Hypertension or arterial hypertension - a condition that is stable, that is, increased blood pressure detected by repeated measurements. Many diseases are considered to be a risk factor for the development of dangerous complications from the cardiovascular system, including myocardial stroke and infarction. Hypertonic disease, as the main cause of the pathology examined, is needed to take medications, the patient's lifestyle and nutrition.
Blood pressure is a force with which blood circulation acts on the wall of blood vessels. Such pressure is called diastolic during systolic and relaxation during the heart contraction. The range of normal values of these indicators is quite wide.
In many observations, scientists have come to the conclusion that the risk of cardiovascular complications increases by 10 mm Hg with all further growth of blood pressure. Art. It starts at 115/75 mm. Art. At the same time, the drug's pressure drop was only over 140/90 mm. Rt. Art. Therefore, exactly such a value can be considered as a criterion for the determination of arterial hypertension.
Reasons
The cases are approx. In 90%, hypertension becomes the cause of stable blood pressure. Such a diagnosis is made for the patient if no other disease was found during the examination with hypertension. Between the latter:
- Kidney pathologies - pyelonephritis, glomerulonephritis, polycystic, diabetic nephropathy, kidney arteries stenosis;
- Adrenal, pancreas or pituitary gland, hyperfunction of thyroid gland, isenko-cushing syndrome, endocrine disorders of feochromocytoma;
- Obstructive Apnoe syndrome in a dream;
- Damage to the valve regions of the aortic or atherosclerotic.
Regular use of many drugs can also cause an increase in blood pressure. These include oral contraceptives, non -steroidal anti -inflammatory drugs, amphetamines, corticosteroids, erythropoetin, cyclosporine, cocaine.
Cardiovascular disease, including hypertension, is closely related to the following risk factors:
- Inadequate nutrition, including sodium salt, saturated fats and trans fats, lack of leafy greens, vegetables and fruits in the diet;
- obesity;
- The pathologies of heart and blood vessels close to relatives;
- Age over 65 years;
- sedentary lifestyle;
- chronic stress;
- Harvest habits - smoking, excessive alcohol consumption.
Classification
If the disease could be identified, which leads to an increase in blood pressure, arterial hypertension is called secondary or symptoms. In the case of an unidentified cause of hypertension, it is considered primary, caused by hypertension.
The latter has a temporary current:
- Section I. There are no obvious signs of violation of the work of the target organs, which have stable growth of blood pressure, kidneys, arterial and venous blood vessels.
- II. Platoon. There is one of the signs listed or all of them, such as the increase in the left ventricle, a major decrease in kidney filtration rate, the albumin of the urine, the thickness of the walls of the carotid arteries or the appearance of atherosclerotic plaques in the lumen. In this case, clinical manifestations of the disease may be missing.
- III. Section hypertension. One or more pathologies in the heart and blood vessels are associated with atherosclerotic processes - myocardial infarction, acute cerebrovascular accident, angina pectoris, lower limbs arteries atherosclerosis, or severe renal impairment showed by screening decrease and/or severe loss of urinary white.
Arterial hypertension is divided into several degrees, depending on the maximum indicators of measured blood pressure:
- The first grade. Systolic blood pressure up to 140-159 mm. Rt. Art. And/or diastolic - between 90 and 99 mm. Rt. Art.
- The second grade. Systolic blood pressure up to 160-179 mm. Rt. Art. And/or diastolic - 100-109 mm. Rt. Art.
- The third degree. Systolic blood pressure is more than 180 mm. Rt. Art. and/or diastolic above 110 mm. Rt. Art.
There is also an isolated form of arterial hypertension in which only systolic pressure shapes in normal diastolic.
Symptoms
Blood pressure increases are often not accompanied by a well deterioration in the well and can be left unnoticed for the patient, so it is so important to regularly measure blood pressure, especially middle and old people.
The following symptoms may be the manifestations of hypertension:
- headache, especially in the morning after awakening;
- Bleeding from the nose;
- bleeding under the mucosa of the eye;
- Violation of the heart rate;
- blurred vision, flies of flies;
- tinnitus.
