A person is alive as long as his heart is beating. The "pump" of the heart ensures the circulation of blood in the vessel. In this regard, there is such a thing as blood pressure. Abbreviated as AD. Any deviation from normal blood pressure levels is fatal.
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Risk of getting hypertension
The risk of developing hypertension or arterial hypertension - high blood pressure - consists of several factors. Accordingly, the more, the more likely a person will develop hypertension.
Risk factors for developing hypertension:
- hereditary tendency. The risk of getting the disease is higher for those who have hypertension in the first relatives: father, mother, grandmother, grandfather, siblings. The more close relatives have high blood pressure, the greater the risk;
- age over 35 years;
- stress (stress hypertension) and mental stress. The stress hormone adrenaline increases your heart rate. It immediately narrows the blood vessels;
- taking certain medications, for example, oral contraceptives, and various dietary supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. Tobacco components trigger spasms of blood vessels - involuntary contraction of their walls. This narrows the blood flow;
- Atherosclerosis - blockage of blood vessels with plaque. Total cholesterol should not exceed 6. 5 mmol/l blood;
- kidney failure (nephrogenic hypertension);
- endocrinopathy of the adrenal gland, thyroid gland or pituitary gland;
- excess salt in food. Table salt causes arterial spasms and retains fluid in the body;
- Not active. Physical inactivity is accompanied by slow metabolism - metabolism - and gradually weakens the body as a whole;
- overweight. Each additional kilogram increases blood pressure by 2 millimeters of mercury - mmHg;
- sudden changes in weather;
- chronic lack of sleep and other "provocateurs".
Most of the risk factors for developing hypertension are closely related. Therefore, heavy smokers in most cases develop atherosclerotic plaques, and passive and malnourished people quickly gain excess weight. The combination of such factors significantly increases the risk of pathological abnormalities in the heart.
Depending on the combination and degree of manifestation of the above factors, as well as the possibility of cardiovascular complications in the next decade, there are 4 types of risk for developing arterial hypertension:
- low (risk less than 15%);
- average (from 15 to 20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the appearance of arterial hypertension are also divided into 2 types based on the possibility of their elimination: correctable (correctable) and not. For example, a person may stop smoking, but he cannot change his genetics. Total risk is inferred from several indicators. Patients with stage 1 hypertension who start abusing alcohol will significantly increase the percentage of chances of developing complications.
Hypertension is quite treatable. Much here depends on the timely diagnosis of the disease, the perseverance of the patient, and his willingness to radically change his lifestyle.
Hypertension degree 1
Arterial hypertension can be primary, i. e. develops independently, and secondary - becomes a complication of other diseases. In the second case, the treatment is carried out comprehensively, because it is necessary not only to normalize the pressure, but also to cure the underlying disease.
A blood pressure reading of 120 per 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is the so-called upper blood pressure or systolic pressure (at maximum contraction of the heart muscle wall). And 80 is a lower indicator or the so-called diastolic pressure (at their maximum relaxation). Accordingly, hypertension is divided into systolic, diastolic and mixed (systole-diastolic), depending on whether the upper or lower indicator exceeds the threshold value.
When the lumen of the blood flow narrows, the heart spends more effort pushing blood into the vessels, it wears out faster and begins to work intermittently. Increased heart rate—heart rate—negatively affects the functioning of the entire body. The air and nutrients contained in the blood do not have time to enter the cells.
Like any disease, hypertension develops if left untreated. The appearance of the first hypertension symptoms is preceded by a prehypertensive state - prehypertension.
The degree of severity depends on the stage of development of the disease:
- "soft" or light;
- moderate or borderline;
- very severe or isolated systolic.
Otherwise, stage 1 arterial hypertension is called a mild form of the disease. The upper blood pressure reading is between 140 to 159, and the lower is 90 – 99 mm Hg. Disturbances in cardiac function occur spasmodically. Attacks usually pass without consequences. This is a form of preclinical hypertension. Exacerbation periods alternate with complete disappearance of disease symptoms. During remission, the patient's blood pressure is normal.
Diagnosis of hypertension is simple: measure blood pressure using a tonometer. For an accurate diagnosis, the procedure is carried out three times a day in a calm environment and in a relaxed state.
