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Arterial hypertension

Arterial hypertension is a pathological state that is characterized by a long increase in the pressure indicators in the arteries of a large bloodstream.A sign of the disease is the increase in diastolic (lower) blood pressure, but in most diagnosed cases, patients have continuing growth of the systolic (upper) pressure.

Which pressure is considered increased

The classification of the blood pressure accepted in 1999 is still valid today.The following is considered normal:

  • Optimal - less than 120/80 mm ed. Art.;
  • Physiological standard - less than 130/85 mm ed. Art.;
  • Normally increased - in the range 130–139/85–89 mm ed. Art.

A pressure increase indicates the formation of high blood pressure.The internal gradation of the pathology looks like this:

  1. Soft (i degree) - 140–159/90–99 mm ed. Art.
  2. Medium (II second degree) - 160–179/100–109 mm ed. Art.
  3. Heavy (III degree) - over 180/110.

Border rifles are diagnosed in indicators in 140-149/90 mm HG.Art.And below.It is accompanied by pressure growth episodes and its spontaneous stabilization.

In isolated systolic hypertension, indicators of 140 and over / 90 and under mm HG are diagnosed.Art.This type of pathology is characterized by diastolic by an increase in the systolic indicator at the physiological level.

AG classification (primary, secondary)

The classification of high blood pressure is based on several characters.When systematization, the doctors took into account:

  • Reasons that cause the development of pathology;
  • Defeated by the target organs;
  • The current level of blood pressure, etc.

Depending on the etiological factors, it is common to distinguish:

  1. Primary (essential).
  2. Secondary (symptomatic) hypertension.

Due to the nature of the passage, a distinction is made between (slowly developed) and maligner (with a rapid deterioration of the condition) arterial hypertension.

Varieties of secondary (symptomatic) hypertension

Secondary (symptomatic) arterial hypertension is a kind of illness that develops due to the damage to the organs responsible for regulating blood pressure.It is characterized by a stubborn course, the lack of a positive reaction to the through blood pressure -lowering therapy and changes in the target organs, in particular on the formation of heart, kidney failure, etc.

When primary hypertension (essential format) occurs as an independent disease, secondary forms are always a symptom of the main pathology.The syndrome of arterial hypertension accompanies a fairly significant number of diseases.It is diagnosed in 10 % of all identified cases of persistent increase in blood pressure.

The classification of symptomatic hypertension is based on factors that cause the disease.

Differentiate:

  1. Neurogenic hypertension.The development is due to the lesion of the central nervous system and the associated pathologies, for example brain neoplasia.
  2. Nephrogen (kidney jump).They are divided into interstitial, renoparchymales, renovascular, mixed and rhinopian forms.
  3. Endocrine AG.There are adrenal, thyroid, pituitary and menopause.
  4. Hemodynamic - provoked by the heart of the heart and large arterial channels.
  5. Dosage form.Its development is due to the use of oral contraceptives, glucocorticosteroid ingredients, etc.

The size and resistance of the increase in blood pressure, the severity of the changes in the state of the left ventricular and the fund on the basis of another classification.Doctors distinguish the following varieties of symptomatic hypertension:

  1. Temporary.For pathology is a typical short -term increase in the pressure indicators.Changes in the state of the fund are completely missing.The hypertrophy of the left ventricles is almost not defined.
  2. Laby.It is characterized by a moderate, short increase in blood pressure (independent acceptance does not occur).There is a weak left ventricular hypertrophy that narrowed the vessels of the retina of the eye.
  3. Stable.It is accompanied by steadily high blood pressure.The myocardial thickening, severe violations in the vessels of the fund are diagnosed.
  4. Malignant (uncontrolled).It is accompanied by a strong increase in blood pressure.The result is unfavorable.

