Hypertension is one of the most common cardiovascular diseases. According to the WHO, more than 1. 1 billion people suffer from it. whole world. High blood pressure increases your risk of other heart diseases. Hypertension is one of the leading causes of death, and the disease is getting younger. It happens not only in older people, but also in young people. Below you will find out why it appears, how to recognize it and control it.
What is hypertension?
This is a chronic condition where the blood pressure is high. It is recorded as two numbers, and the optimal value is 120/80 mmHg. Art. The first number is the systolic pressure, which occurs when blood is ejected from the heart's left ventricle into the aorta during systole (contraction of the heart's ventricles). The second number indicates the diastolic pressure when the heart muscle is relaxed. Blood pressure increases during physical activity and emotional stimulation, but the value should be close to normal at rest. If, with several measurements taken at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure above 90 mmHg. Art. , diagnosed with hypertension.
A persistent increase in blood pressure is associated with a number of factors, including excess weight and lack of physical activity, poor diet, bad habits and high stress levels.
Causes and risk factors
Hypertension can be primary or secondary:
- main (important)hypertension is more common - according to various estimates, in 85-95% of cases. Its appearance is not associated with concomitant diseases, pressure increases under the influence of a complex of factors;
- secondary (symptomatic)hypertension occurs in 5-15%. In this case, high blood pressure is one of the symptoms that may be associated with endocrine disorders, kidney disease, and large vessel abnormalities.
When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its occurrence is usually continuous nerve overstrain. When diagnosing, it is important to determine as accurately as possible what causes hypertension, whether it has a secondary cause (the presence of a disease that causes an increase in blood pressure).
There are several risk factors that increase the chance of getting primary hypertension:
- overweight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drinking alcohol and smoking;
- stress, constant emotional tension;
- lack of sleep, low quality, insomnia;
- excessive salt intake;
- irregular sleep and rest patterns (including due to irregular or excessively long working hours);
- changes in hormone levels (in women, may be associated with taking oral contraceptives, with the onset of menopause);
- hereditary factors (in total, more than 20 genes have been identified that determine the tendency to hypertension);
- age over 65 years (this disease can also occur in young people; it is worth monitoring blood pressure periodically after 35 years);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods high in trans fat and saturated fat);
- kidney disease, diabetes mellitus and several other related conditions and diseases.
Many of these factors are interrelated and reinforce each other. Some of them can be controlled (for example, diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is a simple way to reduce the risk of hypertension or improve your well-being if your blood pressure is already high.
Classification
To classify the disease, two approaches are used: by level and stage. The level of hypertension differs in the value at which the blood pressure rises, the difference between the levels is in the course of the disease, in the number, severity of concomitant organic lesions.
First degree
Systolic blood pressure - more than 139 and less than 159 mmHg. Art. , and diastolic is at the level of 90-99 mm Hg. Art. With high values, blood pressure can be normalized by adjusting your lifestyle. To do this, you need to increase physical activity, adjust your diet, abandon bad habits, and reduce stress levels.
second degree
In the second stage, the blood pressure value becomes high and amounts to 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastolic. With such a value, the load on the heart increases a lot. Blood supply to the brain deteriorates, and this can cause headaches and dizziness, and a decrease in performance. Changes occur in the fundus of the eye. Sclerosis of kidney tissue and blood vessels begins, excretory function is impaired, and kidney failure may develop. The condition of the blood vessels is getting worse. For treatment, you need to change your lifestyle and start taking medication.
third degree
Systolic blood pressure is over 180 mm Hg. Art. , diastolic - over 110 mm Hg. Art. With hypertension, the load on the heart becomes too high and causes irreversible changes. Blood pressure must always be reduced with medication. Without this, there is a threat of acute heart failure, arrhythmia, angina pectoris, myocardial infarction, and other serious conditions. Patients with stage 3 hypertension should be constantly monitored by a doctor. Continuous use of blood pressure lowering drugs is necessary.
| Arterial pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| okay | < 130 | < 85 |
| Normal, so-called prehypertension | 130–139 | 85–89 |
| 1 - mild hypertension | 140–159 | 90–99 |
| 2 - moderate level of hypertension | 160–179 | 100–109 |
| 3 - severe hypertension | ≥ 180 | ≥ 110 |
Hypertension level
The disease develops gradually. There are three levels in total.
