Constantly high blood pressure in medicine has several names: hypertension, arterial hypertension, essential hypertension.The disease can cause damage to the kidneys, heart, blood vessels, cause stroke, heart attack, bleeding from a stomach ulcer and other serious consequences.In order to prevent dangerous health conditions, it is necessary to take timely measures to prevent the disease and know the risk factors that greatly increase the likelihood of hypertension.
What is hypertension
This is a chronic pathology that develops as a result of dysfunction of vascular regulation, renal and neurohumoral mechanisms.Hypertension (HTN) is a dangerous condition of the body in which there is a persistent increase in blood pressure (BP) with levels above 140/90 mmHg.Art.in patients not taking antihypertensive drugs.
Hypertension accounts for approximately 40% of all cardiovascular pathologies.The disease occurs more often in men than in the female population.The risk of developing pathology in both sexes increases with age.Hypertension is mainly diagnosed in patients after 40 years of age, but recently the disease is increasingly being registered in adolescence and young adulthood.
Stages of headache
Hypertension is a chronic pathology that has three stages of development.In an adult, the optimal blood pressure is 120/80 mmHg.Art.A slight deviation from these indicators up to 139/89 mm Hg.Art.also applies to the norm.Higher numbers in medical practice are considered pathology.The diagnosis of “hypertension” is made when indicators above 140/90 are repeatedly recorded in different conditions.
Stage 1 hypertension is characterized by abrupt changes in pressure.This already indicates a pathological process occurring in the body.The disease at an early stage is almost always asymptomatic.The patient does not pay attention to some signs of hypertension, which explains the large percentage of late requests for qualified help.Symptoms of stage 1 hypertension:
- blood pressure indicators: from 140/90 to 159/99 mm Hg.Art.;
- headaches;
- confusion;
- decreased mental performance;
- dyspnea;
- tachycardia;
- increased swelling;
- fluid retention in the body;
- change in the amount and color of urine.
Stage two hypertension is arterial hypertension that occurs in a moderate form.At this stage of the disease, longer periods of increased blood pressure are observed than at the beginning.Blood pressure readings in stage 2 hypertension rarely return to normal.Patient's condition:
- blood pressure indicators: from 160/109 to 179/109 mm Hg.Art.;
- sleep disturbance;
- discomfort in the heart area;
- heart failure;
- memory and vision impairment;
- constant irritability;
- dizziness;
- tinnitus;
- aching pain in the back of the head;
- dilated eye vessels;
- facial skin is hyperemic;
- swelling of the face, hands.
Stage three hypertension is a severe form of the disease.It is characterized by the patient having a history of myocardial infarction, stroke and other serious pathologies.It is possible to completely cure hypertension at this stage in very rare cases, only if high blood pressure lasts a short time or is secondary.Clinic of severe hypertension:
- blood pressure indicators: from 180/110 mm Hg.Art.and above;
- left ventricular hypertrophy;
- hypertrophy of the interventricular septum;
- impaired coordination of movements;
- encephalopathy;
- ischemic or hemorrhagic infarctions;
- various kidney lesions;
- persistent visual impairment;
- prolonged hypertensive crises;
- paralysis and paresis due to cerebral circulation disorders;
- restriction of the ability to move independently and take care of oneself.
Risk factors for hypertension
The development, progression, and complications of arterial hypertension are directly related to the presence of risk factors for the occurrence of this pathological process.Hypertension is the result of a complex interaction of internal (endogenous) and external (exogenous) causes.The occurrence of pathology is facilitated by acquired and congenital characteristics of the body, which weaken its resistance to adverse external conditions.
Risk factors for the development of arterial hypertension are classified according to two indicators: modifiable and non-modifiable.The first depend on the decisions of a person and his lifestyle.These include:
- bad habits;
- physical inactivity;
- smoking;
- drinking alcohol;
- obesity and others.
Unchangeable risk factors for hypertension are those that a person cannot influence: heredity and physiology (gender, age).In many cases, hypertension is a genetically transmitted disease.If one of your relatives suffered from hypertension, then there is a high probability that the next generation will be affected by the disease.As for physiological factors, according to statistics, middle-aged men are more susceptible to the disease.This is explained by the fact that the female body produces estrogens - hormones that perform a protective function.
