Hypertension is a disease of a chronic nature, which is characterized by a persistently high blood pressure due to a violation of the regulation of blood circulation in the human body. Terms such as arterial hypertension and high blood pressure are also used for this condition.
According to medical statistics, high blood pressure is one of the most common diseases today. It usually starts to progress after the age of 40, but there is a risk of progression at any age. Thus, the disease began to be detected more and more often in patients of working age. It should be noted that the decent suffer no more than men. But in men, high blood pressure is more serious, as they are more prone to the development of atherosclerosis of the blood vessels.
As a result of strong mental or physical stress, blood pressure may rise for a short time - this is a completely normal phenomenon. A prolonged increase in blood pressure can be observed in many kidney and endocrine gland diseases, as well as during pregnancy. But in this case, high blood pressure is only one of the symptoms that indicate changes in the organs. In hypertension, the increase in blood pressure is an independent, primary, painful process.
The pathogenesis of high blood pressure is such that, under the influence of exogenous and endogenous factors, the tone of the walls of the arterioles in the body increases. As a result, they gradually narrow and the blood flow in the affected vessels is disturbed. During this pathological process, the blood pressure on the walls of the arteries rises, which leads to additional symptoms.
Etiology
The main reason for the progression of hypertension is the increase in the activity of the sympathetic-adrenal system. The vasomotor center is located in the human medulla oblongata. Certain impulses from it reach the walls of the blood vessels along the nerve fibers, which causes the blood vessels to expand or contract. If this center is in an irritated state, only such impulses will reach the vessels that increase the tone of the walls. As a result, the lumen of the artery narrows.
Arterial hypertension is characterized by a simultaneous increase in systolic and diastolic pressure. This can be observed as a result of various unfavorable factors.
Exogenous risk factors:
- severe nervous strain is the most common cause of the progression of arterial hypertension;
- hypodynamia;
- irrational eating. Failure to follow a diet and eating large amounts of fatty and fried foods;
- excessive consumption of alcoholic beverages;
- smoking;
- use of drugs.
Endogenous risk factors:
- burdened inheritance;
- obesity;
- atherosclerosis of the coronary arteries of the heart;
- increased blood viscosity (the heart cannot fully distill it through the blood vessels);
- kidney diseases such as nephritis, glomerulonephritis, pyelonephritis;
- metabolic disorder;
- presence of endocrine pathologies;
- increased calcium concentration in the blood;
- the effect of adrenaline on the heart in stressful situations;
- increased sodium concentration in the blood.
Classification
During the study of the disease, scientists have developed more than one classification of hypertension - the patient's appearance, etiology, the level of pressure increase, the nature of the course, etc. according toSome have long been obsolete, while others, on the contrary, are being used more and more often.
Degrees of high blood pressure (according to pressure level):
- optimal - indicators 120/80;
- normal - upper 120-129, lower - 80-84;
- increased normal - upper indicators - from 130 to 139, lower ones - from 85 to 89;
- degree of hypertension - SD 140-159, DD - 90-99;
- high blood pressure - systolic pressure increases to 160-179, and diastolic to 100-109;
- high blood pressure - the systolic pressure rises above 140, and the diastolic pressure rises above 110.
Stages of hypertension according to WHO:
- Stage 1 hypertension - the pressure rises, but there are no changes in the internal organs. It is also called transient. The pressure stabilizes after a short rest period;
- Stage 2 or stable. During this stage of hypertension, the pressure rises continuously. The target's major organs are affected. During the examination, it can be established that damage to the heart, fundus vessels, and kidneys;
- Stage 3 or sclerotic. This stage of hypertension is characterized not only by a critical increase in DM and DD, but also by pronounced sclerotic changes in the vessels of the kidney, heart, brain, and fundus. Dangerous complications develop - stroke, coronary artery disease, angioretinopathy, heart attack, etc.
Forms of the disease (depending on which organs are affected):
- kidney shape;
- Heartshaped;
- brain shape;
- mixed.
Types of hypertension:
- benign and slow-flowing. In this case, the symptoms of the progression of the pathology may gradually appear over 20 years. Both exacerbation and remission phases can be observed. The risk of complications is minimal (with timely therapy);
- malicious. The pressure rises sharply. This form of hypertension is practically untreatable. As a rule, the pathology is accompanied by various kidney diseases.
It is worth noting that often with 2 degree and 3 degree hypertension, the patient has hypertensive crises. This is an extremely dangerous condition not only for human health, but also for life. Clinicians distinguish the following types of crisis:
- neurovegetative. The patient is hyperactive and very agitated. Such symptoms of high blood pressure are manifested: hyperhidrosis, tremors of the upper limbs, tachycardia and copious urination;
- hydropic. In this case, the patient is sleepy and his reactions are inhibited. Muscle weakness, swelling of the face and hands, decrease in diuresis, persistent increase in blood pressure;
- convulsive. This option is the most dangerous, as there is a high risk of developing dangerous complications. It is worth noting that this is the least common. Such symptoms are characterized by: convulsions and confusion. Complication - bleeding in the brain.
