Hypertension is one of the most common cardiovascular diseases. According to WHO, more than 1. 1 billion people suffer from it. around the world. High blood pressure increases the risk of developing other heart diseases. Hypertension is among the leading causes of death, and the disease is rapidly aging. It happens not only in old people, but also in young people. Below you will learn why it appears, how to recognize and manage it.
What is hypertension?
It is a chronic condition of high blood pressure. It is recorded as two numbers and the optimal value is 120/80 mmHg. Art. The first number is the systolic pressure, which occurs when blood is ejected from the left ventricle of the heart into the aorta during systole (contraction of the heart's ventricles). The second number shows the diastolic pressure when the heart muscle relaxes. Blood pressure increases during physical activity and emotional arousal, but its value should be close to normal during rest. If the systolic pressure is greater than 139 mmHg with multiple measurements at different times. Art. and/or diastolic blood pressure greater than 90 mmHg. Art. , hypertension was diagnosed.
A persistent increase in blood pressure is associated with several factors, including excess weight and lack of physical activity, poor diet, bad habits and high stress.
Causes and risk factors
Hypertension can be primary and secondary:
- essential (important)hypertension is more common - according to various estimates, in 85-95% of cases. Its appearance is not related to accompanying diseases, the pressure increases under the influence of a number of factors;
- secondary (symptomatic)hypertension occurs in 5-15%. In this case, high blood pressure is one of the symptoms that can be associated with endocrine disorders, kidney diseases and anomalies of large vessels.
When the regulation and maintenance of optimal blood pressure is disturbed, primary hypertension occurs. The reason for its occurrence is usually constant nervous tension. When making a diagnosis, it is important to determine as accurately as possible what causes hypertension, whether it has secondary causes (the presence of diseases that cause an increase in arterial pressure).
There are a number of risk factors that increase the chance of developing primary hypertension:
- overweight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drinking alcohol and smoking;
- stress, constant emotional tension;
- lack of sleep, its poor quality, insomnia;
- excessive salt intake;
- improper sleep and rest regime (including due to irregular or very long working hours);
- changes in hormonal levels (in women, it may be associated with the onset of menopause and taking oral contraceptives);
- hereditary factors (in total, more than 20 genes that determine the tendency to hypertension have been identified);
- Age over 65 years (the disease can also occur in young people; after 35 years, it is worth monitoring blood pressure periodically);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods high in trans fats and saturated fats);
- kidney disease, diabetes mellitus and some other related conditions and diseases.
Many of these factors are interrelated and mutually reinforcing. Some of them can be controlled (for example, diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is a simple way to reduce the risk of hypertension or improve your well-being if your blood pressure is already high.
Classification
Two approaches are used to classify the disease: according to degrees and stages. The degrees of hypertension differ in the values at which the blood pressure rises, the difference between the stages in the course of the disease, the number and severity of accompanying organic lesions.
First degree
Systolic blood pressure - more than 139 and less than 159 mmHg. Art. , and diastolic is at the level of 90-99 mm Hg. Art. With high values, blood pressure can be normalized by adjusting your lifestyle. For this, you need to increase physical activity, adjust your diet, give up bad habits, and reduce stress.
Second degree
In the second degree, blood pressure values increase and are 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastolic. With such values, the load on the heart increases a lot. Blood supply to the brain is impaired, which can lead to headaches and dizziness and reduced performance. There are changes in the bottom of the eye. Sclerosis of the tissues and vessels of the kidneys begins, excretory function is disturbed, kidney failure may develop. The condition of the blood vessels worsens. For treatment, you need to change your lifestyle and start taking medicine.
