Hypertension is one of the most common cardiovascular diseases. According to the WHO, more than 1. 1 billion people suffer from it. world. High blood pressure increases the risk of developing other heart diseases. Hypertension is among the leading causes of death and the disease is rapidly becoming younger. It occurs not only in older people, but also in young people. Below you will discover why it appears, how to recognize it and control it.
What is hypertension?
This is a chronic condition in which blood pressure is high. It is indicated with 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 left ventricle of the heart into the aorta at the time of systole (contraction of the ventricles of the heart). The second number indicates the diastolic pressure when the heart muscle is relaxed. Blood pressure increases during physical activity and emotional arousal, but its value should be close to normal at rest. Yes, with multiple measurements taken at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure exceeds 90 mmHg. Art. , diagnosed with hypertension.
A persistent increase in blood pressure is associated with several factors, including excess weight and lack of physical activity, poor diet, bad habits and high levels of stress.
Causes and risk factors.
Hypertension can be primary or secondary:
- primary (essential)Hypertension is more common: according to various estimates, in 85-95% of cases. Its appearance is not associated with concomitant diseases, the 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 diseases and abnormalities of the great vessels.
When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its appearance is usually a constant nervous overvoltage. When diagnosing, it is important to establish as accurately as possible what causes hypertension, whether it has secondary causes (the presence of diseases that cause an increase in blood pressure).
There are a number of risk factors that increase the chances of developing primary hypertension:
- excess weight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drink alcohol and smoke;
- stress, constant emotional tension;
- lack of sleep, its low quality, insomnia;
- excessive salt intake;
- poorly organized sleep and rest patterns (including due to irregular or excessively long work hours);
- changes in hormonal levels (in women, they may be associated with the reception of oral contraceptives, with the onset of menopause);
- hereditary factors (in total more than 20 genes have been identified that determine the predisposition to hypertension);
- age over 65 years (the disease can also occur in young people; it is worth periodically checking blood pressure after 35 years);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods rich in trans fats and saturated fats);
- kidney disease, diabetes mellitus and some other related conditions and diseases.
Many of these factors are interconnected 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 your risk of hypertension or improve your well-being if your blood pressure is already high.
Classification
Two approaches are used to classify the disease: by grade and by stage. The degrees of hypertension differ in the values to which blood pressure rises, the difference between the stages is in the course of the disease, in the number and severity of concomitant organic lesions.
First grade
Systolic blood pressure: more than 139 and less than 159 mmHg. Art. , And the diastolic is at the level of 90-99 mm Hg. Art. With elevated values, blood pressure can be normalized by adjusting your lifestyle. To do this, it is necessary to increase physical activity, adjust your diet, abandon bad habits and reduce stress levels.
Second grade
In the second degree, blood pressure values rise and amount to 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastolic. With such values, the load on the heart increases sharply. The blood supply to the brain deteriorates and this can lead to headaches, dizziness and decreased performance. Changes occur in the fundus of the eye. Sclerosis of the tissues and blood vessels of the kidneys begins, excretory function is disturbed, and kidney failure may develop. The condition of the blood vessels worsens. For treatment, you must change your lifestyle and start taking medications.
Third degree
The systolic pressure value is above 180 mm Hg. Art. , Diastolic: above 110 mm Hg. Art. With hypertension, the load on the heart becomes too high and causes irreversible changes. Blood pressure must be constantly lowered with medication. Without this, there is a risk of acute heart failure, arrhythmia, angina, myocardial infarction and other serious conditions. Patients with stage 3 hypertension should be constantly monitored by a doctor. Continued use of medications to lower blood pressure is necessary.
| Blood pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Good | < 130 | < 85 |
| Normally, the so-called prehypertension | 130-139 | 85–89 |
| 1 - mild hypertension | 140-159 | 90–99 |
| 2 - moderate degree of hypertension | 160-179 | 100-109 |
| 3 - severe hypertension | ≥180 | ≥ 110 |
Stages of hypertension
The disease develops gradually. There are three stages in total.
- First stage:moderate hypertension. Blood pressure is unstable and can fluctuate throughout the day. At this stage, the state of the internal organs and the central nervous system remains normal, there are no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
- Second stage:severe hypertension. In the second stage, there is a significant increase in blood pressure, health often worsens, and hypertensive crises become severe. At this stage, changes in internal organs begin due to constantly high blood pressure. Vascular disorders appear and the blood supply to the brain deteriorates. The retinal arteries narrow. Hypertrophy of the left ventricle of the heart develops and this increases the risk of serious cardiac pathologies. Signs of kidney dysfunction appear (increased levels of albumin in the urine, increased levels of creatinine in the blood serum)
- Third stage:very severe hypertension. Blood pressure becomes critically high, above 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions intensify, heart failure, thrombosis of cerebral vessels, aneurysms, kidney failure and other serious conditions develop. Severe hypertensive crises often occur.
Symptoms
Even with a significant increase in blood pressure, hypertension may not present symptoms for a long time. For this reason, it is advisable to measure your blood pressure periodically (control is especially important for those over 35 years of age). You can measure your blood pressure with an automatic electronic tonometer; These devices are sold in pharmacies.
The main symptoms of hypertension include headache, dizziness and heaviness in the head. These manifestations are associated with vasospasm and impairment of blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, cardiac arrhythmias. In severe cases of hypertension, weakness, chest pain, nausea, vomiting, and tremors ("shaking" muscles) may occur. Other symptoms include blurred or black spots before the eyes, difficulty sleeping, palpitations, and tinnitus.