The following forms of symptomatic hypertension are found:

  • Pulmonary hypertension (high blood pressure of a small blood circulation).It is determined as a diagnosis when the blood pressure in the lung artery is determined over 25 mm.Rt. Art.
  • Vasorsenal AH is a secondary form of pathology due to an inadequate bloodstream in the kidneys as a result of an impaired arterial throughput.
  • Portal hypertension is one of the types of the symptomatic form of the disease, accompanied by a pressure increase in the gate vene.
  • Hypertension of the Virsungov Canal.Against the background of chronic inflammation of the pancreas.

Consequences and complications

The vessels of the target organs are damaged with long -fluid high blood pressure: heart, brain, kidneys and eyes.Violation of the circulatory process can lead to follow, such as:B.:

  • Angina breast attacks,
  • Myocardial infarction,
  • Neurological complications etc.

Important!The formation of acute conditions against the background of a strong increase in blood pressure requires its reduction in the first few minutes/hours.

Reasons

The reasons for the development of the essential form of pathology are certainly not known to doctors.Several theories are nominated:

  1. Neurogen (inheritance).The cause of the development is chronic stress, significant emotional shocks and psychological injuries.All of this provokes a failure in the process of neural regulation, accompanied by an increase in the activity of the sympathetic system.The result is the deviation of signals to all organs and an increase in the tone of the walls of the vessels.
  2. Voluminous salt.Due to impaired processes of the output of excess liquids and certain trace elements.As a result of the excessive salary of sodium salts, an increase in the total volume of the blood occurs.The body's attempts to maintain the hemostasis process on a physiological level leads to spasming of small vessels.The indicators for the tiny volume of the heart are stabilized, but the total blood pressure is increased.

Important!Doctors argue that the reason for the development of AH is an increase in the activity of the sympathetic system.

Modified (variable) risk factors that can provoke the occurrence of arterial hypertension are:

  • Age - diagnosis of the disease is in people in the age of age;
  • Bad habits - smoking, alcohol absorption;
  • a state of chronic stress;
  • Inadequate physical activity;
  • Obesity;
  • The presence of accompanying pathologies - diabetes is particularly unfavorable;
  • Excess salt with a lack of potassium.

The reasons for increasing blood pressure can be different.The active work of the adrenal glands and a tendency on a genetic level can act as a provocative factor.

Symptoms

In the initial educational phase, arterial hypertension is asymptomatic.The patient only gets to know the presence of a problem after the development of serious complications.

The only sign of the pathology can be described as an increase in the pressure indicators.There are no complaints at all, or they are not specific:

  • Headache located in the area of the forehead and in the back of the head;
  • Dizziness;
  • Noise.

The first complaints are formed against the background of the defeat of the target organs.At this stage, the occurrence of the following symptoms is determined:

  • Dizziness, accompanied by headache, noise - arise as a logical result of circulatory disorders;
  • Problems with memorizing information;
  • Hands/legs deafness;
  • Weakness;
  • Doubling the visible image;
  • Flicker black dots in the field of vision;
  • Language injury (rare);
  • Nephropathy.

The symptoms are typical of the last stages.They come at the beginning of the formation of pathology.

The left ventricle (LV) begins hypertrophically with damage.The cause of the change is the compensatory reaction of the body, which enables increased loads on the wall.An increase in the ventricular is due to an increase in the number of cardiomyocytes.When the condition deteriorates, the heart chambers are expanded.

Such damage to the organ can manifest itself in the form:

  • The formation of heart failure,
  • a sudden cardiac arrest,
  • Ischemic disease,
  • Gastric rhythm disorders,
  • Heart asthma,
  • Strong shortness of breath during the loads.

Important!Cardi pain against the background of the AG develops during the time of absolute calm or as a result of an emotional overvoltage.A characteristic feature is the inability to stop the attack with a pill glycerin.

If the kidneys are damaged, the presence of protein in the urine can be observed.The appearance of blood pollution is not excluded.The likelihood of kidney failure is minimal.

