An increase in blood pressure is a risk factor for the disease. Risk factors for hypertension and its causes

Arterial hypertension is called a pathological increase in blood pressure, another name is hypertension. Pathogenesis hypertension is not simple, to date it has not been fully studied. It is generally accepted that the main cause of development lies in chronic stress.

Unlike hypertension, which is a symptom of more serious pathologies, arterial hypertension is an independent disease, which will be discussed in the article.

When there is a violation of the tone of peripheral vessels, there is a favorable environment for the formation of hypertension. Deformed blood vessels cannot ensure the regulation of metabolism. The medulla oblongata and hypothalamus cease to perform their functions correctly, as a result of the disrupted work of these organs, increased amount pressor substances.

The chain continues in the arterioles, these small arteries stop responding to the minute ejection of blood from the heart. The pressure in the internal organs rises due to the fact that the arteries do not expand.

With an increase in blood pressure in the kidneys, the body begins to actively produce renin. The hormone enters the blood, where it begins to interact with the most powerful pressor substance - angiotensinogen.

There are scientific assumptions that hereditary defects are hidden at the heart of the disease, which manifest themselves under the influence of adverse factors, and it is they who provoke the mechanism for the development of hypertension.

The etiology and pathogenesis of hypertension include primary and secondary hypertension. Primary or essential hypertension is an independent disease, while secondary or symptomatic hypertension is a consequence of more serious pathological processes.

It is difficult to determine the exact causes of hypertension, but it is possible to identify risk factors that provoke the development of hypertension:

• Constant physical or nervous tension - prolonged stress not only gives rise to arterial hypertension, but also contributes to its active progression, in addition, they can cause such dangerous consequences as stroke and heart attack.
• Genetic predisposition - scientists have proven that the chances of developing hypertension directly depend on how many relatives have this disease.
• Excess weight - keep in mind that every ten kilograms of excess subcutaneous and, especially, visceral fat increase blood pressure levels by 2-4 mm Hg. Art.
• Occupational factors - constant eye strain, noise exposure or prolonged mental and emotional stress increase arterial pressure and lead to the development of the disease.
• Excessively salty food - in one day a person should consume no more than 5 grams of salt, exceeding the dosage increases the risk of developing hypertension.
• Bad habits - frequent alcohol consumption, smoking, and excessive coffee consumption increase blood pressure, in addition to hypertension, the risk of heart attack and stroke increases.
• Age-related changes - hypertension often appears in young men as a result of rapid growth, as well as in women in a state of menopause, when hormonal imbalances occur.

Classification of the disease - scheme

The pathogenesis of hypertension is a diagram of the forms of pathology and the meanings during their development:

• With a mild form - systolic 140-180, diastolic - 90-105;
• With a moderate form - systolic 180-210, diastolic - 105-120;
• With a running form - systolic more than 210, diastolic - more than 120.

Stages of hypertension:

• The first stage - blood pressure rises for a short time, quickly returns to normal under favorable conditions for this;
• The second stage - high blood pressure is already stable, the patient needs constant medication;
• The third stage - complications of arterial hypertension develop, changes occur in the vessels and internal organs - the heart, brain of the head, kidneys.

The onset of the disease can be recognized by the development initial symptoms, against the background of overwork or stress, the patient may be disturbed by:

• Pain in the head and dizziness, feeling of heaviness;
• Bouts of nausea;
• Frequent tachycardia;
• Feeling uneasy.

When the disease passes into the second stage, the symptoms appear more often, their appearance takes place in the form of hypertensive crises. Hypertensive crises are sharp and unexpected attacks of the disease.

Pathology in the third stage differs from the first two in defeat internal organs, they manifest themselves in the form of hemorrhages, visual disturbances, kidney diseases. To diagnose arterial hypertension, a conventional tonometer is sufficient.

Hypertension has a chronic course, as with any chronic disease, periods of improvement are replaced by periods of exacerbation. The progression of the disease occurs at a different pace, it has already been mentioned above that two forms of hypertension are separated according to its progression. Slow development includes all three stages, the definition of each is primarily based on the presence or absence of changes in the internal organs - the heart, kidneys, brain, retina.

The internal organs remain unchanged only at the first stage of the pathology. The initial form of the disease is accompanied by increased secretion of adrenaline and noradrenaline, which is more likely for young men during the period of active growth and sexual development. What manifestations are typical for the initial form of hypertension?

Symptoms involve the heart muscle - pain in the heart and tachycardia, pain can radiate to the forearm. Other signs are redness of the face and whites of the eyes, excessive sweating, chills, a sense of fear and internal tension.

There is no enlargement of the left ventricle of the heart, kidney function is not changed, crises are rare. Diastolic pressure 95-104 mm Hg, systolic - 160-179 mm Hg. Art. During the day, pressure indicators can change, if a person is resting, then the pressure returns to normal. The second stage already involves changes in the internal organs - one or more. First of all, violations concern the kidneys - the fluid is retained in the body, as a result of which swelling and puffiness of the face appear.

Patients have numb fingers, frequent complaints relate to headaches, blood flows from the nose. Studies such as ECG, radiography show an increase in the left ventricle, and changes also cover the fundus. Renal blood flow is reduced, glomerular filtration is slowed down.

Renography shows a diffuse bilateral decrease in kidney function. From the side of the central nervous system, manifestations of vascular insufficiency, transient ischemia are possible. In the second stage, diastolic pressure varies from 105 to 114 mm Hg, and systolic is 180-200 mm Hg. Art.

At the last stage, they become pronounced pathological changes in the internal organs, the pressure is constantly in the range of 200-230 / 115-129 mm Hg. Art. The state is characterized by pressure jumps and its spontaneous decrease.

Often there are hypertensive crises, along with them there are violations cerebral circulation, paralysis, paresis. Changes affect the kidneys, the organ undergoes arteriologialinosis, arteriolosclerosis. Such conditions provoke an initially shriveled kidney, which becomes the first step towards chronic renal failure.

1. Factors that cannot be changed
2. genetic predisposition
3. Male gender
4. Age features
5. Factors to be changed
6. Insufficient physical activity
7. Overweight
8. food salt
9. Lack of magnesium and potassium
10. tobacco addiction
11. Alcohol abuse
12. Dyslipidemia
13. stress

The appearance of hypertension is possible in those people who have a predisposition to this. But not all of them have increased pressure and such a diagnosis is established. There are certain risk factors for hypertension. These are conditions and habits that may be irreversible or acquired over a lifetime.

Factors that cannot be changed

Unfortunately, there are moments that a person is not able to change. But you should be aware of them in order to be on your guard and at the first signs of illness, consult a doctor in a timely manner.

genetic predisposition

It has long been proven that people whose close relatives suffered from hypertension have a high chance of joining the ranks of hypertensive patients. In such a family, as a rule, the disease occurs in different generations. The nature of the disease itself in close relatives, the severity, as well as the age when the pressure began to increase, matters. Severe vascular complications observed in relatives further exacerbate the situation.

Probably, the features of biological processes encrypted in genetic information predispose to the development of the disease. This is reflected in the reaction of the cardiovascular system when exposed to external stimuli. Under the influence of provoking factors, the mechanism of development of arterial hypertension is realized.

Male gender

Men are more likely to suffer from high blood pressure than women. This is especially noticeable between the ages of 35 and 55. Representatives of the stronger sex are more prone to harmful addictions: smoking, alcohol. The habit of drinking beer in large quantities contributes to the development of obesity. Stressful situations that are experienced very hard have an impact.

With age, the difference in blood pressure between women and men is leveled. This is due to the fact that some men do not live to old age, neglecting their health and not wanting to be treated on time. And in women with age, there are significant changes in the body that contribute to an increase in blood pressure.

Age features

With age, the likelihood of developing the disease increases significantly. Aging of the body leads to a decrease in the function of all organs and systems. The functional activity of those systems that are responsible for maintaining normal pressure also changes. Typically, people begin to experience high blood pressure at the age of 35 and older. The blood pressure figures are increasing every year. About 50% of people who live to be 60-70 years old suffer from hypertension.

In women, the likelihood of developing hypertension increases during menopause. During this period, significant hormonal changes take place in the body. This affects the state of the cardiovascular system. Women become more emotional, aggravated reactions to external stimuli.

But the development of hypertension with age is not observed in everyone. Here again, lifestyle, bad habits, stress and other negative influences matter.

