Arterial hypertension belongs to the most common disease in the heart and blood vessels, affecting about 25% of the adult population.No wonder it is sometimes referred to as endless outbreaks.High blood pressure with its complications affects the death of the population.Estimates indicate that up to 25% of deaths over the age of 40 are directly or indirectly due to hypertension.The probability of complications determines the level of hypertension.How many levels of hypertension, how are they classified?See below.
IMPORTANT!According to the latest estimates by the World Health Organization in 1993, hypertension in adults was a steady increase in blood pressure to 140/90 mm Hg.Art.
Classification of arterial hypertension, Determination of disease risk stage
In whom, according to the etiology, hypertension is classified into primary and secondary.
With the main hypertension (important) (GB), the main organic cause of increased blood pressure (blood pressure) is unknown.The combination of genetic factors, external influences and violations of internal regulatory mechanisms are taken into account.
External factors:
- environment;
- excessive use of calories, development of obesity;
- Increased use of salt;
- lack of potassium, calcium, magnesium;
- Drink excessively;
- Repeat the stress situation.
The main hypertension is the most common hypertension, in about 95% of cases.
3 stages of hypertension separated:
- Level I - increases blood pressure without organ changes;
- Stage II - increased blood pressure with organ changes, but without damaging their function (left ventricular hypertrophy, proteinuria, angiopathy);
- Stage III - organ accompanied by impaired function (left heart failure, hypertension encephalopathy, stroke, hypertonic retinopathy, kidney failure).
Secondary hypertension (symptomatic) is an increase in blood pressure as a symptom of the underlying disease with the identified cause.The classification of the secondary artery hypertension is as follows:
- Renoparechymal hypertension - occurs due to kidney disease;Reason: kidney parenchymal disease (glomerulonephritis, pyelonephritis), tumor, kidney damage;
- Renovascular hypertension - narrowing of renal arteries with fibromoscular displacements or atherosclerosis, kidney vein thrombosis;
- Endocrine hypertension - major hyperaldosteronism (CONN syndrome), hypertiroidism, pheochromocytoma, kushing syndrome;
- drug -induced hypertension;
- Pregnancy hypertension - high pressure during pregnancy, after childbirth, conditions are often normalized;
- Coarctation of the aorta.
Pregnancy hypertension can cause congenital diseases of children, in particular, retinopathy.2 phases of retinopathy (premature and full) are separated ::
- Active - consisting of 5 stages of development, can cause vision loss;
- Rubts - leads to corneal clouding.
IMPORTANT!Both stages of premature and full child retinopathy lead to anatomical disorders!
Hypertension disease according to the international system (according to ICD-10):
- Main Form - I10;
- Secondary Form - I15.
The level of hypertension also determines the degree of dehydration - dehydration.In this case, the classroom is a lack of water in the body.
Share 3 degrees dehydration:
- Degree 1 - light - deficiency 3.5%;Symptoms - dry mouth, severe thirst;
- Degree 2 - average - deficiency - 3-6%;Symptoms - sharp fluctuations in pressure or reduction of pressure, tachycardia, oliguria;
- Degree 3 - third degree is the worst, characterized by a deficiency of 7-14% of water;shows itself with hallucinations, confusion;Clinic - coma, hypovolemic shock.
Depending on the level and level of dehydration, decomposition is carried out by introducing a solution:
- 5% glucose + isotonic NACL (light degree);
- 5% NACL (average degree);
- 4.2% nahco3(Severe degree).
GB level
Subjective symptoms, especially with mild and moderate levels of hypertension, are often absent, so increased blood pressure is often found at a dangerous level.The clinical picture is divided into 3 stages.Each stage of arterial hypertension has typical symptoms, from which GB classification comes.
Level i
At the level of hypertension, the patient complains of headache, fatigue, rapid heartbeat, disorientation, sleep disorders.At 1 GB stage, objective detection in the heart, ECG, eye background, in laboratory studies present in the normal range.
Stage II
At the 2nd stage, the subjective complaints are the same, at the same time there are signs of left ventricular hypertrophy, there are signs of hypertension angiopathy in the retina, microalbuminuria or proteinuria in urine.Sometimes there is a red blood cell multiplication in urine precipitation.In 2 stages of hypertension, symptoms of renal failure are not present.
Level III
With stage III hypertension, functional disorders are diagnosed in organs owned by increased levels of hypertension risk:
- Damage to the liver - initially, shortness of breath is indicated, then - symptoms of heart asthma or pulmonary edema;
- Vascular complications - damage to the peripheral and coronary artery, the risk of brain atherosclerosis;
- Changes in the fundus - have retinopathic properties of hypertension, neuroretopathy;
- Changes in cerebral blood vessels are indicated by temporary ischemic attacks, typical or hemorrhagic thrombotic vascular stroke;
- In stage III, brain stroke, brain lesions are diagnosed in almost all patients;
- Nephrosclerosis of the renal vessels - leads to reduced glomerular filtration, increased proteinuria, red blood cells, hyperuricemia, and then to chronic kidney failure.