- First stage:moderate hypertension. Blood pressure is unstable and may fluctuate throughout the day. At this stage, the condition of internal organs and central nervous system remains normal, there are no signs of organic damage. Hypertensive crises are rare and relatively mild.
- Second stage:severe hypertension. In the second stage, there is a significant increase in blood pressure, health often worsens, and the hypertensive crisis becomes severe. At this stage, changes in the internal organs begin due to the constantly high blood pressure. Vascular disturbances appear and the blood supply to the brain deteriorates. The retinal artery narrows. Hypertrophy of the left ventricle of the heart develops, and this increases the risk of severe heart pathology. Signs of kidney dysfunction appear (increased albumin level in urine, increased creatinine level in blood serum)
- Third stage:severe hypertension. Blood pressure becomes very critical - over 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions worsen, heart failure, cerebral vessel thrombosis, aneurysm, kidney failure and other serious conditions develop. A severe hypertensive crisis often occurs.
symptoms
Even with a significant increase in blood pressure, hypertension may not have symptoms for a long time. For this reason, you need to measure your blood pressure regularly (monitoring is especially important for those over 35). You can measure your blood pressure with an automatic electronic tonometer - such devices are sold in pharmacies.
The main symptoms of hypertension include headache, dizziness, and heaviness in the head. This manifestation is associated with vasospasm and impaired blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, heart arrhythmia. In severe cases of high blood pressure, weakness, chest pain, nausea, vomiting, and muscle tremors ("tremors") may appear. Other symptoms include blurred or black spots in front of the eyes, trouble sleeping, palpitations, and tinnitus.
As the disease progresses, visual acuity gradually decreases, the sensitivity of the arms or legs may decrease, and in severe cases, paralysis is possible. During periods of stress, against the background of nervous tension or physical activity, symptoms may increase. More often they appear in middle-aged and elderly people. This disease is worse if you are overweight, have bad habits, have a tendency to overeat, or have high stress levels.
You should consult a therapist or cardiologist if you experience frequent headaches, dizziness, or vision problems, or if your blood pressure often rises when you measure your own blood pressure.
Diagnostics
Usually, diagnosis is carried out in three directions:
- blood pressure measurement.Performed at intervals of several hours or over 2-3 days to determine the level of hypertension and its stage;
- identify the cause of the disease.It is important to determine whether the hypertension is primary or secondary (caused by another disease). In the second case, specific treatment may be required;
- general health monitoring.During the examination, the condition of the heart, cerebral vessels, fundus, and kidneys are monitored. Due to high blood pressure, the function of these organs is affected. When diagnosing, it is important to assess their condition.
At the first appointment, the doctor will conduct a survey and collect medical history details related to the disease. Information will be required about how long the patient has had hypertension, what the blood pressure level is, whether there are symptoms of heart disease, apnea, severe snoring, whether the person or a close relative has had a stroke, peripheral artery disease, gout, diabetes, kidney disease. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, taking medication.
For patients with arterial hypertension, the following examinations are carried out:
- blood pressure measurement.It is measured several times during rest (physical activity, caffeine consumption, smoking are excluded half an hour before the measurement), measurements are taken at different times of the day;
- general exam:measure height and weight, waist circumference, palpate abdomen, assess peripheral arterial pulse;
- Urine analysis.Albumin and creatinine levels are important - deviations from the norm indicate kidney dysfunction and require ultrasound;
- blood analysisTo monitor the level of potassium, creatinine, lipids, kidney ultrasound is prescribed. Evaluation of lipid levels is necessary to control lipid metabolism to eliminate the risk of complications from the cardiovascular system;
- ECGperformed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiology or neurological examination or an examination of the respiratory system.