Factors to be changed

These factors can and should be dealt with. There are a lot of them, but they can be corrected. In some cases, this requires some effort.

Insufficient physical activity

Hypertension is a disease of civilization. AT modern society lack of physical activity has become the norm. This is facilitated by sedentary work, rest at the computer. People stopped walking. The main mode of transportation is a private car or public transport. There is often not enough time for sports.

Lack of movement leads to a decrease in the adaptive capacity of the body. Not only the muscular system suffers, but also the respiratory system. The general circulation worsens. With such detraining, even habitual situations can be accompanied by an excessive response of the cardiovascular system. So, moderate exercise or a little stress can lead to a rapid heartbeat or high blood pressure.

Overweight

Excess weight is the result of hypodynamia and malnutrition. If the body mass index is more than 30, then you should seriously think about it. This is obesity. With this weight, the risk of developing hypertension increases by 2 times. The greatest danger is fraught with male-type obesity, when the bulk of fat is deposited in the abdomen.

If in men the waist circumference exceeds 94 cm, and in women - 80 cm, then there is just this type of obesity. Another way to define abdominal obesity is to determine the ratio of waist to hip circumference. In women, this figure should not exceed 0.8. For men, the borderline is 1.0.

Excess fat deposition is accompanied by a violation of metabolic processes, which leads to the activation of the renin-angiotensin-aldosterone system. This disease is characterized by the development of insulin resistance. This is a condition when there is a lot of insulin, but the cells lose their sensitivity to it. This significantly increases the formation of a special biologically active substance - angiotensin II. Under its influence, sodium is retained in the renal tubules. After him, the liquid also lingers.

There is an increase in the volume of circulating blood. In the wall of blood vessels, the content of sodium and calcium increases, which increases its sensitivity to vasoconstrictive factors. And adipose tissue itself produces hormonally active substances that can increase blood pressure. This is primarily leptin, which stimulates the activity of the sympathetic nervous system and increases blood pressure.

Obese people often have elevated blood cholesterol, which leads to atherosclerotic vascular disease. The stiffness of the vascular wall increases, its reaction to various stimuli changes.

food salt

Uncontrolled use of sodium chloride plays an important role in the development of hypertension. Daily salt intake should not exceed 5.0 g. But some people manage to eat from 6 to 18 g of "white death". Moreover, they add salt to food without even trying it.

Excess sodium is accompanied by water retention. And after eating salty food, you want to drink a lot. And almost all of this fluid remains in the body. In addition, excess osmotic pressure in the extracellular fluid pulls water out of the cells. An increase in circulating blood volume contributes to an increase in cardiac output and an increase in blood pressure.

Due to special metabolic mechanisms, an increase in the sodium content outside the cell leads to an increase in calcium inside it. This increases the tone of the smooth muscle cells of the vascular wall and increases blood pressure.

Lack of magnesium and potassium

Microelements such as potassium and magnesium are necessary for the normal functioning of the heart and blood vessels. They are involved in the contraction of the heart muscle, prevent the development of atherosclerosis. Magnesium has a relaxing effect on the smooth muscle cells of the arterial wall, which leads to vasodilation and a decrease in pressure.

Potassium is a sodium antagonist. If an excess of dietary salt enters the body, then potassium reduces the negative effects associated with this. But if there is a deficiency of this trace element, then the effects of sodium will increase many times over. Therefore, insufficient consumption of foods rich in potassium and magnesium, as well as the loss of trace elements, for example, when using diuretics, can cause the development of hypertension.

tobacco addiction

Smokers experience the negative effects of nicotine. It is the strongest cardiotoxin. When tobacco is inhaled, the poison quickly spreads throughout the body and acts on certain receptors. In this case, there is an increased release of adrenaline into the blood. This hormone increases heart rate and blood pressure.

Nicotine causes vascular spasm, has a damaging effect on the walls of the arteries. Favorable conditions are created for the formation of atherosclerotic plaques and the appearance of blood clots. In heavy smokers, atherosclerosis progresses quite quickly. This increases the risk of death from heart attacks and strokes. The problem is that nicotine is a drug. Breaking bad habits is not for everyone.

In addition to the smokers themselves, people who do not want to inhale tobacco smoke can be exposed to the negative effects of nicotine. But involuntarily they have to breathe toxic substances. Second hand smoke often observed in families where it is customary to smoke cigarettes right in the apartment, not paying attention to other family members, including children.

Alcohol abuse

Alcohol is an independent risk factor for the development of hypertension. It has long been proven that people who drink alcohol daily have a systolic pressure level of 6.6 mm Hg. Art. higher than those who drink no more than once a week. The difference in diastolic pressure is 4.7 mm Hg. Art.

For men, daily alcohol consumption should not exceed 30 ml of pure alcohol. This is approximately 60 ml of spirits, 300 ml of wine and 700 ml of beer. In women, the dose is 2 times less. You also need to adjust for weight. With the use of such doses of ethanol, the development of arterial hypertension is unlikely. But if the doses are constantly and repeatedly exceeded, hypertension will definitely make itself felt.

High doses of alcohol disrupt the functioning of the nervous system responsible for the regulation of vascular tone. Initially arising expansion of vessels is replaced by their long spasm. Therefore, the abuse of alcoholic beverages can result in a hypertensive crisis.

Ethanol stimulates the function of the adrenal glands, which contributes to the flow of adrenaline into the blood. Alcohol is often consumed with salty foods, such as mushrooms, cucumbers, and fish. Excess dietary sodium also leads to high blood pressure.

Ethanol itself causes metabolic disturbances in the heart muscle, which is the cause of arrhythmias or heart failure. It contributes to the formation of blood clots not only in large, but also in small vessels. The content of atherogenic fractions of cholesterol in the blood increases, which contributes to the damage of arteries by atherosclerotic plaques. Therefore, alcoholism often leads to the development of a heart attack and acute cerebrovascular accident.

Dyslipidemia

Excess cholesterol usually enters the body with food. Animal fats are especially dangerous, for example, butter, lard, pork, lamb, cheese. Some people eat right and don't eat these kinds of foods, but they also have high cholesterol levels. It does not depend on body weight. Here, the violation of metabolic processes and the hereditary factor matter.

stress

Stressful situations are always accompanied by the activation of the sympathetic nervous system, which leads to an increased release of adrenaline. This biologically active substance causes spasm of peripheral vessels, while improving the blood supply to the brain and heart. Increased cardiac output and heart rate.

Sodium is retained in the renal tubules, followed by water. As a result, the volume of blood in the body increases. All the effects characteristic of an excess of sodium are manifested. Stress affects all organs and systems. These changes together lead to an increase in blood pressure. Chronic stress is the cause of persistent hypertension.

Assessing the likelihood of developing hypertension, it is necessary to take into account all risk factors for the development of the disease. The more of them, the higher the chance of getting sick. But if you pay attention to them in a timely manner and completely eliminate them, you can avoid serious health problems.

Causes and treatment of complications of arterial hypertension

Hypertension is one of the most common pathologies. Lack of treatment and the influence of adverse factors are the reasons why complications of arterial hypertension develop. Chronic form disease often leads to lesions of the heart muscle and brain, which in many cases cause death.

Classification

In medical science, several types of hypertension are distinguished, depending on the nature and origin of the disease. Determining the type of pathology is an integral part of the diagnosis, which directly affects the tactics of further treatment.

Types of hypertension

Based on origin:

1. Primary. High blood pressure acts as an independent disease. It is caused by endocrine, neurological and genetic factors. Mostly found in young people. Accompanied by reddening of the skin, chills, painful pulsation in the temporal region.
2. Secondary. It acts as a symptomatic manifestation in lesions of individual organs. It is characteristic for diseases of the kidneys, endocrine glands, brain. It is also noted for violations of the blood composition, congenital heart defects, the use of certain medicines.

