Arterial hypertension belongs to the most common diseases of the heart and blood vessels, which affect about 25% of the adult population.It is not surprising that it is mentioned as a non -infectious epidemic.Hypertension with its complications significantly affects the mortality of the population.The estimates show that up to 25% of the deaths of people over the age of 40 are directly or indirectly caused by hypertension.The probability of complications determines the phases of hypertension.How many phases does hypertension have, how are they classified?Look below.
Important!According to the latest estimates of the World Health Organization of 1993, hypertension in adults is a constant increase in blood pressure at 140/90 mm hg.Art.
Classification of arterial hypertension, determination of the degree of risk of the disease
In which, according to etiology, hypertension is classified in primary and secondary.
With primary (essential) (GB) hypertension, the main organic cause of the increase in blood pressure (blood pressure) is not known.A combination of genetic factors, external influences and violations of the internal regulatory mechanisms is taken into consideration.
External factors:
- environment;
- Excessive use of calories, development of obesity;
- Increase in salt consumption;
- Lack of potassium, calcium, magnesium;
- excessive drinking;
- Repeating stressful situations.
Primary hypertension is the most common hypertension, in about 95% of cases.
3 hypertension phases are separated:
- Phase I - increase in blood pressure without changes in the organs;
- Stage II - an increase in blood pressure with changes in the organs, but without compromise their function (hypertrophy of the left ventricle, proteinuria, angiopathy);
- Stage III - organs accompanied by compromised functionality (left heart failure, hypertensive encephalopathy, stroke, hypertonic retinopathy, renal failure).
Secondary (symptomatic) hypertension is an increase in blood pressure as a symptom of the underlying disease with the identified cause.The classification of secondary arterial hypertension is as follows:
- Renoparechimal hypertension - occurs due to kidney disease;Reasons: renal parenchymal disease (glomerulonefrite, pyelonefrite), tumors, renal damage;
- Renewal hypertension - narrowing of kidney arteries with fibromoscular dysplasia or atherosclerosis, renal thrombosis in vein;
- Endocrine hypertension - Primary hyperaldosteronism (Conn syndrome), hyperthyroidism, feocromocytoma, Kushing syndrome;
- hypertension caused by drugs;
- Gestational hypertension - high pressure during pregnancy, after childbirth, the condition is often normalized;
- Aorta coercion.
Gestational hypertension can lead to the child's congenital diseases, in particular retinopathy.2 phases of retinopathy (premature and complete children) are separate ::
- Active - consists of 5 development phases, can lead to the loss of vision;
- Rubts: leads to the cloudy of the cornea.
Important!Both phases of the retinopathy of premature and complete children lead to anatomical disorders!
Hypertensive disease according to the international system (according to ICD-10):
- Primary form - i10;
- Secondary form - i15.
The degrees of hypertension also determine the degree of dehydration - dehydration.In this case, the classifier is a lack of water in the body.
Share 3 degrees of dehydration:
- Grade 1 - Light - lack of 3.5%;Symptoms: dry dry, severe thirst;
- Grade 2 - Average - deficiency - 3-6%;Symptoms: acute fluctuations in reducing pressure or pressure, tachycardia, oliguria;
- Grado 3 - The third degree is the most serious, characterized by the lack of 7-14% of the water;It manifests itself with hallucinations, delirium;Clinic - Coma, hypovolemic shock.
Depending on the degree and the dehydration phase, the decomning is carried out by introducing solutions:
- 5% of glucose + isotonic nacl (slight degree);
- 5% NACL (average degree);
- 4.2% Nahco3(severe diploma).
GB phase
The subjective symptoms, in particular with a slight and moderate stadium of hypertension, are often absent, therefore there is often an increase in blood pressure in terms of dangerous indicators.The clinical picture is divided into 3 phases.Each phase of arterial hypertension presents typical symptoms, from which the classification of GB arrives.
Phase I.
In 1 stadium of hypertension, the patient complains of headaches, fatigue, rapid heartbeat, disorientation, sleep disorder.In 1 stadium of GB, the objective detection on heart, ECG, eyeball background, in the laboratory studies are present in the normal interval.
Phase II
In the 2nd phases of Ah, the subjective complaints are similar, at the same time there are signs of hypertrophy of the left ventricle, there are signs of hypertensive angiopathy on the retina, microalbuminuria or proteinuria in the urine.Sometimes there is a multiplication of red blood cells in the precipitation of urine.In 2 phases of hypertension, the symptoms of renal insufficiency are absent.
Phase III
With the hypertension of Stadium III, functional disorders are diagnosed in organs belonging to an increased risk of hypertension:
- Damage to the heart - at the beginning there is a lack of breath, therefore - symptoms of cardiac asthma or pulmonary edema;
- Vascular complications - damage to peripheral and coronary arteries, the risk of brain atherosclerosis;
- Changes on the bottom - they have the nature of hypertensive retinopathy, neuroretinopathy;
- Changes in the cerebral blood vessels occur from transient ischemic attacks, typical thrombotic or hemorrhagic vascular blows;
- In stadium III, a brain stroke, brain lesions are diagnosed in almost all patients;
- The benign nephrosclerosis of the kidney vases - leads to limiting glomerular filtration, an increase in proteinuria, red blood cells, hyperuricemia and after chronic renal failure.
