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Hypertensive disease

blood pressure measurement for hypertension

Hypertension is a chronic disease characterized by persistently high blood pressure as a result of blood circulation disorders in the human body. Also, terms such as arterial hypertension and hypertension are used to refer to this condition.

Medical statistics show that hypertension is one of the most common diseases today. It usually starts to progress in people after age 40, but there is a risk of developing it at any age. Thus, more and more often, the disease began to be detected in able-bodied patients. It should be noted that representatives of the fairer sex suffer several times more than men. However, hypertension is more severe in men, because they are more prone to the development of atherosclerosis of blood vessels.

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

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

Etiology

The main reason for the progression of hypertension is the increased activity of the sympathetic-adrenal system. The vasomotor center is located in the human medulla oblongata. Certain impulses from it go along the nerve fibers to the walls of the vessels and cause 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 negative factors.

Exogenous risk factors:

  • severe nervous tension is the most common reason for the development of arterial hypertension;
  • hypodynamia;
  • irrational nutrition. Not complying with the diet and eating a lot of fatty and fried foods;
  • excessive consumption of alcoholic beverages;
  • to smoke;
  • drug use.

Endogenous risk factors:

  • burdened heredity;
  • obesity;
  • atherosclerosis of the coronary arteries of the heart;
  • increased blood viscosity (the heart cannot fully distill it through the veins);
  • kidney diseases such as nephritis, glomerulonephritis, pyelonephritis;
  • metabolic disorder;
  • presence of endocrine pathologies;
  • increased concentration of calcium in the blood;
  • the effect of adrenaline on the heart in stressful situations;
  • increased sodium concentration in the blood.

Classification

During the entire period of studying the disease, scientists have developed more than one classification of hypertension - according to the appearance of the patient, according to etiology, the level of pressure increase, the nature of the course, etc. Some have been obsolete for a long time, while others, on the contrary, are used more often.

Degrees of hypertension (by pressure level):

  • optimal - indicators 120/80;
  • normal - upper from 120 to 129, lower - from 80 to 84;
  • normal increased - upper indicators - from 130 to 139, lower ones - from 85 to 89;
  • 1st degree hypertension - SD from 140 to 159, DD - from 90 to 99;
  • 2nd degree hypertension - systolic pressure increases to 160-179, and diastolic to 100-109;
  • 3rd degree hypertension - systolic pressure rises above 140 and diastolic above 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 is constantly rising. The target's major organs are affected. During the examination, it can be noted that damage to the heart, undereye veins, kidneys;
  • Stage 3 or sclerotic. This stage of hypertension is characterized not only by a critical increase in DM and DD, but also by obvious sclerotic changes in the blood vessels of the kidneys, heart, brain, and eyeball. Dangerous complications develop - stroke, coronary artery disease, angioretinopathy, heart attack, etc.

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

  • kidney shape;
  • heart shape;
  • brain shape;
  • mixed.

Types of hypertension:

  • good and slow flowing. In this case, the symptoms of the development of the pathology may appear gradually over the course of 20 years. Both exacerbation and remission stages are observed. The risk of complications is minimal (with timely therapy);
  • malignant. The pressure rises sharply. This form of hypertension is practically not suitable for treatment. As a rule, the pathology is accompanied by various kidney diseases.

It should be noted that hypertensive crises often occur in patients with 2nd and 3rd degree hypertension. This is an extremely dangerous situation not only for human health, but also for life. Clinicians distinguish the following types of crises:

  • neurovegetative. The patient is hyperactive and very excitable. Such symptoms of hypertension manifest themselves: hyperhidrosis, tremor of the upper limbs, tachycardia and copious urination;
  • hydropic. In this case, the patient becomes drowsy and his reactions are inhibited. There is muscle weakness, swelling of the face and hands, a decrease in diuresis, a continuous increase in blood pressure;
  • convulsive. This option is the most dangerous, because the risk of developing dangerous complications is high. It should be noted that it is the least common. It is characterized by such symptoms as: convulsions and loss of consciousness. Complication - bleeding in the brain.