By severity:

1. Benign. It is characterized by long development, slow course, low intensity of symptoms. Often, signs of benign hypertension are invisible during diagnostic studies. The likelihood of complications increases in old age, since during this period the vessels are most worn out and subjected to heavy stress.
2. Malignant. The development of hypertension is spasmodic, the symptoms occur quickly, are of high intensity. Exacerbations usually occur at the same time, and the patient's condition is complicated. In the absence of medical assistance, the risk of death increases.

depending on the expression:

1. Soft. It is characterized by a slight rise in pressure up to 159/90 mm. Changes occur abruptly, persist for a long period of time. The mild form of hypertension is usually associated with an unhealthy lifestyle, the presence of bad habits.
2. Moderate. The pressure reaches 170/109 mm. Hypertensive attacks occur frequently, alternating with short remissions. Treatment is by medication.
3. Heavy. The blood pressure index exceeds 180/110 mm and persists for a long time. In hypertensive patients, pressure affects other organs, including the brain, kidneys, liver, the wear of blood vessels is accelerated, as a result of which they become inelastic and brittle. The likelihood of developing complications of hypertension is high.

There are several types of arterial hypertension, which can cause serious pathologies.

Risk factors

Hypertension is considered the most common disease on the planet, with the manifestations of which every person faces throughout life. It is obvious that not in all cases the pathology causes complications, however, under the influence of factors harmful to the body, the risk increases significantly.

Factors that aggravate the course of hypertension:

1. Unhealthy food. Improper nutrition is the main cause of high blood cholesterol. Fatty plaques impair vascular patency, causing hypertension. With severe arterial pollution, the risk of heart attacks and strokes increases.
2. Excess weight. Excess body weight is an additional burden on the cardiovascular system. The body does not have time to pump enough blood to nourish the tissues, which causes the heart rate to increase, and the pressure is constantly elevated.
3. Heart defects. In some congenital anomalies, the rhythm of muscle contractions is disturbed, which increases the volume of blood ejected from the ventricle into the aorta.
4. Diseases of the thyroid gland. With endocrine disorders, the production of hormones that prevent the harmful effects of adrenaline produced during stressful situations is reduced. The vessels lose their elasticity, which is why they are constantly in a narrowed state.
5. Smoking and alcohol. When toxic substances enter the bloodstream, the heart rate (HR) accelerates, against which pressure rises. Due to this, the body seeks to remove the decay products of alcohol, preventing poisoning of brain cells. Cigarette smoke also has a vasoconstrictive effect.
6. Age. Severe, severe hypertension is common in the elderly. This is due to many factors, including a decrease in hormone production, wear and tear of the heart muscle, and slagging of the body.

In general, complications of hypertension often arise due to adverse environmental conditions, bad habits of the patient and non-compliance with the rules of a healthy lifestyle.

Complications due to hypertension

The chronic form of the disease affects the state of the whole organism. First of all, the cardiovascular system is affected, but the impact on other groups of organs is no less dangerous.

Possible complications:

1. Atherosclerosis. A systemic disease in which blood vessels are affected. Fat deposits are deposited on the surface of the walls, as a result of which they become brittle and lose their elasticity. Due to the decrease in blood flow, the flow is disturbed nutrients in the tissue, which provokes atrophic processes. Fluid stagnation is also noted, as a result of which edema occurs, aggravating the course of hypertension.
2. Brain damage. The most dangerous pathology is a stroke, in which blood flow to the brain tissue is disrupted. With prolonged oxygen deficiency, nerve cells die. Without medical intervention, there is a high probability of damage to the brain structures responsible for movement, reflex activity, as a result of which a person will remain physically limited for the rest of his life.
3. Pathology of the heart. With hypertension, coronary artery disease gradually develops. The heart muscle gradually thickens, due to which the amount of blood required to supply increases. At the same time, the load on the ventricle and large arteries increases. Ischemic heart disease leads to disruption of blood supply to the myocardium, resulting in a heart attack.
4. Effect on the kidneys. The function of the organ is to filter the blood. The kidneys regulate the water-salt balance. With hypertension, their performance is impaired. Renal failure develops, in which blood filtration practically stops. A person suffers from intoxication, since harmful substances are not excreted in the urine.
5. Liver diseases. The organ is responsible for the regulation of metabolic processes, the preservation of nutrients and vitamins, and the elimination of toxins. Hypertension affects the liver, reducing its functionality. In severe stages develops acute insufficiency, and in the absence of treatment, a transition to a chronic form occurs.

So there are complications arterial hypertension, differing in severity, nature of manifestation, potential danger to the body.

Signs and symptoms

The clinical picture of hypertension depends on the form and severity of the disease. With a slow course, the symptoms are invisible, and therefore the patient may not assume the presence of pathology. Clinical manifestations often occur simultaneously with complications.

Signs of complications:

1. From the SSS. In addition to high blood pressure, patients have pain in the heart. Severe shortness of breath, arrhythmia, acceleration of contractions are observed. In pre-infarction states, cases of hypertensive crisis become more frequent. The patient, in addition to the above symptoms, experience dizziness, vomiting, watery eyes, hyperemia.
2. From the side of the nervous system. The effect of hypertension on brain structures is usually pronounced, but the resulting symptoms may also indicate other diseases. Symptoms include headaches, frequent dizziness, and tinnitus. There is a strong pulsation in the eye area, sometimes vision deteriorates. There are memory impairments, problems with concentration.
3. From the excretory system. With the development of renal failure against the background of hypertension, a decrease in urine production is observed. When analyzed in the liquid, a high content of protein compounds is detected. The patient develops edema, increased fatigue.
4. From the side of the liver. There are painful sensations in the area where the organ is located. At the same time, sweating may increase, the skin becomes yellow due to the ingress of a pigment substance. With circulatory disorders in the liver, the development of inflammatory diseases is possible. In this case, there is an intense pain syndrome, nausea with vomiting, general malaise.

The nature of symptomatic manifestations in complications of hypertension depends on which organ is affected by the disease.

Therapeutic measures

Treatment of complications associated with hypertension is complex. Therapy is primarily aimed at eliminating the provoking factor, which is high blood pressure. At the same time, procedures are performed, the purpose of which is to improve the condition of the affected organ and prevent further progression of the complication.

The main methods of therapy:

1. Medical reception. After determining the causes of the pathology and confirming the diagnosis, medications are prescribed. The drugs are used for the purpose of basic and symptomatic therapy. These include a group of beta-blockers, agents that prevent the effects of calcium on blood vessels, vasodilators. If necessary, painkillers, diuretics, detoxification drugs are used. The optimal regimen is prescribed by a doctor.
2. Physiotherapy. Activities help strengthen the cardiovascular system, normalize blood pressure, and are used in combination with medication. The most effective are water procedures, magnetotherapy, therapeutic massage.
3. Surgery is used for severe complications, such as stroke, accompanied by intracranial hemorrhage. Some types of operations are used to prevent heart attacks, as well as to normalize other organs. Surgical therapy is performed if conservative medical care is ineffective.
4. Lifestyle change is both therapeutic and preventive. The patient needs to give up heavy physical exertion, bad habits, malnutrition. A day regimen is established, providing for a good sleep. Recommended gymnastic exercises to strengthen blood vessels.

Therapy of hypertension and its consequences is made taking into account the individual characteristics of the patient.

Hypertension is a dangerous pathology that provokes serious complications. The lack of timely assistance can cause the death of the patient or the development of irreversible processes that lead to a limitation of physical capabilities.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Arterial hypertension is one of the pathologies of the cardiovascular system, accompanied by a persistent increase in blood pressure, as well as changes in the functioning of internal organs. The reasons contributing to the development of this disease are very diverse. Below you can get acquainted with the forms of this disease, depending on the reasons that provoke their development. To date, there are also a number of factors that predispose to the formation of this condition.

Causes contributing to the development of arterial hypertension. Etiological classification of hypertension

Classification of arterial hypertension

2. Symptomatic hypertension- occurs against the background of other pathologies, accompanied by a violation of the mechanism of regulation of blood pressure.

• Hemodynamic arterial hypertension- is the result of circulatory disorders inside the heart, as well as through the arteries. This type of arterial hypertension is observed, as a rule, in the presence of atherosclerosis or in pathologies accompanied by damage to the valvular apparatus of the heart.
• Neurogenic arterial hypertension- develops against the background of a violation nervous mechanisms pressure regulation. Most often, it is observed with encephalopathy, which arose due to atherosclerosis, and brain tumors.
• Endocrine arterial hypertension- occurs as a result of diseases of the endocrine system, which are accompanied by excessive secretion of hormones, which tend to increase blood pressure. In this case, we are talking about such ailments as: toxic goiter, Itsenko-Cushing's disease, reninoma, pheochromocytoma .
• Drug-induced arterial hypertension- occurs as a result of taking medications that increase blood pressure.
• Nephrogenic arterial hypertension- is a consequence of various pathologies of the kidneys, in which there is a destruction of the kidney tissue or circulatory disorders within this organ. This form hypertension can be observed with pyelonephritis, atherosclerosis of the renal arteries, after removal of the kidneys, with glomerulonephritis.

