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 consistently rank among the leading causes of death from cardiovascular disease.In terms of the number of complications and unfavorable prognosis, it competes with diabetes mellitus.At the same time, the disease is getting younger quickly.A few decades ago, a 35-year-old stroke patient was considered ridiculous.Lately, such a case would not surprise anyone.

According to the World Health Organization, about a quarter of the world's population suffers from arterial hypertension.Half of people over the age of 65 are hypertensive.

What type of disease is this?

Hypertension refers to diseases of the cardiovascular system.Its presence causes persistent high blood pressure in the systemic circulation arteries.

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

The standard blood pressure for young people (may vary slightly from person to person) is 120/75 mmHg.Art.For those over forty - 130/80, for those over fifty - 135/84.If the pressure often rises to 140/90, the doctor speaks of hypertension.

Blood pressure is divided into two types:

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

Arterial hypertension (hypertension) is not without reason called the "silent killer": it can cause the appearance of various pathologies.The liver and brain are severely affected.In advanced cases, it can also cause heart attacks and strokes.

Classification of hypertension

The risk of hypertension is very impressive, which is why scientists have been studying it since the beginning of the last century.During this time, the classification changed more than once, but two directions were formed:

1. When making a classification according to the stage of development of the disease, doctors think about the relationship between hypertension and risk factors for the development of hypertension.However, they never reached full agreement - the debate continues.
2. Identification of disease variants.This approach investigates the causes of hypertension, stages and mechanisms of its development.

This article will discuss some classifications proposed by scientists.

With 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 the pressure increases, redness on the face and body is noticeable due to capillary dilation.Often red spots appear.In the second case, a person suffering from the disease experiences vascular spasms with pressure spikes, becomes cold and pale.

By origin

Doctors conventionally identify the level of hypertension: primary (hypertensive) and secondary (symptomatic) hypertension.

The specific reason for the emergence and development of the primary has not yet been discovered.It has three degrees.

Arterial hypertension of the 1st degree is called "mild".Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure "jumps", sometimes increases, then returns to normal.First-degree hypertension has borderline subgroups with indicators of 140-149 and 90-94 mm Hg.Art.The possibility of a crisis (sudden sharp jump) is small, if it happens, it rarely happens.

But for grade 2 (moderate) hypertension the risk is greater.The tonometer shows 160-179 and 100-109 mmHg.Art.Hypertension of the second degree is characterized by the fact that the pressure is constantly increased.

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

Sometimes a person has problems with only one type of stress.Then hypertension is called isolated and there are two variants of hypertension:

1. systolic.Pressure more than 140 and less than 90 mmHg.Art.;
2. subgroup: border - 140-149 and less than 90 mmHg.Art.In this case, the "top" pressure creeps up to 140 mmHg.Art.and higher, while "low" remains normal.Then we talk about the isolated form of systolic hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under the age of 35 - in 25%).This type of disease is caused by certain organ diseases.Often, such symptomatic hypertension appears due to kidney problems.Division into endocrine, neurogenic, renal and hemodynamic forms was proposed by the professor.Doctors still use it today.

Hypertension level

In the past, arterial hypertension was divided by experts into three stages.The level of hypertension (first, second and third) shows the progression of the disease over time.Therefore, the part reflects the pathology that has appeared in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease by stage.There are three of them and each means a range of changes in digital blood pressure values (they were discussed above).

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

With chronic high blood pressure, the body cannot cope with the pressure and bad things start to happen to the organs.Those affected earlier than others are called target organs by doctors.Along with the heart and brain, this includes the retina and kidneys.The classification of hypertension into stages is based precisely on the effect on this weak point.

Initially, at stage 1 of the development of hypertension, the organ is still healthy.Often people with hypertension do not go to the hospital at first, because they feel it is acceptable and does not interfere with their lives.Hypertensive crises are the exception rather than the rule.Patients with initial hypertension ignore health problems in vain, because at this stage the disease is easiest to tame.Sometimes treatment for stage 1 hypertension is more about changing your lifestyle than taking medication.But it is necessary.Therefore, when the tonometer periodically shows a high level, it is better to go to a specialist.Timely treatment will help prevent the development of the "silent killer".

