arterial hypertension. Hypertension and hypertension - what is the difference and differences? What does hypertension mean

Chronic disease characterized by a persistent increase in the level blood pressure called arterial hypertension (hypertension).

Pathology affects thousands of people on the planet. The danger of this disease of the cardiovascular system is that it is often asymptomatic. A person can simply die from a heart attack or stroke caused by a sharp rise in blood pressure.

This diagnosis is established if the blood pressure exceeds 140/90 mm Hg.

Modern medicine classifies arterial hypertension into two types - primary and secondary. In most cases, the cause of the disease cannot be identified. Therefore, the treatment regimen provides for the elimination of the primary symptom - high blood pressure.

The degrees of hypertension differ in the severity of symptoms and the severity of the increase in blood pressure.

If, with moderate hypertension, the tonometer fixes the numbers 150/90 mm Hg, then in the severe stage, the pressure can rise above 190 mm Hg.

ICD-10 coding
Diseases characterized by high blood pressure I10-I15

1. I10 Essential (primary) hypertension.
2. I11 Hypertension with cardiac involvement.
3. I12 Hypertension with kidney damage.
4. I13 Hypertension predominantly affecting the heart and kidneys.
5. I15 Secondary hypertension.

What is symptomatic hypertension

To correctly prescribe a course of treatment, the doctor needs to distinguish primary, or essential, hypertension from secondary, or symptomatic. Secondary hypertension is diagnosed if high blood pressure is the result of another disease.

Medicine knows more than 60 diseases that are accompanied by symptomatic hypertension.

Conventionally, all types of secondary disease were divided into several groups according to the localization of disorders that caused an increase in pressure:

1. renal symptomatic hypertension;
2. hemodynamic symptomatic hypertension (with lesions of the heart and blood vessels);
3. endocrine;
4. neurogenic (with pathologies of the central nervous system);
5. drug symptomatic hypertension.

Effective therapy of the underlying disease usually leads to a decrease in blood pressure.

What is mild hypertension

Mild hypertension is a pressure level from 140/90 to 160/100 mm Hg. This form of the disease occurs in 70% of hypertensive patients and is considered the most dangerous.

The danger lies in the fact that this form of hypertension is often asymptomatic. And a person learns about the problem when dire consequences happen ( hypertensive crisis, stroke, heart attack).

What does the diagnosis of "isolated systolic hypertension" mean?

This diagnosis is established if the systolic pressure rises to 160 mm Hg, and the diastolic level remains below 90 mm Hg.

Most often, this form of the disease is diagnosed in elderly patients. It develops due to the loss of elasticity of the vessels. The danger of this form of hypertension lies in the risks of developing a heart attack, cardiac ischemia, and heart failure. An isolated diastolic form of the disease also occurs, but only in 7-9% of cases.

What does "refractory hypertension" mean?

Refractory or refractory hypertension occurs when three or more drugs fail to lower blood pressure.

However, ineffective therapy can also be carried out in cases of an incorrectly established diagnosis, incorrect selection of drugs and violations of the doctor's prescriptions by the patient. In this case, we are no longer talking about true refractory pathology.

What is White Coat Hypertension?

If the patient is simply nervous and worried at the sight of medical workers, then his pressure rises sharply.

This is a fairly common occurrence. Therefore, to establish an accurate diagnosis, monitoring is carried out at home, measuring blood pressure several times a day for the period indicated by the doctor.

White coat hypertension is no less dangerous than other types of this disease, therefore it also needs treatment and constant monitoring.

Diagnosis and diagnosis

If the patient applied to medical institution with complaints of high blood pressure, the doctor should determine:

• the frequency of jumps in blood pressure;
• the presence and stage of pathologies internal organs;
• reason for the high blood pressure.

To establish a diagnosis, you need:

1. monitor pressure indicators for several weeks;
2. pass the laboratory research aimed at identifying symptomatic hypertension;
3. if secondary hypertension is suspected, the patient should also consult with other specialists.

Most often, in middle-aged people, primary hypertension is established during preventive examinations.

In 80% of cases, early diagnosis of hypertension prevents the development of chronic persistent pathology.

Symptoms of high blood pressure

Sustained high blood pressure is characterized by symptoms that are the same for both men and women.

You need to go to a specialist consultation if you are concerned about:

1. headaches and dizziness;
2. numbness of fingers;
3. visual impairment;
4. insomnia;
5. decrease in working capacity;
6. nosebleeds;
7. irritability;
8. noise in ears;
9. increased sweating;
10. swelling;
11. heart pains.

The symptoms of hypertension do not appear all at once. They are added gradually as the disease progresses.

Risk factors

The causes of primary arterial hypertension are not known for certain. However, risk factors such as genetic predisposition and some external factors, significantly affect the development of the disease.

These include:

• The hereditary factor is considered one of the main ones.
• Aging. Physiological changes often cause an increase in pressure.
• Biochemical and physiological factors. This may be a violation of metabolic processes, functions of the central nervous system and other reasons.
• Psychological stress and constant stress. Excitation and any negative emotions in most cases contribute to an increase in blood pressure.
• Professional activity. Constant time pressure, a high degree of responsibility and constant worries make us live in stress, which often leads to the development of hypertension.
• Wrong way of life. This category of risk factors includes the abuse of alcohol, smoking, salty and spicy foods, and strong coffee.

Stages of hypertension and the course of pathology

Hypertension can be benign or malignant, rapidly progressive, with or without hypertensive crises. The severity of the course of the disease depends on the stage.

There are three degrees of the disease:

1. The first, or mild, stage of hypertension is characterized by an increase in blood pressure from 140/90 to 159/99 mm Hg. Pressure buildup is rare. Symptoms accompanying pressure surges are often mistaken for fatigue. Hypertension 1 degree responds well to treatment. With the correct diagnosis, timely therapy and lifestyle changes, all symptoms of the disease can be eliminated.
2. Hypertension of the 2nd degree is the result of neglect of one's health. The second, moderate stage of hypertension is characterized by an increase in pressure from 160/100 to 179/109 mm Hg. The development of the disease is accompanied by accompanying symptoms, as private headaches and heart pains, dizziness. At this stage, the risk of target organ damage is high. Self-medication of the second stage of hypertension can lead to an aggravation of the situation. Treatment is prescribed by a cardiologist.
3. The third stage of pathology is characterized by persistently high blood pressure and the development of pathologies of internal organs. This stage of the disease is dangerous with conditions that can lead to death, so the patient should be treated under strict medical supervision.

The second and third stages of hypertension are sometimes complicated. Often it happens when the patient, feeling better, refuses to take medication prescribed by a cardiologist.

Treatment of arterial hypertension after diagnosis

When making a diagnosis of "Hypertension", the doctor prescribes medication and does not drug treatment. How to treat hypertension in each individual case will be prompted by a general practitioner or cardiologist.

Non-drug therapy is:

• observance of the regime of work and rest;
• normalization of sleep;
• following a diet rich in vitamins and antioxidants;
• rejection of bad habits;
• breathing exercises;
• massage;
• relaxation practices.

If a change in lifestyle has not led to a lasting positive effect, the doctor prescribes an appointment medicines reducing pressure.

The patient is given one or more drugs that affect different symptoms diseases.

In case of a sharp increase in blood pressure or a hypertensive crisis, the patient should always have on hand such means as Derinat, Corinfar or Lofelin.

Treatment of hypertension at home implies a clear prescription from a doctor. Folk methods Therapy is acceptable only in cases where the diagnosis has not been made, and the pressure rarely rises.

Prevention of high blood pressure

To prevent hypertension, you should follow a diet, refusing excessively salty and spicy foods, alcoholic beverages.

If you are at risk, it is important to regularly measure your blood pressure and visit the doctor at least twice a year.

Hypertension is a disease of a chronic nature, which is characterized by a persistent increase in blood pressure to high numbers due to a violation of the regulation of blood circulation in the human body. Also, terms such as arterial hypertension and hypertension are used to refer to this condition.

Medical statistics is such that today hypertension is one of the most common diseases. It usually begins to progress in people after 40 years of age, but there is a risk of its progression at any age. So, more and more often the disease began to be detected in patients of working age. It should be noted that the fair sex suffers several times more often than men. But it is in men that hypertension is more severe, since they are more prone to developing blood vessels.

Blood pressure can increase with strong mental or physical stress for a short time - this is an absolutely normal phenomenon. A longer increase in blood pressure is observed in a number of diseases of the kidneys, endocrine glands, as well as during pregnancy. But in this case, hypertension is only one of the symptoms that indicates changes in the organs. In hypertension, an increase in blood pressure is an independent, primary, painful process.

