What is arterial hypertension? This is a disease characterized by a blood pressure reading above 140 mm Hg. Art. In this case, the patient was presented with headache, dizziness, and a feeling of nausea. Elimination of all the symptoms that have arisen can only be specially selected therapy.
Arterial hypertension can be an independent disease or be accompanied by different diseases, which are their symptoms. High blood pressure is one of the causes of coronary heart disease and severe kidney damage.
In hypertensive patients, indices usually return to normal only after administration of specific drugs, and hypertension may be observed frequently and for unknown reasons. There is no cure for the disease, but preventing serious consequences and learning how to manage stress is a possible task.
Do not self-medicate. At the first signs of illness, consult a doctor.
Reason
To this day, the exact cause of essential arterial hypertension is unknown. There are the following risk factors:
- heredity;
- Malnutrition;
- bad habits;
- violation of fat metabolism;
- kidney disease;
- Diabetes;
- stress;
- inactive lifestyle.
Classification of diseases
On diagnostic examination, it is difficult to determine the location of the focus of pathological factors that cause hypertension. The pathogenesis is also different taking into account the varieties of the disease. There are the following classifications of arterial hypertension:
- Pulmonary essential arterial hypertension - is considered one of the rare types of arterial hypertension, but poses a great danger to human life. It is very difficult to recognize this disease by its symptoms, and even more difficult to treat. Pulmonary hypertension is formed due to an increase in pulmonary vascular resistance and as a result, insufficient blood flow.
- Malignant. Symptoms of such arterial hypertension are presented in the form of an increase in blood pressure up to 220/130. there is a radical change in the background and swelling of the disc of the optic nerve. If the diagnosis is made on time, then this type of arterial hypertension can be cured.
- Regenerative arterial hypertension. The reason for the formation of this type of disease is the presence of such pathologies as vasculitis, atherosclerosis and malignant formations in the kidneys. The pathogenesis of the disease is decreased formation of the characteristic pressure, which can be manifested in normal systolic blood pressure and elevated diastolic pressure.
- Arterial hypertension. For this type of disease, periodic normalization of pressure is characteristic. Patients with this type of arterial hypertension are not called patients, because the condition is not pathological. In some cases, after a while, blood pressure returns to normal.
Symptomatic arterial hypertension and its forms
Secondary arterial hypertension is a pathological process that is associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:
- Hemodynamic - related to violations of hemodynamic conditions due to organic pathology of the great vessels. This symptomatic form of arterial hypertension occurs due to hardening of the walls of the aortic chamber, aortic spasm, and aortic valve insufficiency.
- Neurogenesis. This type of symptoms of arterial hypertension occurs due to diseases of the peripheral nervous system, brain injury, atherosclerosis.
- Endocrine disease. This symptomatic form of arterial hypertension is observed in hormonally active tumors of the adrenal gland, pituitary gland, diffuse toxic goiter.
- Renal arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, compression of them, kidney stones. Renal arterial hypertension is associated with sudden onset, rapid course, and is often malignant. Renal arterial hypertension is divided into two types: neovascular and parenchymal.
- Medicine. This symptomatic form of arterial hypertension has been associated with the use of drugs that raise blood pressure.
Symptom
Before the complications of arterial hypertension, it progresses without definite symptoms. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the formation of headaches in the back of the neck and forehead, dizziness and indistinct hearing in the ears.
Target organ damage
This type of symptoms of arterial hypertension occurs primarily due to the sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. After that, the patient became weak, appeared black dots in front of his eyes, difficult to speak. Such symptoms bother a person at a late stage of the disease. In addition, complications such as cerebral infarction and bleeding may occur.
Heart failure
In this case, the pathogenesis of the disease reduced to left ventricular hypertrophy due to a compensatory response aimed at normalizing wall tension. Consequences are increased afterload, heart failure. When the heart is damaged, the most favorable prognosis is not available, because changes in its work are the cause of heart failure, sudden death and the development of ventricular arrhythmias. Characteristic symptoms are:
- pulmonary edema;
- shortness of breath at the time of physical activity;
- heart asthma.