Even people at low risk of developing hypertension should check their blood pressure regularly. One potentially dangerous factor is enough to more carefully monitor the work of your heart. For those who are prone to heart disease to a significant degree, it is advisable to buy a cardiovisor - a device to take an ECG - electrocardiogram - at home. Any disease is easier to treat in the early stages.
Symptoms of stage 1 hypertension
Symptoms of stage 1 hypertension include:
- headaches that develop with exercise;
- aching or stabbing pain in the left side of the chest, radiating to the shoulder blade and arm;
- black spot in front of the eye.
We must not forget that in the form of mild hypertension, all these symptoms appear occasionally. If after doing intense physical activity, your pulse is getting faster or it's hard to sleep because of noisy neighbors, you don't need to panic and consider yourself hypertensive.
During the period of improvement, the patient feels great. Mild hypertension has all the hallmarks of heart failure. The more severe stage of the disease differs only in the persistence of symptoms and the occurrence of complications.
Complications of grade 1 hypertension
Complications include:
- renal sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most believe that mild arterial hypertension can be cured without consequences. But the risk of complications with grade 1 is average, i. e. about 15%. High pressure in the vessels due to the narrowing of their lumen leads to insufficient blood supply to the tissues. Lack of oxygen and nutrients leads to the death of individual cells and whole organs. Necrosis begins with local, focal lesions. Over time, if left untreated, ischemic stroke is inevitable.
Blood circulation disorders inevitably lead to metabolic disorders. This has adverse effects on the respiration and nutrition of cells of any kind. Pathological changes are inevitable, for example, sclerosis - replacement by connective tissue. With nephrosclerosis, the kidney wall becomes pathologically denser, and the organ "shrinks. "In this case, excretory function is disturbed, and urea enters the bloodstream.
If the blood vessels are narrowed, the heart will strain to push blood through them. This leads to pathological enlargement of the heart muscle. This hypertrophy is called true or functional. The volume and mass of the left ventricle increases due to the thickening of its walls. This pathology is otherwise called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows him to squeeze harder. Apparently, how can this be dangerous? A "swollen" heart can compress adjacent vessels, and uneven muscle growth can block the exit from the left ventricle. Cardiac hypertrophy sometimes leads to sudden death.
Complications from grade 1 hypertension occur very rarely. To avoid it, it is enough to minimize the risk of developing arterial hypertension, i. e. eliminate the prerequisites and causes.
Treatment of stage 1 hypertension
First, the doctor will advise the patient to change his lifestyle. Patients will be advised to sleep well, avoid stress, targeted relaxation exercises, special diet, exercise, etc. If these measures are not sufficient, drug therapy is used.
Cardiologists prescribe the following drugs: sedatives and other antihypertensive drugs.
Medicines are selected strictly individually, because many hypertensive patients have concomitant diseases. The choice of medicine depends on the age of the patient and the medicine he uses.
If it is possible to stop the disease at an early stage and get rid of it completely, prevention should not be neglected in the future. The principle is simple - it is to avoid all risk factors of hypertension. Thanks to a healthy lifestyle, you can prevent the occurrence of even hereditary pathologies.
Hypertension 2 degrees
This is hypertension in a mild form. Upper blood pressure is 160 - 179 mm Hg, and lower blood pressure is 100 - 109 mm Hg. At this stage of the disease, the period of increased pressure is longer. Blood pressure rarely returns to normal.
Depending on the speed of transition of hypertension from one stage to another, benign and malignant arterial hypertension are distinguished. In the second, the disease progresses so quickly that it is often fatal. Hypertension is dangerous because the increased speed of blood movement through the vessels leads to thickening of their walls and greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Typical signs of arterial hypertension appear even in the mild form of the disease.
In the second stage, they are accompanied by the following symptoms:
- throbbing sensation in the head;
- hyperemia - overflow of blood vessels, for example, redness of the skin;
- microalbuminuria - the presence of albumin protein in the urine;
- numbness and tingling in the fingers;
- fundus pathology;
- hypertensive crisis - sudden surge in pressure (sometimes as much as 59 units at once);
- the appearance or deterioration of signs of target organ damage.
Fatigue, lethargy and swelling appear because the kidneys are involved in the pathological process. Hypertensive attacks may be accompanied by vomiting, difficulty urinating and defecating, shortness of breath, and tears. Sometimes it lasts for several hours. Complications of hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, overexcitement, hand tremors, unmotivated panic, dry mouth);
- edematous (lethargy, eyelid swelling, obstructed consciousness);
Symptoms of stage 2 hypertension are more difficult for patients to tolerate. He always had pathological manifestations of high blood pressure. The disease at this stage recedes with difficulty and often returns.