The pathogenesis of hypertension is such that under the influence of exogenous and endogenous factors, the tone of the walls of arterioles in the body increases. As a consequence of this, they gradually narrow and the blood flow in the affected vessels is disturbed. During this pathological process, blood pressure increases on the walls of the arteries, which entails further symptoms.

Etiology

The main reason for the progression of hypertension is an increase in the activity of the sympathetic-adrenal system. The vasomotor center is located in the human medulla oblongata. From it, certain impulses go along the nerve fibers to the walls of the vessels, causing the vessels to expand or contract. If this center is in a state of irritation, then only impulses will come to the vessels that increase the tone of their walls. As a result, the lumen of the artery narrows.

Arterial hypertension is characterized by a simultaneous increase in systolic and diastolic pressure. This is observed under the influence of various adverse factors.

Exogenous risk factors:

• severe nervous strain is the most common cause of progression;
• hypodynamia;
• irrational nutrition. Non-compliance with the diet and eating large amounts of fatty and fried foods;
• excessive consumption of alcoholic beverages;
• smoking;
• the use of narcotic drugs.

Endogenous risk factors:

• burdened heredity;
• atherosclerosis of the coronary vessels of the heart;
• increased blood viscosity (the heart cannot fully distill it through the vessels);
• kidney ailments, such as,;
• metabolic disorder;
• the presence of endocrine pathologies;
• increased concentration of calcium in the blood;
• the action of adrenaline on the heart during stressful situations;
• increased concentration of sodium in the blood.

Classification

For all the time of studying the disease, scientists have developed more than one classification of hypertension - according to appearance patient, by etiology, by the level of pressure increase, the nature of the course, and so on. Some have been out of date for a long time, while others, on the contrary, are used more and more often.

Degrees of hypertension (by pressure level):

• optimal - indicators 120/80;
• normal - upper from 120 to 129, lower - from 80 to 84;
• increased normal - upper indicators - from 130 to 139, lower ones - from 85 to 89;
• hypertension of the 1st degree - SD from 140 to 159, DD - from 90 to 99;
• hypertension of the 2nd degree - systolic pressure indicators increase to 160-179, and diastolic - up to 100-109;
• hypertension of the 3rd degree - systolic pressure increases over 140, and diastolic - over 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. At this stage of hypertension, the pressure rises constantly. The main organs of the target are affected. During the examination, it can be noted that damage to the heart, fundus vessels, 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 blood vessels of the kidneys, heart, brain, and fundus. Dangerous complications develop - angioretinopathy, and so on.

Forms of the disease (depending on the vessels of which organs are affected):

• renal form;
• heart shape;
• brain form;
• mixed.

Types of hypertension:

• benign and slow flowing. In this case, the symptoms of the progression of the pathology can gradually appear over 20 years. Phases of both exacerbation and remission are observed. The risk of complications is minimal (with timely therapy);
• malignant. The pressure rises sharply. This form of hypertension is practically not amenable to therapy. As a rule, pathology is accompanied various diseases kidneys.

It is worth noting that often with hypertension of the 2nd degree and 3 the patient has. This is an extremely dangerous condition not only for human health, but also for his life. Clinicians distinguish the following types of crises:

• neurovegetative. The patient is hyperactive and very agitated. The following symptoms of hypertension appear: tremor of the upper extremities, and profuse urination;
• hydropic. In this case, the patient is drowsy and his reactions are inhibited. noted muscle weakness, swelling of the face and hands, decreased 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 it is the least common. It is characterized by such symptoms: convulsions and impaired consciousness. Complication - hemorrhage in the brain.

Symptoms

Symptoms of the disease directly depend on which stage of hypertension is 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 region of the heart, irritability, headache, tachycardia, a feeling of heaviness in the back of the head. Indicators of SD and DD are increasing, but they can easily be normalized.

sclerotic

The indicated clinical picture is supplemented by the following symptoms:

• increased headache;
• dizziness;
• sensation of a rush of blood to the head;
• bad dream;
• periodic numbness of the fingers on the limbs;
• fast fatiguability;
• "flies" before the eyes;
• persistent increase in blood pressure.

It is worth noting that this stage can progress over several years and at the same time the patients will be active and mobile. But a violation of the supply of certain organs with blood entails a violation of their functioning.

ultimate

Usually at this stage, doctors detect and, as well as a violation of blood circulation in the brain. The outcome of the disease, as well as the development of complications, is determined by the form of hypertension. Crises often occur.

With a cardiac form, the patient gradually progresses to heart failure. Appears shortness of breath, pain in the projection of the heart, swelling. With the brain form of a person, severe headaches, visual impairments disturb.

Hypertension and childbearing

Hypertension during pregnancy is the most common cause of premature birth or perinatal death of the fetus. Usually, a woman's hypertension already exists before the onset of pregnancy and then simply activates, because bearing a child is a kind of stress for the body.

Given the high risk for the mother and unborn child, in the case of diagnosing an ailment, it is important to determine exactly the degree of this risk in order to resolve the issue of further gestation or termination of pregnancy. Doctors distinguish three degrees of risk (based on the stage of arterial hypertension):

• 1 degree of risk - pregnancy complications are minimal, crises rarely develop. Possible angina. Pregnancy in this case is permissible;
• 2 degree of risk - expressed. Complications develop in 20–50% of cases. A pregnant woman has hypertensive crises, insufficiency coronary vessels heart, high blood pressure. Termination of pregnancy is shown;
• 3 degree of risk. Complications of pregnancy occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Possible detachment of the placenta, a violation of blood circulation in the brain. Pregnancy poses a danger to the life of the mother, so it is interrupted.

Patients who are kept pregnant should make sure to visit the doctor once a week so that he can monitor their condition. Mandatory treatment of hypertension. It is allowed to use such antihypertensive drugs:

• antispasmodics;
• saluretics;
• sympatholytics;
• clonidine derivatives;
• rauwolfia preparations;
• ganglioblockers;
• beta blockers.

Also, in order to treat the disease during pregnancy, doctors resort to physiotherapy.

Diagnostics

When the first signs of an illness appear, it is important to immediately contact a medical institution to confirm or refute the diagnosis. The sooner this is done, the less the risk of progression of dangerous complications (damage to the heart, kidneys, brain). During the initial examination, the doctor must measure the pressure on both hands. If the patient is elderly, then measurements are also taken in a standing position. During the diagnosis, it is important to clarify the true cause of the progression of the pathology.

A comprehensive plan for diagnosing hypertension includes:

• collection of anamnesis;
• SMAD;
• determination of the level of bad cholesterol in the blood;
• x-ray;
• examination of the fundus;

Treatment

Treatment of hypertension is carried out in a hospital, so that doctors can constantly monitor the patient's condition and, if necessary, adjust the treatment plan. 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 pressure, the following drugs are prescribed:

• alpha-blockers;
• beta-blockers;
• calcium channel blockers;
• diuretics. This group of drugs is especially important, as it helps to reduce the level of sodium in the blood, thereby reducing the swelling of the walls of blood vessels.

All of these drugs should be taken only as prescribed by the attending physician. Uncontrolled intake of such funds can only worsen the patient's condition. These drugs are taken according to a certain scheme.

Diet

During the treatment of hypertension, in addition to taking medications, it is important to adhere to a special diet. With hypertension, the patient is assigned table number 10. The principles of such a diet:

• add seafood to the diet;
• limit salt intake;
• fractional nutrition;
• limit carbohydrates and animal fats in the diet.

The diet for this pathology implies a restriction:

• Sahara;
• of bread;
• potatoes;
• pasta;
• cereal dishes;
• animal fats;
• ghee;
• sour cream and more.

Diet number 10 is complete and can be followed for a long time. To improve the taste of dishes, you can add to them:

• prunes;
• vinegar;
• jam;
• cranberries;
• lemon.

The diet is indicated not only during treatment, but also after it, so as not to provoke a deterioration in the condition. It is worth noting that the diet is developed strictly individually for each patient, taking into account the characteristics of his body. An important point - during the diet you need to consume no more than 1.5 liters of fluid per day.

