Hypertension is the most common cardiovascular disease, with symptoms affecting a large proportion of the population after the age of 60-65. There are several names for the diagnosis, including essential hypertension (AH), arterial hypertension (AH). The disease is chronic, the main task of each patient is to avoid exacerbation using medicinal and non-pharmacological methods and to prolong the remission period (absence of symptoms).
What is hypertension?
Arterial hypertension is a persistent increase in blood pressure from an acceptable level (starting from 140/90 mm Hg) under the influence of stimuli. This diagnosis is called "silent killer". The pathological process persists in an asymptomatic form for a long time, but during an attack significantly increases the risk of stroke, myocardial infarction and other dangerous diseases. Potential complications of GB can be life-threatening, so timely diagnosis and adequate treatment of the disease is necessary.
Hypertensive disease develops as a result of dysfunction of the upper 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 increasing pain.
Classification of hypertension
In 2003, a single classification of hypertension according to the severity of the disease was established. In this section, the determining factor is the actual blood pressure measured by a tonometer in a particular clinical situation. Hypertension is also classified according to its origin (primary, secondary), stages (transient, stable, sclerotic) and the level of risk of cardiovascular pathology. This classification simplifies the diagnosis and helps to more accurately determine the treatment regimen for each hypertensive patient.
Arterial hypertension rates
With an increase in blood pressure (BP), there is a suspicion that arterial hypertension develops, especially if this health problem cannot be solved by non-pharmacological 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. (SAD) and 85-89 mm. rt. Art. (BABA). Deviation from these figures indicates serious pathologies of the body. Doctors distinguish 3 degrees of GB:
- Grade 1 hypertension (mild) is characterized by unstable blood pressure, ranging from 140/90 to 159/99 mm Hg over several days. Art. The risk of developing a hypertensive crisis is minimal, there are no signs of organic damage to internal organs and the central nervous system. In order to suppress a painful attack, in addition to taking medication, the patient needs a good rest, it is necessary to exclude stressful situations. Positive emotions, walks in the fresh air are especially useful.
- Grade 2 arterial hypertension develops rapidly. Blood pressure index varies between 160/100 and 179/109 mm Hg. Art. , there are signs of hypertensive crisis (cold sweat, goosebumps, redness of the face). The patient is worried about migraine attacks, dizziness, poor sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decreased blood flow in the body), increased blood creatinine, narrowing of the retinal arteries, left ventricular hypertrophy (increased size), microalbuminuria (detection of protein in the urine). ). It is impossible to normalize the situation without medication.
- Grade 3 hypertension (severe) is accompanied by a sharp decrease in visual acuity, poor memory, tachycardia attacks (increased heart rate). Hypertensive crisis develops. BP index - from 180/110 mm Hg. Art. and higher. Possible complications include hypertensive encephalopathy, cerebral vascular thrombosis and aneurysm (pathological vasodilation), left ventricular heart and kidney failure, hemorrhage (sky), and optic nerve swelling. Pathological changes are irreversible.
Degree of cardiovascular risk
The first step in predicting the likelihood of complications in progressive arterial hypertension is to determine the cardiovascular risk index. This requires expert advice and comprehensive 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 cholesterol in the blood;
- sedentary lifestyle;
- obesity, including the abdomen (most of the fat accumulates in the abdominal cavity);
- age (women over 65, men over 55);
- fasting sugar index 5, 6-7, 0 mmol / l;
- impaired glucose tolerance determined using a special test;
- presence of cardiovascular diseases in relatives;
- person.
If there are chronic diseases in addition to hypertension, the patient has a high risk of cardiovascular disease:
- diabetes;
- heart problem;
- disorders of lipid (fat) metabolism;
- bronchial asthma;
- extensive damage to the retina;
- coronary artery disease;
- renal failure stage 4;
- had a stroke;
- cerebrovascular diseases (damage to cerebral vessels);
- symptoms of obliterative diseases of the peripheral arteries of the lower extremities (atherosclerosis);
- damage to other internal organs.
Such information helps the doctor to predict the clinical outcome of the disease. To determine the rate of cardiovascular risk for each degree of hypertension, you should read the following table:
| General Risk Factors (RFR) | Blood pressure | The risk of hypertension is 1 degree | Grade 2 arterial hypertension, risk | Risk of grade 3 hypertension |
|---|---|---|---|---|
| no risk factors | adi risk | short | average | tall |
| 1-2 | short | average | medium high | tall |
| Above 3 | low-medium | medium high | tall | tall |
| damage to other internal organs, stage 3 kidney disease, diabetes mellitus | medium high | tall | tall | very tall |
| Stage 4 chronic kidney disease with CVD, other organ obstruction or common risk factors | very tall | very tall | very tall | very tall |
Treatment of hypertension
Classification of GB by stages and risks helps to correctly determine the drug treatment regimen, quickly stop the painful attack and prolong the remission period. If primary arterial hypertension develops (isolated), the prognosis is favorable according to medical recommendations. The secondary form of the disease often occurs with complications.
If the disease is not treated in time, it is difficult to stabilize high blood pressure, even with medication. The general recommendations of experts, if diagnosed with grade 1, 2 or 3 hypertension, are given below. . It should be supplemented with medication prescribed by a doctor:
- Compliance with therapeutic diet. It is important to enrich the daily diet with foods rich in potassium and magnesium to reduce portions of table salt and strengthen the heart muscle (seeds, nuts, legumes and cereals, greens).
- Give up bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, leave behind a "sedentary" lifestyle and go for a walk in the fresh air.
- Weight control. If a patient with arterial hypertension is obese, it is necessary to avoid fatty, fried and smoked foods, and to organize fasting days regularly.
- Physiotherapy. To prevent and prolong the remission period of GB, it is recommended to do moderate-intensity exercise for 30 minutes 5 times a week.
- Taking multivitamin complexes. Such medicines should contain potassium, magnesium, iron and other trace elements that are important for the body.
Medical therapy
Oral medications depend on the degree of hypertension and the associated symptoms. The following are optimal schemes for the conservative treatment of arterial hypertension:
- In the mild stage of the disease, the patient is prescribed angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
- If the risk of grade 2 arterial hypertension develops, an integrated approach to the problem is needed, which combined several representatives of different pharmacological groups into a single conservative treatment regimen. These are the drugs mentioned above in combination with thiazide diuretics.
- In the complex course of this disease, in addition to the above drugs, doctors recommend alpha or beta-blockers. This is necessary if high doses of diuretics are poorly tolerated by a weakened body).