Hypertonic disease

Hypertension is a disease of a chronic nature, which is characterized by a persistent increase in blood pressure to high numbers due to a violation of the regulation of blood circulation in the human body. Also, terms such as arterial hypertension and hypertension are used to refer to this condition.

Medical statistics is such that today hypertension is one of the most common diseases. It usually begins to progress in people after the age of 40, but there is a risk of its progression at any age. So, more and more often the disease began to be detected in patients of working age. It is worth noting that the fair sex suffers several times more often than men. But it is in men that hypertension is more severe, since they are more prone to the development of atherosclerosis of blood vessels.

Blood pressure can increase with strong mental or physical stress for a short time - this is an absolutely normal phenomenon. A longer increase in blood pressure is observed in a number of diseases of the kidneys, endocrine glands, as well as during pregnancy. But in this case, hypertension is only one of the symptoms that indicates changes in the organs. In hypertension, an increase in blood pressure is an independent, primary, painful process.

The pathogenesis of hypertension is such that under the influence of exogenous and endogenous factors, the tone of the walls of arterioles in the body increases. As a consequence of this, they gradually narrow and the blood flow in the affected vessels is disturbed. During this pathological process, blood pressure increases on the walls of the arteries, which entails further symptoms.

Etiology

The main reason for the progression of hypertension is an increase in the activity of the sympathetic-adrenal system. The vasomotor center is located in the human medulla oblongata. From it, certain impulses go along the nerve fibers to the walls of the vessels, causing the vessels to expand or contract. If this center is in a state of irritation, then only impulses will come to the vessels that increase the tone of their walls. As a result, the lumen of the artery narrows.

Arterial hypertension is characterized by a simultaneous increase in systolic and diastolic pressure. This is observed under the influence of various adverse factors.

Exogenous risk factors:

• severe nervous strain is the most common cause of the progression of arterial hypertension;
• hypodynamia;
• irrational nutrition. Non-compliance with the diet and eating large amounts of fatty and fried foods;
• excessive consumption of alcoholic beverages;
• smoking;
• the use of narcotic drugs.

Endogenous risk factors:

• burdened heredity;
• obesity;
• atherosclerosis of the coronary vessels of the heart;
• increased blood viscosity (the heart cannot fully distill it through the vessels);
• kidney ailments such as nephritis, glomerulonephritis, pyelonephritis;
• metabolic disorder;
• the presence of endocrine pathologies;
• increased concentration of calcium in the blood;
• the action of adrenaline on the heart during stressful situations;
• increased concentration of sodium in the blood.

Classification

For all the time of studying the disease, scientists have developed more than one classification of hypertension - according to the appearance of the patient, according to etiology, according to the level of pressure increase, the nature of the course, and so on. Some have been out of date for a long time, while others, on the contrary, are used more and more often.

Degrees of hypertension (by pressure level):

• optimal - indicators 120/80;
• normal - upper from 120 to 129, lower - from 80 to 84;
• increased normal - upper indicators - from 130 to 139, lower ones - from 85 to 89;
• hypertension of the 1st degree - SD from 140 to 159, DD - from 90 to 99;
• hypertension of the 2nd degree - systolic pressure indicators increase to 160-179, and diastolic - up to 100-109;
• hypertension of the 3rd degree - systolic pressure increases over 140, and diastolic - over 110.

Stages of hypertension according to WHO:

• hypertension stage 1 - the pressure rises, but changes in the internal organs are not observed. It is also called transient. The pressure stabilizes after a short rest period;
• stage 2 or stable. At this stage of hypertension, the pressure rises constantly. The main organs of the target are affected. During the examination, it can be noted that damage to the heart, blood vessels of the fundus, kidneys;
• Stage 3 or sclerotic. This stage of hypertension is characterized not only by a critical increase in DM and DD, but also by pronounced sclerotic changes in the blood vessels of the kidneys, heart, brain, and fundus. Dangerous complications develop - stroke, coronary artery disease, angioretinopathy, heart attack, and so on.

Forms of the disease (depending on the vessels of which organs are affected):

• renal form;
• heart shape;
• brain form;
• mixed.

Types of hypertension:

• benign and slow flowing. In this case, the symptoms of the progression of the pathology can gradually appear over 20 years. Phases of both exacerbation and remission are observed. The risk of complications is minimal (with timely therapy);
• malignant. The pressure rises sharply. This form of hypertension is practically not amenable to therapy. As a rule, pathology is accompanied by various kidney diseases.

It is worth noting that often with hypertension of 2 degrees and 3, the patient has hypertensive crises. This is an extremely dangerous condition not only for human health, but also for his life. Clinicians distinguish the following types of crises:

• neurovegetative. The patient is hyperactive and very agitated. Such symptoms of hypertension are manifested: hyperhidrosis, tremor of the upper extremities, tachycardia and profuse urination;
• hydropic. In this case, the patient is drowsy and his reactions are inhibited. There is muscle weakness, swelling of the face and hands, decreased diuresis, persistent increase in blood pressure;
• convulsive. This option is the most dangerous, as there is a high risk of developing dangerous complications. It is worth noting that it is the least common. It is characterized by such symptoms: convulsions and impaired consciousness. Complication - hemorrhage in the brain.