Urine analysis for arterial hypertension

The most important clinical sign of arterial hypertension is a headache.Appears at any time of the day, but most often in the morning.It is perceived by the patient as bursting or pain.The location of the localization is the back of the head, but the spread to other areas of the head is not excluded.Pain is improved by tipping and coughing.It can occur in response to stressful situations, physical stress.

diagnosis

The diagnosis of the disease should solve the following problems:

  • Establishment of the pathology, determination of the current conclusion;
  • Identification of the origin of high blood pressure (primary/secondary form);
  • Perform differential diagnosis;
  • Determination of the presence/absence of damage to target organs.

During a personal conversation with the patient, the doctor finds out the necessary points:

  1. Are there any cases of diseases in the immediate environment?
  2. How often is the pressure determined.
  3. Is there a prehistory of chronic diseases in the patient, etc.

The Body Mass Index (BMI) is calculated.Obesity is one of the potential provocateurs of forming high blood pressure.

After completing the inspection, blood pressure is measured.In order to determine the degree of arterial hypertension, the patient is prescribed by the performance of the blood pressure profile.H. measurements to the patients themselves at home.It is necessary to make 4 measurements: two in the morning and two in the evening for several days in a row.

The results must be included in the table.When the indicators exceed 140/90 mm HG.Art., We can talk about the presence of arterial hypertension.

Sometimes a brush is prescribed (daily monitoring of blood pressure).The technology is shown when the patient's measurements remain normal, but another symptoms of the disease occurs.

Important!SMAD is several measurements of blood pressure indicators for a whole day.Measurements are carried out by a special device.

In order to determine the real cause of the development of arterial hypertension and to determine the power of damage to the target organs, are prescribed:

  • Examination of the kidney system.Includes the examination of urine - a general test.A theater ultrasound of the kidney system, renography with the introduction of a radioactive isotope is prescribed.
  • Heart test.EKG is used (the electrocardiogram shows the growth of the street R), echocardiography (enables you to see signs of a pathological increase in the left ventricular and other transformations).
  • Ophthalmological examination of the eye.A sign of the disease is the visual impregnation of blood vessels, the seal.Bleeding is not excluded.
  • Ultrasound of the thyroid gland and adrenal glands.
  • The blood test is a general test and an extended biochemistry.

When diagnosing the secondary form of high blood pressure, it is necessary to carry out differential diagnosis (DIF).It continues in two phases:

  • Analysis of the clinical image, increase in complaints, a physics examination of the patient, in particular auscultation, instrumental/laboratory studies;
  • Diagnostic measures with which you can evaluate the functional condition of the organs and existing changes, in particular you have to remove the cardiogram.

The methods used help to confirm the diagnosis, determine the origin of the disease and choose the therapy that is appropriate for the state.

Treatment

The treatment of high blood pressure begins with a revision of the lifestyle and the non -drug therapy.The exception is a secondary hypertension.

The drug therapy of arterial hypertension provides the absorption of the following groups of medicines:

  1. Diuretics.The medication has a positive effect on the condition of the heart cycle system.The reception is not accompanied by the development of side effects.The therapy of the disease begins with diuretics (contraindication - diabetes and gout).Against the background of the treatment, the urine volume removed by the kidneys and correspondingly excess water and sodium salts increases.Diuretics are prescribed in combination with other high blood pressure.
  2. Alpha blocker.Medicines are characterized by good tolerance.They do not affect blood sugar.Provide a decrease in blood pressure with a slight increase in the impulse (frequency of the contraction of the heart muscle).The occurrence of orthostatic hypotension at the beginning of treatment with the drugs of this group becomes a side effect.To rule out its development, it is advisable to take medication before going to bed.
  3. Beta blocker.Reduce the heart rate accompanied by a decrease in blood pressure.
  4. ACE inhibitor.Modern drugs are characterized by a high therapeutic effect and good tolerance.Against the background of taking money in the patient's body, the form of angiotensin II - a hormone that causes the lumen of blood vessels is not occurring.Thanks to this, the peripheral vessels expand, the heart works in a quieter rhythm.There is a decrease in blood pressure indicators.
  5. Antagonist Angiotensin-II.Medications also block angiotensin II. They are appointed if it is impossible to receive ACE inhibitors.
  6. Calcium antagonist.Medicines expand the gaps in the blood vessels and thus prevent the development of stroke.The medication have an excellent therapeutic effect and are well tolerated.Have a small list of contraindications.Most often prescribed as part of the complex therapy.