As the disease progresses, visual acuity gradually decreases, sensitivity in the arms or legs may decrease, and in severe cases, paralysis is possible. During periods of stress, against a background of nervous tension or physical activity, symptoms may increase. They appear more frequently in middle-aged and older people. The disease is more serious if you are overweight, have bad habits, have a tendency to overeat or have a high level of stress.
You should see a therapist or cardiologist if you experience regular headaches, dizziness, or vision problems, or if your blood pressure is often elevated when you measure it yourself.
Diagnosis
Typically, diagnosis is carried out in three directions:
- blood pressure measurement.Performed at intervals of several hours or over 2-3 days to determine the degree of hypertension and its stage;
- Identify the causes of the disease.It is important to determine whether hypertension is primary or secondary (caused by other diseases). In the second case, specific treatment may be necessary;
- monitoring general health.During the examination, the condition of the heart, cerebral vessels, fundus and kidneys are monitored. Due to high blood pressure, the functioning of these organs is affected. When diagnosing, it is important to evaluate your condition.
At the first appointment, the doctor will perform an examination and collect medical history details related to the disease. Information will be needed about how long the patient has been suffering from hypertension, what the blood pressure level is, if there are symptoms of heart disease, apnea, severe snoring, if the person or close relatives have suffered strokes, peripheral arterial disease, gout, diabetes, kidney disease. The doctor will definitely ask you questions about lifestyle: physical activity, bad habits, diet, taking medications.
For patients with high blood pressure, the following tests are performed:
- blood pressure measurement.It is measured several times at rest (physical activity, caffeine consumption, smoking half an hour before measurement is excluded), measurements are taken at different times of the day;
- general exam:measure height and weight, waist circumference, palpate the abdomen, evaluate the pulsation of peripheral arteries;
- Urine analysis.Albumin and creatinine levels are important: deviations from the norm indicate kidney dysfunction and require ultrasound;
- blood testTo monitor the levels of potassium, creatinine, lipids, an ultrasound of the kidneys is prescribed. Evaluation of lipid levels is necessary to control lipid metabolism and eliminate the risk of complications of the cardiovascular system;
- EKGIt is performed when left ventricular hypertrophy is detected to control the condition of the heart.
Additionally, the doctor may refer the patient for a cardiological, neurological, or respiratory system examination.
Hypertension treatment
High blood pressure is a disease that cannot be completely cured, but it can be controlled. Therapy and lifestyle changes can stop the development of hypertension, reduce the frequency and severity of attacks, and eliminate symptoms. But the most important thing is to reduce the risks to the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle adjustments:
- give up smoking;
- refuse to drink alcohol or significantly limit the amount of alcohol;
- Diet: the diet is adjusted, salt intake is reduced (less than 3. 75 g per day), the amount of vegetables and fruits is increased (5 servings per day is ideal), whole grains, dairy products, low-fat products. fats and calorie intake is limited. If there are no contraindications or kidney diseases, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- Increased physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is reduced to target values (below 130/80 mmHg) to reduce the risk of complications. With such a decrease, constant monitoring by a doctor is required. A tonometer used for home measurements must be calibrated periodically. For patients with diabetes, pregnant women, the elderly and debilitated people, the use of antihypertensive drugs requires special caution.
The following can be used to treat hypertension:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and lower blood pressure, but can cause drowsiness and lethargy, so they are rarely used;
- ACE inhibitors.Reduce peripheral vascular resistance, often prescribed to patients with diabetes;
- Angiotensin II receptor blockers.They have a similar effect to ACE inhibitors and are therefore not prescribed together with them. Not prescribed during pregnancy;
- beta blockers.Provide a decrease in blood pressure by slowing the heart rate;
- calcium channel blockers.They reduce total peripheral vascular resistance and can cause reflex tachycardia;
- direct vasodilators.They have a direct effect on blood vessels and are used for severe hypertension;
- diuretics.They reduce the volume of blood plasma, which reduces blood pressure, but can also cause hyperkalemia.
Important! A therapist or cardiologist must prescribe medications and their dosages after an examination. Taking medications without a prescription can be dangerous.
If your doctor prescribes medications, you will need to have regular follow-up exams to evaluate the effectiveness of the treatment and adjust it. It is important to adjust your lifestyle and restore normal health, so that a minimum amount of medication is required to control the course of hypertension.
Possible complications
Due to increased blood pressure, the walls of the arteries lose their elasticity and the heart muscle overworks. This increases the risk of angina, acute heart failure, and heart attack. Due to impaired blood supply to the brain, transient 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 levels of stress accelerate the development of hypertension and complicate its course.
Consequences
Without treatment, high blood pressure causes serious consequences. Constant spasm of cerebral vessels causes ischemia and stroke. They are dangerous with serious disability and even death. When the load on the heart muscle increases too much, tachycardia, arrhythmia, and heart failure occur. Without treatment, it is possible to suffer a myocardial infarction.
The severity of hypertensive crises increases, they become complicated, life-threatening and may be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life against the background of hypertension without adequate therapy and without restoration of a normal state of health decreases sharply, even up to severe disability.
Forecast
The prognosis is good if the patient consults a doctor in time and takes measures 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 high blood pressure, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
To prevent hypertension, self-monitoring of blood pressure is recommended starting at age 35 or when symptoms of hypertension appear. It is important to eliminate the effects of factors that cause an increase in blood pressure: control your diet, stop smoking and drinking alcohol, reduce stress levels, dedicate more time to physical activity: in a word, lead a lifestyle Healthy life.
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 control blood pressure levels, control weight, lead a healthy lifestyle and undergo preventive examinations with a therapist or cardiologist.