Constantly high blood pressure in medicine has several names: hypertension, arterial hypertension, essential hypertension.The disease can cause damage to the kidneys, heart, blood vessels, cause stroke, heart attack, stomach ulcer bleeding and other serious consequences.To prevent dangerous health conditions, it is necessary to take timely measures to prevent the disease and know the risk factors that significantly increase the likelihood of hypertension.
What is hypertension
It is a chronic pathology that develops due to a dysfunction of vascular regulation, renal and neurohumoral mechanisms.Hypertension (HTN) is a dangerous condition of the body in which there is a persistent increase in blood pressure (BP) with levels above 140/90 mmHg.Art.in patients not taking antihypertensive drugs.
Hypertension represents approximately 40% of all cardiovascular diseases.The disease occurs more often in men than in the female population.The risk of developing pathologies in both sexes increases with age.Hypertension is diagnosed mainly in patients after the age of 40, but recently the disease is increasingly recorded in adolescence and young adulthood.
Headache stages
Hypertension is a chronic pathology that has three stages of development.In an adult the optimal blood pressure is 120/80 mmHg.Art.A slight deviation from these indicators up to 139/89 mm Hg.Art.This also applies to the norm.Higher numbers in medical practice are considered pathology.The diagnosis of “hypertension” is made when indicators above 140/90 are repeatedly recorded in various conditions.
Stage 1 hypertension is characterized by abrupt changes in blood pressure.This already indicates a pathological process occurring in the body.The disease in its initial stage is almost always asymptomatic.The patient does not pay attention to some signs of hypertension, which explains the high percentage of late requests for qualified help.Symptoms of stage 1 hypertension:
- blood pressure indicators: from 140/90 to 159/99 mm Hg.Art.;
- heachache;
- confusion;
- decreased mental performance;
- dyspnea;
- tachycardia;
- increased swelling;
- fluid retention in the body;
- change in the amount and color of urine.
Second stage hypertension is arterial hypertension that manifests itself in a moderate form.At this stage of the disease, longer periods of increased blood pressure are observed than at the beginning.Blood pressure values in stage 2 hypertension rarely return to normal.Patient Condition:
- blood pressure indicators: from 160/109 to 179/109 mm Hg.Art.;
- sleep disorders;
- discomfort in the heart area;
- heart failure;
- memory and vision disorders;
- constant irritability;
- dizziness;
- tinnitus;
- aching pain in the back of the head;
- dilated ocular vessels;
- the facial skin is hyperemic;
- swelling of the face, hands.
Stage three hypertension is a serious form of the disease.It is characterized by the fact that the patient has a history of myocardial infarction, stroke and other serious pathologies.It is possible to completely cure hypertension at this stage in very rare cases, only if the hypertension lasts for a short time or is secondary.Severe hypertension clinic:
- blood pressure indicators: from 180/110 mm Hg.Art.and above;
- left ventricular hypertrophy;
- hypertrophy of the interventricular septum;
- impaired coordination of movements;
- encephalopathy;
- ischemic or hemorrhagic infarctions;
- various kidney lesions;
- persistent visual impairment;
- prolonged hypertensive crises;
- paralysis and paresis due to cerebral circulation disorders;
- limitation of the ability to move independently and take care of oneself.
Risk factors for hypertension
The development, progression and complications of arterial hypertension are directly related to the presence of risk factors for the onset of this pathological process.Hypertension is the result of a complex interaction of internal (endogenous) and external (exogenous) causes.The onset of the pathology is facilitated by the acquired and congenital characteristics of the body, which weaken its resistance to adverse external conditions.
Risk factors for the development of arterial hypertension are classified according to two indicators: modifiable and non-modifiable.The former depend on a person's decisions and his lifestyle.These include:
- bad habits;
- physical inactivity;
- smoking;
- drink alcohol;
- obesity and others.
Immutable risk factors for hypertension are those that a person cannot influence: heredity and physiology (gender, age).In many cases, hypertension is a genetically transmitted disease.If one of your relatives suffered from hypertension, there is a high probability that the next generation will be affected by the disease.As for physiological factors, according to statistics, middle-aged men are more susceptible to the disease.This is explained by the fact that the female body produces estrogen, hormones that perform a protective function.