All of the above forms of this disease are accompanied by violations of the regulation of pressure. There is an opinion that essential hypertension occurs due to genetic disorders in which the balance of electrolytes in the extracellular environment or inside the cell is lost. Symptomatic types of this disease make themselves felt against the background of violations of the neurohumoral mechanisms of pressure regulation, which in turn arise due to various pathologies in the body.

Risk factors for arterial hypertension

Floor- in the strong half of humanity, this pathology is observed more often than in the weak half.

Chronic pathologies- if the person has chronic illness liver or kidney or diabetes mellitus, then the risk of arterial hypertension in his particular case is much higher.

Age The older the person, the higher the risk of developing this disease. So, for example, people aged from forty-five to sixty years are especially often ill with it.

Taking an anamnesis for arterial hypertension allows you to find out not only the presence of the disease itself, but also the cause of its development. This allows the doctor to determine the methods of treatment and improve the quality of life of the patient.

Diagnosis, which allows you to draw up a treatment plan, consists of the following steps:

1. Measurement of pressure - using a tonometer, blood pressure is measured at different times of the day for several days. All symptoms and complaints of the patient who applied for help are taken into account.
2. Physical examination - the doctor palpates, examines the patient's skin, measures temperature and body weight, detects or excludes neurological disorders, finds out what medications the patient has taken in the past few months and what diseases have been treated. These methods help to determine secondary blood pressure and identify pathologies of internal organs.
3. Laboratory and instrumental methods - blood and urine tests, biochemical blood tests (allows you to assess coagulability, the presence of cholesterol, identify a tendency to diabetes and atherosclerosis). ECG, ultrasound of the heart and radiography chest help to identify pathologies in the work of the myocardium.

If there are difficulties in making a diagnosis, sometimes additional procedures are performed: ultrasound of the kidneys and thyroid gland.

Clinic

The clinic of hypertension is determined by the stage of the disease and the nature of the course. Before the development of complications, the disease may be asymptomatic. More often, patients are worried about headache in the forehead and neck, dizziness, tinnitus, flickering "flies" before the eyes. There may be pain in the heart, palpitations, shortness of breath with physical activity, violations heart rate.

The onset of the disease is typically between the ages of 30 and 45 and a burdened family history of hypertension.

On clinical examination, the most important symptom is a persistent increase in blood pressure detected by repeated measurements.

Examination - allows you to identify signs of left ventricular hypertrophy (resistant cardiac impulse, displacement of the left border of the heart to the left), expansion of the vascular bundle due to the aorta, accentuation of the tone over the aorta. A more informative method for diagnosing left ventricular hypertrophy is an electrocardiographic study. An electrocardiogram may show abnormal electrical axis heart to the left, increased R wave voltage in I, aVL, left chest leads. As hypertrophy increases in these leads, signs of “overload” of the left ventricle appear in the form of T wave smoothing, then ST segment depression with a transition to an asymmetric T wave.

On a chest x-ray, changes are detected with the development of dilatation of the left ventricle. An indirect sign of concentric hypertrophy of the left ventricle may be rounding of the apex of the heart.

Echocardiographic examination reveals thickening of the walls of the left ventricle, an increase in its mass, in advanced cases, dilatation of the left ventricle is determined.

Risk factors for developing hypertension

Risk factors for hypertension may vary depending on the type of disease. There are two types: primary, or essential, and secondary hypertension. The first type occurs many times more often than the second - it is diagnosed in 95% of patients with hypertension, and its development is associated with three groups of factors: general condition organism, lifestyle and heredity. Secondary hypertension affects 5% of patients, and various pathologies of specific organs are a risk factor for its development. Some of the factors can be kept under control, reducing the risk of developing the disease.

Complications

The majority of the population does not fully understand what hypertension is and what consequences the lack of treatment can lead to. In fact, as a result of the disease, serious complications often develop that threaten the life of the patient:

• Stroke - in the history of some patients, this diagnosis is recorded as a violation of cerebral circulation. With this complication, brain damage occurs due to occlusion of the vessel or its rupture. As a result, many vital functions are impaired in the patient, and in severe cases, death occurs.
• Cerebral edema - the pathophysiology of this condition implies a reaction to vasospasm. In the process of necrosis of small vessels, nearby brain tissues are affected.
• Heart attack - occurs as a result of a circulatory disorder, as a result of which a small area of ​​\u200b\u200bthe heart muscle is necrotized. A heart attack in 30% of cases ends in sudden death of the patient.
• Angina pectoris is a common complication of arterial hypertension. Characterized severe pain in the chest, radiating to the scapula and cervical region. Angina pectoris is considered a pre-infarction condition.

Treatment

To prevent the development of a crisis, hypertension should be treated at an early stage. For charting medical tactics doctors conduct a series of studies on the patient, on the basis of which they make a conclusion. But, unfortunately, such events are impossible in some situations. For example, detecting hypertension in your 20s is very difficult. Young patients rarely seek medical care, since the malaise caused by increased blood pressure is correlated with ordinary overwork.

When identifying any form of hypertension, they immediately begin to select methods of therapy. The main goal is not only to lower blood pressure, but also to keep it at the right level. To do this, combine the use dosage forms with correction of risk factors.

Health food

With hypertension, regardless of the mechanism of development, table number 10 is shown. This diet limits the intake of salt and water, and food should be fortified with potassium. Strong tea and coffee, fatty meat, smoked meats and preservatives, spicy dishes are excluded from the diet. The patient is recommended to consume more vegetables, cereals, beans, lean meat, sea fish.

Active lifestyle

Light physical activity is beneficial for everyone, especially people who lead a sedentary lifestyle. Ideally, if the patient first visits the exercise therapy room.

The medical specialist will draw up a training plan and determine the load. Therapeutic exercise You can practice daily or every other day. The duration of one workout is from 30 to 45 minutes.

Reducing excess weight

Propaedeutics of internal diseases calls obesity the main cause of high blood pressure

In the treatment of hypertension, it is important to get rid of extra pounds. However, it is recommended to lose weight gradually

Sudden weight loss can be hazardous to health.

Rejection of bad habits

Hypertension often occurs against the background of alcohol abuse, smoking and frequent stress. Good rest and a healthy lifestyle is 50% of the successful treatment of any ailment.

Drug therapy

Medicines are prescribed in cases where lifestyle changes have not yielded results or the patient needs urgent care. A large selection of drugs in pharmacies allows you to choose the right one in each case.

Complications of hypertension

This pathological disease refers to a serious deviation in the S.S.S., which can cause various complications in the body as a result of constantly increased pressure in the arteries. Patients who suffer from hypertension are much more likely to experience pain in the temples, weakness, dizziness, noise, accompanied by nausea and vomiting. Therefore, treatment of hypertension that has not been started in time can cause serious complications, such as heart failure, coronary artery disease, and hypertensive crisis. In the second and third stages of the disease, functional disorders of the brain, heart and kidneys can be detected.

by the most dangerous complication Hypertension is considered to be a hypertensive crisis, which develops quite rapidly, causing a sharp rise in blood pressure. Symptomatic manifestations of the crisis are in the form of nausea and incessant vomiting. As a rule, the resulting complications as a result of hypertension are dangerous because of their rapid course and negative effects on the body. This, for example, applies to myocardial infarction, which can last several minutes and cause death.

Also, a dangerous complication of the pathological process is angina pectoris, which is one of the most common pathologies of hypertension. During an attack, dull pains behind the sternum of a strong nature appear with frequent vomiting and general malaise.

The development of coronary artery disease contributes to the late diagnosis of the underlying disease and non-compliance with all prescriptions. complex treatment. In addition, patients diagnosed with hypertension are at risk of coronary artery disease, which contributes to poor blood flow to the coronary vessels, and the heart, as a result, does not receive the necessary nutrition.

Thus, in order to avoid the development of such complications, it is necessary to take the existing hypertension seriously and responsibly and consult a doctor in a timely manner.