Endogenous
Intrinsic risk factors for hypertension are the presence of diseases or conditions that cause high blood pressure.Among them:
- diabetes mellitus;
- atherosclerosis of the coronary vessels of the heart;
- increased blood viscosity;
- metabolic disorder;
- kidney disease (pyelonephritis, nephritis, glomerulonephritis);
- increased concentration of sodium or calcium in the blood;
- the effect of adrenaline during stress;
- dyslipidemia (disorder of fat metabolism);
- increased uric acid content;
- neurocirculatory dystonia;
- pregnancy;
- menopause.
Related to lifestyle and environmental influences
Exogenous risk factors for hypertension are associated with the patient’s lifestyle.The number of acquired causes that can be successfully combated is significant, but each point can be easily adjusted if a person wishes.The main exogenous risk factors for hypertension:
- Insufficient physical activity.Constant work in the office, traveling exclusively by vehicle, lack of time to visit the gym leads to a weakening of the respiratory system, impaired muscle function, and deterioration of blood circulation.All these factors provoke an increase in blood pressure.
- Uncontrolled salt intake.Sodium chloride in large quantities causes thirst and delays the removal of fluid from the body.Water causes an increase in the volume of circulating blood, as a result of which myocardial contractions become more frequent, which leads to an increase in blood pressure.The rate of consumption of table salt is no more than 5 g/day.
- Magnesium and/or potassium deficiency.The body needs these microelements for good functioning of blood vessels and heart muscle.If they are deficient, there is a risk of developing hypertension.
Diagnostics
Hypertension is determined by different methods - the blood pressure level is measured several times using a tonometer and phonendoscope, the clinical picture of the disease is studied, clinical, physical and instrumental studies are prescribed.Main diagnostic approaches:
- Biochemical blood test.The level of high/low density lipoproteins and cholesterol is detected, and the sugar level is determined.These indicators are important for determining the cause of high blood pressure.
- ECG.An electrocardiogram has long been a reliable assistant in diagnosing hypertension.An ECG reveals interruptions in the work of the heart, determines the presence of angina, and provides data on the displacement of the heart from the electrical axis and the state of the myocardium.
- Ultrasound of the heart.The main vessels (carotid arteries) that lead to the brain are illuminated to detect atherosclerotic plaques, assess the condition of the vascular walls and the risk of stroke.
- Arteriography.X-ray method for studying the walls of arteries and their lumen.
- Dopplerography.Ultrasound technique for diagnosing blood flow in veins, arteries, and vessels.
- Ultrasound of the kidneys.Helps identify large tumors in the adrenal glands and lesions of the renal tissue, leading to the occurrence of renoparenchymal hypertension.
- Ultrasound of the thyroid gland.Helps to identify or exclude the influence of the thyroid gland on the development of hypertension in a patient.
Treatment
Treatment for hypertension depends on the cause of the disease.The first thing the patient needs to do is to eliminate all risks associated with hypertension.Then drug therapy is used in combination with non-drug methods: adherence to an anti-cholesterol diet, physical activity, quitting smoking, and drinking alcoholic beverages.Drug treatment is carried out according to different schemes:
- Patients at low to moderate risk of developing hypertension are prescribed one drug to lower their blood pressure.
- Patients at high risk of cardiovascular pathologies are prescribed two or more medications with individual dosages.
The choice of medications and dosage is made by the doctor, taking into account the patient’s age, concomitant pathologies and risk factors.Several groups of drugs are used to treat hypertension:
- Thiazide diuretics.They inhibit the absorption of chlorides and sodium in the kidney tubules so that they do not enter the blood, but are excreted from the body in the urine.
- Calcium channel blockers.They reduce the intake of calcium, as a result of which the load on the myocardium decreases and blood pressure decreases.
- ACE inhibitors.They reduce the concentration of the hormone angiotensin in the blood, which has the ability to narrow the lumen of blood vessels, which increases blood pressure.
- Angiotensin II receptor antagonists.Reduces blood pressure in the first stage of hypertension.
- Beta blockers.They relax the vascular walls, which leads to improved blood circulation and normalization of blood pressure.
- Central alpha-2 agonists.The heart rate is reduced, which is manifested by a decrease in blood pressure.
- Direct vasodilators.Relaxes the smooth muscles of arterioles, which provokes a decrease in blood pressure.
- Renin inhibitors.They promote the dilation of arteries and inhibit the activity of renin, an enzyme with a vasoconstrictor effect.