Prevention

Prevention of hypertension is quite simple. The first thing to do is to normalize your diet, as well as lead an active lifestyle. In order for the vessels to be elastic, you need to eat more vegetables and fruits, drink up to 2 liters of water per day. Can be taken vitamin preparations. Also, the prevention of hypertension involves the exclusion of smoking and drinking alcoholic beverages.

arterial hypertension- This is perhaps the most common disease of the entire cardiovascular system. The word "hypertension" refers to persistently high blood pressure. An increase in blood pressure occurs when there is a narrowing of the arteries and / or their smaller branches - arterioles. Arteries are the main transport routes through which blood is delivered to all tissues of the body. In some people, the arterioles often constrict, initially due to spasm, and later their lumen remains constantly narrowed due to wall thickening, and then, in order for the blood flow to overcome these constrictions, the work of the heart increases and more blood is thrown into the vascular bed. These people usually develop hypertension.

In our country, approximately 40% of the adult population have elevated level blood pressure. At the same time, about 37% of men and 58% of women are aware of the presence of the disease, and only 22 and 46% of them are being treated. Only 5.7% of men and 17.5% of women properly control their blood pressure.

arterial hypertension

arterial hypertension is a chronic disease accompanied by a persistent increase in blood pressure above acceptable limits (systolic pressure above 139 mm Hg or (and) diastolic pressure above 89 mm Hg).

Approximately one in ten hypertensive patients have high blood pressure caused by damage to any organ. In these cases, they speak of secondary or symptomatic hypertension. About 90% of patients suffer from primary or essential hypertension. The reference point for high blood pressure is at least three times the level of 139/89 mm Hg recorded by the doctor. Art. and more in people not taking blood pressure medications. It is important to note that a slight, even persistent increase in blood pressure does not mean the presence of the disease. Unless you have other risk factors and signs of target organ damage in this situation, hypertension is potentially treatable at this stage. However, without your interest and participation, it is impossible to lower blood pressure. The question immediately arises: is it worth taking arterial hypertension seriously if I feel quite well? The unequivocal answer to this question is yes.

Arterial pressure

To understand what blood pressure is, let's first deal with some numbers and we will “dance” from them. It is known that the total amount of blood in the body is 6 - 8% of body weight. Using a simple calculation, you can easily find out the volume of blood in each person. So with a mass of 75 kilograms, the volume of blood is 4.5 - 6 liters. And all of it is enclosed in a system of vessels communicating with each other. So, when the heart contracts, the blood moves through the blood vessels, presses on the wall of the arteries, and this pressure is called arterial. Blood pressure helps move blood through the vessels. There are two indicators of blood pressure:

Systolic blood pressure (SBP), also called "upper" - reflects the pressure in the arteries, which is created when the heart contracts and blood is ejected into the arterial part of the vascular system;

Diastolic blood pressure (DBP), also called "lower" - reflects the pressure in the arteries at the moment of relaxation of the heart, during which it is filled before the next contraction. Both systolic blood pressure and diastolic blood pressure are measured in millimeters of mercury (mmHg).

How to measure blood pressure correctly

You can measure blood pressure yourself with the help of special devices - the so-called "tonometers". Measurement of blood pressure at home provides valuable additional information, both during the initial examination of the patient, and in the further monitoring of the effectiveness of treatment.

When measuring blood pressure at home, you can evaluate it on different days in everyday life and eliminate the “white coat effect”. Self-monitoring of blood pressure disciplines the patient and improves adherence to treatment. Measuring blood pressure at home can help you more accurately assess the effectiveness of treatment and potentially reduce the cost of treatment. An important factor affecting the quality of self-monitoring of blood pressure is the use of devices that meet international standards of accuracy. It is not recommended to use devices for measuring blood pressure on the finger or wrist. You should strictly follow the instructions for measuring blood pressure when using automatic electronic devices.

There are mandatory rules that must be observed when measuring blood pressure:

Situation. The measurement should be carried out in a quiet, calm and comfortable stop at a comfortable temperature. You should sit in a straight-backed chair next to the table. The height of the table should be such that when measuring blood pressure, the middle of the cuff applied to the upper arm is at the level of the heart.

Preparation for measurement and duration of rest. Blood pressure should be measured 1-2 hours after a meal. Do not smoke or drink coffee for 1 hour before the measurement. You should not wear tight, tight clothing. The arm on which the blood pressure measurement will be taken must be bare. You should sit back in your chair with your legs relaxed, not crossed. It is not recommended to talk during the measurement, as this may affect the level of blood pressure. Measurement of blood pressure should be carried out after at least 5 minutes of rest.

Cuff size. The cuff must be wide enough. The use of a narrow or short cuff leads to a significant false increase in blood pressure.

cuff position. Determine with your fingers the pulsation of the brachial artery at the level of the middle of the shoulder. The middle of the cuff balloon should be exactly over the palpated artery. The lower edge of the cuff should be 2.5 cm above the antecubital fossa. Cuff tightness: A finger must pass between the cuff and the surface of the patient's upper arm.

How much to push? Determination of the maximum level of air injection into the cuff is necessary for accurate determination of systolic blood pressure with minimal discomfort for the patient, avoiding "auscultatory failure":

• determine the pulsation of the radial artery, the nature and rhythm of the pulse
• while continuing to palpate the radial artery, rapidly inflate the cuff to 60 mm Hg. Art., then inject 10 mm Hg. Art. until the pulsation disappears
• deflate the cuff at a rate of 2 mm Hg. Art. per second. The level of blood pressure at which the pulse reappears is recorded
• completely deflate the cuff. To determine the level of maximum air injection into the cuff, the value of systolic blood pressure, determined by palpation, is increased by 30 mm Hg. Art.

Stethoscope position. Fingers determine the point of maximum pulsation of the brachial artery, which is usually located immediately above the cubital fossa on the inner surface of the shoulder. The membrane of the stethoscope must fit completely against the surface of the upper arm. Too much pressure with the stethoscope should be avoided, and the head of the stethoscope should not touch the cuff or tubes.

Inflate and deflate the cuff. Inflation of air into the cuff to the maximum level should be carried out quickly. Air is released from the cuff at a rate of 2 mm Hg. Art. per second until the appearance of tones (“thuds”) and then continue to release at the same speed until the sounds disappear completely. The first sounds correspond to systolic blood pressure, the disappearance of sounds (the last sound) corresponds to diastolic blood pressure.

repeated measurements. Once received data are not true: it is necessary to carry out repeated measurements of blood pressure (at least twice with an interval of 3 minutes, then the average value is calculated). It is necessary to measure blood pressure, both on the right and on the left arms.

Symptoms of arterial hypertension

Clinic, i.e. manifestations of hypertension has no specific symptoms. Patients may not know about their illness for many years, do not complain, have a high vitality, although sometimes there may be attacks of "lightheadedness", severe weakness and dizziness. But even then everyone assumes that it is from overwork. Although it is at this moment that it is necessary to think about blood pressure and measure it. Complaints with hypertension occur if the so-called target organs are affected, these are the organs that are most sensitive to increases in blood pressure. The occurrence of dizziness in a patient, headaches, noise in the head, memory and performance decline indicate initial changes in cerebral circulation. This is later joined by double vision, flickering of flies, weakness, numbness of the extremities, difficulty in speech, but at the initial stage, changes in blood circulation are of a coming nature. A far advanced stage of arterial hypertension may be complicated by a cerebral infarction or cerebral hemorrhage. The most early and permanent sign of constantly elevated blood pressure is an increase, or hypertrophy of the left ventricle of the heart, with an increase in its mass due to thickening of heart cells, cardiomyocytes.

First, the thickness of the wall of the left ventricle increases, and then the expansion of this chamber of the heart occurs. Close attention should be paid to the fact that left ventricular hypertrophy is an unfavorable prognostic sign. A number of epidemiological studies have shown that the appearance of left ventricular hypertrophy significantly increases the risk of sudden death, coronary artery disease, heart failure, and ventricular arrhythmias. Progressive dysfunction of the left ventricle leads to symptoms such as: shortness of breath on exertion, paroxysmal nocturnal shortness of breath (cardiac asthma), pulmonary edema (often during crises), chronic (congestive) heart failure. Against this background, myocardial infarction, ventricular fibrillation more often develop.

With gross morphological changes in the aorta (atherosclerosis), it expands, it can be dissected, ruptured. Kidney damage is expressed by the presence of protein in the urine, microhematuria, cylindruria. However, renal failure in hypertension, if there is no malignant course, rarely develops. Eye damage can be manifested by visual impairment, decreased light sensitivity, and the development of blindness. Thus, it is clear that hypertension should be treated more carefully.

So, what are the manifestations of hypertension?

