Hypertonic disease. Hypertension, causes of the disease, modern diagnosis, effective treatment. Heart damage due to hypertension

Hypertension is a disease in which there is a persistent increase in arterial pressure. Signs of this disease can be present in women and men, but in the latter, arterial disease appears much more often.

If blood pressure is too high, a fatal pathology develops of cardio-vascular system. Characteristic surges are dangerous to health, and in the absence of timely treatment, doctors do not rule out a hypertensive crisis. 30% of all patients face this problem, and the symptom is constantly getting younger.

In this article, we will look at: what kind of disease this is, at what age it most often occurs and what causes it, as well as the first signs and methods of treatment in adults.

What is hypertension?

Hypertension is a disease characterized by high blood pressure. In a person who does not have hypertension, normal pressure is approximately 120/80 mmHg, subject to minor deviations.

Arterial hypertension has negative impact on the patient's vessels, which are a short time narrowed and damaged. If the blood flow is too powerful, the walls of the blood vessels cannot withstand it and burst, resulting in hemorrhage in patients.

To “catch” the disease on initial stage when changes are reversible, it is necessary to measure regularly blood pressure. If periodic measurements often reveal values that exceed normal values, blood pressure correction is necessary.

The following numbers are considered normal:

for people aged 16-20 years – 100/70 – 120/80 mm. Hg Art.;
at 20-40 years old – 120/70 – 130/80;
40-60 – not higher than 135/85;
60 years or more – no higher than 140/90.

Who is a hypertensive person?

A hypertensive person is a person with chronically high blood pressure. This dangerous condition, since high blood pressure significantly increases the risk of serious cardiovascular diseases.

A person with blood pressure above 140/90 mm Hg can be called hypertensive. Art.

According to statistics from recent years, 25% of all adults suffer from high blood pressure. And among older people, the percentage of hypertensive patients is even higher - 57%.

So how to identify a true hypertensive patient? Blood pressure should be measured in a supine position and during physical activity. In a healthy person, the difference will not be too noticeable, but a hypertensive person will begin to experience difficulties and his pressure may jump to 220/120 millimeters of mercury. Simply put: a real hypertensive person has a very acute reaction to stress.

If a person has a blood pressure surge only once, this does not mean that it should be forgotten. Even an isolated incident should make the person with whom it happened wary.

Causes

To ensure a long period of remission, it is important to study the etiology of the pathological process. The main causes of hypertension are impaired blood circulation through the vessels and limited flow into the left ventricle of the heart. IN modern medicine there is a completely logical explanation for this - structural changes in blood vessels with age, the formation of blood clots and atherosclerotic plaques in their cavities.

The essence of the development of hypertension is the absence normal reactions(vasodilation) after eliminating stressful situations. Such conditions are typical for the following persons:

Abuse of salty foods - salt consumption in excess of the norm (15 g per day) leads to fluid retention, increased stress on the heart, which can cause spasms arterial vessels;
Lovers alcoholic drinks and smokers;
Persons whose work involves constant night shifts emergency situations, intense physical and intellectual activity, severe stressful situations, frequent negative emotions;
Patients with chronic kidney disease;
People whose relatives had hypertension, suffered a stroke or myocardial infarction.

Important: for men from 35 to 50 years old and for women in menopause the likelihood of developing hypertension increases.

Predisposition to hypertension is genetically determined. Symptoms that appear in close blood relatives are a fairly clear signal about the need to pay close attention to your health.

Stages and degrees

To correctly diagnose hypertension, doctors first need to determine the degree or stage of hypertension in the patient and make, so to speak, an appropriate entry in his medical card. If the diagnosis of the disease occurred on late stages, second or third, then the consequences for the body may be more serious than for the first stage of the disease.

Stage 1 hypertension is a blood pressure of 140–159/90–99 mmHg. Art. The pressure may return to normal levels from time to time, and then rise again;
Stage 2 is blood pressure, which ranges from 160–179/100–109 mmHg. Art. Blood pressure is often abnormal and very rarely returns to normal levels;
Stage 3 – when the pressure rises to 180 or higher/110 mmHg. Art. The pressure is almost constantly high, and its decrease may be a sign of a malfunction of the heart.

1st degree

The first degree of hypertension is initial. The pressure here does not exceed 140/158 to 90/97, and rises spasmodically and periodically, without obvious reasons. Afterwards, the pressure may suddenly return to normal. Present:

headache,
dizziness,
sensation of “floaters” before the eyes,
Sometimes there is tinnitus.

Second degree hypertension

In the second stage of hypertension, the pressure rises to 180/100 mm. Even if the patient takes rest, it does not decrease to normal level. In addition to increased blood pressure, the following may occur:

narrowing of the retinal artery,
hypertrophy of the left ventricle of the heart,
Protein appears in the urine during analysis and a slight increase in creatine in the blood plasma.

May be:

headache,
dizziness,
sleep disorders
angina pectoris
dyspnea.

With this stage may come such misfortunes as heart attacks and strokes.

3rd degree hypertension

The clinical picture of grade 3 hypertension is aggravated by the following symptoms:

Change in gait;
Persistent visual impairment;
Hemoptysis;
Persistent arrhythmia;
Impaired movement coordination;
Hypertensive attack of significant duration with visual and speech impairment, sharp pain in the heart, clouded consciousness;
Limitation of the ability to move independently and cope without assistance.

Symptoms of hypertension in adults

The primary symptom of hypertension, and sometimes the main one, is considered to be a persistent excess of 140/90 mmHg. Other signs of hypertension are directly related to blood pressure parameters. If the pressure rises slightly, the person simply feels unwell, weak, and has a headache.

The latent course of hypertension or the initial stage of the disease can be suspected if the following are periodically observed:

headache;
unmotivated feeling of anxiety;
hyperhidrosis (increased sweating);
chilliness;
hyperemia (redness) of the skin of the facial area;
small spots before the eyes;
memory impairment;
low performance;
irritability for no reason;
swelling of the eyelids and face in the morning;
rapid heartbeat at rest;
numbness of fingers.

Symptoms of hypertension appear in different combinations, not all at once, but as the disease progresses. Headache attacks can develop at the end of the day, coinciding in time with the physiological peak in blood pressure levels. It is not uncommon to have a headache immediately after waking up.

