The hormone responsible for blood pressure. Hypertension as a consequence of adrenal diseases: causes, symptoms and treatments

Tumors of the adrenal glands often lead to the development of arterial hypertension, which are often not diagnosed on time. Formations lead to disturbances in the endocrine system, in which, in addition to thyroid gland, genital and pancreatic glands include the kidneys and adrenal glands. The adrenal glands provide the body with the necessary hormones, and contribute to the body's resistance to nervous shocks and stressful situations.

Arterial hypertension and adrenal glands

The narrowing of blood vessels and arteries leads to the development of arterial disease, and arterial hypertension means constant high blood pressure, significantly exceeding the permissible norm, that is, 120 to 80 mm Hg. Various diseases bodies abdominal cavity, including the adrenal glands, can lead to the development of arterial hypertension.

Muscle weakness may be a symptom of a tumor on the adrenal glands.

It is the presence of a tumor on the adrenal glands that can provoke hypertension, which is difficult to treat, in contrast to benign formations. Particular attention should be paid to the accompanying symptoms and pain, such as tremor of the hands and feet, general muscle weakness, excretion of urine in large volumes, blurred vision and impaired taste perception.

Tumors of the adrenal glands include:

• pheochromocytoma;
• primary hyperaldosteronism;
• Itsenko-Cushing's syndrome.

Pheochromocytoma

This name was given to the tumor formation of the adrenal gland (its medulla), which produces a huge amount of the hormone catecholamine, leading to an increase in pressure. This formation can often lead to hypertensive crisis(sudden increase in pressure). The tumor occurs in people aged 30 to 50 years. The development of the disease is characterized by a non-crisis state, when the pathology develops at a constantly high pressure. Diagnosis of pheochromocytoma is generally not difficult, but its detection does not occur immediately. As a rule, the tumor is detected after undergoing treatment with ineffective medicines prescribed for the treatment of hypertension.

Hypertensive drugs for pheochromocytoma are ineffective.

Primary hyperaldosteronism

A neoplasm on the adrenal cortex can provoke blood pressure of more than 200 mm Hg.

With manifestations of primary hyperaldosteronism, that is, neoplasms of the adrenal cortex, a large amount of the hormone aldosterone is produced, which regulates water and mineral metabolism in the body. Symptoms may include high pressure(more than 200 mm Hg), high potassium in the urine, low concentration of potassium in the blood, frequent urination, especially when lying down. Such symptoms are applicable to many diseases, and it is impossible to determine the tumor without additional tests.

Itsenko-Cushing syndrome

Itsenko-Cushing syndrome is a hormonal disorder in the body with the production of large volumes of the hormone cortisol. Blood pressure in people with this disorder is elevated and is not amenable to conventional therapy. Itsenko-Cushing's syndrome is more likely to affect women aged 25 to 45 years. The initial diagnosis of the syndrome is not difficult, since its effect on the body leads to characteristic changes in the appearance of patients. These people are subject to the so-called Cushing obesity and have a puffy face, with red, bluish-streaked cheeks, accumulation of adipose tissue in the abdomen and limbs, but they remain rather skinny.

Hypertensive crises

A hypertensive crisis is characterized by severe pain in the heart and high blood pressure.

A hypertensive crisis (a sharp increase in blood pressure) is accompanied by headaches, dizziness, nausea and vomiting, and palpitations. There are pains in the heart, the attack is accompanied by trembling and increased sweating, a feeling of dryness in the oral cavity. An attack of a hypertensive crisis has a sudden character and can be provoked by taking contraindicated drugs. alcoholic beverages, a sharp deterioration in the psycho-emotional state of a person, overstrain during physical exertion. The thought of imminent death can aggravate the course of an attack. The duration of its course can vary from several minutes to hours.

After an attack, there is a general lethargy of the body, but the pressure, as a rule, stabilizes to the individual norm. But the course of a crisis in a severe form is dangerous with complications and possible hemorrhages that can lead to a stroke (microstroke), heart failure, and swelling of the abdominal organs. In Addison's disease, the adrenal glands partially or completely stop producing hormones.

