Hypertension or arterial hypertension - an illness marked by stable disease, ie due to repeated measurements, increased blood pressure. Accompanies many diseases and is considered a risk factor for the development of dangerous complications from the cardiovascular system, including myocardial stroke and infarction. Hypertonic diseases as the main cause of pathological pathology must take drugs and normalize the patient's lifestyle and nutrition.
Blood pressure is a force with which circulating blood works on the walls of blood vessels. Such pressure at the time of heart contraction is described as systolic and during relaxation as diastolic. The area of normal values for these indicators is quite wide.
In the course of numerous observations, scientists came to the conclusion that the risk of cardiovascular complications increases by 10 mm Hg with every additional increase in blood pressure. Art. Already with a level of 115/75 mm rt. Art. However, a pressure of the pressure only over 140/90 mm turned out to be appropriate. Rt. Art. Therefore it is exactly one value that is seen as a criterion for determining arterial hypertension.
Reasons
In about 90% of cases, high blood pressure becomes the cause of a stable increase in blood pressure. Such a diagnosis is made to the patient if other diseases were not found by high blood pressure during the examination. Among the latter:
- Kidney pathologies - pyelonephritis, glomerulonephritis, polycystic, diabetic nephropathy, stenosis of renal arteries;
- Endocrine disorders-neoplasms of the adjoining giant, pancreas or pituitary gland, thyroid hyperfunction, Izenko-kushing syndrome, pheochromocytom;
- Obstructive Apnoe syndrome in a dream;
- Valance or atherosclerotic damage to the aorta.
Regular use of a number of pharmaceuticals can also lead to an increase in blood pressure. This includes oral contraceptives, non -steroid anti -inflammatory drugs, amphetamines, corticosteroids, medication that contains erythropoetin, cyclosporin, cocaine.
The likelihood of cardiovascular diseases, including high blood pressure, is closely related to the following risk factors:
- Improper nutrition, including an excess of sodium salt, saturated fats and trans fats, a lack of leafy vegetables, vegetables and fruit in nutrition;
- Obesity;
- Pathologies of heart and blood vessels in nearby relatives;
- Old older than 65 years;
- sitting lifestyle;
- Chronic stress;
- Harvest habits - smoking, excessive alcohol consumption.
classification
If it was possible to identify the disease that led to an increase in blood pressure, arterial hypertension is described as secondary or symptomatic. In the event of an unidentified cause, the high blood pressure is considered primarily, which is caused by high blood pressure.
The latter has a staging current:
- Stage I. There are no obvious signs of violations of the work of target organs, which are affected by a stable increase in blood pressure heart, kidney, arterial and venous vessels.
- Level II. There is one of the listed characters or their entirety, such as: In this case, the clinical manifestations of the disease cannot be present.
- Hypertension in level III. There are one or more pathologies associated with atherosclerotic processes in the heart and in the vessels - myocardial infarction, acute cerebrovascular accident, angina pectoral, atherosclerosis of the arteries of the lower extremities in the lower extremities or a serious kidney damage, which is due to a pronounced demolition of filtration and the significant loss of the urine-Proteis.
The arterial hypertension depends on the maximum indicators of the measured blood pressure into several degrees:
- 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. The systolic blood pressure is more than 180 mm. Rt. Art. and/or diastolic over 110 mm. Rt. Art.
There is also an isolated form of arterial hypertension, in which only the figures of systolic pressure are diastolic diastolic.
Symptoms
Often, an increase in blood pressure will not be associated with a deterioration in the borehole and can remain unnoticed for the patient. Therefore, it is so important to measure blood pressure regularly, especially with medium and older people.
The following symptoms can be the manifestations of high blood pressure:
- Headache, mainly in the morning after awakening;
- Bleeding out of the nose;
- Bleeding under the mucous membrane of the eye;
- Violation of the heart rhythm;
- Various seeing, flickering of flies;
- Tinnitus.
A strong blood pressure jump to high numbers, accompanied by a pronounced deterioration of the well, is called a hypertensive crisis. Most of the time it occurs with an increase in systolic pressure of more than 180 mm hg. Art. and/or diastolic over 120 mm ed. Art. At the same time, the patient has weakness, nausea, vomiting, no relief, impairment of consciousness, fear and fear, muscle tremors, chest pain.