Headache, which, with further progression of the disease, remains one of the main manifestations of arterial hypertension. Headache does not have a clear connection with the time of day, it can occur at any time of the day, but usually at night or early in the morning, after waking up. It is felt as heaviness or fullness in the back of the head and may cover other areas of the head. Usually, patients describe the headache of hypertension as a "hoop" sensation. Sometimes the pain gets worse with strong cough, tilting the head, straining, may be accompanied by slight swelling of the eyelids, face. Improvement in venous outflow (vertical position of the patient, muscle activity, massage, etc.) is usually accompanied by a decrease or disappearance of headache.

Headache with an increase in blood pressure may be due to tension in the muscles of the soft integument of the head or the tendon helmet of the head. It occurs against the background of pronounced psycho-emotional or physical stress and subsides after rest and resolution of conflict situations. In this case, they talk about a tension headache, which is also manifested by a feeling of compression or tightening of the head with a “bandage” or “hoop”, may be accompanied by nausea and dizziness. Long-lasting pain leads to irritability, irascibility, increased sensitivity to external stimuli (loud music, noise).

Pain in the region of the heart with arterial hypertension differ from typical angina attacks:

• localized in the region of the apex of the heart or to the left of the sternum;
• occur at rest or during emotional stress;
• usually not provoked by physical activity;
• last long enough (minutes, hours);
• not stopped by nitroglycerin.

Shortness of breath that occurs in patients with hypertension, first during exercise, and then at rest, may indicate a significant damage to the heart muscle and the development of heart failure.

Swelling of the legs may indicate the presence of heart failure. However, moderately severe peripheral edema in arterial hypertension may be associated with sodium and water retention, caused by a violation of the excretory function of the kidneys or by taking certain medications.

visual impairment characteristic of patients arterial hypertension. Often, with an increase in blood pressure, a fog, a veil or flashing of “flies” appears before the eyes. These symptoms are mainly associated with functional disorders circulation in the retina. Gross changes in the retina (vascular thrombosis, hemorrhage, retinal detachment) may be accompanied by a significant decrease in vision, double vision (diplopia) and even complete loss of vision.

Risk factors for arterial hypertension

Absolutely for all diseases of the internal organs, there are both changeable or modifiable, and unchanged or non-modifiable risk factors for development. Arterial hypertension is no exception. For its development, there are factors that we can influence - modifiable and risk factors that we cannot influence - non-modifiable. Let's dot all the "and".

Unchangeable risk factors include:

H heredity- people who have among their relatives patients with hypertension are most predisposed to the development of this pathology in them.

Male sex - it was found that the incidence of men arterial hypertension significantly higher than the incidence of women. But the fact is that lovely ladies are “protected” by female sex hormones, estrogens, which prevent the development of hypertension. But such protection, unfortunately, is short-lived. The climacteric period sets in, the saving effect of estrogen ends, and women equalize in incidence with men and often overtake them.

Modifiable risk factors include:

P increased body weight- overweight people have a higher risk of developing arterial hypertension;

M sedentary lifestyle– otherwise, physical inactivity, a sedentary lifestyle and low physical activity lead to obesity, which in turn contributes to the development of hypertension;

At alcohol consumption- Excessive alcohol consumption contributes to arterial hypertension. As for alcohol, it is better not to drink alcoholic beverages at all. Ethyl alcohol in the body is formed already enough. Yes, the use of red wine, according to researchers, does have a beneficial effect on the cardiovascular system. But with frequent use of wine under the guise of deliverance and prevention of arterial hypertension, you can easily acquire another disease - alcoholism. Getting rid of the latter is much more difficult than getting rid of high blood pressure.

At eating large amounts of salt- A high-salt diet contributes to high blood pressure. This raises the question of how much salt can be consumed per day? The answer is short: 4.5 grams or a teaspoon without a top.

H unbalanced diet with an excess of atherogenic lipids, excess calories, leading to obesity and contributing to the progression of type II diabetes. Atherogenic, i.e., literally, "creating atherosclerosis" lipids are found in large quantities in all animal fats, meat, especially pork and lamb.

Smoking is another variable and formidable factor in the development of arterial hypertension and its complications. The fact is that the substances of tobacco, including nicotine, create a constant spasm of the arteries, which, when fixed, leads to stiffness of the arteries, which entails an increase in pressure in the vessels.

With tressa - lead to the activation of the sympathetic nervous system, which performs the function of an instant activator of all body systems, including the cardiovascular system. In addition, pressor hormones, i.e., causing spasm of the arteries, hormones are released into the blood. All this, as with smoking, leads to stiffness of the arteries and arterial hypertension develops.

G ruby sleep disturbances by the type of sleep apnea syndrome, or snoring. Snoring is a real scourge for almost all men and many women. Why is snoring dangerous? The fact is that it causes an increase in pressure in chest And abdominal cavity. All this is reflected in the vessels, leading to their spasm. Arterial hypertension develops.

Causes of arterial hypertension

The cause of the disease remains unknown in 90-95% of patients. essential(that is, primary) arterial hypertension. In 5-10% of cases, an increase in blood pressure has an established cause - this is symptomatic(or secondary) hypertension.

Causes of symptomatic (secondary) arterial hypertension:

• primary kidney damage (glomerulonephritis) is the most common cause of secondary arterial hypertension.
• unilateral or bilateral narrowing (stenosis) renal arteries.
• coarctation (congenital narrowing) of the aorta.
• pheochromocytoma (a tumor of the adrenal glands that produces adrenaline and norepinephrine).
• hyperaldosteronism (adrenal gland tumor that produces aldosterone).
• thyrotoxicosis (increased function thyroid gland).
• consumption of ethanol (wine spirit) more than 60 ml per day.
• medicines: hormonal preparations(including oral contraceptives), antidepressants, cocaine and others.

Note. Older people often have isolated systolic arterial hypertension (systolic pressure > 140 mm Hg and diastolic pressure< 90 мм рт.ст.), что обусловлено снижением упругости сосудов.

Risk factors for cardiovascular complications in arterial hypertension

Main:

• men over 55;
• women over 65;
• total blood cholesterol > 6.5 mmol/l, elevated low-density lipoprotein cholesterol (> 4.0 mmol/l) and low high-density lipoprotein cholesterol;
• family history of early cardiovascular disease (in women< 65 лет, у мужчин < 55 лет);
• abdominal obesity (waist ≥102 cm for men or ≥ 88 cm for women);
• level of C - reactive protein in the blood ≥1 mg / dl;
• diabetes mellitus (fasting blood glucose> 7 mmol / l).

Additional:

• impaired glucose tolerance;
• low physical activity;
• an increase in fibrinogen levels.

Note. The accuracy of determining the total cardiovascular risk directly depends on how complete the clinical and instrumental examination of the patient was.

Consequences of arterial hypertension

Many people with hypertension are asymptomatic. However, if arterial hypertension left untreated, it is fraught with serious complications. One of the most important manifestations of hypertension is the defeat of target organs, which include:

• Heart (myocardial hypertrophy of the left ventricle, myocardial infarction, development of heart failure);
• brain (dyscirculatory encephalopathy, hemorrhagic and ischemic strokes, transient ischemic attack);
• kidneys (nephrosclerosis, renal failure);
• vessels (dissecting aortic aneurysm, etc.).

Complications in arterial hypertension

The most significant complications of arterial hypertension are

• hypertensive crises,
• cerebrovascular accidents (hemorrhagic or ischemic strokes),
• myocardial infarction,
• nephrosclerosis (primarily wrinkled kidney),
• heart failure,
• dissecting aortic aneurysm.

Hypertensive crisis

Hypertensive crisis- this is a sudden increase in blood pressure, accompanied by a significant deterioration in cerebral, coronary, renal circulation, which significantly increases the risk of severe cardiovascular complications: stroke, myocardial infarction, subarachnoid hemorrhage, aortic dissection, pulmonary edema, acute renal failure.

They arise under the influence of pronounced psycho-emotional stress, alcoholic excesses, inadequate treatment of arterial hypertension, discontinuation of medications, excessive salt intake, and the influence of meteorological factors.

During the crisis, there is excitement, anxiety, fear, tachycardia, a feeling of lack of air. A feeling of “internal trembling”, cold sweat, “goosebumps”, hand tremor, redness of the face are characteristic. Violation of cerebral blood flow is manifested by dizziness, nausea, single vomiting. Often there is weakness in the limbs, numbness of the lips and tongue, impaired speech. In severe cases, there are signs of heart failure (shortness of breath, dyspnea), unstable angina (chest pain) or other vascular complications.