Third degree
Systolic pressure value is above 180 mm Hg. Art. , diastolic - above 110 mm Hg. Art. With hypertension, the load on the heart is very high and causes irreversible changes. Blood pressure should always be lowered with medication. Without it, there is a danger of acute heart failure, arrhythmia, angina pectoris, myocardial infarction and other serious conditions. Patients with the 3rd stage of hypertension should be under constant medical supervision. Continuous use of drugs that lower blood pressure is necessary.
| Arterial pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Good | < 130 | 85 |
| Normally, the so-called prehypertension | 130–139 | 85–89 |
| 1 - mild hypertension | 140–159 | 90–99 |
| 2 - the average degree of hypertension | 160–179 | 100–109 |
| 3 - severe hypertension | ≥ 180 | ≥ 110 |
Stages of hypertension
The disease develops gradually. There are three stages in total.
- First stage:moderate hypertension. Blood pressure is unstable and can change throughout the day. At this stage, the condition of the internal organs and the central nervous system remains normal, there are no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
- Second stage:severe hypertension. In the second stage, there is a significant increase in blood pressure, health often deteriorates, and hypertensive crises are aggravated. At this stage, changes in internal organs begin due to constant high pressure. Vascular disorders occur and blood supply to the brain deteriorates. Retinal arteries narrow. Hypertrophy of the left ventricle of the heart develops, which increases the risk of serious heart pathologies. Signs of kidney dysfunction appear (increased level of albumin in urine, increased level of creatinine in blood serum)
- The third stage:very severe hypertension. Blood pressure becomes critically high - above 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions intensify, heart failure, thrombosis of cerebral vessels, aneurysms, kidney failure and other serious conditions develop. Severe hypertensive crises occur frequently.
Symptoms
Even with a significant increase in blood pressure, hypertension may not show any symptoms for a long time. For this reason, you should measure your blood pressure periodically (monitoring is especially important for those over 35). You can measure your blood pressure with an automatic electronic tonometer - such devices are sold in pharmacies.
The main symptoms of hypertension include headache, dizziness and heaviness in the head. These manifestations are associated with vasospasm and deterioration of blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, cardiac arrhythmias. In severe cases of hypertension, weakness, chest pain, nausea, vomiting, and tremors ("shaky" muscles) may appear. Other symptoms include blurred or black spots before the eyes, trouble sleeping, palpitations, and tinnitus.
As the disease progresses, the visual acuity gradually decreases, the sensitivity of the arms or legs may decrease, and in severe cases, paralysis may occur. Symptoms may increase during periods of stress, nervous tension or physical activity. More often they appear in middle-aged and elderly people. If you are overweight, have bad habits, tend to overeat or have a high level of stress, the disease is more severe.
If you regularly experience headaches, dizziness or vision problems, or if your blood pressure is often high when you take it yourself, you should see a therapist or cardiologist.
Diagnostics
Typically, the diagnosis is made in three directions:
- blood pressure measurement.To determine the degree of hypertension and its stage, it is carried out at intervals of several hours or more than 2-3 days;
- to determine the causes of the disease.It is important to determine whether hypertension is primary or secondary (caused by other diseases). In the second case, special treatment may be required;
- general health monitoring.During the examination, the condition of the heart, cerebral vessels, fundus of the eyes, and kidneys is monitored. Due to high blood pressure, the activity of these organs is disturbed. It is important to assess their condition when making a diagnosis.
At the first appointment, the doctor will conduct a questionnaire and collect medical history details relevant to the disease. How long the patient has suffered from hypertension, what is the blood pressure level, whether there are signs of heart disease, apnea, severe snoring, whether the person or close relatives have had a stroke, peripheral arterial diseases, gout, diabetes, kidney disease. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, taking medications.
The following examinations are performed for patients with arterial hypertension:
- blood pressure measurement.It is measured several times during rest (physical activity, caffeine consumption, smoking half an hour before the measurement are excluded), measurements are taken at different times of the day;
- general examination:height and weight, measurement of waist circumference, palpation of the abdomen, assessment of pulsation of peripheral arteries;
- Urinalysis.Albumin and creatinine levels are important - deviations from the norm indicate impaired kidney function and require ultrasound;
- blood testAn ultrasound of the kidneys is prescribed to monitor the level of potassium, creatinine, and lipids. Assessment of lipid levels is necessary to monitor lipid metabolism to eliminate the risk of complications from the cardiovascular system;
- EKGIt is performed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiac or neurological examination or an examination of the respiratory system.