Complications affecting the eye

Hypertensive retinopathy is a condition characterized by a spectrum of retinal vascular signs in people with elevated blood pressure. It was first described by Liebreich in 1859. Retinal circulation undergoes a series of pathophysiological changes in response to elevated blood pressure. In the initial, vasoconstrictive stage, there is vasospasm and an increase in retinal arteriolar tone due to local self-regulatory mechanisms. This stage is seen clinically as a generalized narrowing of the small retinal arteries. The constantly elevated blood pressure leads to intimal thickening, media wall hyperplasia and hyaline degeneration in the subsequent, sclerotic, stage. This stage corresponds to more severe generalized and central areas of arteriolar narrowing, changes in the arteriolar and venular junctions, and changes in the arteriolar lung reflex (ie, widening and exposure of the central lung reflex, or "copper wiring").

This is followed by an exudative stage in which there is destruction of the retinal blood barrier, necrosis smooth muscle and endothelial cells, exudation of blood and lipids, and retinal ischemia. These changes are manifested in the retina as microaneurysms, hemorrhages, hard to sweat, and cotton wool spots. Optic disc swelling may appear at this time and usually indicates severely elevated blood pressure (ie, malignant hypertension). Because the best methods for controlling blood pressure are now available in the general population, malignant hypertension is rarely seen. In contrast, other retinal vascular complications of hypertension, such as macroaneurysms and branch vein obstruction, are quite common in patients with chronically elevated blood pressure. These stages of hypertensive retinopathy, however, may not be sequential. For example, signs of retinopathy that reflect the exudative stage, such as retinal hemorrhage or microaneurysm, may be seen in eyes that do not have features of the sclerotic stage, exudative signs are vague since they are seen in diabetes and other conditions.

Kinds

Types of hypertension give a complete picture of the disease. They are divided into two large groups, similar in manifestation, but differing in the principle of treatment.

1. Primary arterial hypertension - doctors cannot determine the causes of increased blood pressure. Most often, it is diagnosed in older people, indicating the stage of manifestation:

• The first degree is mild, blood pressure ranges from 140 to 99 mm Hg. Art. Hypertensive crises and lesions of vital organs (heart, kidneys, brain) are absent.
• The second degree is moderate, the pressure exceeds 179-109 mm Hg. Art. Crises often occur, performance is impaired, lesions are noted in the internal organs.
• The third degree is severe, blood pressure exceeds 180 mm Hg. Art. Crises are accompanied by renal and heart failure.

The first two degrees of arterial hypertension often do not make themselves felt for a long time. The patient seeks help for the first time after the onset of the crisis. Sometimes pathology is detected by chance - during a physical examination.

2. Secondary arterial hypertension - manifests itself as a consequence of other diseases or is a side effect on medications. The patient's blood pressure is greatly increased, and the therapeutic reduction gives little results and a short-term effect.

Secondary can be caused by the following changes in the body:

• endocrine pathologies (malfunction of the adrenal glands and thyroid gland);
• kidney disease (pyelonephritis, urolithiasis disease, glomerulonephritis, neoplasms, nephropathy);
• aggravated hereditary hypercholesterolemia;
• heart failure (malformations, atherosclerotic lesions of the aorta);
• diseases and injuries of brain tissues;
• improper use of drugs (hormones, CNS stimulants).

Unstable pressure can be caused by pregnancy when the load on the kidneys is increased. But after the birth of a child, everything returns to normal.

This type of hypertension can occur in anyone after drinking a cup of strong coffee or an energy drink.

Complications affecting the kidneys

Hypertension is a risk factor for kidney injury and ESRD. Kidney risk appears to be more closely related to systolic than to diastolic blood pressure, and black men are at greater risk than white men for developing ESRD at each blood pressure level.

Atherosclerotic, hypertension-related vascular lesions in the kidney primarily affect the preglomerular small arteries, leading to ischemic changes in the glomeruli and postglomerular structures. A glomerular injury may also result from direct injury to the glomerular capillaries due to glomerular hyperperfusion. The glomerular pathology progresses to gromelurosclerosis, and eventually the renal tubules may also become ischemic and gradually depleted. Renal damage associated with malignant hypertension consists of fibrinoid necrosis of centripetal small arteries, sometimes extending into the glomerulus, and may lead to central necrosis of the glomerular bundle.

Clinically, macroalbuminuria (random urine albumin/creatinine ratio > 300 mg/g) or microalbuminuria (random urine albumin/creatinine ratio 30–300 mg/g) are early markers of renal injury. These are also risk factors for the development of kidney disease and for cardiovascular disease.

The reasons

The causes of persistently high blood pressure are very diverse, but the most common are the states of prolonged neuropsychic stress, with prolonged stressful situations, and emotional stress.

One of the main reasons is hypothermia. When atherosclerosis develops in older people, the vessels are subject to age-related changes.

Violation can develop during menopause, when female body starts to rebuild.

A number of diseases that adversely affect the cardiovascular system contribute to its development.

There are also factors that provoke hypertension:

• overweight;
• brain injury;
• hereditary predisposition;
• infectious diseases;
• viral diseases;
• elevated cholesterol levels;
• smoking and alcohol;
• passion for coffee
• salt in large quantities;
• immobility;
• a sharp release of adrenaline;
• long time at the computer.

Complications linked to diabetes and hypertension

There are several complications of diabetes, one of which is hypertension or high blood pressure. The data indicate that at least 60-80 percent of people who develop diabetes will eventually develop high blood pressure. High blood pressure gradually early stages and may take at least 10-15 years to fully develop. Besides diabetes, other factors that can also increase high blood pressure include obesity, insulin resistance, and high cholesterol levels. In general, less than 25 percent of diabetics have good control of their blood pressure. The presence of high blood pressure in diabetes is associated with a 4-fold increase in death mainly from heart disease and strokes.

The main reason why people with diabetes develop high blood pressure is hardening of the arteries. Diabetes tends to accelerate the process of atherosclerosis. Another fact about diabetes is that it affects both large and small blood vessels in the body. Over time, the blood vessels become clogged with fatty deposits, become unruly and lose their elasticity. The process of atherosclerosis is much faster in diabetic people who do not have good control over their blood sugar. High blood pressure eventually leads to cardiac arrest, strokes, heart attacks, blindness, kidney failure, loss of libido, and poor blood circulation in the legs. When the blood supply to the legs is compromised, the chances of infections and amputations also increase.

All diabetics should be aware that even moderate elevations in blood pressure can be detrimental to health. Studies have shown that diabetics with even a slight elevation in blood pressure have a 2-3 times risk of heart disease compared to people without diabetes.

Blood pressure readings do change, but experts recommend that blood pressure should not be above 130/80.

Secondly, high blood pressure is a silent disease and thus it is vital for all diabetics to get their blood pressure checked regularly or to have it checked at the doctor's office on a regular basis. The American Diabetes Association recommends that all diabetics have their blood pressure measured by a healthcare professional at least 2-5 times a year.

Treatment of diabetic patients with hypertension

Once blood pressure is found to be high in diabetics, there are ways to treat it:

Medications like Angiotensin-converting enzyme inhibitors (ACEI) are widely used to control blood pressure in diabetics. These medicines not only control blood pressure, but also delay or prevent the development of kidney disease in diabetes. Many studies have shown that ACEI should be the drugs of first choice in diabetics with high blood pressure. Other medicines used to treat high blood pressure include water tablets. Sometimes, a combination of medications is used to treat high blood pressure. All diabetics should quit smoking. The combination of diabetes and smoking usually results in amputations of the toes and toes.

Measure your blood sugar regularly and make sure they are well balanced, as most complications of diabetes can be prevented by ensuring that such blood sugar remains within normal limits.

It is also recommended to eat a healthy diet and avoid sugary foods and limit salt intake. Also, ensure that your cholesterol levels are under control. Exercise is a must for all diabetics. Walking twice a day for 30 minutes can be a fair substitute for non-intense gym activities. Losing weight is also beneficial as it has been shown to improve blood sugar control, increase insulin sensitivity and reduce blood pressure.