Signs high blood pressure when the disease develops severely, it is accompanied by complications of the heart and blood vessels:

heart failure,
myocardial infarction.

Great danger arterial hypertension the fact that it can be asymptomatic for a long time and the person does not even realize that it has begun and developing disease. Dizziness, weakness, lightheadedness, and “spots in the eyes” that sometimes occur are attributed to overwork or meteorological factors, instead of measuring blood pressure.

Although these symptoms indicate a disorder cerebral circulation and urgently require consultation with a cardiologist.

Complications

One of the most important manifestations of hypertension is damage to target organs, which include:

Heart (left ventricular myocardial hypertrophy, myocardial infarction, development of heart failure);
brain (dyscirculatory encephalopathy, hemorrhagic and ischemic strokes,
kidneys (nephrosclerosis, renal failure);
vessels (dissecting, etc.).

The most dangerous manifestation Hypertension is a crisis - a condition with a sharp increase or jump in blood pressure. A crisis state is fraught or manifested by the following symptoms:

A sharp, sudden or rapidly growing headache.
Blood pressure readings up to 260/120 mmHg.
Pressure in the heart area, aching pain.
Severe shortness of breath.
Vomiting, starting with nausea.
Increased heart rate, .
Loss of consciousness, convulsions, paralysis.

Diagnostics

If increased blood pressure is detected, the doctor pays attention to the following factors:

the reasons why this condition occurs;
frequency of blood pressure rise;
the presence of pathologies of internal organs - kidneys, brain, heart.

It is also necessary to take at least three blood pressure measurements within a month. Required laboratory research, allowing to identify:

risk factors for other heart and vascular diseases;
establish the degree of target organ damage;
diagnose possible symptomatic hypertension.

The presence of signs characteristic of high blood pressure and the development of hypertension is indicated by incorrect operation heart muscle. The following methods are used to study it:

auscultation - using a phonendoscope, the sounds produced by the organ are listened to, the rhythm of its work is observed;
ECG – interpretation of an electrocardiogram taken from a patient allows for a detailed assessment of the functions of the heart over a certain time period;
Ultrasound and echocardiographic diagnostic methods reveal defects in the myocardium and valves and allow one to correlate the sizes of the atria and ventricles;
Doppler study makes it possible to assess the condition of blood vessels;
arteriography - the result of monitoring informs about changes in the walls of the arteries, their damage, and the location of cholesterol plaques.

How to treat hypertension?

Treatment of hypertension directly depends on the stage of the disease. The main goal of the treatment is to minimize the risk of developing cardiovascular complications and prevent the threat of death.

The goal of drug therapy is to reduce blood pressure, namely to eliminate the cause this state vessels. At the beginning of treatment, mono and combination therapy. If it is ineffective, I use low doses combinations of antihypertensive drugs.

During treatment, patients should lead a calm lifestyle, in which there is no stress or emotional overload. Patients need to spend more time in the fresh air; it is best to take long walks in the forest, in a park, or near a pond. IN mandatory you need to follow a diet, since proper nutrition is the key successful treatment arterial hypertension.

The main groups of drugs for hypertension:

Diuretics (diuretics) promote unloading of blood circulation, removing excess liquid. But along with the liquid, such an element as potassium, which is beneficial for the heart, is removed, so the use of these drugs is strictly dosed and requires correction with potassium preparations (asparkam, panangin). Examples of diuretics: hypothiazide, indapamide.
Drugs that can affect strength cardiac output , on muscle contractions heart (beta blockers and calcium channel blockers). These include bisoprolol, carvedilol, metoprolol, amlodipine.
Medicines that act in different ways on vascular tone. Examples of drugs: lisinopril, monopril, losartan, valsartan.

A sharp increase in blood pressure, not accompanied by the appearance of symptoms from other organs, can be stopped by oral or sublingual (under the tongue) administration of drugs with relatively quick action. These include

Anaprilin (a group of β-blockers, usually if a rise in blood pressure is accompanied by tachycardia),
Nifedipine (its analogues - Corinfar, Cordaflex, Cordipin) (a group of calcium antagonists),
Captopril (a group of angiotensin-converting enzyme inhibitors),
Clonidine (its analogue is Clonidine) and others.

Medicines for relief:

Captopril 10-50 mg orally. The duration of action of the product lasts up to 5 hours;
Nifedipine – taken under the tongue. The duration of action of the product is about 5 hours.
Beta-blockers (atenolol, esmolol) are used for hypertension to normalize the tone of the sympathetic nervous system. They are used when a rise in blood pressure is combined with a decrease in heart rate;
Vasodilators (sodium nitroprusside, hydralazine);
Diuretics (furosemide).

Non-pharmacological treatments include:

weight loss by reducing fats and carbohydrates in the diet,
restriction of consumption table salt(4-5 g per day, and if you are prone to sodium and water retention, 3 g per day;
total amount of fluid consumed - 1.2-1.5 liters per day), spa treatment, methods of physiotherapy and physical therapy,
psychotherapeutic influences.

Diet

Dieting is one of the important points for hypertension. Below, we have compiled a list of recommendations to follow while eating:

There should be as little animal fat as possible: fatty meat, especially pork, butter, fatty dairy products. The only exception is fish, since its fat lowers cholesterol levels. bad cholesterol in blood.
The amount of salt in the diet should be as low as possible, since it retains fluid in the body, which is extremely undesirable.
It is very important that the diet contains fresh fruits, vegetables, herbs, juices.
It is advisable to establish fractional meals With in small portions, But frequent appointments food.
It is necessary to exclude strong tea and coffee from the diet. They should be replaced with compote, herbal drinks, fruit juice.

Doctors give the following advice to hypertensive patients:

balance your diet, eat at certain times at least 4 times a day, give preference to healthy and fresh products;
avoid stress;
get enough sleep;
improve emotional mood;
drink adequate fluids daily;
exercise – exercise is important every morning, after a working day you can visit the pool or gym;
It is forbidden to sit or lie down for a long time at the computer - you need to constantly warm up and do not forget about nutrition;
monitor changes in atmospheric pressure every day and analyze your blood pressure. At the slightest discomfort, you should consult a doctor and undergo a course of therapy;
give up bad habits;
control weight.