Endogenous
Intrinsic risk factors for hypertension are the presence of diseases or conditions that cause hypertension.Among these:
- diabetes mellitus;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity;
- metabolic disorder;
- kidney diseases (pyelonephritis, nephritis, glomerulonephritis);
- increased concentration of sodium or calcium in the blood;
- the effect of adrenaline during stress;
- dyslipidemia (fat metabolism disorder);
- increased uric acid content;
- neurocirculatory dystonia;
- pregnancy;
- menopause.
Related to lifestyle and environmental influences
Exogenous risk factors for hypertension are associated with the patient's lifestyle.The number of acquired causes that can be successfully fought is significant, but each point can be easily changed if a person wishes.The main exogenous risk factors for hypertension:
- Insufficient physical activity.Constant work in the office, travel exclusively by car, lack of time to visit the gym lead to the weakening of the respiratory system, impaired muscle function and deterioration of blood circulation.All these factors cause an increase in blood pressure.
- Uncontrolled salt intake.Sodium chloride in large quantities causes thirst and delays the removal of fluids from the body.Water causes an increase in the volume of circulating blood, as a result of which myocardial contractions become more frequent, resulting in an increase in blood pressure.The consumption rate of table salt does not exceed 5 g/day.
- Magnesium and/or potassium deficiency.The body needs these microelements for the proper functioning of blood vessels and heart muscle.If they are deficient there is a risk of developing hypertension.
Diagnostics
Hypertension is determined by several methods: the blood pressure level is measured several times using a tonometer and a phonendoscope, the clinical picture of the disease is studied, clinical, physical and instrumental studies are prescribed.Main diagnostic approaches:
- Biochemical blood test.The level of high/low density lipoprotein and cholesterol is detected and the sugar level is determined.These indicators are important in determining the cause of hypertension.
- ECG.The electrocardiogram has long been a reliable assistant in the diagnosis of hypertension.An ECG reveals disruptions in the work of the heart, determines the presence of angina and provides data on the displacement of the heart from the electrical axis and the state of the myocardium.
- Ultrasound of the heart.The main vessels (carotid arteries) leading to the brain are illuminated to detect atherosclerotic plaques, evaluate the state of the vascular walls and the risk of stroke.
- Arteriography.X-ray method for studying the walls of arteries and their lumen.
- Dopplerography.Ultrasound technique for diagnosing blood flow in veins, arteries and vessels.
- Ultrasound of the kidneys.It helps to identify large tumors in the adrenal glands and lesions of the renal tissue, which lead to the appearance of renoparenchymal hypertension.
- Ultrasound of the thyroid.It helps to identify or exclude the influence of the thyroid gland on the development of hypertension in a patient.
Treatment
Treatment of hypertension depends on the cause of the disease.The first thing the patient must do is eliminate all risks associated with hypertension.Then drug therapy is used in combination with non-drug methods: adherence to an anticholesterol diet, physical activity, quitting smoking and drinking alcoholic beverages.Pharmacological treatment is carried out according to different schemes:
- Patients at low to moderate risk of developing hypertension are prescribed a drug to lower blood pressure.
- Patients at high risk of cardiovascular disease are prescribed two or more drugs with individual dosages.
The choice of drugs and dosage is made by the doctor, taking into account the patient's age, concomitant pathologies and risk factors.Several groups of drugs are used to treat hypertension:
- Thiazide diuretics.They inhibit the absorption of chlorides and sodium in the renal tubules so that they do not enter the blood, but are excreted from the body through urine.
- Calcium channel blockers.They reduce calcium intake, as a result of which the load on the myocardium decreases and blood pressure decreases.
- ACE inhibitors.They reduce the concentration of the hormone angiotensin in the blood, which has the ability to narrow the lumen of blood vessels, increasing blood pressure.
- Angiotensin II receptor antagonists.Reduces blood pressure in the first stage of hypertension.
- Beta blockers.They relax the vascular walls, which leads to improved blood circulation and normalization of blood pressure.
- Alpha-2 central agonists.The heart rate is reduced, which is manifested by a decrease in blood pressure.
- Direct vasodilators.It relaxes the smooth muscles of the arterioles, causing a decrease in blood pressure.
- Renin inhibitors.They promote the dilation of the arteries and inhibit the activity of renin, an enzyme with a vasoconstrictor effect.