Arterial hypertension is a certain condition in which the blood pressure is continuously increased to 140/90 mm HG.Art.This pathology is found in 40% of the adult population and often occurs not only in the elderly, but also in adolescents, young adults and pregnant women.It has become a real "epidemic of the 21st century", and doctors in many countries call for regular blood pressure measurements starting from the age of 25.
According to statistics, only 20-30% of patients with arterial hypertension receive adequate therapy, and only 7% of men and only 7% of women monitor their blood pressure regularly.In the initial stages, arterial hypertension is asymptomatic, or it is discovered accidentally during an examination, or it is discovered accidentally when patients consult a doctor for the treatment of other diseases.This leads to the progression of pathology and significant deterioration of health.There are many patients who do not seek medical help or simply do not seek the doctor's advice or simply ignore the doctor's advice, or we do not receive permanent treatment for incorrect blood pressure to normal levels (not more than 130/80 mm HG): stroke, myocardial infarction, heart failure, etc.
Development mechanism and classification
An increase in blood pressure occurs due to the transport of the main vessels and arteries (small branches of arteries), complex hormonal and nervous processes.When the walls of the blood vessels narrow, the work of the heart increases and the patient develops essential (ie, primary) hypertension.This pathology occurs in 90% of patients.In the remaining 10%, hypertension is symptomatic (I.E., secondary) and caused by other diseases (generally cardiovascular).
Essential hypertension (or hypertension) does not develop as a result of damage to any organ.Subsequently, this leads to organ damage.
Secondary hypertension causes disturbances in the functioning of the systems and organs involved in blood pressure regulation, that is, an upward change in blood pressure is a symptom of the main disease.It is classified as:
- Kidney (parenmal and rebrascular):Congenital or acquired hydronephrosis, acute or chronic glomerulo- and pyelonephritis, pyelocystic kidney disease, radiation kidney disease, diabetic glomerulonephrosis, etc.;
- Hemodynamic (mechanical and cardiovascular):Aortic valve failure, complete atrioventricular block, aortic atherosclerosis, open aortic channels, aortic costation, Paget's disease, arteriovenous fistulas, etc.;
- Endocrine:Pheochromocytoma (a hormonally active tumor of the adrenal glands), Paragangliomas, Kohn's Syndrome, Acromegaly, Itsenko-Cushing's syndrome or disease, etc.;
- Neurogenic:spinal cord and brain, develop with hypercapnia (an increase in the amount of carbon dioxide in the blood) and acidosis (a change in the acid balance in the acid balance);
- Others:Pregnancy, Thallium and Lead Poisoning, Carcinoid syndrome (blood poisoning with excess hormones), porphyria (pigment metabolism), ether, overdose of catecholamines, overdose of hormonal contraceptives, hormonal contraceptives, foods with mao inhibitors.
According to the nature of the course, arterial hypertension can be:
- transient:An increase in blood pressure is observed sporadically, lasts from several hours to several days, and normalizes without the use of drugs;
- Labile:Blood pressure increases due to the influence of any provoking factor (physical or psycho-emotional stress), drugs are needed to stabilize the drug;
- Fixed:The patient has a constant increase in blood pressure, to normalize it, serious and constant therapy is required;
- Crisis:The patient experiences periodic hypertensive crises;
- Nisign:Blood pressure rises to high levels, the pathology progresses rapidly and can cause severe complications and death of the patient.
Arterial hypertension is classified according to severity:
- I degree: blood pressure rises to 140-159_90-99 mm Hg.Art.;
- Grade II: Blood pressure rises to 160-170 / 100-109 mm Hg.Art.;
- Grade III: Blood pressure rises to 180/110 mm Hg.Art.and higher.
With isolated systolic hypertension, only an increase in systolic pressure above 140 mmHg is typical.Art.This form of hypertension is more common in people over 50-60 years of age, and its treatment has its own characteristics.
Symptoms of arterial hypertension
Patients with arterial hypertension may experience headaches and dizziness.
For many years, patients may not be aware of the presence of arterial hypertension.Some of them, in the initial period of hypertension, note the episodes of weakness, dizziness and anxiety in the psycho-emotional state.With the development of stable or labile hypertension, the patient begins to complain:
- general weakness;
- fluttering of flying before the eyes;
- nausea;
- dizziness;
- throbbing headache;
- numbness and paresthesia in the limbs;
- shortness of breath;
- difficulty speaking;
- heart pain;
- swelling of limbs and face;
- Visual impairment, etc.
When examining the patient, lesions are revealed:
- Kidneys: uremia, polyuria, proteinuria, renal failure;
- Brain: Hypertensive encephalopathy, cerebrovascular accident;
- Heart: thickening of heart walls, left ventricular hypertrophy;
- Vessels: narrowing of the lumen of arteries and arterioles, atherosclerosis, aneurysms, aortic dissection;
- Fundus: hemorrhage, retinopathy, blindness.
Diagnosis and treatment
Patients with symptoms of arterial hypertension can have the following types of examinations:
- blood pressure measurement;
- General urine and blood tests;
- Biochemical blood test to determine the level of total cholesterol, lipoprotein cholesterol, creatinine, potassium, glucose and triglycerides;
- ECG;
- Echo-cg;
- fundus examination;
- Ultrasound of the kidneys and abdomen.
If necessary, the patient may be recommended to undergo an additional examination.After analyzing the obtained data, the doctor selects a drug treatment regimen and gives detailed recommendations to change the patient's lifestyle.