Adrenal insufficiency is manifested in the development of Addison's disease, when the disease takes a chronic course and affects both adrenal glands. Addison's disease is characterized by a partial or absolute stop in the production of hormones by the adrenal glands. The main symptoms of Addison's disease include low blood pressure, pain in digestive system, muscles and joints, changes in the integument of the skin and mucous membranes, which acquire a yellowish tint. In addition, there is a deterioration in cardiac activity.

In Addison's disease, so-called Addisonian crises can occur, which are manifested in an increase in the above symptoms and are considered an acute form of adrenal insufficiency. The acute form of insufficiency proceeds rapidly, when all symptoms appear in a few hours or days. This course of the disease leads to a sharp dysfunction of the adrenal glands. Unlike acute form, chronic form proceeds moderately and often can take place in a latent form.

There is a range painful symptoms to which a diseased thyroid gland leads. High blood pressure, for example, can be caused by hyperthyroidism - an increase in the functions of this endocrine gland and an increase in its production of hormones. Hypothyroidism - a decrease in the production of hormones - also belongs to the violations of the functions of this organ.

The thyroid gland is an organ that produces iodine-containing hormones that take part in metabolism and control the processes of tissue growth - thyroxine, triiodothyronine and calcitonin. It is located in the middle part of the neck under the larynx, in front of the trachea, and consists of two parts connected by an isthmus, weighs 25-30 grams. The thyroid gland in men, as a rule, is larger than in women, in whom its diseases occur 10 times more often than in representatives of the strong half of humanity.

Against the background of a violation of the normal activity of the thyroid gland, hypertension may develop. High blood pressure is one of the signs of hyperthyroidism. The hyperfunction of this endocrine organ is characterized by excessive secretion of hormones, which is determined by a blood test. Timely treatment of this disease helps to prevent many painful symptoms, such as: increased irritability, protrusion eyeballs, the formation of goiter, in which, as a rule, the thyroid gland is enlarged. According to the modern classification, there are 5 stages of its increase. The zero stage characterizes the normal size of the organ. At the first stage of enlargement, the tumor does not deform the neck, but it can be felt quite well. In the second stage of enlargement, this gland noticeably distorts the external curves of the neck during swallowing. At the third stage, the thyroid gland will be noticeable even to a person who is far from medicine. The fourth stage is characterized by noticeable changes in the appearance of a person, and the fifth - by a really gigantic size of the thyroid gland.

The cause of a large number of diseases and painful symptoms can be a sick thyroid gland. High blood pressure, heart rhythm disturbances, emotional lability, causeless irritability, drowsiness or insomnia, shortness of breath, fatigue, hair loss and much more - are the result of a lack or excess of secreted hormones.

With a low level of hormone production, which is characterized as hypothyroidism, obesity and a decrease in vitality are possible. When the thyroid gland secretes an excess amount of hormones, high blood pressure and palpitations are among the first signs of hyperthyroidism. With an increased tone, this gland constantly releases a large amount of hormones into the blood, which are immediately converted into energy. Such patients are always very active and increased appetite almost never fill up. In addition to the fact that an overly active thyroid gland almost always causes increased pressure, it is also the cause of constant elevated temperature bodies - from 37 about to 37.5 about. Symptoms of hyperfunction may lead to

Oddly enough, the most common cause secondary hypertension becomes snoring. True, not simple snoring, but snoring with respiratory arrest. Everyone knows such people: they snore, snore, and then their breathing stops. The silence lasts for a few seconds, and again the man began to snore. So, this is not just a bad habit, but a symptom of a very serious disease called "obstructive sleep apnea syndrome."

What is apnea? It is Greek for "stopping breathing". The walls of the upper respiratory tract collapse, breathing stops, the brain does not receive oxygen, and the person wakes up. Wakes up in order to “turn on” the respiratory center, start breathing again. Most often, he does not wake up completely and in the morning he does not remember about his micro-awakenings, but such a ragged sleep with a violation of the blood supply to the brain causes an increase in pressure and heart rhythm disturbances, up to life-threatening arrhythmias. In the morning, these people wake up sleepy, during the day they feel sleepy, they often fall asleep in public places and even while driving.

