Hypertension, or high blood pressure-a condition characterized by a stable, that is to say detected by repeated measurements, an increase in blood pressure. Supporting many diseases, it is considered a risk factor for the development of dangerous complications in the cardiovascular system, including stroke and infarction. Hypertonic disease, as the main cause of the pathology considered, requires taking medication, normalizing the patient's lifestyle and nutrition.Blood pressure is a force with which the circulating blood acts on the walls of the blood vessels. Such pressure at the time of cardiac contraction is called systolic and during its relaxation - diastolic. The range of normal values for these indicators is quite wide.During many observations, scientists have reached the conclusion that the risk of cardiovascular complications increases with each additional increase in blood pressure by 10 mm Hg. Art. Already starting with a level of 115/75 mm RT. Art. However, a decrease in the drug drug greater than 140/90 mm proved to be appropriate. Rt. Art. , Therefore, it is precisely such a value which is taken as a criterion to determine high blood pressure.
ReasonsIn approximately 90% of cases, hypertension becomes the cause of a stable increase in blood pressure. Such a diagnosis is made to the patient when other diseases accompanied by hypertension were not found during the exam. Among these:Renal pathologies - pyelonephritis, glomerulonephritis, polycystic, diabetic nephropathy, stenosis of renal arteries; Endocrine-nine-free disorders of the adrenal gland, pancreas or pituitary gland, thyroid hyperfunction, Izenko-Cusing syndrome, pheochromocytoma;obstructive apnea syndrome in a dream;Valve vices or atherosclerotic damage to the aorta.Regular use of a certain number of drugs can also cause an increase in blood pressure. These include oral contraceptives, non-steroidal anti-inflammatory drugs, amphetamines, corticosteroids, drugs containing erythropoetine, cyclosporin, cocaine.The probability of cardiovascular diseases, including hypertension, is in close contact with the following risk factors:Bad nutrition, including excess sodium salt, saturated fats and trans fats, a lack of green leaves, vegetables and fruits in the diet;obesity;pathologies of the heart and blood vessels in close relatives;age over 65 years;sedentary lifestyle;Chronic stress;Harvest habits - smoking, excessive alcohol consumption.
ClassificationIf it was possible to identify the disease leading to an increase in blood pressure, high blood pressure is called secondary or symptomatic. In the case of an unidentified cause of hypertension, it is considered primary, caused by hypertension. The latter has a staging current:Step I. There is no obvious sign of violations of the work of the target organs affected by a stable increase in blood pressure, kidneys, arterial and venous vessels.STEP II. There is one of the signs listed or their totality, such as an increase in the left ventricle of the heart, a pronounced decrease in the filtration rate in the kidneys, albumin in the urine, an increase in the thickness of the walls of the carotid arteries or the appearance of atherosclerotic plates in their light. In this case, clinical manifestations of the disease may be absent.Hypertension of stadium III. There is one or more pathologies associated with atherosclerotic processes in the heart and vessels - myocardial infarction, fenced cerebrovascular accident, pectoral chest, atherosclerosis of the arteries of the lower extremities, or a serious renal damage, manifested by a pronounced decrease in filtration and / or a significant loss of proteins of urine.High blood pressure is divided into several degrees, according to the maximum indicators of the measured blood pressure:The first degree. Systolic blood pressure from 140 to 159 mm. Rt. Art. And / or diastolic - from 90 to 99 mm. Rt. Art.The second degree. Systolic blood pressure from 160 to 179 mm. Rt. Art. And / or diastolic - from 100 to 109 mm. Rt. Art. The third degree. Systolic blood pressure is greater than 180 mm. Rt. Art. and / or diastolic on 110 mm. Rt. Art.There is also an isolated form of high blood pressure, in which only systolic pressure figures in the normal diastolic.
SymptomsOften, an increase in blood pressure is not accompanied by a deterioration of well-being and can go unnoticed for the patient, it is so important to measure blood pressure regularly, especially the elderly and the elderly.The following symptoms can be manifestations of hypertension:Headache, mainly in the morning after awakening;Nose bleeding;hemorrhage under the mucosa of the eye;heart rate violation;Blurred vision, flickering flies;tinnitus.A good act of blood pressure with a high number, accompanied by a deterioration pronounced in well-being, is called hypertensive crisis. Most often, it occurs with an increase in systolic pressure of more than 180 mm Hg. Art. and / or diastolic on 120 mm Hg. Art. At the same time, the patient has weakness, nausea, vomiting, which does not bring relief, altered consciousness, anxiety and fear, muscle tremor, thoracic pain.