Contrary to popular belief, not all physical exercises are beneficial for this disease. You shouldn't do strength exercises.

Most effective gymnastics you will have stretching, that is, a set of stretching exercises, as well as muscle relaxation, as in the yoga system.
To better treat hypertension, pay enough attention to fresh air and water procedures.

Folk remedies

Before using folk remedies for hypertension, be sure to consult your doctor. Because There may be contraindications for use.

Black currants and strawberries in combination with honey and beets, you can take a tablespoon 4 times daily;
A teaspoon of lingonberry leaves diluted with 2 glasses of water and boiled for 15 minutes. The solution should be drunk throughout the day;
People with hypertension need to chop a head of garlic, mix with two glasses of fresh cranberries and a glass of honey. It is better to use a blender or meat grinder to obtain a homogeneous mass. The product should be taken 3 large spoons daily immediately after breakfast.
Grind three lemons in a blender with skins and a quarter cup of hazelnut kernels. Add half a glass of honey to the mixture. Take a monthly course of 2 spoons daily.
Instead of tea, when treating hypertension without medication, hypertensive patients are recommended to use decoctions of rose hips and hawthorn.
Take a honeycomb spoon of cranberries, half a tablespoon of fresh and chopped rose hips, and mix with a tablespoon of grated lemon. Add one glass of honey to this mixture. You need to consume this composition one tablespoon every morning and evening.

Prevention

The best cure for hypertension is prevention. With its help you can prevent the development of hypertension or weaken an existing disease:

Let's keep ourselves in check. Try to protect yourself from nervous shock and stress. Relax more often, rest, do not strain your nerves with constant thoughts about the unpleasant. You can take a yoga class or spend time going for walks with your family.
Let's normalize the diet. Add more vegetables, fruits, nuts. Reduce the amount of fatty, spicy or salty foods you consume.
Getting rid of bad habits. It's time to forget about cigarettes and excessive amounts of alcohol once and for all.
Rational nutrition (limiting the consumption of foods with big amount animal fats, no more than 50-60 g per day, and easily digestible carbohydrates). For hypertension, inclusion in daily diet foods rich in potassium, magnesium and calcium (dried apricots, prunes, raisins, baked potatoes, beans, parsley, low-fat cottage cheese, chicken egg yolks).
Combating physical inactivity (exercises in the fresh air and daily physical therapy exercises).
Fighting obesity (trying to lose weight dramatically is not recommended: you can reduce body weight by no more than 5-10% per month).
Normalization of sleep patterns (at least 8 hours a day). A clear daily routine with a constant time of getting up and going to bed.

Hypertension must be treated in order to prevent dangerous complications. When the first signs appear, be sure to consult a cardiologist or neurologist. Be healthy!

Arterial hypertension (hypertension, hypertension) - This is a disease of the cardiovascular system in which blood pressure in the arteries of the systemic (systemic) circulation is consistently increased. In the development of the disease, both internal (hormonal, nervous system), and external factors (excessive consumption of table salt, alcohol, smoking, obesity). Let's look at what this disease is in more detail below.

Arterial hypertension is a condition that is defined by a persistent increase in systolic pressure up to 140 mmHg. century or more; A diastolic pressure up to 90 mm Hg Art. and more.

A disease such as arterial hypertension occurs as a result of disturbances in the functioning of blood pressure regulation centers. Another cause of hypertension is diseases of internal organs or systems.

Such patients have severe headaches (especially in the morning) in the occipital region, causing a feeling of heaviness and staleness in the head. In addition, patients complain of poor sleep, decreased performance and memory, as well as characteristic irritability. Some patients complain of painful sensations behind the sternum, difficulty breathing after performing physical work and blurred vision.

Subsequently, the increase in pressure becomes permanent, affecting the aorta, heart, kidneys, retina and brain.

Kinds

Arterial hypertension can be primary or secondary (according to ICD-10). In approximately one in ten hypertensive patients, high blood pressure is caused by damage to an organ. In these cases we talk about secondary or symptomatic hypertension. About 90% of patients suffer from primary or essential hypertension.

no symptoms of internal organ damage;
with objective signs of damage to target organs (in blood tests, during instrumental examination);
with signs of damage and the presence of clinical manifestations (myocardial infarction, transient cerebrovascular accident, retinal retinopathy).

Primary

The essence of the primary arterial hypertension- a persistent increase in blood pressure without an identified cause. Primary is an independent disease. It develops against the background of heart disease and is most often called essential hypertension.

Essential hypertension (or hypertension) does not develop as a result of damage to any organs. Subsequently, it leads to target organ damage.

It is believed that the disease is based on hereditary genetic disorders, as well as disorders of the regulation of higher nervous activity caused by conflict situations in the family and at work, constant mental stress, heightened feeling responsibility, as well as excess body weight, etc.

Secondary arterial hypertension

As for the secondary form, it occurs against the background of diseases of other internal organs. This condition is also called arterial hypertension syndrome or symptomatic hypertension.

Depending on the cause of their occurrence, they are divided into the following types:

renal;
endocrine;
hemodynamic;
medicinal;
neurogenic.

According to the nature of the course, arterial hypertension can be:

transient: a rise in blood pressure is observed sporadically, lasts from several hours to several days, normalizes without use medications;
Labile: this type of hypertension is considered to be the initial stage of hypertension. Actually, this is not a disease yet, but rather borderline state, since it is characterized by minor and unstable pressure surges. It stabilizes on its own and does not require the use of drugs that lower blood pressure.
Stable arterial hypertension. Persistent increase in blood pressure, which requires serious supportive therapy.
crisis: the patient experiences periodic hypertensive crises;
malignant: blood pressure rises to high levels, the pathology rapidly progresses and can lead to severe complications and death of the patient.

Causes

Blood pressure increases with age. About two thirds of people over 65 years of age have hypertension. People over 55 years of age with normal blood pressure have 90% risk of developing hypertension with time. Because elevated blood pressure is common in the elderly, such “age-related” hypertension may seem natural, but elevated blood pressure increases the risk of complications and mortality.