Please remember: if you or your close person snoring is a reason to draw the doctor's attention to this problem. These patients undergo a special study - during sleep, the main vital signs are recorded: respiratory rate, pulse rate, heart rate, muscle movements of the larynx wall, which are responsible for snoring, blood oxygen saturation. And if there are many episodes of respiratory arrest, then the doctor may recommend the use of a special device called CPAP.

Translated from English, this is "constant positive air pressure in the respiratory tract." A special device is placed on the bedside table, a mask is put on the face, and the patient sleeps all night with this mask. Air "pierces" Airways, as a result of which snoring and respiratory arrest disappear, and the pressure often normalizes or the severity of hypertension is significantly reduced. But with this mask you will need to sleep for the rest of your life.

Renal hypertension

The kidneys are one of the most important blood pressure regulators. Accordingly, some chronic diseases associated with kidney damage, such as diabetes, gout, glomerulonephritis, can lead to increased pressure.

Another cause of "renal hypertension" is narrowing (stenosis) of the renal arteries. In order for the kidneys to function properly, they must have enough blood flow. Sometimes, against the background of severe atherosclerosis, an atherosclerotic plaque appears on one or both sides of the renal arteries, which narrows the lumen. renal artery. The kidneys say that they do not have enough oxygen, and they believe that the pressure in the circulatory system has dropped, which means that it needs to be increased. The body increases the pressure with the help of special mechanisms, but the lumen of the renal artery remained as narrow as it was. The kidneys again say that they lack blood flow. And this vicious circle closes.

This is one of the most severe forms of hypertension. Pressure, especially diastolic, decreases very badly. Renal artery stenosis most often occurs in older smokers, since smoking is the most powerful stimulant for the development of atherosclerosis.

If your hypertension becomes more severe, ceases to respond to therapy, then you should definitely go to the doctor and find out if renal artery stenosis has developed. Ultrasound is done to detect this disease, and better - computed tomography renal arteries. Sometimes, to treat such hypertension, a stent is placed in the lumen of the vessel - a special metal "spring" that restores the lumen of the vessel.

Endocrine (hormonal) hypertension

Sometimes an increase in pressure is associated with an excess of some hormones. One of the most common endocrine diseases is thyrotoxicosis. To recognize it, conduct a study of thyroid-stimulating hormone (TSH) in the blood. Deviation TSH level unambiguously indicates a pathology of the thyroid gland.

By the way, in many countries, for the early detection of these diseases, it is recommended to do an analysis for TSH once every 5 years, even for healthy people. But an ultrasound of the thyroid gland just does not make sense. Ultrasonography does not reflect the function of the organ.

The main endocrine organ involved in the regulation of blood pressure is the adrenal glands. They produce three hormones, more precisely, three groups of hormones, each of which can increase pressure.

The first hormone is aldosterone, the second is cortisol, the third group is adrenaline and norepinephrine. Cells that produce these hormones can develop benign tumors, and in this case, the production of hormones increases tenfold.

If there is an excess of cortisol, this is called Cushing's syndrome (hypercorticism). In such patients, body weight increases sharply, purple stripes appear on the skin of the abdomen - striae, diabetes mellitus often develops. As a rule, this disease is recognized quite quickly, since changes in appearance are one of the obligatory symptoms. To diagnose this disease, a daily urine test for cortisol is used.

The second disease associated with excessive work of the adrenal glands is hyperaldosteronism (excess aldosterone). It can be caused by a tumor (aldosteroma) or hyperplasia (growth of tissue) of the adrenal gland. The disease is very difficult to recognize, because in addition to increasing pressure, it has practically no symptoms. In severe cases, especially during treatment with diuretics, muscle weakness may develop. Sometimes hyperaldosteronism can be suspected by a low level of potassium in biochemical analysis blood, which is necessarily done to hypertensive patients.

Finally, pheochromocytoma is a tumor of the adrenal medulla associated with excessive release of adrenaline or norepinephrine. Most often, this disease is manifested by severe hypertensive crises with strong, palpitations, sweating; pressure at this point rises sharply to 200-250 mm Hg. Art. Then the pressure drops sharply. Quite often such attack comes to an end with a plentiful urination.

