Arterial Hypertension 1, 2 And 3 Degrees - Causes, Symptoms And Treatment Of Arterial Hypertension. Prevention

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-15 09:49

Symptoms, degrees and treatment of arterial hypertension

Content:

• What is arterial hypertension?
• Symptoms of arterial hypertension
• Causes and risk factors
• Arterial hypertension degree
• Types of arterial hypertension
• Diagnosis of arterial hypertension
• Hypertension treatment
• Prevention of arterial hypertension

What is arterial hypertension?

Arterial hypertension is a disease of the cardiovascular system, in which the blood pressure in the arteries of the systemic (systemic) circulation is steadily increased.

Blood pressure is divided into systolic and diastolic:

1. Systolic. The first, top number determines the level of blood pressure when the heart contracts and the blood is pushed out of the artery. This indicator depends on the strength with which the heart contracts, on the resistance of the walls of blood vessels and the frequency of contractions.
2. Diastolic. The second, lower number determines the blood pressure at the moment when the heart muscle relaxes. It indicates the level of peripheral vascular resistance.

Normally, blood pressure readings are constantly changing. They physiologically depend on the age, sex and condition of the person. During sleep, the pressure decreases, physical activity or stress leads to an increase.

The average normal blood pressure in a twenty-year-old person is 120/75 mm Hg. Art., forty years old - 130/80, over fifty - 135/84. With persistent numbers 140/90, we are talking about arterial hypertension.

Statistics show that about 20-30 percent of the adult population is affected by this disease. The prevalence rate rises inexorably with age, and by age 65, 50-65 percent of older people have the disease.

Doctors call hypertension a "silent killer" because the disease quietly but inexorably affects the work of almost all the most important human organs.

Symptoms of arterial hypertension

Symptoms of hypertension include:

• Dizziness, a feeling of heaviness in the head or eye sockets;
• Pulsating pain in the back of the head, in the frontal and temporal parts, radiating to the eye sockets;
• Feeling of a pulse in the head;
• Flickering glare or flies before the eyes;
• Noise in ears;
• Redness and face;
• Swelling of the face after sleep, especially in the eyelids;
• Tingling or numbness in your fingers;

• Nausea;
• Swelling of the limbs;
• Increased sweating;
• Periodic chills;
• Internal tension and feelings of anxiety;
• Tendency to irritability;
• Memory impairment;
• Decreased overall performance;
• Heart palpitations.

Causes and risk factors for arterial hypertension

The main risk factors for arterial hypertension include:

• Floor. The greatest predisposition to the development of the disease is observed in men aged 35 to 50 years. In women, the risk of hypertension increases significantly after menopause.
• Age. People over the age of 35 are more likely to suffer from high blood pressure. Moreover, the older a person becomes, the higher the numbers of his blood pressure.
• Heredity. If first-line relatives (parents, brothers and sisters, grandparents) suffered from this disease, then the risk of its development is very high. It increases significantly if two or more relatives have high blood pressure.
• Stress and increased psycho-emotional stress. In stressful situations, adrenaline is released, under its influence, the heart beats faster and pumps blood in large volumes, increasing pressure. When a person is in this state for a long time, the increased load leads to wear and tear of blood vessels, and the increased blood pressure is converted into chronic pressure.

• Drinking alcoholic beverages. The addiction to the daily consumption of strong alcohol increases blood pressure by 5 mm Hg. Art. Every year.
• Smoking. Tobacco smoke, getting into the bloodstream, provokes vasospasm. Damage to the walls of arteries is caused not only by nicotine, but also by other components contained in it. At the site of damage to the arteries, atherosclerotic plaques appear.
• Atherosclerosis. Excess cholesterol, as well as smoking, lead to loss of elasticity in the arteries. Atherosclerotic plaques interfere with free blood circulation, as they narrow the lumens of the vessels, due to which blood pressure increases, spurring the development of atherosclerosis. These diseases are interrelated risk factors.
• Increased consumption of table salt. Modern people consume much more salt with food than is required by the human body. Excess dietary sodium provokes arterial spasm, retains fluid in the body, which together leads to the development of hypertension.

• Obesity. Obese people have higher blood pressure than people of normal weight. The abundant content of animal fats in the diet causes atherosclerosis. Physical inactivity and excessive consumption of salty foods lead to the development of hypertension. It is known that for every extra kilogram there are 2 units of blood pressure measurement.
• Physical inactivity. A sedentary lifestyle increases the risk of developing hypertension by 20-50%. The heart, not accustomed to stress, copes with them much worse. In addition, the metabolism slows down. Physical inactivity seriously weakens the nervous system and the human body as a whole. All these factors are the cause of the development of hypertension.