In some cases, arterial hypertension in children and adults causes pain in the heart region of a certain nature. They may visit someone who is resting or emotionally overstressed without performing physical activity. The main manifestation of chest pains is the inability to eliminate them with the help of nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the formation of dyspnea in the early stages of the disease after performing a small load or at rest. All this suggests characteristic changes in the myocardium and the formation of heart failure. With such a disease, one experiences swelling of the lower extremities, which is caused by the retention of sodium and water ions in the body.
If the damage has affected the kidneys, then on a urinalysis, a protein will be found in it, and bacteriuria and urinary breakdown are also observed. Very rarely, the pathogenesis of the disease is associated with the occurrence of renal failure.
Eye damage
Infrequently, this arterial hypertension in children and adults affects vision, leading to decreased light sensitivity and blindness. If there is impaired vision against the background of high blood pressure, then the patient has black spots in front of the eyes, fog or veil. The reason for such changes is a violation of blood circulation in the retina. Complications may manifest as diplopia, impaired vision, or complete loss of vision.
Headache
This symptom is considered the most common in arterial hypertension. She makes her patients worry at any time of day or night. It can flare up spontaneously and focus on the back of the head, then spread to the entire head area. Headache increased in arterial hypertension occurs when coughing, tilting the head. This may be accompanied by swelling of the eyelids and face. When performing massage in this case, in patients with arterial hypertension, the blood circulation in the veins improves and this leads to a decrease in pain until it disappears completely.
There are cases where headaches against the background of the presented disease are the result of soft muscles or tendons of the head. The formation of such a pain syndrome occurs after a state of extreme psychological or physical stress. As a rule, such pains are squeezing or tightening in nature. Patients with arterial hypertension have nausea and dizziness. When the pain is prolonged, the pain is characteristic, the patient is irritable, the sensitivity to sharp sounds increases, they become short-tempered.
Stages of the disease
To correctly establish the stage of this pathological process, it is necessary to use classification. It depends on the target organ damage. There are three stages of the disease.
Easy
This stage is characterized by a slight increase in blood pressure of 180/100 mm Hg. Art. unstable pressure level. During rest in patients with arterial hypertension, blood pressure readings return to normal. Due to the pre-determined illness, the pressure will inevitably increase. Very often, people do not complain of the formation of any disorders related to their health. But for an easy period, its own symptoms are characteristic:
- headache;
- noise in the ears;
- do not sleep very well;
- mental decline;
- dizzy;
- epistaxis.
As a rule, there are no manifestations of left ventricular hypertrophy, no abnormalities in the electrocardiogram, no pathological changes in renal function, and no change in the trajectory.
Medium
This stage is characterized by the presence of higher and more stable blood pressure levels. It can reach 180–105 mm Hg. Art. Patients often have headaches, dizziness, pain in the front of the heart, and angina attacks.
This stage is characterized by typical hypertensive crises. The pathogenesis of the disease involves the following signs of target organ damage:
- left hypertrophy;
- weakening of the I tone at the apex of the heart;
- voice II on the aorta;
- In some patients, electrocardiographic symptoms of submyocardial ischemia.
Regarding the central nervous system, there are different manifestations such as insufficiency of vessels, cerebrovascular accident, transient cerebral ischemia. With respect to the orbit, in addition to a decrease in the arterioles, there is compression of the veins, their proliferation, hemorrhage, exudation occurs. Renal blood flow and glomerular filtration rate during this period are reduced. But these manifestations could not be detected on urinalysis.
heavy
This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and steady increase in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230–120 mm Hg. Art. There is no spontaneous normalization of blood pressure. In the advanced stage, the disease affects the following organs:
- heart - angina attacks, circulatory failure, myocardial infarction, arrhythmia are formed;
- brain - ischemia and hemorrhagic infarction, encephalopathy is formed;
- eye orbit;
- kidney - low blood flow and glomerular filtration rate.
Risk factors
Currently, the severity of the disease described is directly dependent on the risk data. The risk lies in the development of cardiovascular complications against the background of high blood pressure. Taking into account the complications presented, the consequential prognosis of arterial hypertension is diagnosed. There are the following risk factors for exacerbation of the disease course and its prognosis:
- age - in men after 50 years, in women after 60 years;
- smoke;
- high cholesterol;
- Genetic factors;
- fat;
- motivational disorder;
- Diabetes.
