Arterial hypertension belongs to the most common heart disease and blood vessels, affecting about 25% of the increased population.No wonder is sometimes referred to as a non -infectious epidemic.High blood pressure with its complications significantly affects the mortality of the population.Assessments show that up to 25% of deaths of people over 40 are directly or indirectly caused by hypertension.The probability of complications determines the stages of hypertension.How many stages does hypertension have, how are they classified?Look below.
Important!According to recent estimates by the 1993 World Health Organization, adult hypertension is a steady increase in blood pressure to 140/90 mm Hg.Art.
Classification of arterial hypertension, determination of the degree of risk of disease
In the WHO, according to etiology, hypertension is classified into primary and secondary.
With primary (essential) hypertension (GB), the main organic cause of increased blood pressure (blood pressure) is unknown.A combination of genetic factors, external influences and violations of internal regulatory mechanisms is taken into account.
External Factors:
- environment;
- excessive use of calories, overweight development;
- Increased salt consumption;
- lack of potassium, calcium, magnesium;
- Excessive drinking;
- Repeating stressful situations.
Primary hypertension is the most common hypertension, in approximately 95% of cases.
3 stages of hypertension are separated:
- Stage I - Increased blood pressure without changes in organs;
- Phase II - an increase in blood pressure with changes in organs, but without damaging their function (left ventricular hypertrophy, proteinuria, angiopathy);
- Phase III - organs associated with damaged function (left heart failure, hypertensional encephalopathy, stroke, hypertonic retinopathy, kidney failure).
Secondary (symptomatic) hypertension is an increase in blood pressure as a symptom of the underlying disease with the identified cause.The classification of secondary arterial hypertension is as follows:
- Renoparechymal hypertension - occurs due to kidney disease;Reasons: parenchymal renal disease (glomerulonephritis, pyelonephritis), tumors, kidney damage;
- Renal hypertension - narrowing of renal arteries with fibromosular dysplasia or atherosclerosis, renal vein thrombosis;
- Endocrine hypertension - primary hyperaldosteronism (Conn syndrome), hyperthyroidism, feocromocytoma, Kushing syndrome;
- drug -induced hypertension;
- Gestational hypertension - high pressure during pregnancy, after childbirth, the condition is often normalized;
- Aorta cooperation.
Gestational hypertension can lead to congenital disease of the child, in particular, retinopathy.2 stages of retinopathy (premature and complete children) are separated ::
- Active - consists of 5 stages of development, can lead to vision loss;
- Rubts - leads to cornea cloud.
Important!Both stages of retinopathy of premature and complete children lead to anatomical disorders!
Hypertensional disease by international system (according to ICD-10):
- Primary form - I10;
- Secondary Form - I15.
The degrees of hypertension also determine the degree of dehydration - dehydration.In this case, the classifier is the lack of water in the body.
Share 3 degrees Dehydration:
- Grade 1 - Light - absence of 3.5%;Symptoms - dry mouth, severe thirst;
- Grade 2 - average - absence - 3-6%;Symptoms - sharp fluctuations in reducing pressure or pressure, tachycardia, oliguria;
- Grade 3 - the third degree is more severe, characterized by the absence of 7-14% of water;manifests with hallucinations, delirium;Clinic - coma, hypovolemic shock.
Depending on the degree and stage of dehydration, decompensation is performed by presenting the solution:
- 5% glucose + isotonic NaCl (soft scale);
- 5% NaCl (average scale);
- 4.2% nahco3(heavy scale).
Stages of GB
Subjective symptoms, especially with the mild and moderate stage of hypertension, are often absent, so an increase in blood pressure is often found at the level of dangerous indicators.The clinical photography is divided into 3 phases.Each stage of arterial hypertension has typical symptoms, from which GB classification comes.
Stage of
At 1 stage of hypertension, the patient complains of headaches, fatigue, rapid heartbeat, misoring, sleep disturbance.At 1 stage of GB, objective heart detection, ECG, eye wallpaper, laboratory studies are present within the normal range.
Stage II
In the 2nd stages of AH, subjective complaints are similar, at the same time there are signs of left ventricle hypertrophy, there are signs of hypertensive angiopathy in the retina, microalbuminuria or proteinuria in the urine.Sometimes there is a multiplication of red blood cells in urine rainfall.In 2 stages of hypertension, the symptoms of kidney failure are missing.
Stage III
With Phase III hypertension, functional disorders are diagnosed in organs that belong to an increased degree of risk for hypertension:
- Heart damage - initially, manifest shortness of breath, then - symptoms of heart asthma or pulmonary edema;
- Vascular complications - damage to peripheral and coronary arteries, risk of brain atherosclerosis;
- Changes in Fundus - have the nature of hypertensional retinopathy, neuroretinopathy;
- Changes in cerebral blood vessels manifest from the transient ischemic period, typical thrombotic or hemorrhagic vascular stroke;
- In phase III, a stroke, brain lesions are diagnosed in almost all patients;
- Benign nephrosclerosis of the kidney vessels - leads to the limitation of glomerular filtration, an increase in proteinuria, red blood cells, hyperuricemia and later in chronic kidney failure.
