What is Arterial Hypertension? This is a disease characterized by blood pressure readings exceeding 140 mm Hg. Art. in this case, the patient is visited by headache, dizziness and nausea. Eliminate all the symptoms that have arisen can only be selected special therapy.
Arterial hypertension can be disease independent or accompany various pathologies, being their symptoms. Hypertension is one of the leading causes of coronary heart disease and severe kidney damage.
In hypertensive patients, the indicators often return to normal only after taking special medications, and pressure surges can be observed frequently and for no apparent reason. It is impossible to cure this disease, but preventing serious consequences and learning to control your stress is a doable task.
Do not self -medicate. At the first sign of illness, seek medical advice.
cause
To this day, the exact cause of essential arterial hypertension can occur is unknown. There are the following risk factors:
- descent;
- Malnutrition;
- bad habits;
- violations of fat metabolism;
- kidney disease;
- diabetes;
- pressure;
- inactive lifestyle.
Classification of diseases
During diagnostic examination, it is very difficult to determine the location of the concentration of pathological factors that cause the increase in stress. The pathogenesis also has differences taking into account the type of disease. There are the following classifications for arterial hypertension:
- Pulmonary essential arterial hypertension - is considered one of the types of arterial hypertension, rare, but represents a great danger to human life. It is very difficult to identify the disease by symptoms, and more difficult to treat. Pulmonary arterial hypertension is formed as a result of increased pulmonary vascular resistance and, consequently, insufficient blood flow.
- Malignant. Symptoms of arterial hypertension are manifested in the form of an increase in blood pressure up to 220/130. there are radical changes in the fundus and swelling of the optic nerve disc. If the diagnosis is made in a timely manner, then it is possible to cure this type of arterial hypertension.
- Renovascular artery hypertension. The reasons for the formation of this type of disease are the presence of pathologies such as vasculitis, vascular atherosclerosis, and malignant formation in the kidneys. The pathogenesis of the disease is reduced to the formation of characteristic stress, which can be represented in normal systolic and elevated diastolic blood pressure.
- Unstable arterial hypertension. For this type of disease, periodic stress normalization is characteristic. Patients with this form of arterial hypertension are not called patients, as the condition is not pathological. In some cases, over a period of time, blood pressure returns to normal.
Symptomatic arterial hypertension and its types
Secondary arterial hypertension is a pathological process associated with diseases of organs involved in the normalization of blood pressure. It has the following classifications:
- Hemodynamics - is associated with violations of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the aortic chamber wall, aortic coarctation, aortic valve insufficiency.
- Neurogenic. Symptomatic arterial hypertension of this type occurs due to diseases of the peripheral nervous system, brain injury, atherosclerosis.
- Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormone -active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
- Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, its compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, a rapid course and is often malignant. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
- Medicated. This form of symptomatic arterial hypertension is associated with the use of medications that increase blood pressure.
symptoms
Before there is a complication of arterial hypertension, it persists without specific manifestations. 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 head and forehead, dizziness and unusual sounds in the ears.
Target organ damage
Symptoms of such arterial hypertension occur primarily due to the increased 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 has weakness, blinking black spots in front of the eyes, difficulty speaking. Such symptoms bother a person in the later stages of the disease. In addition, complications such as cerebral infarction and bleeding may occur.
Heart failure
In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory response aimed at normalizing wall tension. As a result, increased afterload, heart failure. When the heart is damaged, there is no most favorable prognosis, because such changes in its work are the cause of heart failure, sudden death and the development of ventricular arrhythmias. The characteristic symptoms are:
- pulmonary edema;
- difficulty breathing during physical activity;
- cardiac asthma.
In some cases, arterial hypertension in children and adults causes pain in areas of the heart with certain properties. They can visit someone in a state of rest or excessive emotion without doing physical activity. The main manifestation of chest pain presented is the impossibility of their elimination with the help of nitroglycerin.