The risk factors presented can be eliminated (correctable) and may not be corrected. The first type of risk factor is characterized by the presence of diabetes, high cholesterol, smoking, inactivity. Unadjusted risk factors included race, family history, and age.
Taking into account the degree of arterial hypertension and the factors that contribute to the disease, it is possible to predict the development of complications such as heart attack or stroke in the next 10 years.
With a mild degree of arterial hypertension and the absence of risk factors, the formation of complications of the cardiovascular system is minimized during the next 10 years. With a year of non-drug therapy and a modification of your lifestyle, it is possible to eliminate this degree of the pathological process. If the pressure reading is greater than 140/90 mm Hg. Art. , Then treat with prescribed medication.
The average level of risk associated with the development of complications against the background of arterial hypertension in 10 years with a rate of 20%. Grade 2 arterial hypertension is treated in the same way as grade 1, but here arterial control is also corrected for six months. If the blood pressure measurement is not good and it is not stable, then proceed with drug treatment.
High-grade risk factors are associated with the development of complications within 30%. In this situation, a patient with arterial hypertension was assigned a complete diagnosis in conjunction with non-pharmacological treatment.
Given the very high risk, the patient is indicated for the urgent differential diagnosis of arterial hypertension and medication.
Diagnostic method
Only after thorough research can you prescribe effective therapy and eliminate all manifestations of this disease. The diagnosis of arterial hypertension is based on the following types of examination:
- Electrocardiogram, glucose analysis and complete blood count;
- Renal ultrasound, determination of the level of urea, creatinine in the blood, general urinalysis - is performed to exclude the renal nature of the formation of the disease;
- Adrenal ultrasonography is recommended if pheochromocytoma is suspected;
- analysis for hormones, ultrasound of the thyroid gland;
- Brain MRI;
- Consult a neurologist and ophthalmologist.
Effective therapy
Treatment of arterial hypertension should be carried out under the constant supervision of a physician. It is he who is obliged to make an accurate diagnosis, performing additional diagnostics, including examining:
- sponsorship money;
- renal function;
- work of the heart.
Then, the specialist can prescribe antihypertensive treatment, identifying various complications. As a rule, patients with the first detected arterial hypertension syndrome are admitted to the hospital in order to carry out all the necessary studies and select the method of treatment.
Non-drug treatment
Such therapy is recommended for all patients, regardless of the severity of the drug use. Treatment of such hypertension includes:
- Quit smoking. Lifestyle changes are very important, such changes serve as an excellent preventive measure against diseases of the cardiovascular system.
- Eliminate extra pounds. A common cause of high blood pressure is being overweight, so diet plays an important role in this. In addition, a balanced and reasonable diet can help reduce risk factors such as diabetes and myocardial hypertrophy.
- Reduce salt intake. According to ongoing studies, reducing salt intake to 4. 5 g/day reduces systolic blood pressure by about 4-6 mm Hg. Art.
- Insignificant consumption of strong drinks.
- Specially designed diets. Your diet should include vegetables, fruits, foods rich in magnesium, potassium, potassium, fish, seafood. In addition, the diet restricts the intake of animal fats.
- Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very helpful. When you perform isometric loads, you can increase your blood pressure.
Medical treatment
Drug therapy should be prescribed taking into account the following recommendations:
- Treatment begins with a small dose of the drug.
- In the absence of a therapeutic effect, it is necessary to replace the use of one drug with another. The interval between degrees should be less than 4 weeks, provided there is no rapid drop in blood pressure.
- The use of long-acting drugs to achieve an effect in 24 hours with a single dose.
- Application of the optimal combination of devices.
- Therapy must be maintained permanently. It is not allowed to use drugs in the courses.
- Effective blood pressure control throughout the year contributes to a gradual reduction in the dose and amount of medication.
Preventive action
Prevention of arterial hypertension includes the following recommendations:
- If your family members have this condition and you are over 30 years old, you need to have your blood pressure checked regularly.
- Give up smoking and alcohol.
- A low-fat and low-salt diet should be followed.
- Outdoor exercise.
- Avoid various stressful situations.
- Maintain a normal body weight.
With arterial hypertension, a person can live a full normal life, but must follow all the recommendations described. The control of blood pressure in this case is one of the key factors for successful treatment of the disease. So, try not to let the disease kick in and see a doctor in time to avoid various serious complications.