Hypertension, or arterial hypertension - a stable condition, that is, detected by recurrent measurements, increased blood pressure. Accompanying many diseases, it is considered a risk factor for the development of harmful complications from the cardiovascular system, including myocardial stroke and infarction. Hypertonic diseases, as a leading cause of pathology that are considered, require taking medication, normalizing the patient's lifestyle and nutrition.
Blood pressure is a blood circulating force acting on the walls of the blood vessels. Such pressure at the time of heart contraction is called systolic, and during relaxation - diastolic. The various normal values for this indicator are quite broad.
In various observations, scientists concluded that the risk of cardiovascular complications increased with each increase in additional blood pressure by 10 mm Hg. Art. It has begun with the 115/75 mm RT level. Art. However, the decline in pressure in pressure just above 140/90 mm is appropriate. Rt. Therefore, art is like the value taken as a criterion for determining arterial hypertension.
Cause
In about 90% of cases, hypertension is the cause of stable blood pressure. Such a diagnosis is made to the patient when another disease is accompanied by hypertension not found during the examination. Between the last:
- Kidney pathology - pyelonephritis, glomerulonephritis, polycystic, diabetes nephropathy, kidney artery stenosis;
- Endocrine-neoplasm disruption of the adrenal gland, pancreas or pituitary glands, thyroid hyperfaith, Izenko-Cushing syndrome, pheochromocytoma;
- Obstructive apnea syndrome in dreams;
- Vices valve or atherosclerotic damage to the aorta.
Normal use of some drugs can also lead to increased blood pressure. These include oral contraceptives, anti -steroidal drugs, amphetamine, corticosteroids, drugs containing erythropoetin, cyclosporin, cocaine.
The possibility of cardiovascular disease, including hypertension, is in close contact with the following risk factors:
- Improper nutrition, including excess sodium salt, saturated fat and trans fat, leafy lack of leafy, vegetables and fruits in the diet;
- obesity;
- heart pathology and blood vessels in close relatives;
- age older than 65 years old;
- SEDENTARI LIFE;
- chronic stress;
- Harvesting habits - smoking, excessive alcohol use.
Classification
If it is possible to identify the disease that leads to increased blood pressure, arterial hypertension is called secondary or symptoms. In the case of unknown hypertension, it is considered primary, due to hypertension.
The latter has a staging current:
- Level I. There are no clear signs of violation of target organ work affected by the stable increase in blood pressure, kidneys, arterial vessels and veins.
- Stage II. There is one of the signs listed or overall, such as an increase in the left ventricle of the heart, a significant decrease in kidney filtration, albumin in urine, increased carotid arterial wall thickness or atherosclerotic plaque appearance in their lumen. In this case, the clinical manifestation of the disease may not be present.
- Level III hypertension. There is one or more pathologies related to the process of atherosclerotic in the heart and vessels - myocardial infarction, acute cerebrovascular accidents, angina pectoris, arterial atherosclerosis in the lower leg, or serious kidney damage, indicated by significant decreases.
Arterial hypertension is divided into several degrees, depending on the maximum indication of measured blood pressure:
- First degree. Systolic blood pressure from 140 to 159 mm. Rt. Art. And/or diastolic - from 90 to 99 mm. Rt. Art.
- Second degree. Systolic blood pressure from 160 to 179 mm. Rt. Art. And/or diastolic - from 100 to 109 mm. Rt. Art.
- Third degree. 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, where only the number of systolic pressure in the normal diastolic.
Symptom
Often increased blood pressure is not accompanied by deterioration in well -being and may not be aware of the patient, so it is very important to measure blood pressure regularly, especially middle and elderly people.
The following symptoms can be a manifestation of hypertension:
- headache, especially in the morning after the resurrection;
- Bleeding from the nose;
- bleeding under the mucous membranes of the eye;
- violation of heart rhythm;
- blurred vision, flickering;
- Tinnitus.
A sharp jump of blood pressure to a high number, accompanied by a clear decline in well -being, called a hypertension crisis. Often, it occurs with increased systolic pressure of more than 180 mm Hg. Art. and/or diastolic more than 120 mm Hg. Art. At the same time, the patient has weakness, nausea, vomiting, which does not bring relief, impaired consciousness, anxiety and fear, muscle anxiety, chest pain.