Note. Hypertensive crises can develop at any stage of the disease. The development of repeated hypertensive crises in a patient with arterial hypertension often indicates the inadequacy of the therapy.

Malignant arterial hypertension

Malignant arterial hypertension is a syndrome characterized by high blood pressure, rapid progression of organic changes in target organs (heart, brain, kidneys, aorta) and resistance to therapy. The syndrome of malignant arterial hypertension develops in approximately 0.5–1.0% of patients, more often in men aged 40–50 years.

Prognosis of the syndrome of malignant arterial hypertension extremely serious. In the absence of adequate treatment, about 70–80% of patients die within 1 year. Most common cause death is hemorrhagic stroke, chronic renal and heart failure, dissecting aortic aneurysm. Active modern treatment allows to reduce several times the lethality of this category of patients. As a result, about half of patients survive for 5 years.

Blood pressure measurement

The following conditions are relevant for measuring blood pressure:

1. Patient position:
   • Sitting in a comfortable position; hand on the table;
   • The cuff is applied to the shoulder at the level of the heart, its lower edge is 2 cm above the elbow.

2. Circumstances:

   • the use of coffee and strong tea is excluded for 1 hour before the study;
   • do not smoke for 30 minutes before measuring blood pressure;
   • stop taking sympathomimetics (drugs that increase blood pressure), including nasal and eye drops;
   • blood pressure is measured at rest after a 5-minute rest. If the procedure for measuring blood pressure was preceded by significant physical or emotional stress, the rest period should be increased to 15-30 minutes.

3. Equipment:

   • the size of the cuff should correspond to the size of the arm: the rubber inflated part of the cuff should cover at least 80% of the circumference of the arm; for adults, a cuff 12-13 cm wide and 30-35 cm long (medium size) is used;
   • the mercury column or the arrow of the tonometer must be at zero before starting the measurement.

4. Multiplicity of measurement:

   • to assess the level of blood pressure on each arm, at least two measurements should be performed, with an interval of at least a minute; with a difference ≥ 5 mm Hg. make 1 additional measurement; the final (recorded) value is the average of the last two measurements;
   • To diagnose the disease, at least 2 measurements must be performed with a difference of at least a week.

5. Measurement technique:

   • quickly inflate the cuff to a pressure level of 20 mm Hg. exceeding systolic (upper) blood pressure (by the disappearance of the pulse);
   • blood pressure is measured with an accuracy of 2 mm Hg. Art.
   • reduce cuff pressure by 2 mm Hg. per second.
   • the level of pressure at which the first tone appears corresponds to the systolic (upper) arterial pressure;
   • the level of pressure at which the tones disappear - diastolic blood pressure;
   • if the tones are very weak, then you should raise your hand and perform several squeezing movements with the brush; then the measurement is repeated; do not strongly compress the artery with the membrane of the phonendoscope;
   • the first time you should measure the pressure on both hands. In the future, measurements are made on the arm where the blood pressure level is higher;
   • it is advisable to measure the pressure on the legs, especially in patients< 30 лет; измерять артериальное давление на ногах желательно с помощью широкой манжеты (той же, что и у лиц с ожирением); фонендоскоп располагается в подколенной ямке.

Research in arterial hypertension

All patients with arterial hypertension the following research needs to be done:

1. general analysis of blood and urine;
2. the level of creatinine in the blood (to exclude kidney damage);
3. the level of potassium in the blood outside the intake of diuretics (a sharp decrease in the level of potassium is suspicious for the presence of an adrenal tumor or renal artery stenosis);
4. electrocardiogram (signs of left ventricular hypertrophy - evidence of a long course of arterial hypertension);
5. determination of the level of glucose in the blood (on an empty stomach);
6. 6) serum levels of total cholesterol, high and low density lipoprotein cholesterol, triglycerides, uric acid;
7. echocardiography (determination of the degree of myocardial hypertrophy of the left ventricle and the state of contractility of the heart)
8. fundus examination.

• chest x-ray;
• Ultrasound of the kidneys and adrenal glands;
• Ultrasound of brachiocephalic and renal arteries;
• C-reactive protein in blood serum;
• analysis of urine for the presence of bacteria (bacteriuria), quantitative assessment of protein in the urine (proteinuria);
• determination of microalbumin in the urine (mandatory in the presence of diabetes mellitus).

In-Depth Research:

• assessment of the functional state of cerebral blood flow, myocardium, kidneys;
• a study in the blood of the concentration of aldosterone, corticosteroids, renin activity; determination of catecholamines and their metabolites in daily urine; abdominal aortography; CT scan or magnetic resonance imaging of the adrenal glands and brain.

Degree of arterial hypertension

Classification of blood pressure levels (mmHg)

Treatment of arterial hypertension

The main goal of treating patients with arterial hypertension is to minimize the risk of developing cardiovascular complications and death from them. This is achieved through long-term, lifelong therapy aimed at:

• lowering blood pressure to normal level(below 140/90 mm Hg). When arterial hypertension is combined with diabetes mellitus or kidney damage, lowering blood pressure is recommended.< 130/80 мм рт.ст. (но не ниже 110/70 мм рт.ст.);
• "protection" of target organs (brain, heart, kidneys), preventing their further damage;
• active influence on adverse risk factors (obesity, hyperlipidemia, carbohydrate metabolism disorders, excessive salt intake, physical inactivity) that contribute to the progression of arterial hypertension and the development of its complications.

Treatment of arterial hypertension should be carried out in all patients whose blood pressure level consistently exceeds 139/89 mm Hg.

Non-drug treatment of arterial hypertension

Non-drug treatment arterial hypertension is aimed at eliminating or reducing the action of risk factors that contribute to the progression of the disease and the development of complications. These activities are mandatory, regardless of the level of blood pressure, the number of risk factors and concomitant diseases.

Non-drug methods include:

• to give up smoking;
• normalization of body weight (body mass index< 25 кг/м 2);
• reduced consumption of alcoholic beverages< 30 г алкоголя в сутки у мужчин и 20 г/сут у женщин;
• increase physical activity- regular physical activity for 30-40 minutes. at least 4 times a week;
• reduction in salt intake to 5 g / day;
• a change in diet with an increase in the consumption of plant foods, a decrease in the consumption of vegetable fats, an increase in the diet of potassium, calcium contained in vegetables, fruits, grains, and magnesium contained in dairy products;

How to lower blood pressure without medication

A few simple exercises for the cervical spine will help normalize blood circulation and lower blood pressure if performed systematically. It is important to do such gymnastics slowly and smoothly, without sudden movements and neck tension. These are head turns to the right and left, forward and backward movements, alternate tilts to the shoulders, raising the arms above the head.

Gymnastics that effectively reduces blood pressure

pressure medication

Approximately half of patients with mild arterial hypertension (BP 140/90 - 159/99 mm Hg) can achieve the optimal level of blood pressure only with the help of non-drug correction of risk factors. In persons with more high level blood pressure non-drug treatment, carried out in parallel with taking antihypertensive drugs, can significantly reduce the dose of drugs and reduce the risk of side effects these medicines. Refusal to undertake non-drug lifestyle interventions is one of the most common causes of resistance to therapy.

Principles of drug therapy for arterial hypertension

Basic principles drug therapy arterial hypertension:

1. Drug treatment should be started with minimal doses of any class of antihypertensive drugs (taking into account the relevant contraindications), gradually increasing the dose until a good therapeutic effect is achieved.
2. The choice of drug must be justified; antihypertensive drug should provide a stable effect during the day and be well tolerated by patients.
3. It is most advisable to use long-acting drugs to achieve a 24-hour effect with a single dose. The use of such drugs provides a milder hypotensive effect with more intense protection of target organs.
4. With a low efficiency of monotherapy (therapy with a single drug), it is advisable to use optimal combinations of drugs to achieve the maximum hypotensive effect and minimal side effects.
5. Should be implemented long(almost lifelong) medication to maintain an optimal level of blood pressure and prevent complications of arterial hypertension.

Choice of necessary medicines:

Currently, seven classes of drugs are recommended for the treatment of arterial hypertension:

1. diuretics;
2. b-blockers;
3. calcium antagonists;
4. angiotensin-converting enzyme inhibitors;
5. angiotensin receptor blockers;

1. imidazoline receptor agonists;

Causes of resistance (refractoriness) of arterial hypertension to therapy

Refractory or treatment-resistant hypertension is called arterial hypertension, in which the prescribed treatment - lifestyle changes and rational combination therapy using adequate doses of at least three drugs, including diuretics, does not lead to a sufficient decrease in blood pressure.