What phase or degree of hypertension is the most dangerous?Despite the various symptoms, all stadiums and degrees of arterial hypertension are dangerous, they require adequate systemic or symptomatic treatment.
Grade
In accordance with the indicators of blood pressure (blood), determined at the time of diagnosis, 3 degrees of hypertension are distinguished:
- light;
- average;
- heavy.
There is also a fourth concept: the determination of resistant (persistent) hypertension, in which even with the correct choice of a combination of antihypertensive drugs, blood pressure indicators are not reduced below 140/90 mm hg.Art.
A clearer overview of the grades of arterial hypertension is presented in the table.
AG classification and stratification of normal blood pressure according to eSh/ESC 2007 guidelines.
| Category | Systolic pressure, mm hg.Art. | Diastolic pressure, mm hg.Art. |
|---|---|---|
| Optimal | <120 | <80 |
| Normal | 120–129 | 80–84 |
| Normal increase | 130–139 | 85–89 |
| 1 degree | 140–159 | 90–99 |
| 2 degrees | 160–179 | 100–109 |
| 3 degrees | more than 180 | more than 110 |
| Isolated systolic hypertension | more than 140 | Less than 90 |
The patient's difficulties vary in accordance with the separation of hypertension in degrees.The choice of the disease treatment regime depends on the determination of the degree.
Graduates
The disease can only be detected with the regular measurement of blood pressure.Measurements must be performed in a relaxed environment, at least 3 times in a certain period.
This is the only way to evaluate the presence or absence of hypertension.Depending on the degree of increased blood pressure, the clinical picture of the disease differs.
II grade
The 2nd degree of hypertension is characterized by periods of increase in pressure that alternate with a decrease in indicators or an increase in diastolic value only.To this extent, hypertension, cases of growing pressure in certain circumstances are typical, in particular in patients with an unstable nervous system.
III degrees
III degree of AG is characterized by a critical increase in blood pressure.
Grade III of GB is characterized by serious complications that derive due to the harmful effects of high pressure on all organs and systems.First of all, the heart, the kidneys, the eyes, the brain are affected.With the hypertension of grade III, the symptoms and treatment are closely associated - with insufficient or improper treatment, the disease can lead to serious consequences: stroke, brain, renal failure, irreversible eye injuries, blood vessels.The lack of treatment for the degree of hypertension III increases the risk of isolated systolic hypertension.
In this phase of arterial hypertension, the degree of risk increases significantly!Memory disorders, mental activity, frequent loss of consciousness are manifested.
The hypertonic crisis was born as a complication of the third century and is considered art IV.Gb.
Risks
In accordance with the classification of hypertension due to stadiums and degrees, patients are divided into risk groups, depending on the severity of AG.4 categories are distinguished (i.e. there are many of the degrees of hypertension), which are determined by the principle of probability of damage to the internal organs in the future.
Risks on the degree of illness:
- risk of less than 15%;
- risk of up to 20%;
- risk 20-30%;
- The risk is over 30%.
Low, insignificant
A low -risk group includes men up to 55 years and women at 65 from art. Arterial hypertension.In this group, the risk of cardiovascular pathology in the period up to 10 years is less than 15%.We recommend to people who belong to a low risk group to change the lifestyle.If within 6-12 months, non-drug therapy shows no efficacy, it is advisable to prescribe drugs.
Average
The medium risk group includes people from I - II art. Hypertension, provided that there are 1-2 risk factors.The risk increases with high body weight, smoking, an increase in cholesterol, a violation of glucose tolerance, a lack of movement.Hereditary factors are also important.The risk of cardiovascular complications in these people is higher and is 15-20% for 10 years.People relating to this group is advised to conform to a healthy lifestyle.If a reduction in pressure does not occur within 6 months, pharmacotherapy is prescribed.
High
The high risk group includes people from the century I - II.hypertension, subject to the presence of at least 3 risky factors, which include:
- diabetes;
- defeat of the target organs;
- Aterosclerotic vascular diseases;
- Left ventricular hypertrophy;
- increase in creatinine;
- Changes in the eye pots.
This group also includes hypertension of the third century, which has no risky factors (the risk of cardiovascular diseases is 20-30% for 10 years).The representatives of this group are under the supervision of a cardiologist.
Very high
A group of hypertension with a very high risk of cardiovascular diseases (over 30% for 10 years) includes people with III art. Hypertension, provided that there are at least 1 risky factor.In addition, this group includes patients with Ah I - II art.In the presence of a violation of brain circulation, ischemia, nephropathy.This group is controlled by cardiologists, requires active therapy.
Conclusion
The problem of arterial hypertension is that the disease has no typical symptoms, it is characterized by a variety of clinical paintings.Therefore, often a person does not know the presence of the disease.Therefore, the high pressure is detected by chance, during the inspection or in the manifestation of complications.In the diagnosis of hypertension, it is important to correctly inform the patient who can largely influence the course of his illness, following a healthy lifestyle.