It must be said that clinical picture very much like a panic attack panic attack). That is why such patients are sometimes treated for a long time and unsuccessfully by psychotherapists and even psychiatrists. Diagnosis of pheochromocytoma is quite simple: you need to examine the level of metanephrines in the urine; a normal result allows almost 99% to exclude the diagnosis.

But computed tomography of the adrenal glands should be done only when the answer came from the laboratory about the excess of one or another hormone. It is not necessary to start the diagnosis with CT of the adrenal glands. First, a row hormonal diseases have a non-tumor form, we simply will not see them on CT. On the other hand, about 5% healthy people have small, hormonally inactive formations in the adrenal glands. They do not grow, do not cause hypertension and do not affect life expectancy at all.

Patients with endocrine hypertension, as a rule, remain in the doctor's memory for a long time, since the disease proceeds in a very bizarre way and, as a rule, does not fit into our classical ideas about hypertension. First of all, everyone is very surprised by the excellent tolerance of high blood pressure in these patients.

For example, my first patient, a 43-year-old man with an aldosterone tumor of the adrenal gland and a pressure of 260/160 mm Hg. Art., felt so good that he signed a contract to work as a lumberjack in Alaska. The second patient, a 30-year-old woman, walked with a blood pressure of 240/140 for at least two years. Good health and the almost complete absence of symptoms allowed her even to "treat" with Filipino healers, who convinced her that the tumor had disappeared. Six months later, in our clinic, she was successfully operated on and completely freed from hypertension.

Comment on the article "Where does hypertension come from? Checking the kidneys and treating snoring"

The article is extremely interesting, since doctors, as a rule, prescribe antihypertensive drugs after minimal tests. That is, the true cause of hypertension is most often left behind the scenes. In any case, this is how the medicine was prescribed to me in our district clinic. After reading this article, I already know approximately what tests I need to do. With this list, I will go to the clinic. Thank you!

28.11.2014 11:41:07, VALENTINA

Article extremely helpful

11/28/2014 11:32:09 AM, VALENTINA

Total 2 messages .

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Hypertension causes heart disease, kidney disease, stroke, and contributes to the development of diabetes. It is not a direct cause of a heart attack or stroke, but it contributes to a very large extent.

This is perhaps the most important thing, hypertension is a "stress disease". + restrictions on fatty salty spicy food + mild sedative every day + ultrasound and kidney tests + osteopathic course (since cervical osteochondrosis also causes hypertension.

Thank you, I was waiting for an answer :) Tell me, pliz, where were observed this time about hypertension, if you are in Moscow. Yes, I almost forgot, before pregnancy, I also examined the kidneys and the endocrine system (shield gland and adrenal glands) to make sure that the increase in blood pressure with ...

Of course, if the causes of hypertension (kidney pathology, for example) persist, then hypertension will progress. And yet I know a lot of people "sitting" on the same dose of the same drug for 10-20 years.

hypertension. Has anyone else experienced hypertension in a child? in the spring and now the cardiologist measures his pressure - 130/80. At home, too, sometimes 130, sometimes 120. The cardiologist says that this is not from I would also advise you to look for another nephrologist and completely examine the kidneys.

Understand. necessarily, which is primary: hypertension, blood vessels or kidneys. My mother turned out to have renal artery stenosis, after stenting, the pressure returned to normal (although this does not negate, in her case, taking certain drugs).

main role in violation of purine metabolism, the kidneys and adrenal glands play, and, in fact, the liver, that is, you need to contact a nephrologist and an endocrinologist. Increased weight and hypertension can be directly related to impaired kidney function.

There are two main points in the diagnosis of hypertension - to find out whether hypertension is associated with another disease (kidneys, endocrinology, etc.) or is it an independent disease and to determine how damaged the target organs are (heart, brain, kidneys, blood vessels, eyes).

Complications: hypertension, renal failure. I have pyelonephritis of the left kidney ... Some may have two at once. It is said that a third of pregnant women suffer from this disease (often this occurs during pregnancy).

