Classification of hypertension

For several years now, doctors have been sounding the alarm: in developed countries that have overcome the epidemic, arterial hypertension continues to occupy a leading position among the causes of death from cardiovascular diseases.In terms of the number of complications and unfavorable prognosis, it competes with diabetes mellitus.At the same time, this disease is rapidly rejuvenating.A few decades ago, a 35-year-old stroke patient was considered meaningless.Recently, such a case will not surprise anyone.

According to the World Health Organization, about a quarter of the world's population has arterial hypertension.Half of people over 65 years old have high blood pressure.

What kind of disease is this?

Hypertension refers to diseases of the cardiovascular system.Its presence causes persistently high blood pressure in the arteries of the circulatory system.

Pressing on the walls of blood vessels is itself a necessary, normal and necessary process for the movement of blood through them.During sleep, the pressure decreases slightly, and during stress or physical activity - on the contrary.

Standard blood pressure for young adults (can vary slightly from person to person) is 120/75 mmHg.Art.For people over 40 years old – 130/80, for people over 50 years old – 135/84.If blood pressure regularly rises to 140/90, doctors talk about hypertension.

Blood pressure is divided into two types:

1. Systolic.The first, top number indicates the intensity of blood pressure at the moment the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lower number shows blood pressure when the myocardium (heart muscle) relaxes.

Arterial hypertension (hypertension) is not without reason called the “silent killer”: it can cause the appearance of many different pathologies.The heart and brain are especially affected.In severe cases, it can even lead to heart attack and stroke.

Classification of hypertension

The risk of hypertension is great, which is why scientists have been studying it since the beginning of the last century.During this period of time, the classification changed many times, but two directions were formed:

1. When creating classifications according to the stage of development of the disease, doctors thought about the connection between hypertension and risk factors for the development of hypertension.However, they never came to a complete consensus - the debate is still ongoing.
2. Identify disease variants.The approach delves into the causes of hypertension, its stages and mechanisms of development.

This article will discuss some classification methods proposed by scientists.

By external signs

This is how a German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when pressure increases, the face and body will turn red due to the expansion of capillaries.Red spots often appear.In the second case, a person with the disease experiences vasospasm with increased pressure, becomes cold and pale.

According to origin

Doctors often define degrees of hypertension: primary hypertension (hypertension) and secondary hypertension (symptomatic).

The specific causes for the appearance and development of the primary have not yet been found.It has three degrees.

Grade 1 arterial hypertension is called “mild.”Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure "spikes", sometimes increases, then returns to normal.Grade one hypertension has borderline subgroups with indices 140–149 and 90–94 mm Hg.Art.The possibility of a crisis (sudden spike) is very small, if it happens it is very rare.

But for stage 2 (moderate) hypertension, the risk will be greater.The manometer showed 160–179 and 100–109 mmHg.Art.Second degree hypertension is characterized by the fact that the pressure is constantly increasing.

Stage 3 (severe) disease can be life-threatening, especially with comorbidities.This level is characterized by indicators greater than 180 and greater than 110 mmHg.Art.

Sometimes a person has problems with just one type of pressure.Hypertension is then called isolated hypertension and there are two variations of hypertension:

1. Systolic.Blood pressure greater than 140 and less than 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and less than 90 mmHg.Art.In this case, the “upper” pressure increases to 140 mmHg.Art.and higher, while “lower” levels remain normal.Then we are talking about an isolated form of systolic hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under 35 years old - in 25%).This type of disease is caused by disease of a specific organ.Most often, such symptoms of hypertension appear due to kidney problems.The division into endocrine, nervous, renal and hemodynamic forms was proposed by the professor.Doctors still use it today.

Stages of hypertension

Previously, experts divided arterial hypertension into 3 stages.The stages of hypertension (first, second, and third) show the progression of the disease over time.Thus, the division reflects the pathologies that appear in the body over the years.

In 1999, scientists decided that classifying the disease by severity would be more accurate.There are three of them and each one means a series of changes in the digital blood pressure value (they were discussed above).

In some classifications you can find the fourth degree of hypertension.Its lower limit: systolic index - 210, diastolic - more than 110. When the specialist notes the 4th degree of the disease, he means digital pressure indicators, not the patient's condition, because hypertension is stage 3. which is also considered severe.

With chronic high blood pressure, the body cannot cope with stress and bad things start to happen to the organs.Organs that are affected earlier than others are called target organs by doctors.Along with the heart and brain, they include the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weaknesses.

At first, in stage 1 of the development of hypertension, the organs remain healthy.Often people with hypertension do not go to the hospital initially because they feel it is tolerable and does not particularly interfere with their lives.Hypertensive crises are the exception rather than the rule.Patients with newly begun hypertension ignore health problems in vain, because at this stage the disease is easiest to control.Sometimes treating stage 1 hypertension is more about changing your lifestyle than taking medication.But it is necessary.Therefore, when the tonometer periodically reports high levels, it is better to see a specialist.Timely treatment will help prevent the progression of the "silent killer".

Stage 2 hypertension is characterized by persistent high blood pressure.The heart is the first organ to give up - the left ventricle begins to enlarge and "thicken".Some, in addition to abnormalities in the functioning of the heart, also develop defects in the blood vessels of the retina.People with hypertension are in stage 2. Crises occur much more frequently.But the disease is still treatable.If the doctor diagnoses "Stage 2 Hypertension", his recommendations must be followed especially carefully.Because as the disease progresses, it will begin to threaten life.

