In medicine, constant high blood pressure has several names: hypertension, arterial hypertension, essential hypertension.The disease can damage the kidneys, heart, blood vessels, cause stroke, heart attack, bleeding from stomach ulcer and other serious consequences.In order to prevent dangerous health conditions, it is necessary to take timely measures to prevent the disease and to know the risk factors that greatly increase the likelihood of hypertension.
What is hypertension?
This is a chronic pathology that develops as a result of dysfunction of vascular regulation, kidney and neurohumoral mechanisms.Hypertension (HTN) is a dangerous condition of the body in which there is a persistent increase in blood pressure (BP) with levels above 140/90 mmHg.Art.in patients not taking antihypertensive drugs.
Hypertension accounts for about 40% of all cardiovascular pathologies.The disease occurs more often in men than in women.The risk of developing pathology in both sexes increases with age.Hypertension is mainly diagnosed in patients after the age of 40, but recently, the disease is more often recorded in adolescents and young adults.
Stages of headache
Hypertension is a chronic pathology that has three stages of development.The optimal blood pressure in adults is 120/80 mmHg.Art.A slight deviation from these indicators up to 139/89 mm Hg.Art.also applies to the norm.In medical practice, higher numbers are considered pathological."Hypertension" is diagnosed when indicators above 140/90 are repeatedly recorded in different conditions.
Stage 1 hypertension is characterized by a sharp change in pressure.This indicates a pathological process already occurring in the body.In the early stages, the disease is almost always asymptomatic.The patient does not pay attention to some signs of hypertension, which explains the large percentage of late referrals for qualified help.Symptoms of hypertension in the 1st stage:
- blood pressure readings: from 140/90 to 159/99 mm Hg.Art.;
- headaches;
- confusion;
- decreased mental performance;
- shortness of breath;
- tachycardia;
- increased swelling;
- fluid retention in the body;
- change in the amount and color of urine.
Stage 2 hypertension is arterial hypertension that occurs in a mild form.At this stage of the disease, longer periods of arterial pressure are observed than at the beginning.In stage 2 hypertension, blood pressure indicators rarely normalize.Patient condition:
- blood pressure readings: from 160/109 to 179/109 mm Hg.Art.;
- sleep disorder;
- discomfort in the heart region;
- heart failure;
- memory and vision impairment;
- constant irritation;
- dizziness;
- tinnitus;
- aching pain in the back of the head;
- dilated eye vessels;
- facial skin is hyperemic;
- swelling of the face and hands.
Third stage hypertension is a severe form of the disease.It is characterized by the presence of myocardial infarction, stroke and other serious pathologies.It is rarely possible to completely cure hypertension at this stage, only if the high pressure lasts for a short time or is secondary.Severe hypertension clinic:
- blood pressure indicators: from 180/110 mm Hg.Art.and above;
- left ventricular hypertrophy;
- hypertrophy of the interventricular septum;
- violation of coordination of movements;
- encephalopathy;
- ischemic or hemorrhagic heart attacks;
- various kidney lesions;
- persistent visual impairment;
- long-term hypertensive crises;
- paralysis and paresis due to impaired cerebral circulation;
- limiting the ability to act independently and take care of oneself.
Risk factors for hypertension
The development, progression and complications of arterial hypertension are directly related to the presence of risk factors for the occurrence of this pathological process.Hypertension is the result of a complex interaction of internal (endogenous) and external (exogenous) causes.The occurrence of pathology is facilitated by acquired and congenital characteristics that weaken the body's resistance to negative external conditions.
Risk factors for the development of arterial hypertension are classified according to two indicators: modifiable and non-modifiable.First, it depends on a person's decisions and lifestyle.These include:
- bad habits;
- physical inactivity;
- smoking;
- drink alcohol;
- obesity etc.
Immutable risk factors for hypertension are factors that a person cannot influence: heredity and physiology (gender, age).In many cases, hypertension is a genetically transmitted disease.If one of your relatives suffers from hypertension, then there is a high probability that the next generation will get this disease.As for physiological factors, according to statistics, middle-aged men are more susceptible to the disease.This is explained by the fact that the female body produces estrogens - hormones that perform a protective function.
