or during the manifestation of complications.When diagnosed with hypertension, it is important to inform the patient correctly that, after a healthy lifestyle, it can largely affect the process of your disease.