Stage 2 hypertension is characterized by persistent high blood pressure.The heart is the first to give up - the left ventricle begins to enlarge and "thick".Some, in addition to abnormalities in heart function, also have defects in retinal blood vessels.A person with hypertension is stage 2. crises occur more often.But this disease can still be treated.If the doctor diagnoses "Hypertension stage 2", his recommendations should be followed carefully.Because the disease, with further development, began to threaten life.

When stage 3 high blood pressure occurs, all target organs make themselves known with heaps of complications.Pressure spikes in hypertension, stage 3. may be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is observed when the patient has already suffered from bleeding in the fundus, heart attack, aneurysm, stroke and other diseases.

Signs of blood pressure problems

Identifying hypertension in time and understanding how long a person has 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 hypertension are heredity, being overweight, smoking, frequent stress, high cholesterol levels, an inactive lifestyle, and old age.

Alarm bells ring if you see:

• occasional headache;
• "threatening" pain in the back of the head or knocking in the temple;
• often feel nauseous and dizzy;
• flashing glare in the eyes or flying "black flies";
• everything is annoying or protected by indifference;
• fingers tingling or numbness;
• swelling of the arms, legs and/or face;
• suddenly a rapid heartbeat appeared.

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

Diagnosis of arterial hypertension

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

The first, easiest is to measure your blood pressure.

The second is a complete physical examination.It can only be carried out by experts.He conducts palpation and auscultation (sound analysis accompanying the work of various organs), percussion (pressing various parts of the body and drawing conclusions based on sound), and standard examination.

In the third case, the electrocardiograph helps to draw a conclusion.

So, what awaits you when you arrive at the hospital with suspected hypertension?

First, the doctor will check your blood pressure using a special device - a tonometer.By the way, in people with an easily excited nervous system, the blood pressure figure can increase even with a small emotional upheaval.When visiting the doctor, such patients experience the "white coat" syndrome: as soon as the doctor starts measuring blood pressure, it rises.But the cause of these fluctuations is stress, and not disease at all.Although such a response to shock in the long term can provoke disturbances in the normal functioning of the heart and kidneys.In such susceptible patients, health care providers will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight, and body mass index was collected.Specialists look for evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient - nowhere.It is necessary to know what diseases a person has faced before and whether there are any diseases at present.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; determine whether there is diabetes), whether parents have hypertension.
• Physical examination.First, the doctor will listen to the heart using a phonendoscope.Its task is to identify sounds, changes in tone or the presence of extraneous sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about his condition against the background of hypertension.
• Biochemical blood test.It is needed to know the level of sugar, cholesterol and lipoproteins, and to understand how susceptible a person is to atherosclerosis.
• ECG.An electrocardiogram is an important element in the diagnostic process.It helps to see irregularities in the heart rhythm.Having the results in hand, we can assess the presence of hypertrophy of the left side of the heart, typical of arterial hypertension.
• Heart ultrasound.With its help, the doctor can see the picture of changes and defects of the heart, assess the function and condition of the valves.
• X-ray examination.Doctors perform arteriography and aortography.With their help, specialists study the walls of the arteries and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaque.
• Dopplerography.When diagnosing arterial hypertension, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while helping to determine the intensity of blood flow through arteries and veins.
• Ultrasound of the thyroid gland.Along with other data, doctors need blood test results to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will become 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 channels are very susceptible to hypertension.The study helps assess their condition.

Treatment methods

Today there are many methods to treat hypertension.Some come to us from ancient times;pharmacists and scientists worked on the creation of others for many years.

The most common method is drug treatment.Doctors use several types of drugs to normalize blood pressure.

1. Calcium antagonists are intended to reduce heart rate.
2. Diuretics, usually thiazide diuretics, work to increase urine output and waste.
3. Adrenergic drugs.
4. Vasodilators widen the blood vessels and thereby flatten the condition.

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

Various methods that come from the past are classified as alternative medicine.These include foot parkas, vinegar lotions and more.

Non-traditional remedies based on valerian, motherwort, beet, 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.l.motherwort, valerian root and cumin.Mix it up.Pour a tablespoon of this mixture into a glass of boiling water and leave for an hour.Drink medicine three times a day, 1/3 cup.This course is designed for one month.

There are also monastery teas intended to help with hypertension, and homeopathic remedies.However, it is better 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 rhythm of modern life often contributes to the development of this disease.And whatever the stage and degree of hypertension, without treatment it can lead to fatal consequences.