Hypertension or arterial hypertension - a condition characterized by stable, ie detected by repeated measurements, increased blood pressure. Following many diseases, it is considered a risk factor for the development of hazardous complications from the cardiovascular system, including myocardial and infarction stroke. Hypertonic disease, as the main cause of the pathology, which is considered, requires taking drugs, normalizing the lifestyle of the patient and nutrition.
Blood pressure is the force with which the circulating blood acts on the walls of blood vessels. Such pressure in the time of heart contraction is called systolic and during relaxation - diastolic. The range of normal values for these indicators is quite wide.
During numerous observations, scientists have reached the conclusion that the risk of cardiovascular complications increases with each additional increase in blood pressure by 10 mm Hg. Art. Already begins with a level of 115/75 mm RT. Art. However, reduced drugs above 140/90 mm were interrupted to be appropriate. Rt. Art. Therefore, it is precisely such a value that is taken as a criterion for determining arterial hypertension.
Reasons
In approximately 90% of cases, hypertension becomes the cause of a stable increase in blood pressure. Such a diagnosis is performed by the patient when other diseases are accompanied by hypertension during the test. Among the latter:
- Kidney pathology - pilonephritis, glomerulonephritis, polycistical, diabetic nephropathy, kidney stenosis;
- Endocrine disorders-neoplasms adrenal glands, pancreas or pituitary thyroid hyperfunction, izenko-cushing syndrome, feochromocytoma;
- obstructive sleep apnea syndrome;
- Valve valve or aortic damage to the aorta.
Regular use of multiple medications can also cause blood pressure to increase. They include oral contraceptions, not -steroidal anti -infalmator drugs, amphetamines, corticosteroids, medications containing erythropoetin, cyclosporin, cocaine.
The probability of cardiovascular diseases, including hypertension, in the immediate relationship with the following risk factors:
- Incorrect nutrition, including excess sodium salts, saturated fats and trans fat, lack of leafy greenery, vegetables and fruits in the diet;
- obesity;
- heart pathologies and blood vessels in close relatives;
- Older than 65 years;
- Sedentary lifestyle;
- Chronic stress;
- Harvest food - smoking, excessive alcohol consumption.
Classification
If it was possible to identify a disease leading to increasing blood pressure, arterial hypertension is called secondary or symptomatic. In the event of an unidentified cause of hypertension, it is considered primary, caused by hypertension.
The latter has a liquid:
- Stage I. There are no obvious signs of violation of targeted bodies that affect a stable increase in blood pressure, kidneys, arterial and venous veins.
- Phase II. There is one of the listed signs or their totality, such as the increase in the left ventricle, the reduces in the kidneys, albumin in the urine, increasing the thickness of the walls of the carotid arteries or the appearance of atherosclerotic plaques in their lump. In this case, there may be absent clinical manifestations of the disease.
- Phase III hypertension. There are one or more pathologies associated with atherosclerotic processes in the heart and ships, an acute cerebrovascular accident, angina pectoris, the achievement of the lower extremities, manifested from the pronounced reduction in filtration and / or significant loss of urine protein.
Arterial hypertension is divided into several degrees, depending on the maximum indicators of measured blood pressure:
- First degree. Systolic blood pressure from 140 to 159 mm. Rt. Art. And / or diastolic - from 90 to 99 mm. Rt. Art.
- Another degree. Systolic blood pressure from 160 to 179 mm. Rt. Art. And / or diastolic - from 100 to 109 mm. Rt. Art.
- Third degree. Systolic blood pressure is greater than 180 mm. Rt. Art. and / or diastolic over 110 mm. Rt. Art.
There is also an isolated form of arterial hypertension, in which only figures are systolic pressure in normal diastolic.
Symptoms
Often increasing blood pressure does not follow the deterioration in the benefit and may go unnoticed for the patient, so it is so important to regularly measure blood pressure, especially medium and older people and the elderly.
The following symptoms can be manifestations of hypertension:
- Headache, mostly in the morning after waking;
- Nose bleeding;
- bleeding under the mucous membrane of the eye;
- a violation of a heart rate;
- blurred vision, flickering flies;
- Tinnitus.