Symptoms

Symptoms of the disease directly depend on which stage of hypertension is observed in the patient.

neurogenic

An increase in blood pressure is usually observed against the background of severe psycho-emotional stress or due to increased physical exertion. At this stage, there may be no signs of pathology at all. Sometimes patients begin to complain of pain in the heart, irritability, headache, tachycardia, a feeling of heaviness in the back of the head. Indicators of SD and DD are increasing, but they can easily be normalized.

sclerotic

The indicated clinical picture is supplemented by the following symptoms:

• increased headache;
• dizziness;
• sensation of a rush of blood to the head;
• bad sleep;
• periodic numbness of the fingers on the limbs;
• fast fatiguability;
• "flies" before the eyes;
• persistent increase in blood pressure.

It is worth noting that this stage can progress over several years and at the same time the patients will be active and mobile. But a violation of the supply of certain organs with blood entails a violation of their functioning.

ultimate

Usually at this stage, doctors detect kidney and heart failure, as well as a violation of blood circulation in the brain. The outcome of the disease, as well as the development of complications, is determined by the form of hypertension. Crises often occur.

With a cardiac form, the patient gradually progresses to heart failure. Appears shortness of breath, pain in the projection of the heart, hepatomegaly, edema. With the brain form of a person, severe headaches, visual impairments disturb.

Hypertension and childbearing

Hypertension during pregnancy is the most common cause of premature birth or perinatal death of the fetus. Usually, a woman's hypertension already exists before the onset of pregnancy and then simply activates, because bearing a child is a kind of stress for the body.

Given the high risk for the mother and unborn child, in the case of diagnosing an ailment, it is important to determine exactly the degree of this risk in order to resolve the issue of further gestation or termination of pregnancy. Doctors distinguish three degrees of risk (based on the stage of arterial hypertension):

• 1 degree of risk - pregnancy complications are minimal, crises rarely develop. Possible angina. Pregnancy in this case is permissible;
• 2 degree of risk - expressed. Complications develop in 20–50% of cases. A pregnant woman has hypertensive crises, insufficiency of the coronary vessels of the heart, high blood pressure. Termination of pregnancy is shown;
• 3 degree of risk. Complications of pregnancy occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Possible detachment of the placenta, uremia, impaired blood circulation in the brain. Pregnancy is a danger to the life of the mother, so it is interrupted.

Patients who are kept pregnant should make sure to visit the doctor once a week so that he can monitor their condition. Mandatory treatment of hypertension. It is allowed to use such antihypertensive drugs:

• antispasmodics;
• saluretics;
• sympatholytics;
• clonidine derivatives;
• rauwolfia preparations;
• ganglioblockers;
• beta blockers.

Also, in order to treat the disease during pregnancy, doctors resort to physiotherapy.

Diagnostics

When the first signs of illness appear, it is important to immediately contact a medical institution to confirm or refute the diagnosis. The sooner this is done, the less the risk of progression of dangerous complications (damage to the heart, kidneys, brain). During the initial examination, the doctor necessarily measures the pressure on both hands. If the patient is elderly, then measurements are also taken in a standing position. During the diagnosis, it is important to clarify the true cause of the progression of the pathology.

A comprehensive plan for diagnosing hypertension includes:

• collection of anamnesis;
• SMAD;
• Analysis of urine;
• blood biochemistry;
• determination of the level of bad cholesterol in the blood;
• x-ray;
• ECG;
• examination of the fundus;
• ultrasound.

Treatment

Treatment of hypertension is carried out in a hospital, so that doctors can constantly monitor the patient's condition and, if necessary, adjust the treatment plan. It is important to normalize the patient's daily routine, correct his weight, limit the use of table salt, and completely abandon bad habits.

To correct pressure, the following drugs are prescribed:

• alpha-blockers;
• beta-blockers;
• calcium channel blockers;
• diuretics. This group of drugs is especially important, as it helps to reduce the level of sodium in the blood, thereby reducing the swelling of the walls of blood vessels.

All of these drugs should be taken only as prescribed by the attending physician. Uncontrolled intake of such funds can only worsen the patient's condition. These drugs are taken according to a certain scheme.

Diet

During the treatment of hypertension, in addition to taking medications, it is important to adhere to a special diet. With hypertension, the patient is assigned table number 10. The principles of such a diet:

• add seafood to the diet;
• limit salt intake;
• fractional nutrition;
• limit carbohydrates and animal fats in the diet.

The diet for this pathology implies a restriction:

• Sahara;
• of bread;
• potatoes;
• pasta;
• cereal dishes;
• eggs;
• animal fats;
• ghee;
• sour cream and more.

Diet number 10 is complete and can be followed for a long time. To improve the taste of dishes, you can add to them:

• honey;
• prunes;
• vinegar;
• jam;
• cranberries
• lemon.

The diet is indicated not only during treatment, but also after it, so as not to provoke a deterioration in the condition. It is worth noting that the diet is developed strictly individually for each patient, taking into account the characteristics of his body. An important point - during the diet you need to consume no more than 1. 5 liters of fluid per day.

Prevention

Prevention of hypertension is quite simple. The first thing to do is to normalize your diet, as well as lead an active lifestyle. In order for the vessels to be elastic, you need to eat more vegetables and fruits, drink up to 2 liters of water per day. You can take vitamin preparations. Also, the prevention of hypertension involves the exclusion of smoking and drinking alcoholic beverages.

If possible, stress should be avoided, as they are one of the provoking factors of the disease. Prevention of hypertension should be addressed as early as possible in order to minimize the risk of developing the disease.