Stopping the treatment even after stabilizing blood pressure is strictly prohibited.In this case, the disease will progress again, which negatively influences the condition of the target organs.In addition, the risk of developing heart attack and stroke increases significantly.

The disease is treated outpatient: the patient occupies independently selected medication.Hospital stay in the hospital is only recommended in severe cases.

The treatment of pathology in addition to taking medication ensures a massage.Processes not only contribute to reducing the pressure, but also to the overall reinforcement of the body, improve the activity of the cardiovascular system etc. Read more about different types of massage in our article: Massage with high pressure - classic, dot and other effective methods.

Nutrition

Compliance with the principles of nutrition of nutrition is one of the most important phases to stabilize blood pressure indicators.In the event of high blood pressure, diet No. 10 is recommended.

In the initial phase of the formation of pathology (AH 1 degree), it is necessary to stick to diet No. 5.It provides for a restriction when using table salt.With a deterioration of the state and the development of violations in the work of the heart and the vascular system, the transition to nutrition No. 5 A. is recommended

If the disease becomes complicated by atherosclerosis, diet No. 10 C. Hypocholestere indiet is prescribed to reduce the used fat animal origin, easily digestible carbohydrates.The diet should include food with a high content of food fibers, vegetable fats and proteins.

The list of permissible products is shown by the following positions:

  • Bread - wheat, rye, whole grain, with bran.Not -love back, bake.
  • Grain -seasoned vegetable soups.
  • Food varieties of meat: poultry, rabbits.It can cook and bake.
  • Sea/river fish.Seafood.
  • Seasonal vegetables.You can prepare the stew from them.
  • Sour dairy products and cottage cheese made of low -fat cheese.Sour cream with low fat (placed in a bowl).
  • Soft eggs (not more than 3 pieces a week).
  • Milk and tomato sauces.
  • Croats, pasta.
  • Oil (to the task of a finished dish).
  • Fruits/berries (in any form).It can be used to prepare compota, jelly, jelly.
  • Juices, tea with milk, rose hip kochlung.

It must be completely excluded from the diet:

  • Freshly baked bread, Sdoba, complicated pastries.
  • Brew favorites.
  • Fat meat.
  • Smoked meat, sausages.
  • Fish (salty/smoked), caviar.
  • Fettsauces, cheese, cream.
  • Spring, radishes, spinach, horseradish, mushrooms.
  • Ice, chocolate, confectionery, strong tea, coffee.

The salt consumption must be significantly reduced.

Salt with arterial high blood pressure

prevention

The prevention of the disease is not specific.Standard matters:

  1. Note the principles of nutrition of nutrition without taking out the volume of certain products or significantly reducing.Reduce the consumption of animal salt and fats.While cooking, it is advisable not to suck any food at all.It is necessary to give up fat/sharp/fried dishes.
  2. Daily physical activity according to the age group.The execution of gymnastics improves people well.It is recommended to deal with running, walking, swimming, visiting the gym and doing breathing exercises.At the beginning of the lesson, the body should receive a minimum burden.It has to be gradually increased.
  3. The normalization of the weight is one of the prerequisites for successful prevention.
  4. It is necessary to learn how to control stressful situations, since it is exactly a violation of the work of the central nervous system, which doctors almost describe the main reason for the development of the disease.Autotoring, meditation, self -hypnosis helps well.
  5. A complete rejection of bad habits.Smoking and alcohol can also provoke a pathology.

Pathophysiology sees arterial hypertension as one of the most serious pathologies, not only a deterioration in the patient's quality of life, but also able to cause death.Therefore, it is necessary if the episodes appear with increased blood pressure, start a specialist advice and, if necessary, start treatment.