Hypertension is one of the most common cardiovascular diseases. According to the WHO, more than 1. 1 billion people suffer from it. world. High blood pressure increases the risk of developing other heart diseases. Hypertension is among the leading causes of death and the disease is rapidly becoming younger. It occurs not only in the elderly, but also in the young. Below you will find out why it appears, how to recognize and control it.
What is hypertension?
This is a chronic condition in which the blood pressure is high. It is marked as two numbers and the optimal value is 120/80 mmHg. Art. The first number is the systolic pressure, which occurs when blood is ejected from the left ventricle of the heart into the aorta during systole (contraction of the heart's ventricles). The second number shows the diastolic pressure when the heart muscle is relaxed. Blood pressure increases during physical activity and emotional arousal, but its value should be close to normal at rest. If with multiple measurements taken at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure exceeds 90 mmHg. Art. , diagnosed with hypertension.
A persistent increase in blood pressure is associated with several factors, including excess weight and lack of physical activity, poor diet, bad habits and high levels of stress.
Causes and risk factors
Hypertension can be primary or secondary:
- primary (core)hypertension is more common - according to various estimates, in 85-95% of cases. Its appearance is not associated with concomitant diseases; pressure increases under the influence of a complex of factors;
- secondary (symptomatic)hypertension occurs in 5-15%. In this case, high blood pressure is one of the symptoms that can be associated with endocrine disorders, kidney disease and large vessel abnormalities.
When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its appearance is usually constant nervous overload. During diagnosis, it is important to determine as accurately as possible what causes hypertension, if it has secondary causes (the presence of diseases that cause an increase in blood pressure).
There are a number of risk factors that increase the chances of developing primary hypertension:
- excess weight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drinking alcohol and smoking;
- stress, constant emotional tension;
- lack of sleep, its low quality, insomnia;
- excessive intake of salt;
- irregular organized sleep and rest patterns (including due to irregular or very long working hours);
- changes in hormonal levels (in women, may be associated with taking oral contraceptives, with the onset of menopause);
- hereditary factors (in total, more than 20 genes have been identified that determine predisposition to hypertension);
- age over 65 years (the disease can also appear in young people; it is worth periodically monitoring blood pressure after 35 years);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods rich in trans fats and saturated fats);
- kidney diseases, diabetes mellitus and some other related conditions and diseases.
Many of these factors are interrelated and reinforce each other. Some of them can be controlled (for example, diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is a simple way to reduce the risk of hypertension or improve your well-being if your blood pressure is already high.
Distribution
To classify the disease, two approaches are used: according to degrees and stages. The degrees of hypertension differ in the values in which the blood pressure increases, the difference between the stages is in the course of the disease, in the number and severity of the accompanying organic lesions.
First step
Systolic blood pressure - more than 139 and less than 159 mmHg. Art. , and diastolic is at the level of 90-99 mm Hg. Art. With elevated values, blood pressure can be normalized by adjusting your lifestyle. To do this, you need to increase physical activity, adjust your diet, give up bad habits and reduce stress levels.
Second degree
In the second degree, blood pressure values become high and reach 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastolic. With such values, the load on the heart increases greatly. The blood supply to the brain deteriorates and this can cause headaches and dizziness and reduced performance. Changes occur in the fundus of the eye. Sclerosis of kidney tissues and blood vessels begins, the excretory function is impaired and renal insufficiency may develop. The condition of blood vessels worsens. For treatment, you need to change your lifestyle and start taking medications.
The third degree
The value of systolic pressure is above 180 mm Hg. Art. , diastolic - over 110 mm Hg. Art. With hypertension, the load on the heart becomes too high and provokes irreversible changes. Blood pressure must be continuously lowered with medication. Without this, there is a threat of acute heart failure, arrhythmia, angina pectoris, myocardial infarction and other serious conditions. Patients with stage 3 hypertension should be constantly monitored by a doctor. Continuous use of drugs to lower blood pressure is necessary.
| Arterial pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Good | < 130 | < 85 |
| Normally, the so-called prehypertension | 130–139 | 85–89 |
| 1 - mild hypertension | 140–159 | 90–99 |
| 2 - moderate degree of hypertension | 160–179 | 100–109 |
| 3 - severe hypertension | ≥ 180 | ≥ 110 |
Stages of hypertension
The disease develops gradually. There are three stages in total.