Which stage or degree of hypertension is most dangerous?Despite various symptoms, all stages and degrees of arterial hypertension are dangerous, they require proper systemic or symptomatic treatment.
degree
In accordance with blood pressure indicators (blood), determined at the time of diagnosis, 3 degrees hypertension is distinguished:
- light;
- medium;
- Heavy
There is also a 4th concept-determination of resistant (persistent) hypertension, in which even with the proper choice of a combination of antihypertensive drugs, blood pressure indicators do not decrease below 140/90 mm Hg.Art.
A clearer summary of the stairs of arterial hypertension is shown in the table.
AG classification and normal blood pressure stratification according to the guidelines ASH/ESC 2007.
| CATEGORY | Systolic pressure, mm Hg.Art. | Diastolic pressure, mm Hg.Art. |
|---|---|---|
| optimum | <120 | <80 |
| Normal | 120–129 | 80–84 |
| Increased normal | 130–139 | 85–89 |
| 1st degree | 140–159 | 90–99 |
| 2 stairs | 160–179 | 100-109 |
| 3 degrees | More than 180 | More than 110 |
| Insulated systolic hypertension | More than 140 | Less than 90 |
The patient's difficulties vary in accordance with the division of hypertension in the scale.The choice of the disease treatment regimen depends on the determination of the degree.
I rank
The disease can only be detected by regular measurement of blood pressure.Measurements should be performed in a quiet environment, at least 3 times in a given period.
This is the only way to assess the presence or absence of hypertension.Depending on the degree of increased blood pressure, the clinical appearance of the disease changes.
Rank
The 2nd degree of hypertension is characterized by periods of increased pressure alternating with a decrease in indicators, or a single increased diastolic value.To this extent, hypertension, increasing pressure cases in certain circumstances are typical, especially in patients with an unstable nervous system.
Rank III
III The degree of AG is characterized by a critical increase in blood pressure.
Grade III of GB is characterized by severe complications that arise as a result of the harmful effects of high blood pressure on all organs and systems.First of all, the heart, the kidneys, eyes, brains are affected.With degree III hypertension, symptoms and treatment are closely related - with insufficient or improper treatment, the disease can lead to serious consequences: stroke, encephalopathy, renal failure, irreversible eye lesions, blood vessels.Lack of treatment for degree III of hypertension increases the risk of insulated systolic hypertension.
At this stage of arterial hypertension, the risk rate increases significantly!Memory disorders, mental activity, frequent loss of consciousness are manifested.
The hypertonic crisis arises as a complication of the III century, and is considered IV art.GB.
THREATS
In accordance with the classification of hypertension due to stages and degrees, patients are divided into risk groups, depending on the severity of the AG.4 Categories are distinguished (that is, there are so many of them as the degrees of hypertension), which are determined by the principle of probability of damage to the internal organs in the future.
Risks to the degree of disease:
- risk less than 15%;
- risk up to 20%;
- Risk 20-30%;
- The risk is over 30%.
Low, insignificant
A low -risk group includes men up to the age of 55 and women up to the age of 65 by me art.Arterial hypertension.In this group, the risk of cardiovascular pathology in the period of up to 10 years is less than 15%.People who belong to a low -risk group are recommended to change their lifestyle.If within 6-12 months non -drug therapy does not show effectiveness, it is advisable to prescribe medication.
Average
The average risk group includes people from art I - II.Hypertension, provided there are 1-2 risk factors.The risk increases with high body weight, smoking, an increase in cholesterol, a violation of glucose tolerance, lack of movement.Inherited factors are also important.The risk of cardiovascular complications in these people is higher, and is 15-20% for 10 years.People related to this group are recommended to respect a healthy lifestyle.If a pressure reduction does not occur within 6 months, pharmacotherapy is prescribed.
High
The high -risk group includes people of the 1st - II century.Hypertension, subject to the presence of at least 3 dangerous factors, which include:
- diabetes;
- loss of target organs;
- Atherosclerotic vascular diseases;
- left ventricular hypertrophy;
- growth of creatinine;
- Changes in eye vessels.
This group also includes 3rd century hypertension, which do not have dangerous factors (the risk of cardiovascular disease is 20-30% for 10 years).Representatives of this group are under the supervision of a cardiologist.
High
A group of hypertension with a very high risk of cardiovascular disease (more than 30% for 10 years) includes people with III Art.Hypertension, provided there are at least 1 dangerous factor.In addition, this group includes patients with Art Ah I - II.In the presence of a violation of cerebral circulation, ischemia, nephropathy.This group is controlled by cardiologists, requires active therapy.
cONcluSiON
The problem of arterial hypertension is that the disease has no typical symptoms, characterized by a variety of clinical photography.Therefore, often a person does not know about the presence of the disease.Therefore, high pressure is detected by accident, during inspection or in manifestation of complications.When diagnosing hypertension, it is important to correctly inform the patient that he can mainly affect the course of his illness, following a healthy lifestyle.