They highlight the most common reasons hypertension:

Kidney diseases,
Men are over 55 years old, women over 60 years old.
Adrenal tumor
Side effects of drugs
Increased blood pressure during pregnancy.
Hypodynamia, or inactivity.
History of diabetes mellitus.
Increased blood cholesterol (above 6.5 mol/l).
High salt content in food.
Systematic abuse of alcoholic beverages.

The presence of even one of the listed factors is a reason to start preventing hypertension in the near future. Neglecting these measures will most likely lead to the formation of pathology within several years.

Determining the causes of arterial hypertension requires ultrasound, angiography, CT, MRI (kidneys, adrenal glands, heart, brain), studies of biochemical parameters and blood hormones, and blood pressure monitoring.

Symptoms of arterial hypertension

As a rule, before the appearance various complications, arterial hypertension quite often occurs without any symptoms, and its only manifestation is an increase in blood pressure. In this case, patients have practically no complaints or they are non-specific, however, headaches are periodically noted on the back of the head or in the forehead, and sometimes they may feel dizzy and have noise in the ears.

Arterial hypertension syndrome has the following symptoms:

Pressing headache that occurs periodically;
Whistling or ringing in the ears;
Fainting and dizziness;
Nausea, vomiting;
"Floaters" in the eyes;
Cardiopalmus;
Pressing pain in the heart area;
Redness of the facial skin.

The described signs are nonspecific and therefore do not raise suspicion in the patient.

As a rule, the first symptoms of arterial hypertension make themselves felt after the pathological changes in internal organs. These signs have incoming character and depend on the affected area.

It cannot be said that the symptoms of hypertension in men and women are significantly different, but in fact, men are indeed more susceptible to this disease, especially in the age group from 40 to 55 years. This is partly due to the difference physiological structure: men, unlike women, have greater body weight, and accordingly, the volume of blood circulating in their vessels is significantly higher, which creates favorable conditions for high blood pressure.

A dangerous complication of arterial hypertension is an acute condition characterized by a sudden rise in blood pressure by 20-40 units. This condition often requires calling an ambulance.

Signs you should definitely pay attention to

What signs should you pay attention to and consult a doctor, or at least start measuring your blood pressure yourself using a tonometer and recording it in your self-monitoring diary:

dull pain in the left side of the chest;
heart rhythm disturbances;
pain in the back of the head;
periodic dizziness and tinnitus;
deterioration of vision, appearance of spots, “floaters” before the eyes;
shortness of breath on exertion;
cyanosis of hands and feet;
swelling or swelling of the legs;
attacks of suffocation or hemoptysis.

Degrees of arterial hypertension: 1, 2, 3

On clinical picture Arterial hypertension affects the degree and type of disease. In order to assess the level of damage to internal organs as a result of persistently elevated blood pressure, there is a special classification of hypertension, consisting of three degrees.

1st degree

At the first stage there are no objective symptoms disorders of target organs: heart, brain, kidneys.

2nd degree arterial hypertension

The second degree of the disease comes with systematic and persistent surges in blood pressure, the patient needs rest, drug treatment, hospitalization.

3rd degree hypertension

Systolic is above 180 mm Hg, diastolic is above 110 mm Hg. Grade 3 is considered a severe form, the pressure is stably at the level of pathological indicators, occurs with severe complications, and is difficult to correct with medications.

How does arterial hypertension occur in children?

Arterial hypertension in children is much less common than in adults, and remains one of the most common chronic diseases in pediatrics. According to various studies, the incidence of this pathology among children and adolescents ranges from 1 to 18%.

The causes of childhood and adolescent hypertension usually depend on the age of the child. Most of the pathology is caused by kidney disorders.

Uncontrolled excessive intake of drugs from the group of adrenergic agonists can increase blood pressure. These include naphthyzin and salbutamol.

Risk factors for developing arterial hypertension include:

constant psycho emotional stress, conflict situations in family and school;

the child’s personal characteristics (anxiety, suspiciousness, tendency to depression, fear, etc.) and his reaction to stress;

excess body weight;

metabolic features (hyperuricemia, low glucose tolerance, imbalance in the ratio of cholesterol fractions);

excessive consumption of table salt.

Prevention of arterial hypertension should be carried out at the population and family levels, as well as in risk groups. First of all, prevention consists of organizing healthy image life of children and adolescents and correction of identified risk factors. Basic preventive measures it is necessary to organize in the family: the creation of a favorable psychological atmosphere, correct mode work and rest, nutrition that helps maintain normal weight body, adequate physical (dynamic) load.

Complications and consequences for the body

One of the most important manifestations of hypertension is target organ damage. Patients with arterial hypertension usually die in early age. The most common cause of death among them is heart disease. Renal failure is also common, especially in individuals with severe retinopathy.

Among the most significant complications arterial hypertension include:

hypertensive crises,
cerebrovascular accidents (hemorrhagic or ischemic strokes),
myocardial infarction,
nephrosclerosis (primarily shriveled kidney),
heart failure,
exfoliating

Diagnostics

Diagnosis of arterial hypertension is carried out based on the results of changes in blood pressure. History, physical examination and other research methods help identify the cause and clarify target organ damage.

Diagnosis of arterial hypertension is based on the following types of examination:

ECG, glucose test and general blood test;
Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general urine analysis - are carried out in order to exclude the renal nature of the formation of the disease;
Ultrasound of the adrenal glands is advisable to perform if pheochromocytoma is suspected;
hormone analysis, ultrasound thyroid gland;
MRI of the brain;
Consultation with a neurologist and ophthalmologist.

When examining the patient, lesions are revealed:

kidneys: uremia, polyuria, proteinuria, renal failure;
brain: hypertensive encephalopathy, cerebrovascular accident;
heart: thickening of the cardiac walls, left ventricular hypertrophy;
vessels: narrowing of the lumen of arteries and arterioles, atherosclerosis, aneurysms, aortic dissection;
fundus: hemorrhages, retinopathy, blindness.

Treatment

Normalizing blood pressure levels and correcting the influence of risk factors help to significantly reduce the likelihood of complications from internal organs. Therapy includes the use of non-drug and drug methods.

For treatment and examination for hypertension, you need to see a doctor. Only a specialist, after a full examination and analysis of the examination results, will be able to correctly diagnose and prescribe competent treatment.