ComplicationsA stable increase in blood pressure with hypertension considerably increases the risk of cardiovascular pathologies, including patient life. These include:acute brain circulation (stroke);pectoralis, myocardial infarction;Vascular dementia (dementia);chronic renal and heart failure;Atherosclerotic lesions of the vessels of the lower limbs.
DiagnosisThe main symptom of hypertension is a stable increase in blood pressure, revealed at least three dimensions in different days in a calm environment. To the first measure of blood pressure in a hospital or clinic for the accuracy of the results, it is important to comply with the following rules:Before examining, the patient must sit for several minutes in a quiet room to calm down;The size of the cuff of the tonometer must correspond to the thickness of the arm and the device itself - to be attached to the heart of the heart;Two measurements are made with an interval of 1 to 2 minutes on each hand, with a large difference in the numbers obtained, an additional measure is carried out;In elderly patients, as well as people with diabetes mellitus, or in the event of suspected blood pressure reduction in the event of a change in body position, the measure is carried out in the first and fifth minutes in a standing; In addition, the heart rate is measured within 30 seconds.The doctor in an interview with the patient clarifies at what age the pressure started to increase, if there are symptoms such as snoring with respiratory stops in a dream, episodes of muscle weakness or sudden palpitations with perspiration and headache, and unusual impurities in urine. It is also important to discover what drugs and biodes it takes.As part of the first step in the exam, the following tests are carried out for hypertension:Clinical blood test;General analysis of urine, microalbumin detection in its parts at a time and daily;Biochemical blood test (cholesterol, lipoproteins to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium, as well as glucose and creatinine);Determination of the level of glycated hemoglobin;Determination of hormone concentration - thyroxine, triiodothyronin and thyroid hormones, antibodies against thyroid -peroxidase and thyroïglobulin, aldosterone.In the event of suspicion of hereditary predisposition to the disease, it is possible to determine the polymorphisms of the genes associated with the development of high blood pressure.In order to clarify the risk factors for developing and identifying cardiovascular pathologies existing for hypertension, instrumental diagnostic methods are used: Daily monitoring of blood pressure;electrocardiographic study;echocardiography;Holter daily surveillance;Duplex scanning of the brachiocephalous, renal or iliac arteries;Ultrasound study of kidneys and adrenal glands;Inspection of the bottom of the eyes.With hypertension, control of blood pressure at home is important to maintain a newspaper in which it is necessary to repair all the results of temporal measures, to take medication and stress episodes which can cause an increase in blood pressure. At the same time, the measurements must be carried out in a seated position, after several minutes of rest, holding hands at the same level with the heart.
TreatmentWith a moderate and low risk of cardiovascular complications, the patient is only recommended to change lifestyle, food correction, weight loss, increase in physical activity and special gymnastics for hypertension, rejection of bad habits in the context of ordinary blood pressure. Often these measurements are sufficient to normalize blood pressure.The diet for hypertension implies the limitation of table salt, caffeine, pointed, salted, smoked and spicy dishes, products with a high fat content, offal, confectionery with cream of oil and alcoholic drinks. It is allowed not to use more than 5 g of salt per day outside the exacerbation of the disease. The recommended daily liquid level is 1 to 1, 2 liters. In the case of without success without success for several months, as well as with a high risk of complications, resorting to hypotensive treatment using drugs for hypertension, the aim of which is a decrease in blood pressure below 140/90 mm. Rt. Art. For patients with diabetes or people who are already suffering from cardiovascular system pathologies, the target pressure level is still lower-10/80 mm. Rt. Art.The modern drug treatment of hypertension includes a combination of two or more drugs of the following groups:calcium antagonists;enzyme inhibitors angiotenzinzinoproding;angiotensin II blockers;diuretics (diuretics);Blockers B;Alpha-blockers.The vast majority of them are produced in the form of tablets from hypertension.
PreventionThe prevention of hypertension exacerbations includes a timely diagnosis and therapy for diseases of cardiovascular, nervous, urinary and endocrine systems, followed by doctor's recommendations, including treatment and non -unionized drugs, as well as the regular measurement of blood pressure.