Hypertension in advanced stages

In the later stages of hypertension, cardiac output decreases and the pulmonary-pressor mechanism becomes increasingly important. Increased secretion of renin leads to the formation of a significant amount of angiotensin, which stimulates the production of aldosterone. Aldosterol contributes to the accumulation of sodium in the walls of arterioles, resulting in their swelling, and they become more sensitive to pressor agents, angiotensin and catecholamines, which leads to an increase in the tone of the vascular walls; the result is arterial hypertension. An increase in vascular tone becomes persistent, organic changes develop in their walls (plasma impregnation, hyalinosis, atherosclerosis), which leads to organ ischemia, depletion of humoral intrarenal depressor mechanisms and, as a result, to the predominance of repressor and mineralocorticoid influences. In the process of prolonged stress and hyperfunction, metabolic disturbances and depletion of the reserves of a number of the most important structures and systems of the body occur - first in the central nervous system, then in the kidneys and heart.

Risk factors for arterial hypertension

Arterial hypertension causes the development of a number of cardiovascular diseases - ischemic heart disease, myocardial infarction, cerebral stroke, heart failure, etc. The formation of arterial hypertension is influenced by a number of factors, the fight against which is included in the system preventive measures. These include:

- age. In general, the level of DBP increases up to 55 years, and then almost does not change. SBP steadily increases with age.

- floor. The average level of blood pressure and the prevalence of arterial hypertension in women of young and middle age is less than in men. With age, this dependence changes up to reversion.

- racial and ethnic characteristics. In representatives of the Negroid race, the incidence of hypertension is slightly higher than in representatives of other races.

- heredity. One of the most significant factors in the development of hypertension in the future. A close correlation between blood pressure in the next of kin was revealed.

- genetic aspects. Experimental studies have confirmed the genetic basis of high BP, and although some monogenic human hypertensive disorders have been described, hypertension is predominantly a polygenic disease.

- features of the neonatal period. An unfavorable environment during fetal development and premature birth are risk factors for diseases of the cardiovascular system, in particular arterial hypertension.

- obesity in the central (abdominal) type and metabolic syndrome. Obesity is directly correlated with blood pressure levels. Combination of obesity, insulin resistance, hyperinsulinemia, lipid disorders. A relationship has been established between an increase in insulin levels and an increase in blood pressure.

- body mass. The correlation between body weight and blood pressure levels is direct, significant and persistent. Excess body weight is associated with a 2-6-fold increase in the risk of arterial hypertension.

Alimentary factors:

- table salt (NaCl). Its use in an amount exceeding the physiological norm directly correlates with arterial hypertension.

- Other macronutrients. There is an inverse relationship between the intake of K, Ca, Mg and AG.

- Proteins, fats, carbohydrates, dietary fiber. The predominance of vegetables, fruits, fish, chicken meat in the diet, limiting the intake of saturated fats, foods high in cholesterol and sweets helps to reduce blood pressure.

- Coffee. Among people who drink 1 to 5 cups of coffee a day, hypertension develops three times more often than among those who do not drink coffee at all. Caffeine causes an increase in DBP by 8 mm Hg in men with high blood pressure. Art., and with normal - by 3 mm. rt. Art.

- Alcohol. Alcohol consumption is directly correlated with blood pressure levels.

- Smoking. Cerebral stroke and coronary artery disease in smokers develop 2-3 times more often than in non-smokers with the same level of blood pressure.

- Physical activity. People who lead a sedentary lifestyle have a 20-50% higher risk of developing hypertension than those who are physically active.

— Environmental factors. Noise, air pollution, soft water are risk factors for developing hypertension. The prevalence of arterial hypertension among the adult population of most countries of the world is 15-30%.

Risk groups for hypertension.

There are 4 risk groups for the development of cardiovascular complications:

Low risk. Men and women who are under 55 years of age, who have arterial hypertension of the 1st degree and do not have other diseases of the cardiovascular system, have a low risk of developing cardiovascular complications, which does not exceed 15%.

Average level. This group includes patients who have risk factors for the development of complications, in particular, high blood pressure, high blood cholesterol, impaired glucose tolerance, age over 55 years for men and 65 years for women, and a family history of hypertension. At the same time, target organ damage and associated diseases are not observed. The risk of developing cardiovascular complications is 15-20%.

High risk. This risk group includes all patients who have signs of target organ damage, in particular, left ventricular hypertrophy according to instrumental studies, narrowing of the retinal arteries, signs of initial kidney damage.

Very high risk group. This risk group includes patients who have associated diseases, in particular coronary heart disease, have had a myocardial infarction, have a history of acute cerebrovascular accident, suffer from heart or kidney failure, as well as people who have a combination of hypertension and diabetes mellitus.

Complications affecting the heart

Hypertensive heart disease is the result of structural and functional adaptation leading to left ventricular hypertrophy, diastolic dysfunction, CHF, flow abnormalities due to atherosclerotic coronary artery disease and capillary disease, and cardiac arrhythmias. People with left ventricular hypertrophy are at increased risk for stroke, CHF, and sudden death. Aggressive control of hypertension may return or reverse left ventricular hypertrophy and reduce the risk of cardiovascular disease.

left ventricular hypertrophy is seen in 25% of patients with high pressure and can be easily diagnosed by echocardiography. The main mechanisms of hypertensive left ventricular hypertrophy are of 2 types: mechanical, mainly causing myocyte to hypertrophy; neuro-hormonal, mainly resulting in fibroblastic proliferation.

Abnormalities in diastolic function, ranging from asymptomatic heart disease to frank cardiac arrest, are common in patients with high blood pressure. Patients with diastolic cardiac arrest have a preserved ejection fraction, which is a measure of systolic function. Diastolic dysfunction is an early consequence of hypertension-related heart disease and is exacerbated by left ventricular hypertrophy and ischemia.

Treatment

In the treatment of hypertension, first of all, the level of blood pressure is controlled, and drugs are taken to maintain the pressure in a state of stability.

These drugs work by different mechanisms to lower blood pressure.

1. b-blockers - to reduce heart rate and peripheral vascular resistance - "Visken", "Atenolol", "Lokren", "Metoprolol".
2. ACE inhibitors - to block the production of renin, which is produced by the kidneys and causes an increase in pressure - Tritace, Methiopril, Capoten, Prestarium, Cilazapril, Spirapril, Moex, Enalapril.
3. Diuretics - diuretic drugs that reduce the volume of fluid in the body and blood pressure decreases - "Chlorthiazide", "Indapamide", "Hydrochlorothiazide", "Clopamide". These drugs are also good because when they are taken, potassium is not washed out of the body.
4. Calcium antagonists - block calcium channels in the walls of blood vessels, increase the lumen of blood vessels, which reduces blood pressure - "Felodipine", "Corinfar", "Amlodipine". However, these drugs have side effect in the form of dizziness, swelling or headache.

It is equally important to try to avoid stress

Complications

Complications of hypertension of the first degree can be expressed in a microinfarction of the brain, hypertrophy of the heart muscle, kidney sclerosis (nephrosclerosis). Usually consequences occur only in 15%, but the need to minimize the risk of developing hypertension is clear.

In the second degree, diseases such as cerebral thrombosis, angina pectoris, atherosclerosis, encephalopathy, and aortic aneurysm can develop.

The third degree, if left untreated, can cause heart failure, stroke, cardiac asthma, myocardial infarction, affect peripheral arteries, cause pulmonary edema, blindness, diabetic nephropathy, kidney failure.

Prevention

To reduce the risk of arterial hypertension, you need to follow preventive recommendations. This is especially true for people with a hereditary predisposition to this disease.

It is necessary to give up bad habits, this is the basis of prevention.

Lead an active lifestyle modern world the person began to move a little. Doctors call hypertension "syndrome of sedentary death." But it’s enough to walk a couple of stops, do a few exercises, slowly climb to your floor, ignoring the elevator.

You need to learn how to deal with stress. If it doesn’t work out on your own, contact psychologists or experienced specialists.

It is necessary to be in the fresh air more often, go out of town, get up early in the morning and do jogging, enjoying the world around you.

If a person is diagnosed with hypertension, he must strictly follow all the prescriptions prescribed by the doctor. Medicines are taken for life, in order to avoid complications. Daily control of blood pressure, using a tonometer in the morning and in the evening. And, most importantly, remember that health is in the hands of the patient himself.

If symptoms of hypertension appear, which are confirmed by the indicators of the tonometer, you need to contact a therapist or cardiologist.