Non-drug treatments

First of all, non-drug methods are based on changing the lifestyle of a patient suffering from arterial hypertension. It is recommended to avoid:

smoking, if the patient smokes;
consumption of alcoholic beverages, or reducing their intake: for men up to 20-30 grams of ethanol per day, for women up to 10-20, respectively;
increased consumption of table salt with food, it must be reduced to 5 grams per day, preferably less;
a diet limiting animal fats, sweets, salt and liquids if necessary;
using medications containing potassium, magnesium or calcium. They are often used to reduce high blood pressure.

Medicines for arterial hypertension

Drug therapy should be prescribed taking into account the following recommendations:

Treatment begins with small doses of drugs.
With absence therapeutic effect it is necessary to replace the use of one drug with another.
The interval between degrees must be less than 4 weeks, unless necessary rapid decline HELL.
Use of medications long acting to obtain a 24-hour effect with a single dose.
Application of optimal combination of devices.
Therapy should be permanent. It is not allowed to use the drug in courses.
Effective blood pressure control throughout the year helps to gradually reduce the dose and amount of medications.

It is recommended to constantly change medications prescribed by a specialist for arterial hypertension, alternating analogues. IN otherwise an addiction effect is observed when a productive drug for cardiac hypertension is no longer able to stabilize normal indicator HELL.

Nutrition

Along with lifestyle Special attention In the prevention of arterial hypertension, nutrition is given importance. Need to eat more natural products, without any additives or preservatives (if possible). The menu should contain a sufficient amount of fruits, vegetables, unsaturated fats (flaxseed, olive oil, red fish).

The diet of a patient with hypertension must include fiber. It is this that helps lower cholesterol levels in the blood and prevents its absorption. Therefore, it is worth eating more fruits and vegetables.

If you are overweight, you need to lose daily calorie content up to 1200-1800 kcal.

What is better to avoid if you have arterial hypertension:

fish and meat fatty varieties, store-bought sausages, canned food, smoked meats, lard, cheese;
margarine, pastry cream, butter in excess (you can spread butter on the bread with a thin, translucent layer);
sweets (cakes, cookies, candies, sugar, pastries);
alcoholic drinks, strong tea (this applies to both green and black tea), coffee;
too salty, spicy, fatty foods;
store-bought mayonnaise, sauces and marinades;

What a patient with hypertension should know and do:

support normal weight and waist circumference;
constantly study physical exercise;
eat less salt, fat and cholesterol;
consume more minerals, in particular potassium, magnesium, calcium;
limit the consumption of alcoholic beverages;
stop smoking and using psychostimulants.

Forecast

The higher the blood pressure and the more pronounced changes in the retinal vessels or other manifestations of target organ damage, the worse the prognosis. The prognosis depends on pressure indicators. The higher its indicators, the more pronounced the changes in blood vessels and internal organs.

At diagnosis of hypertension and during evaluation possible consequences experts mainly rely on indicators upper pressure. If all medical prescriptions are followed, the prognosis is considered favorable. Otherwise, complications develop that make the prognosis questionable.

Prevention

As a rule, the prevention of this disease consists of maintaining proper nutrition and performing physical exercises that significantly improve the well-being of patients or healthy people. Any physical exercise in the form of running, walking, swimming, exercise, etc. breathing exercises only contribute to increased working capacity and significantly stabilize high blood pressure.

If hypertension is detected, there is no need to despair; it is important, together with your doctor, to take an active part in selecting effective treatment.

Patients with this disease often have to change their normal daily routine to stop the progression of the pathology. These changes concern not only nutrition, but also habits, the nature of work, daily stress, rest schedule and some other nuances. Only if you follow the doctors' recommendations, the therapy will be quite effective.

Hypertension develops as independent disease and is the cause of more than 90% of cases of all persistent arterial hypertension. This the most common chronic pathology . More than 30% of the world's population suffers from this disease.

Definition of “hypertension”:

Arterial hypertension should be considered a persistently elevated systolic blood pressure (SBP) and/or diastolic blood pressure (DBP).
In digital values, hypertension is indicated by a stable increase in systolic blood pressure above 140 mm Hg. Art. and/or diastolic blood pressure up to 90 mm Hg. Art. and more. These blood pressure numbers should be confirmed by several repeated measurements (at least two to three times on different days over four weeks).
Hypertension (primary or essential hypertension) must be distinguished from symptomatic hypertension (secondary), in which an increase in blood pressure is caused by some obvious reason(for example, with kidney pathology or certain endocrine diseases).

Typically, essential hypertension develops in middle-aged and older people, however, hypertension is increasingly being recorded even in adolescents. Men and women get sick equally often. Among urban residents, hypertension is diagnosed approximately 25% more often than among rural residents.

CAUSES

The main reason for the formation of essential hypertension is a disorder of the regulatory function of the central nervous system, which controls the activity of internal organs and the cardiovascular system in particular.

Of great importance in such disorders is the presence of any risk factors, the influence of which increases the likelihood of the formation of this pathology.

Risk factors for primary hypertension:

Age. It has been established that systolic blood pressure increases steadily with age. Diastolic increases on average until age 55, and then changes little.
Floor. Men get sick more often in young and middle age (up to 40-45 years). In women, the incidence increases sharply with the onset of menopause (45-55 years).
Heredity. A close relationship was revealed between arterial hypertension in close relatives.
Overweight. The risk of arterial hypertension in obese people increases several times.
Excessive consumption of table salt (over 5 grams).
Caffeine abuse.
Bad habits (alcoholism, smoking).
Unbalanced diet.
Psycho-emotional stress.
Socio-economic status.
Flaw physical activity(hypodynamia). However, in persons whose professional duties are associated with physical overstrain, it is noted increased risk formation of arterial hypertension.
Some somatic diseases, which are not direct causes of the formation of essential hypertension, but, especially in combination with other factors, can contribute to its occurrence - diabetes, atherosclerosis, pathology of the thyroid gland, etc.

CLASSIFICATION

Hypertension is classified according to several criteria.

According to the flow variant:

Benign.
Malignant.

According to the level of increase in blood pressure:

Mild: SBP 140-159; DBP 90-99 mm Hg. Art.
Average: SBP 160-179; DBP 100-109 mm Hg. Art.
Severe: over 180/110 mm Hg. Art.