When stage 3 hypertension occurs, all target organs exhibit many complications.Increased blood pressure in hypertension, stage 3. may be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina, kidney failure and other "gifts" often develop.Most often, the third stage of hypertension is noted when the patient has hemorrhage in the fundus, heart attack, aneurysm, stroke and other diseases.

Signs of blood pressure problems

Timely identification of hypertension and understanding how long a person has had it is the number one problem.Many hypertensive patients learn about the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing high blood pressure are genetics, being overweight, smoking, frequent stress, elevated cholesterol levels, a sedentary lifestyle and old age.

Alarm bells will ring if you see:

• occasional headache;
• "threatening" pain in the back of the head or hitting the temples;
• often feel nauseous and dizzy;
• bright lights in the eyes or flying black flies;
• everything is unpleasant or covered with indifference;
• tingling or numb fingers;
• swelling of the hands, feet and/or face;
• suddenly appeared fast heartbeat.

If you recognize yourself, you should at least measure your blood pressure systematically.But of course it's better to go to the hospital.

Diagnosis of arterial hypertension

If chronic hypertension is suspected, doctors use three diagnostic methods.

The first and simplest way is to measure blood pressure.

Second is a comprehensive health check.It can only be done by a professional.He performs palpation and auscultation (analysis of sounds accompanying the activity of various organs), percussion (tapping on different parts of the body and drawing conclusions based on the sounds) as well as standard examinations.

In the third case, the electrocardiogram helps draw conclusions.

So what awaits you when you go to the hospital with suspected high blood pressure?

First, your doctor will check your blood pressure with a special device - a sphygmomanometer.By the way, in people with an excitable nervous system, blood pressure indicators can skyrocket even with minor emotional fluctuations.When visiting a doctor, such patients experience the “white coat” syndrome: as soon as the doctor starts measuring blood pressure, it increases.But the cause of these fluctuations is stress, not illness.Although such a reaction to a shock in the long term can cause disruption of the normal functioning of the heart and kidneys.In such impressionable patients, the health care provider will test the pressure multiple times and under different conditions.

• See the doctor.Information about the patient's height, weight, and body mass index was collected.Experts look for evidence of high blood pressure symptoms.
• Medical history.No patient interviews - nowhere.It is necessary to find out what diseases a person has had in the past and whether he has any diseases now.Risk and lifestyle factors are analyzed (presence/absence of bad habits, diet, cholesterol level; determine if diabetes is present), whether parents have hypertension or not.
• Physical examination.First, the doctor will listen to the heart with a cardiac monitor.The task is to identify noise, changes in tone or the presence of external sounds, if any.After this study, it will be possible to exclude heart defects and draw preliminary conclusions about its condition against the background of hypertension.
• Biochemical blood test.It is necessary to find out the level of sugar, cholesterol and lipoproteins, and also understand how susceptible a person is to atherosclerosis.
• ECG.An electrocardiogram is an indispensable part of the diagnostic process.It helps detect abnormalities in heart rhythm.With the results in hand, we can assess the presence of hypertrophy of the left heart wall, typical of arterial hypertension.
• Echocardiography.With its help, the doctor can visually see changes and defects of the heart, evaluate the function and condition of the valves.
• X-ray examination.Doctors perform angiography and angiography.With their help, specialists study the walls of the arteries and their lumens to rule out the presence of congenital aortic stenosis (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing arterial hypertension, the doctor will check the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, and helps determine the intensity of blood flow through the arteries and veins.
• Thyroid ultrasound.Along with other data, the doctor needs the results of blood tests to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will be clear whether the thyroid gland plays any role in the development of the disease and what treatment should be prescribed.
• Kidney ultrasound.These organs and their blood vessels are susceptible to high blood pressure.Research helps evaluate their condition.

Treatment methods

Currently there are many methods to treat high blood pressure.Some come to us from ancient times;Pharmacists and scientists have been working to create others for many years.

The most common method is drug treatment.Doctors use several medications to normalize blood pressure.

1. Calcium antagonists aim to reduce heart rate.
2. Diuretics, usually thiazide diuretics, work to improve urine production and excretion.
3. Adrenergic drugs.
4. Vasodilators dilate blood vessels and thereby resolve the situation.

In some cases, a surgical method called excision is used.This procedure is not easy.A catheter with a device that generates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.To prevent scarring from appearing after the intervention, the entire length of the vein will be affected.Performed under local anesthesia.

A variety of established methods have historically been classified as alternative medicine.This includes leg parkas, vinegar lotions and more.

Non-traditional remedies based on valerian, motherwort, beets, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal decoctions for the treatment of arterial hypertension.Here is an example:

Take 1 tbsp.I.motherwort, valerian root and caraway.Mix.Pour a spoonful of this mixture into a cup of boiling water and leave for an hour.Take the medicine three times a day, 1/3 cup.The course is designed for one month.

There are also monastic teas intended to help treat high blood pressure and homeopathic medicines.However, it is best to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if left untreated.You need to monitor your health at any age, because the modern pace of life often contributes to the development of diseases.And regardless of the stage and severity of hypertension, leaving it untreated can lead to serious consequences.