Hypertension is a disease characterized by a persistent and prolonged increase in blood pressure. It is due to a violation of the regulation of vascular tone, as well as changes in the work of the heart. According to the definition of the World Health Organization, indicators above 140/90 mmHg are considered to be an increase in pressure. The magnitude of the pressure is shown by two numbers, the upper one is systolic, and the lower one is diastolic.
According to statistics, 30% of the adult population have periods of high blood pressure, while almost always it is a sign of an independent pathology or the so-called primary hypertension. The Russian Federation ranks 49th in the world in the number of patients with this disease.
Without treatment, complications of hypertension arise:
- myocardial infarction ;
- a stroke ;
- acute heart failure ;
- hypertensive crisis .
The insidiousness of the pathology is that in half the cases, patients do not suspect a dangerous disease, therefore they do not take any action, and hypertension begins to manifest itself as unpleasant symptoms. In many countries, preventive programs have been launched that are aimed at combating pathology. New safe medicines are being developed to control blood pressure. At the same time, only 1/3 of the hypertensive patients receive adequate therapy and take care of their health.
Doctors around the world believe that in every home there must be a device for measuring pressure, along with a thermometer. This is especially true for families where relatives already suffered from cardiovascular diseases.
Causes of Hypertension
At present, the exact causes of hypertension have not been established. The main risk factor is considered to be prolonged or severe psycho-emotional stress. Other causes of pathology include:
- overweight: with excess weight, each kilogram adds blood pressure by two mm Hg ;
- sedentary lifestyle;
- eating canned food, smoked meats, fatty foods, hot cheese;
- excessive use of salt in cooking;
- frequent stress;
- smoking – harmful substances contained in cigarettes contribute to mechanical damage to the walls of arteries;
- busy schedule;
- alcohol consumption;
- very tall or too short stature in men;
- physical and nervous overwork;
- the use of proteins of animal origin, which is not limited.
Also, risk factors include hereditary predisposition. Increased blood pressure in first-line relatives guarantees a high risk of developing the disease.
It is worth paying attention to age, after 35 years, men have a greater chance of acquiring this disease. In women, the pathology is associated with the onset of menopause.
Symptoms of Hypertension
Often with pathology there are no signs, but sometimes the following symptoms can be observed:
- headache ;
- rapid or weak heartbeat ;
- dizziness ;
- swelling of the eyelids, legs and arms, puffiness of the face;
- memory impairment ;
- numbness of the fingers ;
- facial redness;
- chills ;
- increased sweating ;
- anxiety ;
- internal stress ;
- decreased performance ;
- irritability;
- the appearance of “midges” before the eyes.
All these manifestations do not bother patients constantly, but arise only in a certain period of time. This is the insidiousness of the disease, so when the above symptoms appear, you should consult a doctor for advice. If therapy is not started on time, then over time the disease will begin to progress and can lead to serious complications. Therefore, it is important to control blood pressure. For this, there are now many special tonometers, from conventional mechanical devices to fully automated models. The work of tonometers with a phonendoscope is more complicated, it is not always possible to distinguish the sounds of the pulsation, but after some preparation and practice, practically everyone can learn this.
Before measuring pressure, do not smoke, drink alcohol or coffee, it is advisable to spend a few minutes at rest. The measurement is carried out in a sitting position, the cuff should be fixed slightly above the elbow, where the pulse is best felt. Most often, aneroid (lever and inflatable type) and automatic devices are used to determine the pressure. On an outpatient basis, devices are used that can monitor pressure changes for a whole day.
Each age has its own pressure standards:
- 16-20 years – pressure 100/70 – 120/80;
- up to forty years the norm is 120/70 – 130/80;
- from forty to sixty – to 135/85;
- after sixty years, up to 140/90 are considered normal pressure.
In cases where the indicators exceed the norm for several days in a row, this is an obligatory reason for visiting a doctor, even if there are no symptoms other than the data of the device. A competent doctor will give recommendations on the lifestyle for hypertension at an early stage, which will avoid complications.
Hypertension – classification
During the study of the disease, many different classifications were developed with a division: by etiology, patient’s appearance, stability and level of pressure, reasons for the increase, the nature of the course. Doctors use some of them now.
The very first classification of hypertension subdivided it into red and pale. The decisive role in this division was played by the appearance of the patient. With a pale variety, the patient had cold limbs and an unhealthy complexion, due to vascular spasm. With red hypertension at the time of increasing blood pressure, the patient’s face, on the contrary, acquires a red color and becomes covered with spots.
In practice, one of the most important classifications is the separation of disease by origin. The primary or essential form is distinguished, which arises as an isolated pathology. Moreover, diseases of other organs and systems are absent.
The secondary form is a symptom of the pathology of organs that are involved in the regulation of vascular tone. These include – kidneys, endocrine and nervous systems.
There is no single systematization of hypertension, but, as a rule, doctors use the classification recommended by the World Health Organization. It is characterized by the degree of pressure increase.
- Hypertension of the 1st degree is a mild form, which is characterized by a pressure of 140/90 to 159/99 mmHg.
- Hypertension of the 2nd degree – moderate hypertension, pressure rises to 79/109 mm RT. Art. Sometimes doctors diagnose “hypertension 2 degree 2 risk 2”, which means that there is one or two risk factors and the possibility of complications.
- Hypertension of the 3rd degree is characterized by a severe course, the pressure rises to 180/110 mm RT. Art. and even higher. If during the examination the doctor diagnosed “hypertension 3 degree 4 risk”, then you need to immediately begin treatment and seek help at the hospital. In this case, the likelihood of developing complications increases to 30%.
The organs that are most prone to complications of hypertension:
- brain – DEP, dementia , strokes , memory loss;
- kidneys – the development of chronic renal failure ;
- heart – heart failure , heart attack , coronary death;
- blood vessels;
- eyes.
Doctors classify the disease depending on the damage to the above organs. Stages of hypertension:
- Stage I – the cardiovascular system is not broken, patients usually do not complain about their condition.
- Stage II – an increase in the left ventricle, blood pressure rises. Local narrowing of the retinal vessels may be noted.
- Stage III – there are signs of organ damage: chronic renal failure , angina pectoris , hypertensive encephalopathy, disorders that the optometrist can detect when examining the fundus (swelling of the optic nerve, hemorrhage), aortic aneurysm.
The classification takes into account options for increasing pressure. In this case, the following forms are distinguished:
- diastolic – lower pressure rises;
- systolic – only the upper indicators increase;
- systolodiastolic;
- labile form – in this case, the pressure rises briefly and returns to normal without special drugs.
There are certain types of hypertension that are not included in any of the classifications. These are refractory hypertension and hypertensive crises.
Refractory hypertension is arterial hypertension that cannot be corrected with medication. Pressure does not decrease even with more than three drugs. Sometimes this form of the disease is mistaken when medications are incorrectly selected or even the diagnosis is incorrectly made.
Hypertensive crisis – a condition in which pressure rises to critical levels. Because of this, the patient experiences dizziness, severe headaches, cerebral circulation is disturbed, and hyperthermia of the brain may occur .
Hypertension during pregnancy
In a healthy woman throughout the pregnancy, the pressure should remain within normal limits. However, starting from week 20, some patients may develop gestosis , which occurs due to vasospasm. As a result, there is an increase in pressure, swelling and nausea. In severe cases, high blood pressure threatens with a stroke ; this condition is dangerous for both the child and the woman.
Therefore, it is important for pregnant women to constantly monitor their pressure. With an increase in blood pressure, it is necessary to inform the doctor who selects the appropriate treatment for hypertension that is safe during this period.