Hypertension, or arterial hypertension - a condition characterized by stability, which is detected by repetitive measurements, hypertension. Comes with many diseases, it is considered a risk factor for the development of dangerous complications from the cardiovascular system, including myocardial stroke and infarction. Hypertonic disease, which is the main cause of the disease being considered, requires medication, normalization of patients' lifestyle and nutrition.
Blood pressure is a force that circulates blood impact on the walls of blood vessels. Such pressure at the time of heart spasm is called the systolic, and in the process of relaxation - diastolic. The range of normal values for these indicators is quite wide.
During the observation process, scientists came to the conclusion that the risk of cardiovascular complications increased with each more 10 mm Hg hypertension. Art. It has started at 115/75 mm RT. Art. However, a pressure -reducing drug is only over 140/90 mm as appropriate. RT. Art. Therefore, it is exactly a value considered to be a criterion to determine arterial hypertension.
ReasonIn about 90% of cases, hypertension becomes the cause of stable increased blood pressure. Such diagnosis is performed for patients when other diseases accompanied by hypertension were not found during the test. Among the following:
Kidney disease - pleural inflammation, glomerulonephritis, polycystic, diabetes kidney disease, narrowing of kidney artery;
Endocrine disorders-Neoplasms of adrenal glands, pancreas or pituitary glands, thyroid hypertension, Izenko-Cushing syndrome, pheochromocytoma;
Obstructed apnea syndrome in a dream;
Valve evils or atherosclerosis damage to the aorta.
Regular use of some drugs can also cause hypertension. They include oral contraception, anti -inflammatory drugs, amphetamine, corticosteroids, drugs that contain erythropoetin, cyclosporine, cocaine.
The ability of cardiovascular diseases, including hypertension, has a close relationship with the following risk factors:
Improper nutrition, including excess sodium salt, saturated fat and trans fat, lack of green vegetables, vegetables and fruits in the diet;
obesity;
The disease of the heart and blood vessels in close relatives;
Old age over 65 years old;
Sedentary lifestyle;
chronic tension;
Harvesting habits - smoking, excessive alcohol consumption.
ClassifyIf possible, the disease can lead to hypertension, arterial hypertension is called secondary or symptomatic. In the case of unknown cause of hypertension, it is considered to be primary, caused by hypertension.
The latter has the current:
Phase I. There is no clear sign of the work of the target organs affected by the stability of blood pressure, kidney, blood vessels and venous veins.
Stage II. There is one of the listed signs or the total of them, such as the increase in the heart ventricles of the heart, reducing the filtration rate in the kidneys, albumin in urine, the increase in the thickness of the artery walls or the appearance of their atherosclerosis. In this case, the clinical manifestations of the disease may not be available.
Hypertension stage III. There are one or more diseases related to the atherosclerosis processes in the heart and blood vessels - myocardial infarction, acute cerebrovascular accident, angina, atherosclerosis of the arteries of the lower limbs, or serious kidney damage.
Aortic hypertension is divided into several degrees, depending on the maximum indicators of the measured blood pressure:
The first level. The systolic blood pressure is from 140 to 159 mm. RT. Art. And/or diastolic - from 90 to 99 mm. RT. Art.
The second level. The systolic blood pressure is from 160 to 179 mm. RT. Art. And/or diastolic - from 100 to 109 mm. RT. Art.
The third level. The systolic blood pressure is more than 180 mm. RT. Art. and/or diastolic above 110 mm. RT. Art.
There is also a form of arterial hypertension isolated, of which only the data of the systolic pressure in normal diastoles.
SymptomUsually the hypertension is not accompanied by a good decline and may not be noticed for the patient, so it is very important to regularly measure blood pressure, especially middle -aged and the elderly.
The following symptoms may be a manifestation of hypertension:
Headache, mainly in the morning after waking up;
Bleeding from the nose;
Bleeding under the mucous membrane of the eye;
Violation of heart rate;
Fuzzy vision, flashing flies;
Tinnitus.
A high dance of blood pressure to high quantities, accompanied by a significant decline in good, is called a hypertension crisis. Typically, it occurs with an increase in central pressure of more than 180 mm Hg. Art. and/or diastolic above 120 mm Hg. Art. At the same time, the patient is weak, nausea, vomiting, does not bring relief, weakening consciousness, anxiety and fear, trembling muscles, chest pain.