Causes of secondary hypertension lie in the field of dysfunction endocrine system. Environmental factors that affect the human body - weather conditions, temperature conditions, as well as ongoing changes in work internal organs in the process of evolution created a unique system of adaptation. Stress and a sense of danger cause the release of hormones into the blood, which cause both low blood pressure and high blood pressure.

How are hormones and blood pressure related?

The task of the circulatory system is to ensure timely access of oxygen to one or another organ. To do this, a certain vessel narrows or expands. This happens due to receptors located in tissue cells. Receptors respond to certain hormones, triggering the desired process. Regulates the process of the pituitary gland, influencing the work of the adrenal glands, synthesizing substances that affect the following parameters:

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• vascular tone, causing their sharp narrowing,
• work of the heart, causing it to beat faster.

Causes of hormonal hypertension

Causes of hormonal hypertension are associated with pathological processes occurring in the pituitary, thyroid, and adrenal glands. Diseases such as: pheochromocytoma, Cushing's syndrome, Kohn's syndrome and thyrotoxicosis lead to excessive synthesis of hormones that can constrict blood vessels, affect the pulse rate, heartbeat and retain water in the body. The result is secondary hypertension.

Hormones that increase blood pressure

Synthesized by the adrenal glands

A tumor in the adrenal medulla causes high blood pressure.

The adrenal glands consist of a cortical layer and an inner medulla. The latter produces adrenaline, the release of which speeds up the heartbeat, constricts blood vessels and dilates the pupils. A tumor of the adrenal medulla, pheochromocytoma, provokes the release of adrenaline and norepinephrine. This leads to a hypertensive crisis with headache and palpitations.

In the case when cortisol is elevated, diseases are formed - hypercortisolism, Cushing's syndrome and diabetes mellitus develops. The systolic pressure is elevated. An excess of another adrenal hormone, aldosterone, causes Cohn's syndrome, or hyperaldosteronism. The reason for the excess release of aldosterone is a tumor (often benign) or hyperplasia (tissue growth) of the adrenal gland. Aldosterone stores water and sodium in the walls of blood vessels and removes potassium. This affects the work of the heart muscle and leads to an increase in blood pressure.

Steroid hormones

By enzymatic reaction from the androgens testosterone and androstenedione, steroid hormones, estrogens, are formed. They are called estradiol and estrone, respectively, under the control of which is reproductive system. They also affect the work of the cardiovascular system, prevent the development of atherosclerosis and are able to increase the content of thyroxin T4 in the blood. The body does not always respond in time to an increase or decrease in estrogen. This explains the cause of high blood pressure in adolescence, "flushing" of blood to the head, redness and increased sweating during menopause. In men, excess estrogen increases blood pressure and increases blood clots.

Prolactin

synthesized by the thyroid gland

An increase in prolactin synthesis provokes hypertension.

The hormones that increase blood pressure are thyroid hormones. The role of the thyroid gland in the human body is to store iodine and synthesize iodine-containing hormones, which, in turn, regulate metabolism - thyroxine T4 (tetraiodothyronine) and triiodothyronine T3. The principle of operation of T3 and T4 is as follows: in response to a change in the environment, when it gets colder or physical activity increases, a person is subjected to emotional stress, then thyroid increases hormone levels. This leads to a rush of blood to the surface of the body and an increase in body temperature up to 37 degrees. The blood pressure rises. The heart beats faster. Blood vessels are in good shape, the arteries are narrowed.

Thyrotoxicosis

Thyrotoxicosis, a disease of the thyroid gland that causes excessive synthesis of hormones. All the positive points discussed above lead to negative consequences. The heart and vascular walls are forced to work at elevated pressure. Thus, they wear out faster. Irritability appears, a person cannot control the psycho-emotional state. The metabolism is accelerated.

Hormones that lower blood pressure

In the event of a large blood loss, an increase in ambient temperature and in a situation of lack of oxygen, the level of T3 and T4 should be reduced. To survive in these conditions is to lower blood pressure and slow down the heart. Decreased thyroid function leads to hypothyroidism. Inadequate synthesis of thyroxine and triiodothyronine leads to hypotension. As a result, the work of the brain is disrupted due to an insufficient amount of oxygen entering the blood. The work of the heart is disturbed by arrhythmia, bradycardia. Body temperature is within 34.2-36.4. A dangerous complication is myxedematous coma.