A sharp jump of blood pressure on high numbers, with a pronounced deterioration in well-being, is called a hypertensive crisis. The most commonly occurs increase in systolic pressure more than 180 mm Hg. Art. and / or diastolic over 120 mm Hg. Art. At the same time, the patient has weakness, nausea, vomiting, which does not make relief, weakened awareness, anxiety and fear, muscle shivers, chest pain.
Complications
A stable increase in blood pressure hypertension significantly increases the risk of cardiovascular pathology, including the patient's life. They include:
- Acute cerebral circulation (stroke);
- Angina pectors, myocardial infarction;
- vascular dementia (dementia);
- Chronic renal failure and heart heart;
- Atherosclerotic lesions of lower extremity vessels.
Diagnostics
The main symptom of hypertension is a stable increase in blood pressure, at least three dimensions in different days during the peaceful environment. In the first measurement of blood pressure in the hospital or the clinic for the correctness of the results, it is important to adhere to the following rules:
- Before testing the patient should sit for a few minutes in a quiet room to calm down;
- The size of a chief tonometer should match the thickness of the hand, and the device itself - which is attached to the heart level;
- The two measures are performed with an interval of 1-2 minutes on each hand, with a large difference in the obtained numbers, additional measurement was performed;
- In older patients, as well as people suffering from Mellitus diabetes, or in case of doubt in reducing blood pressure in case of change in a body position, measurement is carried out in the first and fifth minute in a permanent position;
- In addition, the heart rate is measured within 30 seconds.
The doctor in an interview with a patient explains at which the age of pressure began to grow first, if there are symptoms such as snoring breathing, in blackness, and a headache muscular weakness or sudden ability to urine. It is also important to find out which medications and biodes take.
As part of the first phase of the test, the following tests are performed for hypertension:
- Clinical blood test;
- General urine analysis, microalbumines detection in its time and daily part;
- Biochemical blood test (cholesterol, lipoprotes for assessing atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium, as well as glucose and creatinine);
- Determination of glycle hemoglobin levels;
- Determination of hormone concentration - thyroxine, triodothyronine and thyroid hormone, thyroid antibodies - Proxide and starlight, Aldosteron.
In case of doubt in the hereditary predisposition of the disease, it is possible to determine the polymorphism of genes associated with the development of arterial hypertension.
To clarify risk factors for the development and identification of existing cardiovascular pathology for hypertension, instrumental diagnostic methods are used:
- daily blood pressure monitoring;
- Electrocardiographic study;
- echocardiography;
- Holter daily monitoring;
- Duplex scan of brahiocephalus, kidney or ilikon arteries;
- Ultrasonic study of kidney and adrenal glands;
- Overview of the bottom of the eye.
With hypertension, blood pressure control is important with maintenance of a diary in which it is necessary to solve all time measurement results, taking drugs and stressing episodes that can cause blood pressure. At the same time, measurements must be performed in a sitting position, after a few minutes of rest, holding a hand on the same level with the heart.
Treatment
At a moderate and low risk of cardiovascular complications, the patient is only recommended to change the lifestyle, weight loss, increasing physical activity and special gymnastics for the bad habits in relation to the background of ordinary blood pressure. These measures are often enough to normalize blood pressure.
Hypertension diet includes a limitation of a table, caffeine, sharp, salty, smoked and spicy dishes, a high-fat, cover, confectionery products with oil cream and alcoholic beverages. It is allowed to use no more than 5 g salutes a day outside the disease deterioration. The recommended daily fluid rate is 1-1, 2 liters.
In the event of an unsuccessful treatment of an early few months, as well as with high risk complications, he resorts to hypotensive therapy using hypertension drugs, whose purpose is reduced blood pressure less than 140/90 mm. Rt. Art. For patients with diabetes or persons that already suffer from the pathology of the cardiovascular system, the level of target pressure is even lower-130/80 mm. Rt. Art.
Modern hypertension drugs includes a combination of two or more drugs from the following groups:
- Calcium antagonists;
- Enzyme inhibitors of angiotensonization;
- Angiotenzin II blockers;
- diuretics (diuretics);
- B-blockers;
- Alpha-blockers.
The vast majority of them are produced in the form of tablets from hypertension.
Prevention
Prevention of exacerbation of hypertension includes timely diagnosis and therapy for cardiovascular, nervous, urinary and endocrine systems, non-reliant, and the following are non-union treatment and medications, as well as regular blood pressure measurement.