The main causes of refractory hypertension:

• not identified secondary forms of arterial hypertension;
• lack of adherence to treatment;
• continued use of drugs that increase blood pressure;
• violation of recommendations for lifestyle changes: weight gain, alcohol abuse, continued smoking;
• volume overload due to the following reasons: inadequate diuretic therapy, progression of chronic renal failure, excessive consumption of salt;

Pseudo-resistance:

• isolated office arterial hypertension ("white coat hypertension");
• using a cuff of the wrong size when measuring blood pressure.

Cases of hospitalization in a hospital with arterial hypertension

Indications for hospitalization of patients with arterial hypertension are:

• ambiguity of the diagnosis and the need for special, often invasive, research methods to clarify the form of arterial hypertension;
• difficulties in the selection of drug therapy - frequent hypertensive crises, refractory arterial hypertension.

Indications for emergency hospitalization:

• Hypertensive crisis that does not stop at the prehospital stage;
• Hypertensive crisis with severe manifestations of hypertensive encephalopathy (nausea, vomiting, confusion);
• complications of hypertension requiring intensive care and constant medical supervision: cerebral stroke, subarachnoid hemorrhage, acute visual impairment, pulmonary edema, etc.

Emergency treatment for arterial hypertension

If the rise in blood pressure is accompanied by the following symptoms:

• severe retrosternal pain of a pressing nature (possibly unstable angina pectoris, acute myocardial infarction),
• increase in dyspnea, worsening in horizontal position(possibly acute heart failure),
• severe dizziness, nausea, vomiting, impaired speech or impaired mobility of the limbs (possibly acute cerebrovascular accident),
• blurred vision, double vision (possibly retinal thrombosis),

need to apply for urgent medical care for the implementation of an immediate (within minutes and hours) lowering blood pressure with the help of parenterally administered drugs (vasodilators, diuretics, ganglionic blockers, antipsychotics).

Note. Blood pressure should be reduced by 25% in the first 2 hours and up to 160/100 mmHg. over the next 2 to 6 hours. Do not lower blood pressure too quickly to avoid ischemia of the brain, kidneys and myocardium. At blood pressure > 180/120 mm Hg. it should be measured every 15 - 30 minutes.

Actions for a sharp increase in blood pressure:

A sharp increase in blood pressure, not accompanied by the appearance of symptoms from other organs, can be stopped by oral or sublingual (under the tongue) administration of drugs with a relatively rapid effect. These include

• Anaprilin (a group of β-blockers, usually if the rise in blood pressure is accompanied by tachycardia),
• Nifedipine (its analogues are Corinfar, Cordaflex, Cordipin) (a group of calcium antagonists),
• Captopril (a group of angiotensin-converting enzyme inhibitors),
• Clonidine (its analogue is Clofellin) and others.

Hypertension is a disease in which there is high blood pressure that does not change over time. Approximately 90% of patients suffering from this pathology are diagnosed with arterial essential hypertension.

Often, hypertension develops against the background of other ailments. In particular, high blood pressure is often observed in pregnant women. In addition, it develops due to long-term use of certain types of drugs or due to genetic changes. And today, about 25 combinations of genes are distinguished, which lead to a persistent increase in pressure in humans.

Causes

The reason why hypertension is often referred to as essential (a disease of unknown etiology) is that modern medicine cannot give an answer why persistent high blood pressure is formed. There are many theories that explain this problem. However, they are all invalid. Moreover, doctors, adhering to a certain theory, can "put" the patient on pills, treat the disease, but without achieving noticeable success.

Blood pressure rises due to various factors. For example, severe stress causes the walls of some blood vessels to tense up. As a result, the receptors located in them are irritated, which transmit excitation to the medulla oblongata. At the same time, depressor neurons are activated. They expand the walls of blood vessels, due to which the pressure is restored.

Such a system ensures the normal functioning of the whole organism. That is, in a healthy person, blood pressure rises for a short time.

It is believed that hypertension occurs due to the following factors:

Basically, the problem under consideration occurs with metabolic disorders, which is characterized by a sharp increase in the level of cholesterol in the blood. This disease is called metabolic syndrome. It occurs with an increase in weight, the number of certain fats (triglycerides), and other pathologies.

Symptoms

In hypertension, the clinical picture is usually unclear. Often patients are not even aware that they have such a problem. They live as if nothing is happening to them. Patients write off even rare attacks of nausea, dizziness, weakness as an accident and do not pay attention to them, since these symptoms quickly disappear on their own. Most often, hypertensive patients turn to a doctor when the disease has already affected the internal organs, disrupting their work.

The initial stages of hypertension are characterized by the following:

• headache;
• dizziness;
• noises in the head;
• decrease in working capacity;
• memory deterioration.

All this may indicate a decrease in the blood supply to the brain. These symptoms go away on their own over time. But later they are joined by:

• double vision;
• "flies" before the eyes;
• weakness;
• numbness of the limbs;
• speech difficulty.

Serious complications of hypertension that occur with a long course of the disease include heart attacks and strokes. In the early stages of the development of pathology during the study of the heart, an increase in the size of the left ventricle of the myocardium is detected.

It begins to grow due to the thickening of the walls of blood vessels. Later, if no measures are taken, the so-called hypertension of the heart occurs. With such a disease, atherosclerosis sometimes occurs, characterized by morphological changes that occur in the aorta: the latter begins to exfoliate. As a result, death occurs.

Most hallmark hypertension is a frequent headache. It occurs at different times of the day. Basically, the pain is localized in the occipital region. In some hypertensive patients, edema of the extremities is observed, which indicates heart failure or impaired renal function.

Hypertensive crisis

Among all diseases that affect the cardiovascular system, arterial hypertension is the most common. It occurs due to the narrowing of the arteries.

The arteries themselves are a kind of highway along which blood moves, delivering oxygen and nutrients to organs and tissues. The narrowing of the walls is observed quite often. However, a persistent process is diagnosed somewhat less frequently.

Narrowing occurs due to thickening of the walls of blood vessels. The heart has to work harder to deliver blood. As a result, there is a greater release of fluid into the vascular bed, which increases the overall pressure.

Unfortunately, hypertension is a chronic disease. Moreover, every tenth patient has a lesion of one or more internal organs. In the latter case, we are talking about the so-called symptomatic, or secondary, hypertension.

One of the most common complications of this pathology is hypertensive crisis. It is divided into two types.

The following symptoms are characteristic of the first stage of the disease:

• hypertrophic encephalopathy;
• acute left ventricular failure;
• eclampsia and other pathologies.

With a hypertensive crisis related to the first stage, it is necessary to urgently lower the level of blood pressure (BP). In some patients, there is an increase in the level of catecholamines in the blood.

The second stage of the crisis is characterized by:

• malignant arterial hypertension, in which complications are not observed;
• hypertension with high (more than 140 mm) diastolic pressure.

Blood pressure in such a crisis must be reduced within 12-24 hours.

Degrees and stages

During the diagnosis, the doctor needs to identify the current degree of hypertension and the stage of its development. This will allow you to create the most effective treatment. Moreover, the longer the disease develops, the more likely the malfunction of the internal organs.

Normal pressure readings look like this:

• systolic - below 130 mm;
• diastolic - below 85 mm.

Increased blood pressure is diagnosed at 135-140 and 90-95 mm, respectively.

For the first degree of the disease, both indicators are 140-160 and 90-100 mm. The second degree of hypertension is indicated by systolic pressure, which is at the level of 160-180 mm, and diastolic - 100-110 mm. Severe disease is characterized by the following indicators: more than 180 mm and 110 mm.

At the first stage of development, hypertension often resolves on its own without external influence. If you measure the pressure now, the device will show no more than 160/10 mm. The pressure level is normalized in about 1-2 weeks. Clinical picture at the first stage it has a mild character or the symptoms do not manifest themselves in any way. In some cases, patients suffer from mild headache and weakness.

In the second stage, systolic pressure rises to 180 mm. At the same time, diastolic blood pressure remains at 100 mm. Now the patient has shortness of breath, dizziness, frequent headaches, problems with falling asleep. Possible angina pectoris.

When contacting a doctor, a specialist during the examination reveals:

• narrowing of the artery located in the retina;
• left ventricular hypertrophy.

Protein is found in urine tests, and an increased content of creatine is found in the blood.