Sometimes isolated systolic hypertension occurs - only an increase in SBP of more than 140 mm Hg is recorded. Art., the DBP value remains normal.

In addition to the level of increase in blood pressure, it is important to consider the presence and severity of target organ damage. These include the vessels of the fundus, heart, kidneys and some other structures. Involvement in pathological process of such organs, even at a relatively low level of blood pressure, aggravates the course of the disease.

Clinical stages:

First. Target organs are not involved in the pathological process.
Second. There are objective symptoms of target organ damage without obvious damage or dysfunction (left ventricular hypertrophy; microalbuminuria and/or mild creatininemia; narrowing of retinal arterial vessels; detection of atherosclerotic plaque).
Third. Obvious damage to target organs is revealed with a pronounced impairment of their functions (heart attack, retinal hemorrhages, etc.), which are, in fact, complications of hypertension.

SYMPTOMS

Hypertension is characterized by quite diverse manifestations, which depend mainly on the value of blood pressure, as well as on the nature of the pathology and the severity of target organ damage.

The main signs of hypertension:

At the beginning of its development, essential hypertension is characterized by the occurrence of periodic headaches, which are most often localized in the occipital region.
Headaches in a significant number of cases are accompanied by dizziness, noise and ringing in the ears, a feeling of heaviness and pulsation in the head.
Sleep disturbances often occur fast fatiguability, lethargy.
As the disease progresses, shortness of breath appears during any physical activity (fast walking, running, climbing stairs, etc.).
With consistently high blood pressure levels, facial hyperemia, numbness of the fingers and toes, a feeling of interruptions in the heart and pain in its area, swelling of the face and extremities, especially the lower ones, occur.
When the fundus of the eye is affected, a “veil” appears before the eyes, flashing “spots”, and a decrease in visual acuity.

DIAGNOSTICS

To identify hypertension, a set of measures is used to establish the fact of an increase in blood pressure that is not associated with organic reasons. It is also necessary to diagnose the presence and severity of target organ damage.

Principles for diagnosing hypertension:

Anamnesis.
Measurement of blood pressure in both upper and lower extremities.
Auscultation of the heart, cervical vessels.
General clinical blood and urine tests.
Biochemical blood test.
Determination of blood electrolytes (Na, K).
Serum sugar level.
Electrocardiogram.
Ophthalmoscopy.
Ultrasound scanning of the heart and urinary system.

According to indications, other studies are also used: Dopplerography of the carotid arteries, examination of the level daily protein in urine, glucose tolerance test, etc.

TREATMENT

Therapy for hypertension is based on integrated approach, which is based on the use of medicinal and non-medicinal principles.

Unfortunately, it is impossible to completely cure this disease. However, with the right approach to treatment, you can significantly improve your quality of life and minimize the risk of complications.

Non-drug treatment is aimed at lifestyle modification, since it is based on the elimination of risk factors that can cause the progression of hypertension.

It is important to note that the treatment of this pathology continues throughout life, since course therapy for hypertension is unacceptable.

Principles of non-drug therapy:

Activities aimed at weight loss with concomitant obesity.
Avoid smoking and drinking alcohol.
Daily physical exercise (mostly dynamic).
Limit the daily amount of table salt consumed to a maximum of 5 g.
A balanced and proper diet that contains sufficient amounts of potassium, calcium and magnesium. You should also reduce your consumption of foods containing increased amount saturated fat and cholesterol.

Principles of drug therapy for hypertension:

It is advisable to prescribe long-acting drugs, since these are the forms that prevent fluctuations in blood pressure throughout the day and are also more convenient for use.
Preference is given antihypertensive drugs first line (diuretics, ACE inhibitors, long-acting calcium antagonists, angiotensin II receptor blockers, beta-blockers).
The dosage, as well as the type of antihypertensive drug, is selected strictly individually and depends on the level of blood pressure and the presence of associated complications.
A combination is usually prescribed antihypertensive drugs, one of which is a diuretic.
The goal of antihypertensive therapy is to reduce blood pressure to normal levels.
At home, daily blood pressure monitoring should be carried out. If necessary, therapy is adjusted.
Antihypertensive therapy is used for life.
Also held symptomatic treatment identified concomitant pathology.

COMPLICATIONS

Hypertension is dangerous due to its complications, the development of which can significantly worsen the prognosis and even lead to death.

The most a common complication this disease is development hypertensive crisis - an acute condition, which is characterized by a sudden increase in blood pressure to high levels. Failure to provide emergency medical care at the same time it is fraught with development severe consequences, up to cerebral stroke and death.

The main complications of hypertension:

Acute (myocardial infarction) and chronic coronary insufficiency.
Acute () and transient disorders of cerebral circulation.
Hypertensive encephalopathy and dementia.
Hemorrhages and exudative lesions of the retina, often with concomitant papilloedema.
Impaired renal function with the development of hypercreatininemia.
Dissecting aortic aneurysm.
Occlusive damage to peripheral arteries, etc.

PREVENTION

Main directions preventive measures regarding hypertension - maintaining a healthy lifestyle and addressing all identified risk factors.

Prevention of hypertension:

Limiting table salt intake.
Correction of excess weight.
Limit the consumption of alcoholic beverages.
Quitting smoking.
Fighting physical inactivity, moderate physical exercise.
Psycho-emotional relief, relaxation.

Such prevention reduces the risk of developing essential hypertension by more than half.

PROGNOSIS for hypertension

Forecast in plan full recovery - adverse, since this disease is considered incurable. However, with timely and adequate correction of essential hypertension in compliance with all principles of treatment, it is possible to significantly slow down the progression of the disease and prevent the development of complications.

Malignant course, target organ damage, occurrence of the disease in at a young age significantly worsen the prognosis.

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Hypertensive heart disease is a common disease of the cardiovascular system accompanied by persistent high blood pressure.

The disease is based on a narrowing of the arteries, which is caused by an increase in the tonic functions of the smooth muscles of the arterial walls, and a subsequent change in cardiac output.

The trigger mechanism for this pathology is prolonged mental and emotional stress or a violation of the higher sphere of nervous activity, which leads to improper regulation of vascular tone.