Endogenous
Intrinsic risk factors for hypertension are the presence of diseases or conditions that cause high blood pressure.Among them:
- diabetes mellitus;
- atherosclerosis of the coronary arteries of the heart;
- increased blood viscosity;
- metabolic disorder;
- kidney disease (pyelonephritis, nephritis, glomerulonephritis);
- increased concentration of sodium or calcium in the blood;
- effect of adrenaline during stress;
- dyslipidemia (fat metabolism disorder);
- increased uric acid;
- neurocirculatory dystonia;
- pregnancy;
- menopause
It is related to lifestyle and environmental influences
Exogenous risk factors for hypertension are associated with the patient's lifestyle.The number of earned causes that can fight success is significant, but each point can be easily fixed if a person wants to.The main exogenous risk factors for hypertension:
- Insufficient physical activity.Working in a permanent office, traveling only by means of transport, not having time to visit the gym leads to a weakening of the respiratory system, impaired muscle function, and poor blood circulation.All these factors cause an increase in blood pressure.
- Uncontrolled salt intake.A large amount of sodium chloride causes dehydration and delays the removal of fluid from the body.Water causes an increase in the volume of circulating blood, as a result of which the myocardium contracts more often, which leads to an increase in blood pressure.The rate of consumption of table salt does not exceed 5 g per day.
- Magnesium and/or potassium deficiency.The body needs these trace elements for the proper functioning of blood vessels and heart muscles.If they are missing, there is a risk of developing hypertension.
Diagnostics
Hypertension is determined by various methods - the level of blood pressure is measured several times using a tonometer and phonendoscope, the clinical picture of the disease is studied, clinical, physical and instrumental studies are prescribed.Main diagnostic approaches:
- Biochemical blood test.The level of high/low density lipoproteins and cholesterol is determined, and the level of sugar is determined.These indicators are important to determine the cause of high blood pressure.
- EKG.The electrocardiogram has long been a reliable assistant in the diagnosis of hypertension.The EKG detects interruptions in the work of the heart, determines the presence of angina, and provides information about the displacement of the heart from its electrical axis and the condition of the myocardium.
- Ultrasound of the heart.The main vessels leading to the brain (carotid arteries) are illuminated to detect atherosclerotic plaques, assess the condition of the vessel walls and the risk of stroke.
- Arteriography.X-ray method for studying the walls of arteries and their lumen.
- Dopplerography.Ultrasound technique for diagnosis of blood flow in veins, arteries and veins.
- Ultrasound of the kidneys.It helps to identify large tumors in the adrenal glands and kidney tissue damage, causes renoparenchymal hypertension.
- Ultrasound of the thyroid gland.It helps to determine or exclude the influence of the thyroid gland on the development of hypertension in a patient.
Treatment
Treatment of hypertension depends on the cause of the disease.The first thing the patient should do is to eliminate all the risks associated with hypertension.Then drug treatment is used in combination with non-drug methods: following an anti-cholesterol diet, physical activity, quitting smoking and drinking alcohol.Drug treatment is carried out according to different schemes:
- Patients with a low and moderate risk of developing hypertension are prescribed a drug to lower blood pressure.
- Patients with a high risk of cardiovascular pathologies are prescribed two or more drugs in individual doses.
The choice of drugs and dosage is made by the doctor taking into account the patient's age, accompanying pathologies and risk factors.Several groups of drugs are used to treat hypertension:
- Thiazide diuretics.They block the absorption of chlorides and sodium in the renal tubules, so that they do not enter the blood, but are excreted from the body in the urine.
- Calcium channel blockers.They reduce the intake of calcium, as a result, the load on the myocardium decreases and blood pressure decreases.
- ACE inhibitors.They reduce the concentration of angiotensin hormone in the blood, which has the ability to narrow the lumen of blood vessels, which increases blood pressure.
- Angiotensin II receptor antagonists.Reduces pressure in the first stage of hypertension.
- Beta blockers.They relax the vessel walls, which leads to improved blood circulation and normalization of blood pressure.
- Central alpha-2 agonists.The heart rate decreases, which is manifested by a decrease in blood pressure.
- Direct vasodilators.It relaxes the smooth muscles of the arterioles, which leads to a decrease in blood pressure.
- Renin inhibitors.They promote vasodilation and inhibit the activity of renin, an enzyme with a vasoconstrictor effect.