Symptoms

Symptoms of the disease directly depend on the stage of hypertension 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 strength. At this stage, signs of the presence of pathology may not be present at all. Sometimes patients begin to complain of heartache, nervousness, headache, tachycardia, heaviness in the back of the head. SD and DD are increased, but they can be easily normalized.

sclerotic

The indicated clinical picture is completed by the following symptoms:

  • increased headache;
  • dizziness;
  • sensation of rush of blood to the head;
  • bad sleep;
  • periodic numbness of the fingers in the extremities;
  • rapid fatigue;
  • "flies" before the eyes;
  • persistent increase in blood pressure.

It should be noted that this stage can develop over several years, and at the same time, patients will be active and mobile. However, disruption of blood supply to certain organs causes disruption of their activity.

the end

Usually, at this stage, doctors detect kidney and heart failure, as well as impaired 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 the heart form, the patient gradually passes to heart failure. Shortness of breath, pain in the projection of the heart, hepatomegaly, edema appear. With the shape of a person's brain, severe headaches and visual disturbances are disturbing.

Hypertension and childbirth

Hypertension during pregnancy is the most common cause of preterm birth or perinatal death of the fetus. Usually, a woman's hypertension already exists before the start of pregnancy, and then it simply becomes active, because giving birth is a kind of stress for the body.

Given the high risk for the mother and the unborn child, it is important to accurately determine the degree of this risk in order to decide on the issue of subsequent pregnancy or termination of pregnancy in case of a diagnosis of a disease. Doctors distinguish three degrees of risk (according to the stage of arterial hypertension):

  • 1 degree risk - complications of pregnancy are minimal, crises rarely develop. Possible angina. In this case, pregnancy is allowed;
  • 2 degree of risk - expressed. Complications develop in 20-50% of cases. A pregnant woman has hypertensive crises, insufficiency of the coronary vessels of the heart, high blood pressure. Termination of pregnancy is indicated;
  • 3 degrees of risk. Pregnancy complications occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Perhaps placental abruption, uremia, blood circulation in the brain. The pregnancy poses a threat to the mother's life, so it is terminated.

Patients who become pregnant should visit the doctor once a week to monitor their condition. Mandatory treatment of hypertension. The use of such antihypertensive drugs is allowed:

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

Also, doctors refer to physiotherapy to treat the disease during pregnancy.

Diagnostics

When the first signs of the disease appear, it is important to immediately contact a medical institution to confirm or deny the diagnosis. The sooner this is done, the lower the risk of developing dangerous complications (damage to the heart, kidneys, brain). During the initial examination, the doctor must measure the pressure of both hands. If the patient is elderly, measurements are also taken standing. During the diagnosis, it is important to clarify the real reason for the development of the pathology.

A comprehensive plan for diagnosing hypertension includes:

  • anamnesis collection;
  • SMAD;
  • urinalysis;
  • blood biochemistry;
  • determining the level of bad cholesterol in the blood;
  • x-ray;
  • ECG;
  • examination of the fundus;
  • ultrasound.

Treatment

Treatment of hypertension is carried out in the hospital so that doctors can constantly monitor the patient's condition and, if necessary, adjust the treatment plan. It is important to normalize the daily routine of the patient, correct his weight, limit the use of table salt and completely give up bad habits.

The following drugs are prescribed to correct the pressure:

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

All 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, it is important to follow a special diet in addition to taking medication. Table number 10 is given to the patient with hypertension. The principles of such a diet:

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

Diet restriction for this pathology involves:

  • Sahara;
  • bread;
  • potato;
  • pasta;
  • cereal bowls;
  • eggs;
  • animal fats;
  • oil;
  • sour cream etc.

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

  • honey;
  • plum;
  • vinegar;
  • jam;
  • cranberry
  • lemon.

The diet is indicated not only during treatment, but also after it in order not to worsen the condition. It should be noted that the diet is prepared strictly individually for each patient, taking into account the characteristics of his body. An important point - during the diet, you should consume no more than 1. 5 liters of liquid 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 flexible, you need to eat more vegetables and fruits and drink up to 2 liters of water a day. You can take vitamin preparations. Also, the prevention of hypertension involves the exclusion of smoking and alcohol consumption.

If possible, stress should be avoided, as it is one of the provoking factors of the disease. Prevention of hypertension should be carried out as early as possible to minimize the risk of developing the disease.