Typically, hypertension with predominant defeat heart disease is diagnosed in 10-20% of adults over 40 years of age. It is necessary to understand what stages of the disease are distinguished, and what treatment is prescribed?

Most main feature hypertensive disease is episodic or constant increase blood pressure, characterized by periodic hypertensive crises.

However, in some people the disease occurs with virtually no noticeable symptoms.

Most often, the patient feels the manifestation of the disease during a hypertensive crisis. The following symptoms occur:

Migraine.
Dizziness.
Panic state.
Dyspnea.
Chest pain.

As a rule, most people with high blood pressure experience heaviness in the back of the head, “spots” flash before their eyes, and unreasonable fatigue appears. A little less often, a person may feel sick or have a nose bleed.

If a patient has been diagnosed with hypertension for several years, angina pectoris may develop, the left ventricle enlarges, vision and kidney function are impaired.

The risk group usually includes middle-aged and elderly people - men over 40 years old, women over 50 years old, as well as those with a history of diabetes mellitus. In addition, hereditary factors also play an important role in the development of the disease.

Hypertensive disease develops under the influence of such factors:

Bad habits such as smoking and drinking alcohol.
Overeating, as a result, excess weight.
High cholesterol levels.
Stressful conditions.
Sedentary lifestyle.
Sclerotic vascular lesions.

Persistent high blood pressure affects the functioning of all internal organs, most noticeably on last stage diseases. Most often, with hypertension, the heart muscle suffers.

As a result, the term hypertensive heart arose.

The classification of hypertension is based on the level of increase in blood pressure:

139-160/89-98 – first degree.
159-180/99-110 – second degree.
More than 180/100 – third degree.

There are also stages in the development of the disease. At the first stage, a moderate transformation of the left ventricle occurs. And also, blood pressure increases slightly, but quickly returns to normal. At this stage, there are no disturbances in the functioning of the cardiovascular system.

At the second stage, it constantly changes, hypertrophy of the left ventricle is pronounced, the walls of the arterioles change, large and medium-sized arteries are affected. Usually, if a disease is diagnosed at this stage, it is safe to say that the patient has a hypertensive heart.

At the third stage, blood pressure is constantly elevated, there are negative changes in the heart, kidneys, cerebral hemispheres. As a consequence, the development of cardiac ischemia, renal and heart failure.

In heart failure, there is a low pumping function of the heart muscle, that is, the heart cannot provide a complete blood supply to the body:

This condition develops due to weakening of the myocardium, or the walls of the heart lose their elasticity.
Due to the fact that in heart failure there is little blood flow through the vessels, the pressure in the heart itself increases.
This leads to the fact that the main organ can no longer fully deliver oxygen and nutrients along with blood to the soft tissues.
In response to this, the heart begins to function at an accelerated rate to compensate for the lack of blood flow.
But, over time, it cannot contract with the same intensity because the muscle weakens.

As a result, the kidneys retain fluid and sodium in the body, which leads to swelling of the soft tissues and congestion in the lungs and other internal organs. Thus, congestive heart failure occurs.

Treatment

Diagnosis of the disease is focused on methods that will help identify the underlying causes. Based on the results general analysis blood, ultrasound and ECG of internal organs, x-ray of the heart and blood vessels, MRI, the doctor prescribes individual treatment, the guideline of which is stabilization of pressure.

Typically, treatment is as follows:

Recommendations for eliminating stressful situations, good sleep and rest, special diet with the exception of fat, salt, sugar.
The use of medications of various mechanisms of action that affect the endurance of the heart muscle and vascular tone.
Diuretics.
Herbal teas with a sedative effect or stronger medications.

In the modern world, there are many medications aimed at treating hypertensive disease. Medicines not only help reduce blood pressure, but also protect internal organs from harmful changes.

To the main medicines include the following categories:

Diuretics.
ACE inhibitors.
Sartans.
Beta blockers.
Calcium channel blockers.

Treatment of heart failure is carried out with the help of drugs that stabilize the functioning of the heart muscle.

Treatment with diuretics helps to reduce the amount of blood circulating in the vessels, which leads to normalization of blood pressure. They are generally the first-line treatment for hypertension.

ACE inhibitors prevent the formation of a substance called angiotensin-2. This substance is a powerful agent that constricts blood vessels. Drugs in this category help dilate blood vessels and reduce blood pressure.

Sartans block receptors for angiotensin, as a result of which its vasoconstrictor ability is lost.

Beta blockers help reduce the frequency of contraction of the heart muscle, as a result, the minute volume of blood flow decreases and blood pressure decreases.

Calcium antagonists dilate peripheral vessels, peripheral vascular resistance decreases and blood pressure normalizes.

It is worth noting that treatment medications it is prescribed only by a doctor, because all medications have their contraindications and side effects.

As a rule, the doctor prescribes a comprehensive treatment regimen, which includes several drugs with different mechanisms of action.

In a number of situations, diuretics are prescribed, which help remove excess fluid and also have the following effects on the patient’s body:

They have a beneficial effect on the cells that filter the kidney tubules.
Reduce the volume of fluid inside the vessels.
Reduces the sensitivity of arterial walls. Due to this, the walls are not so sensitive to hormones that can contribute to their narrowing.

Some diuretics wide range actions can block vascular channels, dilating them. As a result, you can not only reduce blood pressure, but also protect yourself from complications arising from hypertensive heart disease.

Misconceptions about the disease

There is an opinion that slightly elevated blood pressure is a natural phenomenon for older people.

In reality this is not so, such a concept does not exist in official medicine. The pressure should be within the established norm, regardless of age group and gender. Misconceptions of patients about hypertension:

You can treat in episodes, the pressure has dropped, the treatment is over.
The focus of treatment is only to reduce blood pressure.
Possibility of self-treatment.
There are enough medications, but excess weight and alcohol have nothing to do with it.

Episodic treatment is unacceptable. You can cope with the disease only with the help of daily drug therapy, which helps maintain blood pressure.

Conservative therapy involves not only the normalization of numbers, but also prevents dangerous and serious complications.

Without knowing the reasons for the development of the disease, self-medicating can lead to the situation serious complications, even death.

By giving up smoking, alcoholic drinks, excluding harmful products from your diet, you can double your chances of recovery.