The sharp leap of blood pressure to the large number, which is accompanied by a spoiled deterioration in the well, is called a hypertensive crisis. Most often with the increase in systolic pressure, more than 180 mm Hg. Art. and/or diastolic over 120 mm hg. Art. At the same time, the patient has weakness, nausea, vomiting, which does not bring relief, impaired consciousness, anxiety and fear, muscle trembling, chest pain.
Complication
The increase in stable blood pressure associated with hypertension significantly increases the risk of cardiovascular pathologies, including the patient's life. They belong to:
- acute cerebral circulation (stroke);
- Angina pectoris, myocardial infarction;
- vascular dementia (dementia);
- chronic kidney and heart failure;
- Atherosclerotic injuries to the lower limbs.
Diagnosis
The main symptom of hypertension is a stable increase in blood pressure, which showed at least three dimensions on different days in a relaxed environment. When the first measurement of blood pressure in the hospital or clinic, it is important to follow the following rules for the correctness of the results:
- Before the examination, the patient should sit in a quiet room for a few minutes to calm down;
- The size of the tonometer cuffs must correspond to the thickness of the arm and the device itself - attached to the heart level;
- Two measurements are carried out on both hands with a 1-2 minute interval, with a large difference between the numbers resulting, and further measurement;
- Elderly patients, as well as persons with diabetes, or suspected blood pressure, the measurement is made in the first and fifth minutes when the body position changes;
- In addition, the heart rate is measured within 30 seconds.
In an interview with the patient, the physician clarifies how much the pressure began to grow when there are symptoms such as snoring with breathing stops in a dream, muscle weakness or sudden heartbeat with sweating and headaches, and unusual dirt of urine. It is also important to find out what medicines and biodies you are taking.
In the framework of the first stage of the test, the following tests are performed for high blood pressure:
- Clinical blood test;
- General urine analysis, detection of microalbumin in the concomitant and daily doses;
- Biochemical blood tests (cholesterol, lipoproteins to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium, and glucose and creatinine);
- Determining the level of glycated hemoglobin;
- Determination of hormones -tyroxine, triiodothyronine and thyroid hormone concentrations, thyroid peroxidase and antibodies against thyroid lobulin, aldosterone.
In the event of a hereditary predisposition of the disease, the polymorphs of genes associated with the development of arterial hypertension may be determined.
Instrumental diagnostic methods are used to clarify the risk factors of existing cardiovascular pathologies of hypertension:
- daily monitoring of blood pressure;
- Electrocardiographic examination;
- echocardiography;
- Holter Daily Monitoring;
- duplex scanning of brachiocephalus, kidney or iliac arteries;
- Ultrasound examination of kidneys and adrenal glands;
- Checking the bottom of the eye.
In the case of hypertension, home blood pressure control is important to maintain a log that requires capturing all the results of timings, taking medicines and stress episodes that can cause an increase in blood pressure. At the same time, the measurements should be done in a sitting position, after a few minutes of rest, holding the hand at the same level with the heart.
Treatment
With a moderate and low risk of cardiovascular complications, the patient is only to change their lifestyle, to correct diet, to increase weight loss, to increase exercise and to have special gymnastics of hypertension, reject bad habits, and reject regular blood pressure background. These measures are often sufficient to normalize blood pressure.
The diet of hypertension includes restrictions on table salt, caffeine, sharp, salty, smoked and spicy foods, high -fat products, oil cream and alcoholic drinks. It is permitted to use up to 5 g of salt per day outside the worsening of the disease. The recommended daily fluid speed is 1-1, 2 liters.
For several months, they have failed non -medication and, in the event of a high risk of complications, hypotensive the drugs of hypertension, which aims to reduce blood pressure less than 140/90 mm. Rt. Art. In the case of persons with pathologies in the cardiovascular system, the target pressure level is even lower 130/80 mm. Rt. Art.
Modern drug treatment for hypertension includes combination of two or more drugs in the following groups:
- calcium antagonists;
- enzyme inhibitors angiotensinoproding;
- blockers for angiotensin II;
- diuretics (diuretics);
- B-blockers;
- Alpha blockers.
The vast majority of these are produced in the form of high blood pressure tablets.
Prevention
Prevention of hypertension aggravation includes timely diagnosis and therapy of cardiovascular, nervous, urinary and endocrine systems, medical recommendations, including non -trade union treatment and medication, and regular blood pressure.