Treatment of hypertension
Arterial hypertension is a disease that cannot be completely cured, but can be controlled. Therapy and lifestyle changes can stop the progression of hypertension, reduce the frequency and severity of attacks, and relieve symptoms. But the most important thing is to reduce the risks for the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle changes:
- to give up smoking;
- refuse to drink alcohol or significantly limit the amount of alcohol;
- diet: the diet is regulated, salt intake is reduced (less than 3. 75 g per day), the amount of vegetables and fruits is increased (ideally, 5 servings per day are needed), whole grains, dairy products, low-fat products and calorie intake are limited. If there are no contraindications or kidney diseases, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt, etc. );
- increased physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is lowered to target values (below 130/80 mmHg) to reduce the risk of complications. With such a decrease, constant monitoring by a doctor is required. A tonometer used for home measurements should be calibrated regularly. The use of antihypertensive drugs for diabetic patients, pregnant women, the elderly and debilitated people requires special attention.
The following can be used to treat hypertension:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and lower blood pressure, but can cause drowsiness and lethargy, and therefore are rarely used;
- ACE inhibitors.Reduce peripheral vascular resistance, which is often prescribed to patients with diabetes;
- angiotensin II receptor blockers.They have a similar effect to ACE inhibitors and therefore are not prescribed together with them. It is not prescribed during pregnancy;
- beta blockers.Lowering blood pressure by slowing the heart rate;
- calcium channel blockers.They reduce total peripheral vascular resistance and can cause reflex tachycardia;
- direct vasodilators.They have a direct effect on blood vessels and are used for severe hypertension;
- diuretics.They reduce the volume of blood plasma, which reduces blood pressure, but can also cause hyperkalemia.
It is important!The therapist or cardiologist should prescribe the drugs and their doses after the examination. Taking medicine without a doctor's prescription can be dangerous.
If your doctor prescribes medication, you should undergo periodic re-examinations to assess the effectiveness of the treatment and adjust it. It is important to adjust your lifestyle and restore normal health so that the minimum amount of medication is required to control the progression of hypertension.
Possible complications
Due to the increased blood pressure, the walls of the vessels lose their elasticity and the heart muscle works hard. This increases the risk of angina, acute heart failure and heart attack. Transient ischemic attacks and strokes are possible due to impaired blood supply to the brain. Without treatment and lifestyle correction, the severity of hypertension will increase: the pressure will continue to rise, which will cause damage to internal organs and deterioration of general health and well-being. Smoking, drinking alcohol, overeating, lack of physical activity and high stress accelerate the development of hypertension and make its course more complicated.
Results
Without treatment, arterial hypertension leads to serious consequences. Constant spasm of cerebral vessels causes ischemia and stroke. They are dangerous with severe disability and even death. When the load on the heart muscle increases too much, tachycardia, arrhythmia, heart failure occur. Myocardial infarction is possible without treatment.
The severity of hypertensive crises increases, they become complicated, life-threatening and can be accompanied by stroke, acute coronary syndrome and other serious conditions. Without adequate therapy and the restoration of normal health, the quality of life on the background of hypertension is sharply reduced, even to severe disability.
Forecast
If the patient consults a doctor in time and takes measures to control the factors affecting pressure and hypertension, the prognosis is good. In this case, it is possible to avoid the long-term consequences of hypertension and its severe course. Even with severe arterial hypertension, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
To prevent hypertension, self-monitoring of blood pressure is recommended for those over 35 years of age or when symptoms of hypertension appear. It is important to eliminate the influence of factors that cause high blood pressure: control your diet, give up smoking and alcohol, reduce stress levels, devote more time to physical activity: in short, lead a healthy lifestyle.
The result
Hypertension is a dangerous disease, but it can be managed by maintaining normal health and reducing the risk of complications. For this, it is important to monitor the level of blood pressure, control weight, lead a healthy lifestyle, and undergo preventive examinations with a therapist or cardiologist.