When the second stage of the pathology is detected, it is necessary to start its treatment as early as possible, since heart attacks and strokes are among the complications of the disease.

In the third stage, diastolic pressure rises to a level of 110 mm. Systolic blood pressure remains unchanged. At this stage, the patient is determined:

In addition, the third stage is characterized by the symptoms described above. Treatment must be carried out immediately, since against the background of pathology, kidney and liver failure develop, in most cases heart attacks or strokes occur.

Therapy

Treatment of hypertension is carried out through two methods:

• with the use of drugs;
• without the use of medicines.

Therapy begins with the elimination of concomitant diseases that caused an increase in blood pressure. The same goals are pursued by the treatment of AD both with and without medication. In addition, taking appropriate medications contributes to the expansion of the walls of blood vessels. In the early stages of the development of the disease, certain medications are often prescribed. In the future, if the therapy did not have the desired effect, they resort to combined treatment.

Medications used to treat hypertension include:

Hypertension should be treated only after consulting a doctor and with the direct participation of a specialist. Without making an accurate diagnosis, identifying concomitant diseases and determining other indicators, it is impossible to prescribe effective therapy. High blood pressure is a sign of serious disorders in the body. Self-medication in this case will only harm the patient's condition.

Non-drug methods of therapy include adherence to a certain diet, from which salt is excluded. Also, patients are advised to relax more, spend time in the fresh air. In addition, it is necessary to give up bad habits and protect yourself from stressful situations. If these methods do not restore normal blood pressure (provided that hypertension is in the first stage), then resort to drug therapy.

Only with constant interaction between the doctor and the patient can significant progress be made in the treatment of hypertension. In particular, this approach allows you to normalize the work of the heart, reduce the level of cholesterol in the blood, improve the patient's condition.

Diet

An important component effective therapy pathology is diet. It ensures the satisfaction of the needs of the human body in vitamins and minerals, while protecting against the ingress of harmful and carcinogenic substances.

The functions of the cardiovascular system are strongly interconnected with the work of the digestive organs. Therefore, dieting always has a positive effect on the heart and blood vessels. For example, when overeating, the stomach expands in size, putting pressure on the diaphragm. Because of this, the heart cannot function normally, resulting in a decrease in the volume of blood produced.

Abundant salt intake leads to the fact that water begins to actively accumulate in the tissues of the body, which causes swelling of the hands and feet.

The basic principles of the diet:

The diet for hypertension requires limiting the following:

Nutritionists advise checking the calorie content of each product included in the daily diet. It is necessary to spend the so-called fasting days, during which you need to eat only a certain product (apples, kefir, meat or something else). In any case, a doctor should prescribe a diet, since even a diet that is suitable in terms of personal preferences can seriously harm the body.

The following elements play an important role in the treatment of hypertension:

In order to treat hypertension, bee venom is also used. It not only has a strong diuretic effect, but also dilates blood vessels, like magnesium, thereby reducing the likelihood of spasms. It is recommended to use poison no more than twice a week.

Royal jelly and propolis are natural antioxidants. Regular intake of these substances contributes to the active cleansing of the body of harmful trace elements and toxins. Also, royal jelly with propolis has a tonic effect, simultaneously creating a reliable psychological barrier against stress.

For the treatment of hypertension, you can take the fruits of chokeberry. And it doesn’t matter what condition they will be in: juice, fruit drink, compote and the like. Fruits should be consumed three times a day before meals.

Content

High blood pressure (BP) or hypertension, as a rule, affects pensioners, although recently the disease has begun to appear more and more among young people. At the same time, people are often unaware of a serious problem, many attribute headaches to poor sleep or bad weather. Left untreated, high blood pressure can lead to stroke and heart attack. Therefore, for the timely detection of the disease, it is necessary to study in detail the main causes of hypertension.

What is hypertension

Arterial hypertension(AH), essential hypertension or hypertension is a serious chronic disease characterized by a persistent increase in blood pressure (with systolic upper pressure above 140 mmHg and diastolic lower pressure above 90 mmHg). Hypertension is the most common disease of the cardiovascular system. An increase in blood pressure in the vessels occurs due to the narrowing of the arteries and their small branches - arterioles.

The value of blood pressure depends on peripheral resistance, vascular elasticity. When the receptors of the hypothalamus are irritated, renin-angiotensin-aldosterone hormones begin to be produced in greater quantities, which cause spasms of microvessels and arteries, thickening of their walls, and an increase in blood viscosity. This leads to the appearance of arterial hypertension, which eventually becomes irreversible, stable. There are two forms of high pressure:

1. Essential (primary). It accounts for 95% of cases of hypertension. The reason for the appearance of this form is a combination of different factors (heredity, poor ecology, overweight).
2. Secondary. It accounts for 5% of cases of hypertension. High blood pressure in this form is caused by disturbances in the functioning of the body (disease of the kidneys, liver, heart).

The initial stage of the disease or its latent course can be suspected if a person has:

• memory impairment;
• headache;
• unmotivated feeling of anxiety;
• chilliness;
• hyperhidrosis (excessive sweating);
• small spots before the eyes;
• numbness of the fingers;
• hyperemia (redness) of the skin of the facial area;
• cardiopalmus;
• irritability;
• low performance;
• puffiness of the face in the morning.

Causes of hypertension

During normal functioning of the body, the heart drives the blood through all the vessels, delivering nutrients and oxygen to the cells. If the arteries lose their elasticity or become clogged, the heart begins to work harder, the tone of the vessels increases and their diameter narrows, which leads to high pressure. The onset of hypertension is due to disorders of the autonomic and central nervous system, which are closely related to emotions. Therefore, when a person is nervous, his pressure often begins to rise.

After 60 years, the development of arterial hypertension is associated with the appearance of atherosclerosis ( chronic disease arteries) when cholesterol plaques block normal blood flow. In this case, the patient's upper pressure can rise to 170 mm Hg. Art., and the bottom to remain less than 90 mm Hg. Art. Also, many physicians common causes arterial hypertension:

• circulatory disorders of all vital organs;
• psycho-emotional overstrain;
• spasm of the muscles of the cervical vertebrae;
• genetic pathology;
• decrease in elasticity, thickening of blood vessels;
• hypokinesia (sedentary lifestyle);
• hormonal changes;
• diseases of internal organs (liver, kidneys).
• excess salt intake;
• bad habits.

In men

The appearance of hypertension, as a rule, affects men aged 35 to 50 years. High blood pressure is diagnosed in patients who already have a stable form of the disease. This is due to the fact that men ignore the first signs of the disease. Often the reasons for the appearance of high blood pressure in a strong half of humanity are provoked by their work. The disease affects those people whose activities are associated with heavy physical and mental stress. Responsible employees suffer from illness, for whom any mistake is always a strong stress. Other causes of hypertension in men:

• smoking, alcohol abuse;
• sedentary lifestyle;
• non-compliance with the rules of nutrition (fast food, sweets);
• kidney disease (glomerulonephritis, pyelonephritis, urolithiasis);
• taking medications (remedies for colds, runny nose, sleeping pills or hormonal medications);
• neglect of physical activity;
• vascular problems (atherosclerosis);
• traumatization of the central nervous system (CNS).

Among women

The symptoms of arterial hypertension in women and men do not differ much (shortness of breath, headache, tinnitus, dizziness), but the weaker sex is much more likely to experience such an ailment. The causes of hypertension in women may differ from those in men, and this is due to hormones. There are even forms of the disease that stronger sex not typical at all - this is hypertension during menopause and pregnancy.

As a rule, in women, hypertension is diagnosed during menopause (after 45-50 years). The body at this time undergoes significant changes: the amount of estrogen produced begins to decrease. In addition, the causes of hypertension in women may be the following:

• taking contraceptives;
• stress, overload;
• insufficient amount of potassium in the body;
• physical inactivity (a sedentary lifestyle);
• excess body weight;
• poor nutrition;
• childbirth;
• bad habits (alcoholism, smoking);
• diabetes;
• failure of cholesterol metabolism;
• pathology of the kidneys, adrenal glands;
• vascular diseases;
• obstructive sleep apnea syndrome (stop breathing).

In young age

Hypertension is rarely seen in people under 25 years of age. Often, an increase in blood pressure at a young age is associated with neurocirculatory dystonia (a complex of disorders of the cardiovascular system), when only upper pressure changes. The cause of these violations in children can be a large load during school hours. In almost all cases, high blood pressure in a child is a consequence of pathology. endocrine system, i.e. childhood hypertension is usually secondary. Developing arterial hypertension at a young age may have other causes:

• hereditary factor;
• overeating, eating too much salt;
• weather;
• diseases of the spinal column.
• electromagnetic, sound radiation;
• nervous strain;
• kidney pathology;
• taking medications that affect the state of blood pressure;
• overweight;
• lack of potassium in the body.
• non-compliance with sleep patterns.