Performed

WSO student

4 courses 3 groups

Lomteva Nadezhda

Alexandrovna

Arterial hypertension (AG) - syndrome of high blood pressure. 90-95% of cases of hypertension is essential arterial hypertension, in other cases, secondary, symptomatic arterial hypertension is diagnosed: renal (nephrogenic) 3-4%, endocrine 0.1-0.3%, hemodynamic, neurological, stress, caused by the intake of certain substances and hypertension in pregnant women, in which increased blood pressure is one of the many symptoms of the underlying disease.

Hypertonic disease(essential hypertension) is a disease, the leading symptom of which is arterial hypertension, not associated with any other disease, and resulting from dysfunction of the centers that regulate blood pressure, followed by the inclusion of neurohumoral and renal mechanisms in the absence of diseases of organs and systems, when arterial hypertension is one of the symptoms.

Classification

Optimal blood pressure< 120/80 мм рт. ст.

normal blood pressure< 130/85 мм рт. ст.

Elevated normal blood pressure 130-139 / 85-90 mm Hg. Art.

1 degree (mild hypertension) - SBP 140-159 / DBP 90-99.

Grade 2 (borderline hypertension) - SBP 160-179 / DBP 100-109.

Grade 3 (severe hypertension) - SBP 180 and above / DBP 110 and above.

· Isolated systolic hypertension - SBP above 140/dBP below 90.

The risk factors that affect the prognosis in patients with hypertension, according to WHO recommendations, include:

Risk factors cardiovascular diseases:

Increased blood pressure III degree;

Men - age over 55;

Women - age over 65;

Smoking;

Serum total cholesterol greater than 6.5 mmol/L (250 mg/dL);

Diabetes;

Family history of cardiovascular disease. Other factors affecting the prognosis:

Reduced high-density lipoprotein cholesterol;

Increasing the level of low-density lipoprotein cholesterol;

Obesity;

Unhealthy Lifestyle;

Increased fibrinogen level;

Group of high socioeconomic risk;

Target organ damage:

Left ventricular hypertrophy;

Proteinuria and / or a slight increase in plasma creatinine (1.2-2 mg / dl);

Ultrasound or radiological (angiographic) signs of the presence of atherosclerotic plaques (carotid, iliac, femoral artery, aorta);

Generalized or focal narrowing of the retinal arteries. Cerebrovascular:

Ischemic stroke;

hemorrhagic stroke;

Transient ischemic attack. Heart disease:

myocardial infarction;

angina;

History of coronary revascularization surgery;

Heart failure. Kidney diseases:

diabetic nephropathy;

Renal failure (increased plasma creatinine more than 200 µmol/l).

Vascular diseases:

Dissecting aneurysms;

Occlusive lesions of peripheral arteries. Complicated retinopathy:

Hemorrhages or exudates;

Edema of the optic disc.

Clinic

The clinic of hypertension is determined by the stage of the disease and the nature of the course. Before the development of complications, the disease may be asymptomatic. More often, patients are worried about headache in the forehead and neck, dizziness, tinnitus, flickering "flies" before the eyes. There may be pain in the region of the heart, palpitations, shortness of breath on exertion, and heart rhythm disturbances.

The onset of the disease is typically between the ages of 30 and 45 and a burdened family history of hypertension.

On clinical examination, the most important symptom is a persistent increase in blood pressure detected by repeated measurements.

Examination - allows you to identify signs of left ventricular hypertrophy (resistant cardiac impulse, displacement of the left border of the heart to the left), expansion of the vascular bundle due to the aorta, accentuation of the tone over the aorta. A more informative method for diagnosing left ventricular hypertrophy is an electrocardiographic study. On the electrocardiogram, it is possible to detect a deviation of the electrical axis of the heart to the left, an increase in the voltage of the R wave in I, aVL, left chest leads. As hypertrophy increases in these leads, signs of “overload” of the left ventricle appear in the form of T wave smoothing, then ST segment depression with a transition to an asymmetric T wave.

On a chest x-ray, changes are detected with the development of dilatation of the left ventricle. An indirect sign of concentric hypertrophy of the left ventricle may be rounding of the apex of the heart.

Echocardiographic examination reveals thickening of the walls of the left ventricle, an increase in its mass, in advanced cases, dilatation of the left ventricle is determined.

Prevention of arterial hypertension

1 If you are overweight, you should at least partially lose it, as excess weight increases the risk of developing hypertension. Having lost weight by 3-5 kg, you will be able to reduce pressure and subsequently control it well. By achieving a lower weight, you can also lower your cholesterol, triglycerides, and blood sugar levels. Weight normalization remains the most effective method pressure control.

2 Start every morning with a shower cold water. The body is tempered, the vessels are trained, the immune system is strengthened, blood circulation improves, the production of biologically active substances and blood pressure.

3 For the prevention of arterial hypertension, it is extremely useful to live above the 4th floor in a building without an elevator. Constantly going up and down, you train the vessels, strengthen the heart.

4 Walking at a good pace, jogging, swimming, cycling and skiing, practicing oriental health exercises are an excellent prevention of arterial hypertension and related troubles. Physical exercises performed from a prone position; with breath holding and straining; quick bends and lifts of the body; such emotional game sports as tennis, football, volleyball, in those who are prone to arterial hypertension, can cause a sharp increase in blood pressure and cerebrovascular accident.

5 The air, saturated with the smells of chamomile, mint, garden violet, rose and especially fragrant geranium, is an effective medicine for those who have "playing around" pressure. Inhalation of these aromas significantly reduces blood pressure, soothes, raises vitality.

6 Good and "healthy" characters in an optimistic and balanced sanguine, slow and calm phlegmatic. Arterial hypertension practically does not threaten them. Neuroses and arterial hypertension most often occur in two extreme types: an easily excitable choleric and a melancholic who quickly becomes discouraged.

8 Are you at risk? Get a tonometer and regularly (once a week, and if it’s not the first day that your head hurts, you suffer from insomnia, the feeling of fatigue doesn’t go away, stress “presses”, then more often: 1-2 times a day) measure blood pressure. You can do it in the morning without getting out of bed. Constantly elevated blood pressure is a sure sign indicating the development of arterial hypertension.

9 In autumn and spring, not only arterial hypertension exacerbates more often, but also many other diseases occur during this period. To support your body during this dangerous time, take: - motherwort infusion, 2-3 tablespoons before meals (2 tablespoons of chopped herbs, pour 0.5 liters of boiling water and leave for 2 hours); - infusion of lemon balm (2 tablespoons of chopped herbs, pour 2 cups of boiling water, after cooling, strain and drink throughout the day).

10 Stuffiness, tightness psychologically cannot be endured by all predisposed to arterial hypertension. It is hard for them to be in the crowd, among a large number of people.

11 Turtlenecks and sweaters are not clothing for people prone to hypertension. A high collar tightly wrapped around the neck, as well as a tight-fitting shirt collar, a tightly tightened tie can cause an increase in blood pressure.

12 Red, orange, yellow colors cause irritation, an influx of excess energy, excite, increase blood pressure.

13 Excessive salt intake retains sodium in the body and causes an exacerbation of arterial hypertension. When preparing food, do not salt it, but add a little salt, already served.

14 The food should not be very fatty. Observations show that a low-fat diet helps lower blood cholesterol levels and thereby reduce the risk of coronary artery disease. In addition, a low-fat diet promotes weight loss.

15 Dutch cheese, bananas, pineapples can increase blood pressure. It turns out that these products, absorbed in large quantities, due to the special substances they contain, often lead to an increased production of hormones that provoke “jumps” in blood pressure.

16 Limit your alcohol intake. It has been noticed that people who drink alcohol excessively are more likely to experience hypertension, weight gain, which makes it difficult to control blood pressure. Best not to drink alcoholic drinks generally, or limit consumption to two drinks a day for men and one for women. The word "drink" in this case means, for example, 350 ml of beer, 120 ml of wine or 30 ml of 100% liqueur.

17 Eat more potassium as this can also lower your blood pressure. Sources of potassium are various fruits and vegetables. It is advisable to eat at least five servings of vegetable or fruit salads, desserts per day.

In the modern world, diseases of the cardiovascular system are very common. One of these is hypertension. This pathology is getting younger every year. If earlier middle-aged and elderly people were more and more at risk, now arterial hypertension is also diagnosed in young people. This disease is called the "silent killer" because it can be asymptomatic for many years. Next, let's talk about who is at risk. What is the prevention of arterial hypertension. And, of course, consider the symptoms, diagnosis and treatment of this disease.