Preventive actions

Everyone knows that it is better to prevent any disease than to treat it later. Hypertension often develops due to a genetic predisposition:

In this situation, if a person assumes that the occurrence of a disease is not excluded, it is worth monitoring your diet and giving up smoking and alcohol.
In addition, do not forget about medical examination for the purpose of prevention.

Hypertensive disease most often occurs in men after 40, and in women after menopause. Such features should be taken into account when monitoring your blood pressure, not forgetting about visiting a therapist.

Optimal physical activity and walking in the fresh air are beneficial; they will bring many benefits. physiotherapy, swimming. In addition, it is worth eliminating or reducing salt intake, monitoring blood cholesterol levels, and also monitoring your blood pressure.

Cyclic or persistent deterioration of the condition, expressed by headaches, weakness, fatigue - it is possible that this is a sign of high blood pressure, or hypertension. To begin with, you should define what it is, its types, diagnosis, prevention and treatment.

If a person has healthy blood vessels, then he will easily survive emotional outbursts, because in vascular walls a positive tone is maintained, and they easily adapt to any conditions.

In the case when the walls of blood vessels are inelastic, spasms appear in small arteries, hormonal imbalance - all this, of course, will disrupt vascular tone. This is how a severe pathology arises - hypertension, which can lead to dysfunction of the brain, as well as other organs, and disability in the future.

Stages

The stages of hypertension are formed sequentially:

transient;
stable;
sclerotic.

At the first stage, or, as is already known, transient, there is a cyclical increase to 150-179/94-105 mm Hg. Art. It recovers quickly if you rest a little. Here, studies found no obvious abnormalities in the vessel walls.

Second (stable) stage hypertension is characterized by a steady increase in blood pressure (180-200/105-115 mm Hg). There is a deterioration in renal function, and the test results are satisfactory.

Third (sclerotic hypertension)– pressure greatly exceeds the norm (200-230/115-120 mm Hg), also visible sclerotic disorders in the heart vessels, brain, kidneys and fundus. This explains the appearance of ischemia, stroke, angioretinotherapy of types 2 and 3.

Hypertension can develop over many years, but with all this, there is another classification of this disease - malignant, when a person experiences all stages of hypertension and as a result dies from a stroke or heart attack.

Types by origin

Hypertension is divided not only according to its characteristic degree, but also according to its origin:

Hypertension of the 1st degree () - the disease appears as a separate anomaly, in the absence of disturbances in other organs and systems of vascular tone.
Hypertension of the 2nd degree - here there are diseases of the organs (kidneys, endocrine and nervous systems) that are involved in the functioning of vascular tone.

Causes

The main causes of this type of hypertension are genetic predisposition and lifestyle. If a person has close relatives who have had cyclical or constant symptoms, then there is a big threat of developing the same disease by middle age.

Hypertension also develops at the initial stage as a result of addictions and an extremely intense rhythm of life (high position in working with people, great physical and emotional stress).

Causes of secondary hypertension:

This classification is also known as symptomatic, since this type does not develop due to in full health. The reasons are various: severe pathologies of chromosomes, diseases of the nervous and endocrine systems, kidney diseases.

Kidney hypertension

A person often suffers from hypertension due to kidney disease, because infectious and autoimmune phenomena increase the permeability and tone of the vascular walls.

There are kidney diseases that cause hypertension:

chronic pyelonephritis;
periarthritis, renovascular anomalies and other kidney diseases;
tumors, renal polycystic disease;
chronic renal failure varying degrees complications.
Endocrine system hypertension
Endocrine disease can be acquired or congenital, but even it sometimes acts as a hypertensive symptom.

Diseases are distinguished:

Acromegaly (abnormal skeletal growth);
Hyperparathyroidism (excessive release of thyroid hormones);
Page's syndrome is a disordered diencephalon;
Itsenko-Cushing syndrome;
Pheochromocytoma (damage to the sympathoadrenal system).

Hypertension of cardiac or vascular origin

With this pathology, vascular obstruction and high blood pressure are observed.

In addition, hypertension of cardiac and vascular origin includes:

Congestion in the heart;
Aortic insufficiency;
Hypertension of neurogenic and pulmonary origin

Of the pronounced symptoms of bronchopulmonary and neurological disease- this is an exacerbation of blood pressure.

Persistent hypertension is present in people with:

pneumosclerosis;
pulmonary emphysema;
bronchial asthma;
brain tumor;
diencephalic syndrome.

Iatrogenic hypertension

Prescribed treatment due to hormonal imbalance, infectious diseases, mental disorders, in which patients must take medications that have an effect that increases blood pressure and can cause iatrogenic hypertension.

Some medications that cause hypertension:

catecholamine;
central nervous system stimulants;
drugs that contain estrogen and glucocorticoids.

While taking them, your doctor monitors your blood pressure. If the condition worsens and the blood pressure rises, the dosage is revised or use is stopped completely.

In pregnant women

If pregnancy proceeds without significant complaints, then blood pressure is stable. But closer to the 20th week, there are women with late gestosis, or toxicosis, as a result of vascular spasms.

These spasms are characterized by persistent high pressure blood, and in case of complications - constant nausea, convulsions, dehydration. A stroke may occur, which threatens the life of not only the mother, but also the child.

Hypertension in pregnant women is accompanied by blood pressure control, and in case of high blood pressure, it is necessary to urgently consult a doctor so as not to endanger the health of the baby and mother.

Symptoms of hypertension depend on its causes and severity. They can be short-term and disappear quickly.

If blood pressure has increased, patients usually complain of:

dizziness;
temporal and occipital pulsation;
incoordination;
fear of bright rooms, noise;
, vomit.

Prevention

As an adult, it is necessary to begin the prevention of hypertension: in order to prevent the possible appearance of hypertension.
Don't shoot all the time headache special drugs, because most of them contain caffeine, which further increases blood pressure. It is better to measure your blood pressure if you have a headache.
Pass annually medical examinations. It happens that a person finds out about the presence of such a disease during a medical examination.
Giving up bad habits and a calm lifestyle will prevent the occurrence of vascular disorders.

Emotional disorders damage our nerves, hurt us vascular system. Don't get angry, upset, control stressful situation. Then you are guaranteed good health.