- The first phase:moderate hypertension. Blood pressure is unstable and can fluctuate throughout the day. At this stage, the condition of the internal organs and the central nervous system remains normal, there are no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
- Second phase:severe hypertension. In the second stage, there is a significant increase in blood pressure, health often deteriorates and hypertensive crises become severe. At this stage, changes in the internal organs begin due to constantly high blood pressure. Vascular disorders appear and the blood supply to the brain deteriorates. The retinal arteries narrow. Hypertrophy of the left ventricle of the heart develops and this increases the risk of serious cardiac pathologies. Signs of kidney dysfunction appear (increased levels of albumin in the urine, increased levels of creatinine in the blood serum)
- The third stage:very severe hypertension. Blood pressure becomes extremely high - over 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions intensify, heart failure, thrombosis of cerebral vessels, aneurysms, renal failure and other serious conditions develop. Severe hypertensive crises often occur.
Symptoms
Even with a significant increase in blood pressure, hypertension may not have symptoms for a long time. For this reason, you should periodically measure your blood pressure (monitoring is especially important for those over 35). You can measure your blood pressure with an automatic electronic tonometer - such devices are sold in pharmacies.
The main symptoms of hypertension include headache, dizziness and heaviness in the head. These manifestations are associated with vasospasm and deterioration of blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, cardiac arrhythmia. In severe cases of hypertension, weakness, chest pain, nausea, vomiting and tremors (muscle "tremors") may occur. Other symptoms include cloudy or black spots before the eyes, trouble sleeping, palpitations, and tinnitus.
As the disease progresses, visual acuity gradually decreases, the sensitivity of the arms or legs may decrease, and in severe cases, paralysis is possible. During periods of stress, against the background of nervous tension or physical activity, symptoms may increase. Most often they appear in middle-aged and elderly people. The disease is more severe if you are overweight, have bad habits, tend to overeat or have a high level of stress.
You should consult a therapist or cardiologist if you regularly experience headaches, dizziness or vision problems, or if your blood pressure is often elevated when you measure your blood pressure yourself.
Diagnosing
Typically, the diagnosis is carried out in three directions:
- blood pressure measurement.It is performed at intervals of several hours or over 2-3 days to determine the degree of hypertension and its stage;
- identifying the causes of the disease.It is important to determine whether the hypertension is primary or secondary (caused by other diseases). In the second case, specific treatment may be required;
- general health monitoring.During the examination, the condition of the heart, cerebral vessels, fundus and kidneys is monitored. Due to high blood pressure, the functioning of these organs is impaired. During diagnosis, it is important to assess their condition.
At the first appointment, the doctor will conduct an examination and collect details of the medical history related to the disease. Information will be needed on how long the patient has been suffering from hypertension, what is the blood pressure level, if there are symptoms of heart disease, apnea, severe snoring, if the person or his close relatives have had a stroke, illnessperipheral arterial, gout, diabetes, kidney disease. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, taking medications.
For patients with arterial hypertension, the following examinations are performed:
- blood pressure measurement.It is measured several times at rest (physical activity, caffeine consumption, smoking are excluded half an hour before the measurement), measurements are taken at different times of the day;
- general examination:measurement of height and weight, waist circumference, palpation of the abdomen, evaluation of the pulsation of peripheral arteries;
- Urine analysis.Albumin and creatinine levels are important - deviations from the norm indicate kidney dysfunction and require an ultrasound;
- blood testTo monitor the levels of potassium, creatinine, lipids, ultrasound of the kidneys is prescribed. Assessment of lipid levels is necessary to control lipid metabolism to eliminate the risk of complications from the cardiovascular system;
- ECGperformed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiac or neurological examination or an examination of the respiratory system.