Reasons for the development of hypertension

The occurrence of hypertension in 90% of patients is associated with cardiovascular problems (atherosclerosis, diseased heart etc.). The remaining 10% are symptomatic hypertension, i.e. high blood pressure is a sign of another disease (inflammation of the kidneys, tumors of the adrenal glands, narrowing of the renal arteries), hormonal failure, diabetes, traumatic brain injury, stress. Risk factors for the development of hypertension are classified according to two indicators:

• Immutable. Causes that a person cannot influence. This includes:

1. Heredity. Arterial hypertension is considered a disease transmitted through genes. Therefore, if there were patients with hypertension in the family, it is likely that the disease will appear in the next generation.
2. physiological factor. Middle-aged men are more susceptible to the disease than the fairer sex. This is explained by the fact that in the period from 20 to 50 years, a woman's body produces more sex hormones that perform a protective function.

• Changeable. Factors that depend on the person, his lifestyle and decisions:
  • passive lifestyle;
  • excess weight;
  • stress;
  • bad habits;
  • insomnia;
  • the use of large amounts of caffeine, salt, cholesterol;
  • taking medications;
  • weight lifting;
  • weather fluctuation.

Heredity

One of the factors predisposing to arterial hypertension is heredity. It can be anatomical features that are passed down through the genes. They are expressed in the difficulty of blood flow, which affects the increase in blood pressure. The presence of hypertension in relatives of the first link (mother, father, grandmother, grandfather, siblings) means a high probability of developing the disease. The risk of the onset of the disease increases if high blood pressure was observed in several relatives at once.

As a rule, not hypertension itself is genetically inherited, but only a predisposition to it, this is due to neuropsychic reactions and metabolic characteristics (carbohydrates, fats). Often the realization of a tendency to pathology is inherited due to external influences: nutrition, living conditions, adverse climatic factors.

Diseases

Cardiovascular diseases (heart disease, ischemia) can provoke high blood pressure. With these ailments, the lumen of the aorta is partially narrowed - which means that the pressure increases. Vascular defects in polyarthritis nodosa also contribute to the increase in blood pressure. Diabetes- Another reason for the appearance of arterial hypertension. The presence of atherosclerotic plaques narrows the lumen of the vessels, which is an obstacle to normal blood circulation. The heart begins to work in an enhanced mode, creating increased pressure. Diseases that can provoke hypertension:

• kidney inflammation;
• pathology lymphatic system and liver;
• cervical osteochondrosis;
• violation of the pancreas and thyroid gland;
• arterial sclerosis;
• vegetative-vascular dystonia;
• adrenal tumor;
• traumatic brain injury;
• narrowing of the renal arteries.

Hormonal changes

Violations of the endocrine organs (thyroid gland, hypothalamus, pancreas, adrenal glands) are common causes of high blood pressure. Data pathological processes slow down the production of sex hormones and their effect on the lower cerebral appendage, especially for women during menopause. Serious causes of increased blood pressure, contributing to excessive synthesis of hormones, are the following diseases:

• Cushing's syndrome;
• thyrotoxicosis (hyperthyroidism) - an increase in thyroid function;
• neoplasms on the adrenal glands;
• acromegaly (impaired function of the anterior pituitary gland);
• pheochromocytoma (hormonal active tumor);
• Kohn's syndrome.

Age

Hypertension tends to be more common in the elderly. This is due to the fact that over time, the arteries lose their elasticity, and this has a great impact on pressure. In addition, in people after 40 years, metabolic processes slow down, against the background of the consumption of a large amount of high-calorie food and the wrong attitude to food, obesity develops, and then hypertension.

Today, such a cause of the disease as age has changed. The disease is noticeably younger, about 10% of adolescents are prone to pathology, and as they grow older, the percentage only increases. Every third person over 40 suffers from high blood pressure. Indeed, in addition to the natural decline in the body's resistance, the influence of heredity, the way of life changes with age.

Lifestyle

Another cause of hypertension is the lack of physical activity. Sport has a beneficial effect on blood circulation and the body as a whole, but not many people decide to start an active lifestyle in order to protect themselves from the development of hypertension. Absence exercise causes obesity and overweight and, as a result, increased blood pressure.

Hypokinesia is a common disease of our time, when a person moves little, and this leads to disruption of the blood vessels. Unhealthy diet, bad habits, unhealthy lifestyle provoke high blood pressure, as weakening muscle tissue and the spine reduces vascular tone, which is necessary for good blood circulation. Working at a computer also increases the risk of the disease.

Nutrition

The next factor contributing to the appearance of high blood pressure is poor nutrition. Salty, sweet, fried, spicy, smoked and fatty foods often provoke an unplanned rise in pressure. After all, it takes a certain amount of time for the kidneys to remove excess sodium from the body. Until this happens, excess salt retains water, which causes swelling in people suffering from hypertension.

Potassium deficiency can increase blood pressure. This element helps blood vessels to relax, and the body to get rid of sodium. There is a lot of potassium in tomatoes, dairy products, cocoa, potatoes, legumes, parsley, prunes, melon, bananas, green vegetables, sunflower seeds. These foods should be included in your daily diet. It is necessary to refuse fat, fatty meat and smoked meats, because. they lead to excess weight and often high blood pressure that accompanies it. In addition, the following foods are harmful to the body:

• butter;
• canned food;
• offal;
• fat sour cream, cream;
• spicy seasonings;
• flour products;
• tonic drinks with caffeine;
• sweet carbonated drinks.

Bad habits

A high dose of alcohol and the hangover caused by this negatively affects the state of health. Regular and excessive drinking of alcoholic beverages can increase the heartbeat, dramatically increase blood pressure, cause a heart attack. Smoking is also bad for blood pressure. Nicotine contributes to increased heart rate, rapid wear of the heart, which leads to the development coronary disease and atherosclerosis.

Tobacco and alcoholic beverages have a negative effect on the entire body. When smoking and drinking alcohol, first expansion occurs, and then a sharp contraction of blood vessels, as a result of which their spasm is created and blood flow worsens. Hence the increase in blood pressure. In addition, chemicals found in cigarettes can disrupt the elasticity of blood vessel walls and form plaques that clog arteries.

Excess weight

A common cause of hypertension is obesity and overweight. Excess weight occurs due to a sedentary lifestyle, metabolic disorders, abundant intake of food high in fat, carbohydrates, salt. Obese people are always at risk, because their high blood pressure increases along with the load on blood vessels and the heart.

In addition, obesity raises blood cholesterol, which can lead to diabetes. Overweight patients are 3 times more likely to suffer from hypertension than people with normal body weight. An obese person is more prone to atherosclerosis, which is an additional factor in the appearance of high blood pressure. Losing even 5 kg of weight will noticeably lower blood pressure and improve blood sugar levels.

Ecology

Many people react painfully to changes in the weather, i.e. they are weather dependent. Even quite healthy man, which is rarely outdoors and leads a sedentary lifestyle, can be sensitive to changes in the weather. As a rule, meteocrises in people suffering from hypertension appear in unusual climatic and landscape conditions, so you should prepare a first-aid kit before traveling.

The bad ecology of the city also seriously increases blood pressure, causing harm cardiovascular system and developing hypertension. Even short exposure harmful substances, which a person inhales every day, in 3 months can provoke the development of hypertension. Three common pollutants in all modern cities - nitrogen dioxide, ozone, sulfur dioxide - negatively affect blood pressure and vascular function.

stress

Neuro-emotional overstrain (stress, nervous breakdown, excessive emotionality) is the most common cause of exacerbation of hypertension. Any negative unexpressed and suppressed emotions are dangerous for human health. A long experience of stress is a constant tension that wears out blood vessels and the heart faster than it would in a calm environment. The consequence of a nervous breakdown is often an increase in blood pressure and a hypertensive crisis. Especially harmful stress in combination with alcohol and smoking, because. this combination dramatically increases blood pressure.

As a rule, in a person with hypertension, the pressure rises and lasts longer, even with slight emotional stress. Gradually, with repeated increases in blood pressure, which can last for many months, the apparatus responsible for regulating blood pressure gets used to the load, and blood pressure is slowly fixed at a certain level.