Hypertension is the most common cardiovascular disease, whose symptoms after 60-65 years affect a large part of the population. The diagnosis has several names, including essential hypertension (AH), arterial hypertension (AH). The disease is chronic, the main task of each patient is to avoid exacerbations and prolong the period of remission (disappearance of symptoms) with drugs and non-drug methods.
What is hypertension
Arterial hypertension is a constant increase in blood pressure above acceptable levels (starting from 140/90 mm Hg) under the influence of provoking factors. This diagnosis is called the "silent killer". The pathological process takes a long time in an asymptomatic form, but during the attack significantly increases the risk of stroke, myocardial infarction and other dangerous diseases. Potential complications of GB can endanger the patient's life, so the disease needs timely diagnosis and adequate treatment.
Hypertensive disease occurs as a result of dysfunction of the higher centers of neurohumoral regulation, kidneys, blood vessels. In the absence of timely treatment, the pathological process leads to organic and functional disorders of the heart, organs of the central nervous system and kidneys. Improperly chosen therapy can lead to disease progression with increased pain.
Classification of hypertension
In 2003, a unique classification of hypertension according to the severity of the disease was defined. The deciding factor in this division is considered to be the actual blood pressure indicator, determined by the tonometer in a particular clinical case. Hypertension is also classified according to origin (primary, secondary), stages (transient, stable, sclerotic) and level of risk of cardiovascular pathologies. This classification simplifies the diagnosis, helps to more precisely determine the treatment regimen for each hypertensive patient.
Degrees of arterial hypertension
With an increase in blood pressure (BP), there is a suspicion that arterial hypertension is progressing, especially if this health problem cannot be solved by non-drug methods. It is important to know that the optimal blood pressure is 120/80 mm Hg. Art. , normal - 120-129 mm Hg. Art. (systolic pressure - SBP) and 80-84 mm Hg. Art. (diastolic - DBP), high normal - 130-139 mm. rt. Art. (USA) and 85-89 mm. rt. Art. (DAD). Deviation from these figures indicates serious pathologies of the body. Doctors distinguish 3 degrees GB:
- Grade 1 hypertensive disease (mild) is characterized by unstable pressure, which ranges from 140/90 to 159/99 mm Hg for several days. Art The risk of developing a hypertensive crisis is minimal, there are no symptoms of organic damage to internal organs and the central nervous system. To suppress a painful attack, in addition to taking medication, the patient needs a good rest, exclusion of stressful situations. Positive emotions, walks in the fresh air are especially useful.
- Grade 2 arterial hypertension developed rapidly. Blood pressure index varies from 160/100 to 179/109 mm Hg. Art. , there are symptoms of a hypertensive crisis (cold sweat, chills, flushing). The patient is worried about migraine attacks, dizziness, poor sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decrease in blood flow in the organ), increase in blood creatinine, narrowing of retinal arteries, hypertrophy (increase in size) of the left ventricle, microalbuminuria (detection of protein in urine analysis). It is not possible to normalize the condition without medication.
- Grade 3 hypertensive disease (severe) is accompanied by a sudden drop in visual acuity, poor memory, tachycardia attacks (increased heart rate). A hypertensive crisis develops. Blood pressure indicator - from 180/110 mm Hg. Art. and more. Possible complications are hypertensive encephalopathy, cerebral vascular thrombosis and aneurysm (pathological vascular expansion), heart and kidney failure of the left ventricle, bleeding (bruising) and swelling of the optic nerve. Pathological changes are irreversible.
Degree of cardiovascular risk
To predict the likelihood of complications in progressive arterial hypertension, the first step is to determine the cardiovascular risk index. This requires expert advice, complex diagnostics. The degree of hypertension, the circumstances that cause relapse (physiological and pathological) are taken into account. Common risk factors are:
- smoking, other bad habits;
- high blood cholesterol;
- sedentary lifestyle;
- obesity, including abdominal (most fat is deposited in the abdomen);
- age (women over 65, men over 55);
- fasting sugar index 5, 6-7, 0 mmol / l;
- impaired glucose tolerance, determined by a special test;
- the presence of diseases of the cardiovascular system in relatives;
- male.
The patient has a high degree of cardiovascular risk if, in addition to hypertension, there are accompanying chronic diseases:
- diabetes;
- Heart Failure;
- violation of lipid metabolism (fat);
- bronchial asthma;
- extensive retinal damage;
- coronary artery disease;
- renal failure stage 4;
- suffered a stroke;
- cerebrovascular diseases (damage to blood vessels of the brain);
- signs of obliterating diseases of the peripheral arteries of the lower extremities (atherosclerosis);
- damage to other internal organs.
Such information helps the doctor predict the clinical outcome of the disease. To determine the cardiovascular risk indicator for each degree of hypertension, you must familiarize yourself with the table below:
> zxtable border = "1" cellpadding = "0" >Treatment of hypertension
Classification of GB according to phases and risks helps to correctly determine the drug therapy regimen, quickly stop the painful attack and prolong the remission period. If primary arterial hypertension (isolated) develops, with medical recommendations, the prognosis is favorable. The secondary form of the disease often occurs with complications.
If the disease is not cured in time, it is difficult to stabilize high blood pressure even with medication. General recommendations of specialists, if hypertension of 1, 2 or 3 degrees is diagnosed, are shown below. . It should be supplemented by taking medication prescribed by a doctor:
- Compliance with therapeutic diet. It is important to reduce portions of table salt, enrich the daily diet with foods with potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and cereals, cabbage).
- Rejecting bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, abandon the "sedentary" lifestyle and walk in the fresh air.
- Weight control. If a patient with arterial hypertension is obese, it is necessary to abandon fatty, fried and smoked foods, and regularly organize fasting days.
- Physiotherapy. In order to prevent and prolong the period of GB remission, it is recommended to perform moderate-intensity physical exercises for 30 minutes 5 times a week.
- Intake of multivitamin complexes. The composition of such drugs should contain potassium, magnesium, iron and other trace elements important to the body.
Medical therapy
Oral medications depend on the degree of hypertension and the associated symptoms. Below are the optimal schemes for conservative treatment of arterial hypertension:
- In the milder phase of the disease, the patient is prescribed angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, and calcium channel blockers.
- If arterial hypertension of risk level 4 develops, an integrated approach to the problem is needed, which unites several representatives of different pharmacological groups in one conservative treatment regimen. These are the above drugs in combination with thiazide diuretics.
- In the complicated course of this disease, in addition to the listed drugs, doctors recommend alpha- or beta blockers. The need for this arises if the weakened organism does not tolerate high doses of diuretics).