Complications
A stable increase in blood pressure with high blood pressure increases the risk of cardiovascular pathologies, including the patient's life. This includes:
- Acute brain circulation (stroke);
- Angina pectoris, myocardial infarction;
- vascular dementia (dementia);
- Chronic kidney and heart failure;
- Atherosclerotic lesions of the vessels of the lower extremities.
Diagnosis
The main symptom for high blood pressure is a stable increase in blood pressure, which revealed at least three dimensions on different days in a quiet environment. When measuring blood pressure in a hospital or a clinic for the correctness of the results, it is important to adhere to the following rules:
- Before the examination, the patient has to sit in a quiet room for a few minutes to calm down.
- The size of the tonometer cuff should correspond to the thickness of the arm and the device itself in order to be attached to the level of the heart;
- Two measurements are carried out with an interval of 1-2 minutes on each hand, with a large difference in the numbers obtained being carried out an additional measurement;
- In older patients and people suffering from diabetes mellitus, or in the event of suspicion of reducing blood pressure when changing the body position, the measurement is carried out in the first and fifth minutes in the standing position.
- In addition, the heart rate is measured within 30 seconds.
In an interview with the patient, the doctor illustrates in old age, at which age the pressure initially increases when there are symptoms such as snoring with breathing stops in a dream, muscle weakness or sudden palpitations with sweating and headache as well as unusual contaminants in the urine. It is also important to find out which medication and biodes he occupies.
As part of the first phase of the examination, the following tests for high blood pressure are carried out:
- Clinical blood test;
- General urine analysis, the detection of microalbumin in the only daily and daily parts;
- Biochemical blood test (cholesterol, lipoproteins to assess the risk of atherosclerosis, blood electrolyte - potassium, sodium, chlorine, calcium as well as glucose and creatinine);
- Determination of the glycated hemoglobin level;
- Determination of the concentration of hormones thyroxine, triiodothyronine and thyroid hormone, antibodies against thyroid peroxidase and thyroid hormone, aldosterone.
In the event of suspicion of an inherited disposition for the disease, it is possible to determine the polymorphisms of genes associated with the development of arterial hypertension.
In order to clarify the risk factors for the development and identification of existing cardiovascular pathologies for high blood pressure, instrumental diagnostic methods are used:
- daily monitoring of blood pressure;
- Electrocardiographic study;
- Echocardiography;
- Holter Daily Monitoring;
- Duplex scanning of brachiocephalous, kidney or iliacal arteries;
- Ultrasound examination of the kidneys and adrenal glands;
- Inspection of the eye floor.
With high blood pressure, blood pressure control is important at home in order to maintain a diary in which all results of the time measurements, drugs and stress episodes are taken that can cause an increase in blood pressure. At the same time, the measurements must be carried out in the sitting position after a few minutes, which hold the hand with the heart at the same level.
Treatment
With a moderate and low risk of cardiovascular complications, the patient is only recommended to change the lifestyle, correction of nutrition, weight loss, the increase in physical activity and the special gymnastics for high blood pressure, rejection of bad habits against the background of regular blood pressure. These measures are often sufficient to normalize blood pressure.
The diet for high blood pressure includes the limitation of table salt, caffeine, sharp, salty, smoked and spicy dishes, products with high fat content, offal, confectionery with oil cream and alcoholic beverages. It is permissible not to use more than 5 g salt per day outside the deterioration of the disease. The recommended daily liquid rate is 1-1, 2 liters.
With an unsuccessful treatment of non -drug treatment for several months and with a high risk of complications, you can use hypotensive therapy using medication against high blood pressure, the purpose of taking blood pressure of less than 140/90 mm. Rt. Art. In patients with diabetes or people who are already suffering from pathologies of the cardiovascular system, the target pressure level is even below 130/80 mm. Rt. Art.
The modern drug treatment of high blood pressure includes a combination of two or more drugs from the following groups:
- Calcium antagonists;
- Angiotinezinoproding -Ezym inhibitors;
- Blocker for angiotensin II;
- Diuretics (diuretics);
- B blocker;
- Alpha blocker.
The vast majority of them are produced in the form of tablets from high blood pressure.
prevention
The prevention of exacerbations of high blood pressure includes a timely diagnosis and therapy for diseases of cardiovascular, nervous, urine and endocrine systems, relentlessly, followed by the doctor's recommendations, including treatment and medication without union, as well as regular measurement of blood pressure.