Treatment of hypertension
Arterial hypertension is a disease that cannot be completely cured, but can be controlled. Therapy and lifestyle changes can stop the progression of hypertension, reduce the frequency and severity of crises and eliminate symptoms. But the most important thing is to reduce the risk for the cardiovascular system, brain, and kidneys.
Treatment begins with lifestyle adjustments:
- to stop smoking;
- refusal to drink alcohol or significantly limit the amount of alcohol;
- diet: adjusted diet, reduced salt intake (less than 3. 75 g per day), increased amount of vegetables and fruits (ideally you need 5 servings per day), whole grains, dairy products, low-fat products, and intakecalories are limited. If there are no contraindications or kidney disease, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increase in physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is reduced to a target value (below 130/80 mmHg) to reduce the risk of complications. With such a decrease, constant monitoring by a doctor is required. Tonometers used for home measurements must be calibrated regularly. For diabetics, pregnant women, the elderly and frail people, the use of antihypertensive drugs requires special attention.
The following can be used to treat hypertension:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and reduce blood pressure, but can cause drowsiness and lethargy, and are therefore rarely used;
- ACE inhibitors.Reduces peripheral vascular resistance, often prescribed to diabetic patients;
- angiotensin II receptor blockers.They have a similar effect to ACE inhibitors, and therefore are not prescribed together with them. Not prescribed during pregnancy;
- beta blockers.Provides a decrease in blood pressure by slowing the heart rate;
- calcium channel blockers.They reduce total peripheral vascular resistance and can trigger reflex tachycardia;
- direct vasodilator.They have a direct effect on blood vessels and are used for severe hypertension;
- diuretic.They reduce the amount of blood plasma, which reduces blood pressure, but can also trigger hyperkalemia.
Important!The therapist or cardiologist should prescribe the drug and its dosage after examination. Taking medicine without a doctor's prescription can be dangerous.
If your doctor prescribes medication, you will need to undergo regular follow-up examinations to assess the effectiveness of the treatment and adjust it. It is important to adjust your lifestyle and restore normal health so that the minimum amount of medication is needed to control the course of hypertension.
Possible complications
Due to increased blood pressure, the arterial walls lose their elasticity, and the heart muscle works too hard. This increases the risk of angina, acute heart failure, and heart attack. Due to interruption of blood supply to the brain, temporary ischemic attacks and strokes are possible. The severity of hypertension will increase without treatment and lifestyle correction: the pressure will continue to increase, and this will lead to damage to internal organs and worsen overall health and well-being. Smoking, drinking alcohol, overeating, lack of physical activity and high stress levels accelerate the development of hypertension and make its course more complex.
Consequences
Without treatment, arterial hypertension causes serious consequences. Continuous spasm of cerebral vessels leads to ischemia and stroke. They are dangerous with severe disability and even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia, and heart failure occur. Without treatment, myocardial infarction is possible.
The severity of the hypertensive crisis increases, it becomes complicated, life-threatening and can be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life on the background of hypertension without adequate therapy and restoration of normal health conditions decreases sharply, even to severe disability.
Prediction
The prognosis is good if the patient consults a doctor in time and takes steps to control blood pressure and factors that affect hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its severe course. Even with severe arterial hypertension, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
To prevent hypertension, self-monitoring of blood pressure is recommended at the age of 35 and above or when symptoms of hypertension appear. It is important to eliminate the effects of factors that trigger an increase in blood pressure: control your diet, eliminate smoking and drinking alcohol, reduce stress levels, devote more time to physical activity: in a word, live a healthy lifestyle.
Conclusion
Hypertension is a dangerous disease, but it can be controlled by maintaining normal health and reducing the risk of complications. To do this, it is important to monitor blood pressure levels, control weight, lead a healthy lifestyle, and undergo preventive examinations with a therapist or cardiologist.