Treatment of hypertension
Arterial hypertension is a disease that cannot be completely cured, but it can be controlled. Therapy and lifestyle changes can stop the development of hypertension, reduce the frequency and severity of attacks and eliminate symptoms. But the most important thing is to reduce the risks to the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle adjustments:
- to quit smoking;
- refusing to drink alcohol or significantly limiting the amount of alcohol;
- diet: the diet is adjusted, salt intake is reduced (less than 3. 75 g per day), the amount of vegetables and fruits is increased (ideally you need 5 portions per day), cereals, dairy products, low-fat products andcalorie intake is limited. If there are no contraindications or kidney disease, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increasing physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is reduced to target values (below 130/80 mmHg) to reduce the risk of complications. With such a decrease, constant monitoring by a doctor is required. The tonometer used for home measurements should be calibrated regularly. For patients with diabetes, pregnant women, the elderly and debilitated people, the use of antihypertensive drugs requires special care.
The following tools can be used to treat hypertension:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and lower blood pressure, but they can cause drowsiness and lethargy, so they are rarely used;
- ACE inhibitors.Decreased peripheral vascular resistance, often prescribed for patients with diabetes;
- angiotensin II receptor blockers.They have a similar effect to ACE inhibitors, and therefore are not prescribed together with them. Not recommended during pregnancy;
- beta blockers.Provide a decrease in blood pressure by slowing down the heart rate;
- calcium channel blockers.They reduce total peripheral vascular resistance and can provoke reflex tachycardia;
- direct vasodilators.They have a direct effect on blood vessels and are used for severe hypertension;
- diuretics.They reduce the volume of blood plasma, which lowers blood pressure, but can also provoke hyperkalemia.
Important!A therapist or cardiologist should prescribe medications and their dosages after an examination. Taking medications without a doctor's prescription can be dangerous.
If your doctor prescribes medication, you will need to undergo periodic follow-up examinations to assess the effectiveness of the treatment and adjust it. It is important to adjust your lifestyle and restore normal health so that a minimal amount of medication is required to control the course of hypertension.
Possible complications
Due to the increase in blood pressure, the walls of the arteries lose their elasticity and the heart muscle works hard. This increases the risk of angina, acute heart failure and heart attack. Due to damage to the blood supply to the brain, transient ischemic attacks and strokes are possible. The severity of hypertension will increase without treatment and lifestyle correction: the pressure will continue to rise and this will lead to damage to the internal organs and worsen the general health and well-being. Smoking, drinking alcohol, overeating, lack of physical activity and high levels of stress accelerate the development of hypertension and make its course more complex.
Consequences
Without treatment, arterial hypertension provokes serious consequences. Continuous spasm of cerebral vessels leads to ischemia and stroke. They are dangerous with severe disability and even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia and heart failure occur. Without treatment, myocardial infarction is possible.
The severity of hypertensive crises increases, they become complicated, life-threatening and can be associated with stroke, acute coronary syndrome and other serious conditions. The quality of life on the background of hypertension without adequate therapy and restoration of a normal state of health is significantly reduced, even in severe disability.
prediction
The prognosis is good if the patient consults the doctor in time and takes measures to control blood pressure and the factors that affect hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its severe course. Even with severe arterial hypertension, it is necessary to undergo treatment and adjust your lifestyle.
Preventing
To prevent hypertension, self-monitoring of blood pressure is recommended over the age of 35 or when symptoms of hypertension appear. It is important to eliminate the effects of factors that provoke an increase in blood pressure: control your diet, eliminate smoking and drinking alcohol, reduce stress levels, devote more time to physical activity: in a word, lead a healthy lifestyle.
CONCLUSION
Hypertension is a dangerous disease, but it can be controlled by maintaining normal health and reducing the risk of complications. To do this, it is important to monitor blood pressure levels, control weight, lead a healthy lifestyle and undergo preventive examinations with a therapist or cardiologist.