What is arterial hypertension

This is a chronic pathology with persistent high blood pressure.

A little about how our cardiovascular system works. The heart works like a pump that pumps blood and maintains a constant blood pressure in the vessels. The work of the heart is influenced by many factors, such as:

The vascular bed is a system of branched channels through which blood returns to the heart. Its volume is not constant, because the smallest vessels that are in the walls of arterioles, in muscle tissue, contract, narrow the lumen of the vessels and can redirect blood flow depending on the needs of the body. The regulation of vascular tone directly depends on the nervous and hormonal systems. The force that exerts an effect on the walls of blood vessels during the flow of blood is called pressure.

This is an increase in systolic pressure to 140 mm Hg. Art. and more, and diastolic up to 90 mm Hg. and more. The norm is considered to be the pressure in an adult 120/80 mm Hg. Art.

Disease classification

There are two degrees of arterial hypertension:

• Primary.
• Secondary.

Primary is divided into several degrees. Namely:

Arterial hypertension of 2 degrees and 3, as a rule, already gives complications in the form of such disorders:

• vascular atherosclerosis.
• Asthma.
• Heart disease.
• Pulmonary edema.

Secondary arterial hypertension is accompanied by pathology of internal organs. It is violations in the operation of these systems that provoke stable pressure surges:

• Pathology of the heart and aorta.
• Brain tumors and consequences of TBI.
• Kidney diseases.
• Endocrine pathologies.
• Tumor of the adrenal and pituitary glands.
• Removal of two kidneys.

Also, excessive use of certain drugs can cause arterial hypertension. What are these drugs:

Therefore, people who suffer from arterial hypertension should definitely consult a doctor before taking a new drug.

Symptoms of the disease

For different characteristics different symptoms. often begins with the fact that the patient did not have any serious complaints. However, you should pay attention to frequently recurring conditions:

Other symptoms are also possible. For the first degree of arterial hypertension, damage to the internal organs is not characteristic. However, in order to stop the deterioration of the situation in a timely manner, it is necessary to pay attention to the above listed symptoms.

Arterial hypertension of the 2nd degree can provoke the following conditions:

• Spasm of the vessels of the fundus.
• The walls of the left ventricle may be enlarged.
• There may be protein in the urine.
• There are signs of damage to the walls of large vessels by the atherosclerotic process.

Arterial hypertension of the 3rd degree is characterized by the involvement of the affected organs in the process of pathological processes. The following diseases may appear:

• Heart failure.
• Edema of the optic nerve.
• Angina.
• Myocardial infarction.
• The development of atherosclerotic processes narrowing and obstruction of blood vessels.

Arterial hypertension of the 3rd degree has a significant number of complications.

Manifestations of the secondary form of pathology are more pronounced. The following phenomena are possible:

• Edema.
• Pain in the lumbar region.
• Dysuric phenomena.
• Signs of inflammatory processes in the blood test.
• Changes in urinalysis.

Causes of arterial hypertension

This disease cannot occur without a cause, like any other. Let's name some reasons:

However, it is worth noting that the above causes are only suitable for primary hypertension. The secondary form develops due to an already existing disease that provokes an increase in blood pressure. These are usually the following diseases:

• Kidney diseases.
• Tumors of the adrenal glands.
• Late toxicosis during pregnancy.
• Use of certain medications.

How is hypertension diagnosed?

Before an accurate diagnosis of arterial hypertension, it is necessary to conduct a thorough diagnosis. And at the first visit to the doctor, such a diagnosis is not made. Where to start? Diagnosis of arterial hypertension begins with an examination and questioning of the patient. It is necessary to identify hereditary diseases, past illnesses, what lifestyle is being led and much more.

1. High blood pressure should be measured and recorded. It is necessary to measure three times, observing all the rules of measurement.

A medical history is started, arterial hypertension, as the diagnosis is at first in doubt. The next record of the doctor's visit will not be earlier than in 2 weeks. Measuring after a short period of time can create a false picture. If the measurements have borderline figures, then in this case, it is recommended to measure the pressure daily. In this case, the values ​​are recorded. Such a system allows you to choose the necessary drugs to normalize the condition.

After determining the blood pressure, it is necessary to determine how seriously the target organs are affected. Diagnosis of arterial hypertension includes the following additional examinations:

This diagnosis will help the doctor to correctly diagnose and prescribe the appropriate treatment. The doctor should also tell you what the prevention of arterial hypertension is.

Risk factors for primary hypertension

There are several risk factors for primary arterial hypertension:

• Large amounts of salt in the diet. This factor is especially reflected in the elderly, those who are obese with kidney disease, as well as those who have a genetic predisposition.
• genetic predisposition.
• Pathology of the arteries. A decrease in their elasticity leads to an increase in pressure. This is typical for people with obesity, low mobility. Also in older people and in people with high salt intake.
• Excessive production of renin by the kidney apparatus.
• Inflammatory processes contribute to jumps in blood pressure.
• Obesity increases the risk of high blood pressure by 5 times. More than 85% of those with arterial hypertension have a body mass index of more than 25.
• Diabetes.
• There are observations that snoring can also be a risk factor for arterial hypertension.
• age factor. With age, the number of collagen fibers in the vessels increases, as a result, the walls of the vessels thicken, and their elasticity is lost.

Prevention of arterial hypertension is necessary to reduce risk factors. We will consider recommendations a little later.

Risk factors for a secondary form of pathology

We know what is associated with the pathology of organs and systems. These are such diseases as:

It should be said that secondary arterial hypertension can contribute to kidney disease in the same way that kidney disease can provoke an increase in pressure. The risk of arterial hypertension can be reduced through preventive actions, which we will discuss a little later. And now let's move on to the methods of treatment.

Ways to treat arterial hypertension

Therapy of arterial hypertension in the first stage does not involve the use of drugs. Your doctor may prescribe a diet, reduced salt intake, increased physical activity, and weight loss.

However, if at the second visit to the doctor it persists high blood pressure, or while still growing, the doctor may prescribe the following medications:

• Beta blockers are prescribed. They help lower your heart rate, thereby lowering your blood pressure. However, people with heart disease and asthmatics should not use them.
• Diuretics are used in conjunction with other drugs. Promote the removal of salt and water from the body.
• Drugs that limit the access of calcium to muscle cells.
• Angiogenesis receptor blockers allow vasoconstriction as a result of the production of aldosterone.
• In heart failure and kidney disease, ACE inhibitors are prescribed.
• Drugs that constrict arterioles and affect the central nervous system.
• Together with other drugs, drugs of central action are prescribed.

Prevention of arterial hypertension

If high blood pressure is periodically noted, measures must be taken. Contacting a doctor should be immediate. But there are some things you can do to make yourself feel better too. These actions can be qualified as the prevention of arterial hypertension.

• Control your weight. Dropping extra pounds, you can immediately notice a slight decrease in pressure.
• Move more, walk, exercise.
• Reduce the intake of salt in your diet. Refuse semi-finished products and canned foods.
• Refrain from drinking alcoholic beverages.
• Eat more vegetables and fruits that contain potassium.
• Eradicate bad habits like smoking.
• Limit your intake of fatty foods. This will help you lose weight and lower your cholesterol levels.
• Constantly monitor blood pressure. Visit a doctor and take prescribed medications. It is also necessary to inform the doctor about the changes that have occurred while taking the drugs.
• It is worth remembering that even if the pressure has normalized, the medication should not be stopped. They must be taken regularly.
• Also avoid stressful situations.

Features of treatment and prevention in the elderly

The older the person, the more difficult it is to treat arterial hypertension. For several reasons:

• Vessels are no longer as elastic and are easily damaged.
• There are already atherosclerotic lesions.
• Pathological changes in the work of the kidneys and adrenal glands can cause hypertension.
• Drugs are prescribed very carefully in small doses.
• With coronary heart disease, it is impossible to reduce the pressure to normal.
• Pressure must be measured in a sitting and lying position.

Prevention of arterial hypertension in the elderly is also:

• Leading a healthy lifestyle.
• Maintaining normal cholesterol levels.
• Move more, walk more, do exercises.
• Stick to proper nutrition.

We examined what arterial hypertension means. The risk factors and prevention indicated in the article will help you take timely measures to improve your health so that you do not have to deal with this disease.