The pathogenesis of this pathological process in some patients is reduced to the formation of shortness of breath in the early stages of the disease after the implementation of a small load or rest. All this indicates characteristic changes in the heart muscle and the formation of heart failure. With such diseases, people experience swelling in the lower part of the legs, the cause of which is the retention of sodium ions and water in the body.
If the lesion has affected the kidneys, then upon passing the urine test, proteins are found in them, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.
Eye damage
Less frequently, arterial hypertension in these children and adults affects vision, resulting in decreased light sensitivity and blindness. If there is a visual disturbance against the background of high blood pressure, then the patient has black spots in front of the eyes, fog or lids. The reasons for such changes are violations of blood circulation in the retina. Complications can manifest as diplopia, visual impairment or complete loss of vision.
Headache
These symptoms are considered most common in arterial hypertension. He worries the patient at any time of the day or night. It can become ruptured naturally and focus on the back of the head, and then spread to the rest of the head area. Increased headache in arterial hypertension occurs when coughing, tilting the head. This may be accompanied by swelling of the eyelids and face. When performing a massage in this case, in patients suffering from arterial hypertension, there is an increase in the outflow of blood in the veins, and this leads to a decrease in pain until it disappears completely.
There are cases when the headache against the background of the presented disease is the result of a tense soft muscle of the head itself or a tendon. The formation of such pain syndromes occurs after excessive psycho-emotional or physical stress. As a rule, such pain squeezes or tightens its nature. Patients suffering from arterial hypertension have nausea, dizziness. With the presence of prolonged pain, relentless pain is characteristic, irritation occurs in patients, sensitivity to sharp sounds increases, they become irritable.
Disease stage
For the correct determination of this stage of the pathological process, it is necessary to use classification. It depends on the damage to the target organ. 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 levels. During rest in patients with arterial hypertension, blood pressure indicators return to normal. Due to the fixation of the disease, stress inevitably increases. Often, people do not complain about the formation of any disorders of their health. But for the simple stage, the symptoms themselves are characteristic:
- Headache;
- noise in the ears;
- poor sleep;
- mental decline;
- dizziness;
- nose bleed.
As a rule, there are no manifestations of left ventricular hypertrophy, ECG has no abnormalities, renal function without pathological changes, fundus does not change.
Simple
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 experience headache, dizziness, pain in the heart area, who have angina pectoris.
This stage is characterized by a typical hypertensive crisis. The pathogenesis of the disease involves the following signs of damage to the target organ:
- skin hypertrophy;
- weakens the I tone at the apex of the heart;
- accent II tone on the aorta;
- in some patients, ECG symptoms of subendocardial ischemia.
Regarding the central nervous system, there are various manifestations of vascular insufficiency, cerebral stroke, transient cerebral ischemia. For the fundus, in addition to reducing the arterioles, there is compression of the veins, their increase, bleeding, exudates occur. Blood flow in the kidneys and glomerular filtration rate for this stage are reduced. But it is impossible to detect this manifestation in urine analysis.
heavy
The stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and stable increase in blood pressure, as well as the development of arteriosclerosis and atherosclerosis of the larger vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. no spontaneous normalization of blood pressure. In severe stages, the disease affects the following organs:
- heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
- brain - ischemic and hemorrhagic infarction, encephalopathy is formed;
- fundus ocular;
- kidneys - low blood flow and glomerular filtration.
Risk factors
Currently, the severity of the disease described directly depends on the risk facts. The risk lies in the formation of cardiovascular complications against the background of high blood pressure. Taking into account the complications presented, the prognosis due to arterial hypertension is diagnosed. There are the following risk factors that worsen the course of the disease and its prognosis:
- age - in men after 50 years, in women after 60 years;
- smoking;
- high cholesterol;
- hereditary factors;
- obesiti;
- hypodynamics;
- diabetes.
The risk factors presented can be eliminated (can be corrected) and may not be corrected. The first type of risk factor is characterized by the presence of diabetes mellitus, high cholesterol, smoking, lack of physical activity. Uncorrected risk factors include race, family history, and age.