ComplicationHypertension stability with hypertension significantly increases the risk of cardiovascular disease, including patients' lives. They include:
Acute brain circulation (stroke);
angina, myocardial infarction;
Vascular memory loss (dementia);
Chronic heart and heart failure;
The atherosclerotic lesions of the circuits of the lower limbs.
DiagnoseThe main symptom of hypertension is stable hypertension, showing at least three dimensions in different days in a calm environment. In the first blood pressure measurement in the hospital or clinic about the accuracy of the results, it is important to comply with the following rules:
Before checking, the patient needs to sit for a few minutes in a quiet room to calm down;
The size of tonometer shackle must correspond to the thickness of the arm and the device itself - attached to the level of the heart;
Two measurements are made with about 1-2 minutes per hand, with a big difference in the amount obtained, the additional measurement is made;
In elderly patients, as well as people with diabetes, or in case of suspicion of reducing blood pressure in case of changing body position, the measurement is done in the first and fifth minute in a standing position;
In addition, the heart rate is measured within 30 seconds.
The doctor in an interview with the patient clarified at the age when the first pressure started to increase, if there were symptoms such as snoring with the breath in the dream, muscle weakness or sudden brushing of chest drum with sweat and headache, and abnormal impurities in urine. It is also important to learn the drugs and biology he uses.
In the framework of the first stage of the exam, the following tests are done for hypertension:
Clinical blood tests;
Analysis of urine in general, the detection of microalbumin in its first and daily parts;
Biochemical testing (cholesterol, lipoprotein to assess the risk of atherosclerosis, electrolyte - potassium, sodium, chlorine, calcium, as well as glucose and creatinine);
Determine the degree of glycated hemoglobin;
Determine the concentration of hormone -Thyroxine, triiodothyronine and the -mer thyroid gland, antibodies to the -peroxidase thyroid and thyroidoglobulin, aldosterone.
In case of suspicion of a genetic tendency for the disease, it is possible to determine the polymorphism of genes associated with the development of arterial hypertension.
To clarify the risk factors for the development and identification of existing cardiovascular diseases for hypertension, the diagnostic methods used:
Monitoring daily blood pressure;
Electrocardiogram research;
Echocardiography;
Holter daily monitoring;
Parallel scanning of Brachiocephalous arteries, kidneys or iliac;
Research on kidney and adrenal glands;
Check the bottom of the eye.
With hypertension, blood pressure control at home is very important with maintaining diary in which it is necessary to overcome all the results of time measurements, medication and stress attacks that can cause hypertension. At the same time, the measurements must be performed in a sitting position, after a few minutes of rest, holding hands at the same level as the heart.
TreatmentWith the risk of moderate and low cardiovascular complications, patients are recommended to change their lifestyle, adjust their diet, lose weight, increase physical activity and special tools to increase blood pressure, reject bad habits against regular blood pressure. Usually these measures are sufficient to normalize blood pressure.
The diet of hypertension is related to restricting salt, caffeine, sharp, salty, smoked and spicy, products with high fat content, internal organs, confectionery with oil cream and alcoholic beverages. It is allowed to use no more than 5 g of salt daily outside the seriousness of the disease. The recommended daily liquid speed is 1-1, 2 liters.
In case of treatment is not unsuccessful for a few months, as well as a high risk of complications, using antihypertensive therapy to use drugs to increase blood pressure, the purpose of reducing blood pressure below 140/90 mm. RT. Art. For patients with diabetes or those who have had the pathology of the cardiovascular system, the target pressure level is even lower than 18/80 mm. RT. Art.
Treatment of modern hypertension includes a combination of two or more drugs from the following groups:
Calcium antagonism;
Angiotenzinoproding enzyme inhibitors;
Baseball for angiotensin II;
diuretics (diuretics);
B-Blocker;
Alpha blockers.
Most of them are produced in the form of tablets from hypertension.
PreventPreventing hypertension including diagnosis and timely treatment of diseases of cardiovascular, nervous, urinary and endocrine systems, continuously followed by a doctor's recommendations, including non -union and drug treatment, as well as regular blood pressure.