Complication
Increased blood pressure with hypertension significantly increases the risk of cardiovascular pathology, including the life of the patient. These include:
- acute cerebral circulation (stroke);
- Angina pectoris, myocardial infarction;
- vascular dementia (dementia);
- chronic kidney and heart failure;
- Wounds -The atherosclerotic vessels -Caped at the bottom.
Diagnostics
The main symptoms of hypertension are a stable increase in blood pressure, revealing at least three dimensions on different days during a quiet environment. In the first measurement of blood pressure at the hospital or clinic for the accuracy of the decision, it is important to comply with the following rules:
- Before examining, the patient should sit for a few minutes in a quiet room to calm down;
- The size of the cuff tonometer corresponds to the arm thickness, and the device itself - to be attached to the heart level;
- Two measurements are done with a 1-2 minute interval on each hand, with a large difference in the number obtained, additional measurements are made;
- In elderly patients, as well as people suffering from diabetes mellitus, or in suspected reducing blood pressure in terms of changes in body position, measurement is performed in the first and fifth minute in a standing position;
- In addition, heart rate is measured within 30 seconds.
Doctors in an interview with patients explain at what age starts -start to increase, if symptoms such as snoring with breathing stop in dreams, attacks of muscle weakness or flutter -Defined by sweating and headache, and unusual impurities in the urine. It is also important to know the medications and biodes it takes.
In the first stage of the examination, the following tests are conducted for hypertension:
- Clinical blood tests;
- General urine analysis, microalbumin detection in one and daily parts;
- Biochemical blood tests (cholesterol, lipoprotein to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium, and glucose and creatinine);
- Determination of glycated hemoglobin levels;
- Determination of hormone concentrations -thyroxine hormones, triiodothyronine and thyroid -mmer, antibodies to thyroid -xidase and thyroidoglobulin, aldosterone.
If it is suspected of hereditary tendency to the disease, it is possible to determine the polymorphism of the gene associated with the development of arterial hypertension.
To explain the risk factors of development and identification of existing cardiovascular pathology for hypertension, instrumental diagnostic methods are used:
- daily monitoring of blood pressure;
- Electrocardiographic study;
- echocardiography;
- Holter daily monitoring;
- Brachiocephalous artery duplex scanning, kidneys or iliac;
- Study of kidney ultrasound and adrenal glands;
- Inspection of the bottom of the eye.
With hypertension, blood pressure control at home is important by maintaining a diary where it is necessary to prescribe all time measurement results, take drugs and stress episodes that can cause blood pressure increases. At the same time, measurement must be done in a sitting position, after a few minutes of rest, holding hands at the same level as the liver.
Treatment
With the risk of moderate and low cardiovascular complications, patients are only recommended to change lifestyle, diet correction, weight loss, increased physical activity and special gymnastics for hypertension, rejection of bad habits to normal blood pressure backgrounds. Usually these steps are sufficient to normalize blood pressure.
Diets for hypertension include table salt restrictions, caffeine, sharp dishes, salty, smoked and spicy, products with high fat content, outside, cakes with oil creams and alcoholic beverages. It is allowed to use no more than 5 g of salt a day outside the hunting of the disease. The recommended daily fluid rate is 1-1. 2 liters.
In cases of unsuccessful treatment for several months, as well as at high risk of complications, using hypotension therapy using drugs for hypertension, the purpose is to decrease blood pressure less than 140/90 mm. Rt. Art. For diabetic patients or people who are already experiencing the pathology of the cardiovascular system, the target pressure level is lower-130/80 mm. Rt. Art.
Modern hypertension drug treatment includes a combination of two or more drugs from the following groups:
- calcium antagonists;
- enzyme enzyme angiotenzinzinoproding;
- blockers for angiotensin II;
- diuretics (diuretics);
- B-blockers;
- Alpha-blockers.
Most of them are produced in tablets of hypertension.
Prevention
Prevention of increased hypertension includes timely diagnosis and therapy for cardiovascular system diseases, nerves, urine and endocrine, non -stop followed by doctor's recommendations, including treatment and non -unity drugs, as well as frequent blood pressure measurement.