Hypertension is the most common cardiovascular disease, the symptoms of which after the age of 60-65 affect a large portion of the population. The diagnosis has several names, including essential hypertension (AH), arterial hypertension (AH). The disease is chronic, the main task of each patient is to prevent exacerbation and prolong the period of remission (loss of symptoms) using drug and non -drug methods.
What is hypertension
Arterial hypertension is a stable increase in blood pressure above an acceptable level (starting from 140/90 mm Hg) under the influence of provoking factors. This diagnosis is called the "silent killer". The pathological process takes place in an asymptomatic form for a long time, but during the attack it significantly increases the risk of stroke, myocardial infarction, and other dangerous diseases. The potential complications of GB can be life -threatening for patients, so the disease requires timely diagnosis and adequate treatment.
Hypertensive disease develops as a result of dysfunction of the higher neurohumoral regulatory centers, kidneys, blood vessels. In the absence of timely treatment, the pathological process leads to organic disorders and function of the heart, organs of the central nervous system, and kidneys. Improperly chosen therapy can lead to disease progression with increased pain.
Classification of hypertension
In 2003, the unified classification of hypertension was defined according to the severity of the disease. The determining factor in this section is considered to be a true indicator of blood pressure, determined by a tonometer in a particular clinical case. Hypertension is also classified according to origin (primary, secondary), stage (temporary, stable, sclerotic) and level of risk of cardiovascular pathology. This classification simplifies diagnosis, helping to more accurately determine the treatment regimen for each hypertensive patient.
Stages of arterial hypertension
With an increase in blood pressure (BP), there is a suspicion that arterial hypertension is developing, especially if this health problem cannot be solved by non -drug methods. It is important to know that the optimal blood pressure is 120/80 mm Hg. Art. , usual - 120-129 mm Hg. Art. (systolic pressure - SBP) and 80-84 mm Hg. Art. (diastolic - DBP), normal height - 130-139 mm. rt. Art. (SAD) and 85–89 mm. rt. Art. (FATHER). Deviations from this figure indicate serious pathology of the body. Doctors distinguish 3 degrees GB:
- Stage 1 (mild) hypertension is characterized by unstable pressure, which for several days ranges from 140/90 to 159/99 mm Hg. Art The risk of experiencing a hypertensive crisis is minimal, there are no symptoms of organic damage to internal organs and the central nervous system. To suppress a painful attack, in addition to taking medication, the patient needs good rest, the exclusion of stressful situations. Positive emotions, walking in the fresh air are very useful.
- Stage 2 arterial hypertension develops rapidly. The blood pressure index varies from 160/100 to 179/109 mm Hg. Art. , there are symptoms of hypertensive crisis (cold sweats, chills, redness of the face). Patients worry about migraine attacks, dizziness, lack of sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decreased blood flow in organs), increased creatinine in the blood, narrowing of the retinal arteries, hypertrophy (increased size) of the left ventricle, microalbuminuria (protein detection in urine analysis. ). It is impossible to normalize the condition without medication.
- Level 3 (severe) hypertension is accompanied by a sharp decrease in visual acuity, poor memory, tachycardia attacks (increased heart rate). The hypertensive crisis is developing. BP indicator - from 180/110 mm Hg. Art. and higher. Possible complications include hypertensive encephalopathy, cerebral vascular thrombosis and aneurysms (development of vascular pathology), left ventricular heart and renal failure, bleeding (bruising) and swelling of the optic nerve. Pathological changes are irreversible.
Level of cardiovascular risk
To predict possible complications in progressive arterial hypertension, the first step is to determine the cardiovascular risk index. This requires expert advice, complex diagnostics. The degree of hypertension, provoking recurrent conditions (physiological and pathological) is taken into account. Common risk factors are:
- smoking, other bad habits;
- high cholesterol in the blood;
- sedentary lifestyle;
- obesity, including the stomach (most fat is stored in the stomach);
- age (women over 65, men over 55);
- fasting sugar index 5. 6-7. 0 mmol/l;
- impaired glucose tolerance, determined using special tests;
- the presence of diseases of the cardiovascular system in relatives;
- man.
Patients have a high level of cardiovascular risk if, in addition to hypertension, there is a corresponding chronic disease:
- diabetes;
- heart failure;
- violation of lipid (fat) metabolism;
- bronchial asthma;
- extensive damage to the retina;
- coronary artery disease;
- stage 4 renal failure;
- having a stroke;
- cerebrovascular disease (damage to brain channels);
- signs of the disease obliterate the peripheral arteries of the lower limbs (atherosclerosis);
- damage to other internal organs.
Such information helps doctors predict the clinical outcome of the disease. To determine cardiovascular risk indicators for each level of hypertension, you need to familiarize yourself with the table below:
| General Risk Factor (RFR) | Blood pressure | The risk of hypertension is 1 degree | Stage 2 arterial hypertension, risk | Risk of grade 3 hypertension |
|---|---|---|---|---|
| no risk factors | ordinary risk | short | simple | height |
| 1-2 | short | simple | medium high | height |
| more than 3 | low-simple | medium high | height | height |
| damage to other internal organs, stage 3 kidney disease, diabetes mellitus | medium high | height | height | very high |
| CVD, stage 4 chronic kidney disease with involvement of other organs or common risk factors | very high | very high | very high | very high |
Treatment of hypertension
Classification of GB by stage and risk helps determine the drug therapy regimen correctly, stops painful attacks quickly, and prolongs the remission period. If primary arterial hypertension develops (isolated), subject to medical recommendation, the prognosis is favorable. Secondary forms of the disease often occur with complications.
If the disease does not heal in time, it is difficult to stabilize high blood pressure even with medication. General recommendations of experts, if grade 1, 2 or 3 hypertension is diagnosed, are presented below. . Should be supplemented by taking medication as prescribed by the treating physician:
- Adherence to a therapeutic diet. It is important to reduce the portion of table salt, enrich the daily diet with foods with potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and cereals, vegetables).
- Rejection of bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, abandon a "sedentary" lifestyle, and take a walk in the fresh air.
- Weight control. If patients with arterial hypertension have obesity, it is necessary to abandon fatty, fried and smoked foods, and regularly arrange fasting days.
- Physiotherapy. To prevent and prolong the period of GB remission, it is recommended to do moderate -intensity physical exercise for 30 minutes 5 times a week.
- Acceptance of multivitamin complexes. The composition of the drug should contain potassium, magnesium, iron, and other trace elements that are important for the body.
Medical therapy
Oral medications depend on the degree of hypertension and associated symptoms. The following is the optimal scheme for the conservative treatment of arterial hypertension:
- In the mild stage of the disease, patients are prescribed angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
- If risk arterial hypertension of grade 4 develops, an integrated approach to the problem is needed, combining several representatives of different pharmacological groups in one conservative treatment regimen. These are the above drugs in combination with thiazide diuretics.
- In the complicated course of the disease, in addition to the above drugs, doctors recommend alpha or beta blockers. The need for this arises if high doses of diuretics are not well tolerated by the weakened body).