Symptoms
The symptoms of the disease depend directly on which stage of hypertension was observed in the patient.
neurogenic
An increase in blood pressure is usually observed against the background of severe psycho-emotional stress or due to increased physical exertion. At this stage, there may be no signs of the presence of pathology at all. Sometimes patients begin to complain of pain in the heart, irritability, headache, tachycardia, heaviness in the back of the head. SD and DD indicators increase, but can be easily normalized.
sclerotic
The indicated clinical picture is complemented by the following symptoms:
- increased headache;
- dizziness;
- sensation of rush of blood in the head;
- poor sleep;
- periodic numbness of the fingers on the limbs;
- rapid fatigue;
- "flies" before the eyes;
- persistent increase in blood pressure.
It is worth noting that this stage can progress over several years, but at the same time patients will be active and mobile. But a violation of the blood supply to certain organs leads to a violation of their functioning.
final
Usually, at this stage, doctors notice kidney and heart failure, as well as a violation of blood circulation in the brain. The outcome of the disease and the development of complications are determined by the form of high blood pressure. Crises often occur.
With the cardiac form, the patient gradually develops heart failure. Shortness of breath, pain in the projection of the heart, hepatomegaly, edema appear. With the brain shape of a person, severe headaches and visual disturbances bother me.
Hypertension and childbearing
High blood pressure during pregnancy is the most common cause of premature birth or perinatal death of the fetus. Usually, high blood pressure in women already exists before the beginning of pregnancy, and then it is simply activated, because having a child is a kind of stress for the body.
Considering the high risk for the mother and the unborn child, when the disease is diagnosed, it is important to accurately determine this risk in the matter of further pregnancy or termination of pregnancy. Doctors distinguish three levels of risk (based on the stage of arterial hypertension):
- Risk level 1 - pregnancy complications are minimal, crises rarely develop. Possible angina. Pregnancy is allowed in this case;
- 2 degrees of risk - expressed. Complications develop in 20-50% of cases. A pregnant woman has hypertensive crises, insufficiency of the coronary arteries of the heart, high blood pressure. Termination of pregnancy appears;
- 3 risk levels. Pregnancy complications occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Perhaps detachment of the placenta, uremia, impaired blood circulation in the brain. The pregnancy is a threat to the mother's life, so it is terminated.
Pregnant patients should visit the doctor once a week to monitor their condition. Mandatory treatment of high blood pressure. The use of such antihypertensive drugs is allowed:
- anticonvulsants;
- saluretics;
- sympatholytics;
- clonidine derivatives;
- rauwolfia preparations;
- ganglion blockers;
- beta blockers.
In addition, to treat the disease during pregnancy, doctors use physiotherapy.
Diagnostics
When the first signs of the disease appear, it is important to immediately contact a medical institution to confirm or deny the diagnosis. The sooner it happens, the lower the risk of the progression of dangerous complications (heart, kidney, brain damage). During the initial examination, the doctor necessarily measures the pressure on both hands. If the patient is elderly, the measurements are also performed in a standing position. During the diagnosis, it is important to clarify the real reason for the progression of the pathology.
A comprehensive plan for diagnosing high blood pressure includes:
- collection of anamnesis;
- SMAD;
- Analysis of urine;
- blood biochemistry;
- determining the level of bad cholesterol in the blood;
- X-ray;
- EKG;
- fundus examination;
- ultrasound.
Treatment
High blood pressure is treated in a hospital, so doctors can constantly monitor the patient's condition and adjust the treatment plan if necessary. It is important to normalize the patient's daily routine, correct his weight, limit the use of table salt and completely abandon bad habits.
To correct the pressure, the following drugs are prescribed:
- alpha blockers;
- beta blockers;
- calcium channel blockers;
- diuretics. This group of drugs is particularly important because it helps reduce sodium levels in the blood, thereby reducing the swelling of the walls of blood vessels.
All of these medications should only be taken as prescribed by your doctor. Uncontrolled intake of such funds can only worsen the patient's condition. These drugs are taken according to a certain system.
Diet
During the treatment of high blood pressure, in addition to taking medications, it is important to follow a special diet. In case of high blood pressure, the patient receives table 10. The basic principles of such a diet:
- add seafood to your diet;
- limit salt intake;
- fractional nutrition;
- limit carbohydrates and animal fats in your diet.
The diet of this pathology is a restriction:
- Sahara;
- of bread;
- potato;
- pasta;
- cereal foods;
- egg;
- animal fats;
- ghee;
- sour cream and so on.
Diet number 10 is complete and can be followed for a long time. To improve the taste of food, you can add them:
- Honey;
- prunes;
- vinegar;
- jam;
- blueberry
- citron.
The diet is recommended not only during the treatment, but also after it, so as not to provoke a worsening of the condition. It is worth noting that the diet is created strictly individually for each patient, taking into account the characteristics of the body. Important point - during the diet, you should consume no more than 1. 5 liters of liquid per day.
Prevention
Preventing high blood pressure is quite simple. The first thing is to normalize the diet and lead an active lifestyle. In order for the vessels to be flexible, it is necessary to eat more vegetables and fruits, and to drink no more than 2 liters of water per day. You can take vitamin preparations. Prevention of high blood pressure also includes the exclusion of smoking and the consumption of alcoholic beverages.
Stress should be avoided as much as possible, as it is one of the provoking factors of the disease. Prevention of high blood pressure should be addressed as soon as possible to minimize the risk of developing the disease.