Complications of hypertension 2 degrees
Complications of stage 2 hypertension include the following diseases: aortic aneurysm - pathological protrusion of its wall.
To target an organ, i. e. Internal organs affected by hypertension include:
- Bleeding in various organs occurs because the walls of blood vessels thicken, lose their elasticity and become fragile. Increased blood flow easily destroys such vessels. The opposite process occurs with the development of an aneurysm. Here the walls become tense and thin due to increased blood circulation. They are so weak that they tear easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis - fatty deposits in the wall - and thrombosis - its blockage with blood clots. Brain cell bleeding leads to oxygen starvation and death. This phenomenon is called encephalopathy. Ischemia is the oxygen starvation of the heart. Angina pectoris is persistent chest pain.
Pathological processes associated with the underlying disease develop in connection with it. Therefore, if you do not start treatment on time or violate medical prohibitions, there will be more target organs, and it will be almost impossible to restore health.
2nd degree hypertensive disability
Hypertensive patients are constantly monitored at the dispensary and checked regularly. In addition to daily blood pressure measurements, they are often prescribed an ECG. In some cases, ultrasound may be necessary - ultrasound examination of the heart, urine test, blood test and other diagnostic procedures. Hypertensive patients with moderate forms of the disease are less productive than healthy people.
If there is a continuous deterioration of body functions caused by hypertension, the patient is sent to the bureau for examination to obtain a medical and social examination report. In rare cases, hypertensive patients are examined at home, in the hospital, or even absent. Sometimes additional exam programs are available. For people with disabilities, experts from the Bureau of Medical and Social Expertise develop a mandatory individual rehabilitation program.
To determine the disability group, the expert commission, along with the level of hypertension, takes into account the following factors:
- information from medical history about hypertensive crisis;
- the patient's working conditions.
The procedure for establishing a disability group is necessary for proper employment. Whether it's easy to find employers willing to put up with the work of "lowly" workers is another question. If an applicant for a job submits documents confirming his disability, then, according to federal law, he must be provided with the necessary working conditions.
Employers refuse to hire people with disabilities because. . . working hours for them have been reduced while maintaining full wages (for groups 1 and 2). In addition, they have to take sick leave more often than other workers, and their annual leave has been increased. In this regard, most disabled people of group 3 hide their illness in order to get a high-paying place. Violation of medical instructions regarding working conditions leads to the deterioration of the disease over time.
Group 3 disabled people receive cash benefits and are allowed to engage in professional activities with some restrictions:
- strong vibrations and sounds are contraindicated;
- You may not work overtime, on weekends or night shifts without the employee's permission;
- Constant physical or psycho-emotional pressure is not allowed;
- prohibition of working at high altitudes, in hot shops, near dangerous mechanisms;
- reduce the duration of work that involves a high concentration of attention;
- seven hours a day work.
A special case is malignant arterial hypertension of the 2nd degree. The development is so rapid, and the patient's condition is serious, that the commission gives him a group 2 disability. This is no longer a working group. For 2 and 3 degrees of disability, medical and social examinations are conducted annually. Persons with disabilities from the following categories are exempted from re-examination:
- men over 60 years old;
- women over 55 years old;
- people with irreversible anatomical defects.
The assignment of disabled groups is due to the need for social protection of hypertensive patients. His ability to engage in work activities is limited.
Treatment of stage 2 hypertension
At this stage of the disease, there is no way to do without medicine. Tablets are taken periodically, if possible at the same time. Patients should not think that to get rid of the disease it will be enough to just take medicine. If he does this at the same time carried away, for example, by fatty foods and alcohol, then the positive effect of therapy will quickly disappear. The disease will move to the next stage, where any treatment is no longer effective.
Hypertension 3 degrees
Why are doctors concerned about deviations in blood pressure readings from the norm, even by one? The fact is that when the pressure increases by several units, the risk of developing cardiovascular complications increases by the same percentage. For example, if a person has mild hypertension and blood pressure deviates from normal 120 to 80 mm Hg. as many as 39 units, then there is a very high probability of pathological abnormalities occurring in various organs (39%). What can be said about the 3rd stage of the disease, where the deviation is at least 60 units?