Taking into account the level of arterial hypertension and the contributing factors of the disease, the prognosis is observed with the formation of complications such as heart attack or stroke for the next 10 years.
With mild levels of arterial hypertension and the absence of risk factors, the formation of complications of the cardiovascular system is minimized for the next 10 years. With non -drug therapy for a year and a review of your lifestyle, it is possible to eliminate the stage of this pathological process. If the pressure reading is greater than 140/90 mm Hg. Art. , then drug treatment is prescribed.
The average level of risk is accompanied by the formation of complications against the background of arterial hypertension for 10 years in a ratio of 20%. Stage 2 arterial hypertension was treated in the same way as stage one, but here dynamic control was also adjusted for six months. If there are poor blood pressure results and its stable maintenance, then drug treatment is carried out.
High -level risk factors are accompanied by the formation of complications within 30%. In this condition, patients suffering from arterial hypertension are prescribed a complete diagnosis in combination with non -drug treatment.
At very high risk, patients are prescribed an immediate differential diagnosis of arterial hypertension and take medication.
Diagnostic methods
Only after a thorough study you can prescribe effective therapy and eliminate all manifestations of the disease. The diagnosis of arterial hypertension is based on the following types of examinations:
- ECG, glucose analysis and complete blood count;
- Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general urinalysis - is carried out to exclude the nature of the disease formation kidneys;
- Ultrasound of the adrenal glands is advised to perform if pheochromocytoma is suspected;
- analysis for hormones, ultrasound of the thyroid gland;
- MRI of the brain;
- Consultation with a neurologist and ophthalmologist.
Effective Therapy
Treatment of arterial hypertension should be carried out under the constant supervision of a physician. He is responsible for making an accurate diagnosis, for performing additional diagnostics, which include examinations:
- fundus;
- kidney function;
- heart work.
After that, the specialist can prescribe antihypertensive treatment, determining various complications. As a rule, patients in whom arterial hypertension syndrome is detected for the first time are admitted to the hospital to carry out all necessary studies and treatment options.
Non -drug treatment
Such therapy is recommended for all patients, regardless of the degree of the disease the use of drugs. Such treatments for hypertension include:
- To quit smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
- Elimination of extra pounds. The most common cause of high blood pressure is being overweight, so diet plays an important role in this. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
- Reduce the amount of salt intake. According to ongoing studies, reducing the amount of salt consumed to 4. 5 g / day helps reduce systolic blood pressure by 4-6 mm Hg. Art.
- Insignificant alcohol consumption.
- Specially designed diet. Your diet should include vegetables, fruits, foods high in magnesium, potassium, potassium, fish, seafood. In addition, the diet involves a limited intake of animal fats.
- Active lifestyle. Here, brisk walking for 30 minutes 3-4 times a week is very useful. When doing isometric loads, you can trigger an increase in blood pressure.
Medical treatment
Therapy with medication should be prescribed taking into account the following recommendations:
- Treatment begins with a small dose of medication.
- If there is no 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 that a rapid drop in blood pressure is not required.
- The use of long -acting drugs to obtain a 24 -hour effect with a single dose.
- Optimal use of device combination.
- Therapy must be permanent. It is not allowed to use medication in the course.
- Effective blood pressure control throughout the year contributes to a gradual reduction in the dose and amount of medication.
Precautions
Prevention of arterial hypertension includes the following recommendations:
- If a family member has the disease and you are over 30 years old, then you need to regularly measure your stress.
- Quit smoking and alcohol.
- A low fat and low salt diet should be followed.
- Exercise outdoors.
- Avoid a variety of stressful situations.
- Maintain a normal weight.
With arterial hypertension, a person may live a normal full life, but subject to all the recommendations described. Blood pressure control in this case is one of the key components of successful treatment of this disease. Therefore, try not to start the disease and visit the doctor on time to avoid various serious complications.