Pressure and hormones are closely related, because the latter change the diameter and tone of blood vessels, and also affect the activity of the myocardium. Vegetative nervous system coordinates the actions of systems among themselves. This interaction is called neurohumoral regulation. The hypothalamus, which is part of the central nervous system, activates the production of specific mediators by the pituitary gland. Releasing hormones affect the adrenal glands, thyroid and other endocrine glands, triggering the synthesis of vasopressor hormones.

Relationship between blood pressure and hormones

The hypothalamus increases blood pressure at the expense of pressor centers and stimulates the neurohypophysis, which releases vasopressin, which constricts blood vessels.

Blood pressure depends on the concentration in the blood of certain hormonal substances, the level of which is regulated by the hypothalamic-pituitary system. This is of great adaptive importance, since the deficit of autonomic nervous influences is compensated by humoral factors. The neurohumoral system has the greatest influence on the production of the main vasopressors - catecholamines and glucocorticoids (GCs).

Why does hormones cause hypertension?

A number of hormonal molecules have a tropic effect on the receptors of blood vessels and the heart. Adrenaline secreted by the adrenal cortex acts on the myocardium. It increases cardiac output and increases heart rate. Norepinephrine, which is also produced in the adrenal cortex, affects the vessels. The latter have specific adrenergic receptors, the configuration of which allows hormones to attach to them and activate them. HA and other molecules work on a similar principle.

Hormones that increase blood pressure

Cortisol contributes to the increase in blood pressure indicators.

High blood pressure occurs when there is an excessive release into the blood of catecholamines (adrenaline, noradrenaline), HA (cortisol), sex hormones (estradiol, estrogen, testosterone), molecules synthesized in the kidneys (renin, angiotensin, aldosterone) and brain (vasopressin). They act on the receptors of the vascular wall or the myocardium of the heart. Hormones that indirectly affect hypertension are ACTH and gonadotropic.

Thyroid hormone: thyroxine

T3 and T4 ensure the normal growth of organs, the skeleton, the functioning of the brain, and directly affect the cardiovascular system. Thyroxine and triiodothyronine stimulate blood flow to organs in stressful situations and at high physical activity. The system is regulated by thyroid-stimulating hormone produced in the central nervous system. With excessive production of thyroxin molecules, thyrotoxicosis occurs. The level of blood pressure is steadily elevated, while the heart rate increases. In hypothyroidism, the opposite situation is observed.

T3 and T4 are used for replacement therapy patients with hypothyroidism. Excessive administration of these substances leads to the side effect of malignant hypertension.

Hormonal molecules synthesized by the adrenal glands

Cortisol can speed up the heart muscle's rate of contraction.

The adrenal gland produces glucocorticosteroids and catecholamines. The former are synthesized in the cortical layer, the latter in the medulla. Cortisol may affect the regulation of blood pressure by increasing the frequency of myocardial contractions. Adrenaline and norepinephrine have a direct effect on the receptors of blood vessels and the heart.

prolactin and estradiol

Some hormones that are responsible for the production and secretion of breast milk during lactation can cause increased pressure in the vessels. Prolactin acts on the female reproductive organs, which respond by releasing their own hormones. Estradiol is one of the most powerful hypertensive agents. Its products - estrogens - get from the ovaries to big circle circulation, spread through cardiovascular system, contribute to an increase in the tone of the vascular wall, provoking the development of hypertension.

Hormones that lower blood pressure

Low blood pressure is caused by vasodilators. These include nitric oxide. These blood pressure-lowering molecules are considered antioxidants that have a positive effect on cells and tissues, preventing the aging of the body. Blood levels of thyroxine and triiodothyronine are important for lowering blood pressure. With hypothyroidism, SBP and DBP do not exceed 100 and 60 mm Hg. Art. respectively. If the kidneys do not produce enough renin, angiotensin II and aldosterone, hypotension occurs. Low concentration of testosterone is also accompanied by a drop in pressure.