Stage 3 hypertension is a severe and chronic form of the disease. Blood pressure rises above 180/110 mm Hg, it never drops to the normal level of 120/80. Pathological changes are irreversible.
Symptoms of stage 3 hypertension
Symptoms of stage 3 hypertension include:
- impaired movement coordination;
- persistent visual impairment;
- paresis and paralysis due to cerebral circulation disorders;
- prolonged hypertensive crisis with speech disorders, clouded consciousness and sharp pain in the heart;
- significant limitations in the ability to move independently, communicate and care for oneself.
In severe cases, hypertensive patients can no longer cope without outside help; they need constant attention and care. The above signs of hypertension indicate that the patient's well-being gradually deteriorates, the disease spreads to new organ systems, and there are more complications.
Complications of grade 3 hypertension
Complications of grade 3 hypertension include the following diseases:
- myocardial infarction - the middle muscle layer of the heart;
- cardiac asthma - attacks of shortness of breath;
- peripheral arterial damage;
- hypertensive retinopathy affects the retina of the eye;
- A scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of grade 3 arterial hypertension are otherwise called associated clinical conditions. When cerebral circulation is affected, a stroke develops, accompanied by loss of sensation in the limbs and fainting. Heart failure is a complex of all heart pathologies. The kidneys gradually fail. If hypertension is a secondary disease and occurs on the background of diabetes mellitus, then nephropathy is inevitable.
The more advanced the disease, the more devastating and severe the consequences. The circulatory system is so important to the life of the body that the slightest deviation in its function has a powerful destructive effect.
3rd degree hypertensive disability
In case of severe disease, disability group 1 is established. At this stage, the patient is practically unable to work. Sometimes they are recognized as partially able to work and continue to work, but only at home or in special circumstances.
But even with the most severe degree of disability, patients must undergo rehabilitation procedures. In this situation, this is necessary to avoid death.
Treatment of stage 3 hypertension
As the course of the disease worsens, more and more effective drugs are prescribed or their list remains the same, but the dosage increases. At this stage of hypertension, the effect of drug therapy is minimal. Patients with chronic hypertension are destined to take pills for life.
When the disease becomes severe, surgery may be necessary. This operation is indicated for certain pathologies of blood vessels and heart. The method of stem cell therapy for stage 3 arterial hypertension is considered innovative.
Hypertension 4 degrees
Some experts also identify stage 4 of the disease, which is very severe. In most cases, death is imminent. They try to ease the patient's suffering as much as possible, and with each hypertensive crisis they provide first aid. The patient is laid down, raising his head. He was immediately given medication that lowered his blood pressure dramatically.
Without treatment, new complications appear. Some of them provoke others, and the disease overtakes a person. To stop this destructive process in time, you just need to monitor the dynamics of changes in your blood pressure, at least using a regular tonometer.
An example of risk calculation depends on the level of hypertension
Stage of hypertension Other risk factors, POM or disease BP (mmHg)
| Normal high | Degree 1 | Degree 2 | Degree 3 | ||
| GARDEN 130-139 DBP 85-89 |
GARDEN 140-159 DBP 90-99 |
GARDEN 160-179 DBP 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FRs | Low risk (risk 1) |
Low risk (risk 1) | Medium risk (risk 2) |
High risk (risk 3) |
| 1-2 FR | Low risk (risk 1) |
Medium risk (risk 1) |
simple / high risk |
High risk (risk 3) |
|
| ≥3 FR | short / medium risk (risk 1) |
simple / high risk |
High risk (risk 3) |
High risk (risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without organ damage |
simple / high risk |
High risk (risk 3) |
High risk (risk 3) |
height / very high risk |
| Stage III | Established CVD, CKD stage ≥4 or diabetes with organ damage |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
GB - hypertension
SBP - systolic blood pressure
DBP - diastolic blood pressure
RF is a risk factor
CVD - cardiovascular disease
CKD - chronic kidney disease
DM - diabetes mellitus
POM - target organ damage
Once the risk category is determined, doctors can identify factors that can be influenced to reduce it. Among these modifiable features:
- Obesity (with a BMI over 30), as well as central or visceral obesity, determined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, severe heart rhythm disorders such as atrial fibrillation, etc. can also increase the risk.