Which level or level of hypertension is the most dangerous?Despite various symptoms, all levels and degrees of arterial hypertension, they require systemic treatment or appropriate symptoms.
Degree
In accordance with blood pressure indicators (blood), determined at the time of diagnosis, 3 degrees of hypertension are distinguished:
- light;
- average;
- heavy.
There is also a 4 -th concept of resistant (continuous) hypertension, where even with the right choice of antihypertensive drugs, blood pressure indicators are not reduced below 140/90 mm Hg.Art.
A clearer overview of the degree of arterial hypertension is shown in the table.
AG classification and normal blood pressure stratification in accordance with ESH/ESC Guidelines 2007.
| Category | Systolic pressure, mm Hg.Art. | Diastolic pressure, mm Hg.Art. |
|---|---|---|
| Optimal | <120 | <80 |
| Regular | 120-129 | 80-84 |
| Increased normal | 130-139 | 85-89 |
| 1 degree | 140-159 | 90-99 |
| 2 degrees | 160-179 | 100-109 |
| 3 degrees | More than 180 | More than 110 |
| Isolated systolic hypertension | More than 140 | less than 90 |
Difficulty Different Disadvantages -Different according to the separation of hypertension to the degree.The choice of disease treatment regimen depends on the determination of the degree.
I degree
The disease can only be detected by regular blood pressure measurement.Measurements should be carried out in a relaxed environment, at least 3 times during a period of time.
This is the only way to assess the presence or absence of hypertension.Depending on the degree of increased blood pressure, the clinical picture of the disease is different.
Degree
The level of hypertension is characterized by an increased period of intermediate pressure -other than a decrease in the indicator, or an increase in diastolic value only.At this point, hypertension, cases of increased pressure under certain circumstances are typical, especially in patients with unstable nervous system.
Degree III
III AGAINS is characterized by critical increases in blood pressure.
Stage III GB is characterized by severe complications that arise from the harmful effects of high blood pressure on all organs and systems.First of all, the heart, the kidneys, the eyes, the brain are affected.With degree of hypertension III, symptoms and treatment are closely associated - with inadequate or improper treatment, the disease can cause serious consequences: stroke, encephalopathy, kidney failure, irreversible eye injury, blood vessels.Lack of treatment for hypertension III increases the risk of isolated systolic hypertension.
At the level of arterial hypertension, the risk level increases significantly!Memory disorders, mental activity, frequent loss of consciousness are shown.
Hypertonic crisis arises as a complication of century III, and is considered art IV.GB.
Risk
In accordance with the classification of hypertension due to stage and degree, the patient is divided into risk groups, depending on the severity of the AG.4 categories are distinguished (that is, there are many of them as a degree of hypertension), which is determined by the principle of probability of damage to the internal organs in the future.
Risk about the level of the disease:
- risk less than 15%;
- risk up to 20%;
- risk 20-30%;
- The risk is over 30%.
Low, not important
Low -risk groups include men up to 55 years old and women up to 65 years from my art.arterial hypertension.In this group, the risk of cardiovascular pathology in up to 10 years is less than 15%.People owned by low risk groups are recommended to change their lifestyle.If within 6-12 months of non -Drug therapy does not show effectiveness, it is advisable to prescribe the drug.
Average
Average risk groups include people from art I - ii.Hypertension, provided there are 1-2 risk factors.Risk increases with high weight, smoking, increased cholesterol, violation of glucose tolerance, lack of movement.Descent factors are also important.The risk of cardiovascular complications in people is higher, and 15-20% for 10 years.People related to this group are recommended to adhere to a healthy lifestyle.If the pressure decrease does not occur within 6 months, pharmacotherapy is prescribed.
High
High groups include the people of the century I - ii.Hypertension, subject to the presence of at least 3 risk factors, including:
- diabetes;
- defeat of the target organ;
- atherosclerotic vascular disease;
- left ventricular hypertrophy;
- increased creatinine;
- Change in the eye ships.
The group also includes the 3rd century hypertension, which has no risk factors (the risk of cardiovascular disease is 20-30% for 10 years).Representatives of this group are under the supervision of a cardiologist.
Very high
A group of hypertension with very high risk of cardiovascular disease (over 30% for 10 years) including people with art III.Hypertension, provided there are at least 1 risk factor.In addition, this group includes patients with AR I -II Art.In the presence of violations of cerebral circulation, ischemia, nephropathy.The group is controlled by cardiologists, requiring active therapy.
Conclusion
The problem of arterial hypertension is that the disease has no common symptoms, characterized by various clinical pictures.Therefore, usually one does not know the presence of the disease.Therefore, high pressure is detected by accident, during examination or in the manifestation of complications.When diagnosing hypertension, it is important to inform the patient correctly that he or she can largely affect the course of the disease, following a healthy lifestyle.