Arterial hypertension degree

The clinical picture of hypertension is influenced by the stage and type of the 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.

Arterial hypertension 1 degree

There are no manifestations of changes in target organs. This is a "mild" form of hypertension, which is characterized by periodic rises in blood pressure and an independent rise to normal values. Pressure surges are accompanied by mild headaches, sometimes sleep disturbances and rapid fatigue during mental work.

Indicators of systolic pressure range from 140-159 mm Hg. Art., diastolic - 90-99.

Arterial hypertension 2 degrees

"Moderate" form. At this stage, objective lesions of some organs can already be observed.

Diagnosed:

• localized or widespread narrowing of the coronary vessels and arteries, the presence of atherosclerotic plaques;
• hypertrophy (enlargement) of the left ventricle of the heart;
• chronic renal failure;
• vasoconstriction of the retina.

With a given degree of remission, they are rarely observed, and high blood pressure parameters persist. Indicators of upper pressure (SBP) - from 160 to 179 mm Hg. Art., lower (DBP) - 100-109.

Arterial hypertension 3 degrees

This is a severe form of the disease. It is characterized by impaired blood supply to organs, and, as a result, is accompanied by the following clinical manifestations:

• on the part of the cardiovascular system: heart failure, angina pectoris, the development of myocardial infarction, blockage of arteries, detachment of the aortic walls;
• retina: edema of the optic nerve head, hemorrhages;
• brain: transitory disorders of cerebral circulation, stroke, vascular dementia, hypertensive encephalopathy;
• kidney: renal failure.

Many of the above manifestations can be fatal. With AH III degree, the upper pressure is stable 180 and higher, the lower - from 110 mm Hg. Art.

Types of arterial hypertension

In addition to the above classification by the level of blood pressure, on the basis of differential parameters, doctors divide arterial hypertension into types by origin.

Primary arterial hypertension

The causes of this type of disease have not yet been clarified. However, it is this form that is observed in 95 percent of people suffering from high blood pressure. The only reliable information is that heredity plays the main role in the development of primary hypertension. Geneticists claim that the human genetic code contains more than 20 combinations that contribute to the development of hypertension.

In turn, primary arterial hypertension is subdivided into several forms:

• Hyperadrenergic. This form is observed in about 15 percent of cases of early hypertension, and often in young people. It occurs due to the release of adrenaline and norepinephrine into the bloodstream.

  Typical symptoms: change in complexion (a person may turn pale or redden), a feeling of a pulse in the head, chills and anxiety. Resting heart rate - from 90 to 95 beats per minute. If the pressure does not return to normal, a hypertensive crisis may follow.

• Hyporenin. Occurs in people of advanced age. A high level of aldosterone, a hormone of the adrenal cortex that traps sodium and fluid in the body, in combination with the activity of renin (a component that regulates blood pressure) in the blood plasma creates favorable conditions for the development of this type of hypertension. The external manifestation of the disease is a characteristic "renal appearance". Patients should refrain from eating salty foods and drinking plenty of fluids.
• Hyperrenic. People with rapidly progressing hypertension suffer from this form. The incidence is 15-20 percent, often young men. Differs in a severe course, typical sudden jumps in blood pressure. SBP can reach 230, DBP - 130 mm Hg. Art. With an increase in blood pressure, the patient feels dizziness, intense headache, nausea and vomiting. Left untreated, the disease can cause renal artery atherosclerosis.

Secondary arterial hypertension

This type is called symptomatic hypertension, as it develops with external lesions of systems and organs responsible for the regulation of blood pressure. The cause of its occurrence can be identified. In fact, this form of hypertension is a complication of another disease, which makes it more difficult to treat.

Secondary hypertension can also be divided into various forms, depending on which disease caused the hypertension:

• Renal (renovascular). Narrowing of the renal artery impairs blood circulation in the kidneys, in response to this, they synthesize substances that increase blood pressure.

  The reasons for the narrowing of the artery are: atherosclerosis of the abdominal aorta, atherosclerotic plaques of the renal artery and inflammation of its walls, blockage by a thrombus, trauma, compression by a hematoma or tumor. Congenital renal artery dysplasia is not excluded. Renal hypertension can also develop against the background of glomerulonephritis, amyloidosis or renal pyelonephritis.

  With all the complexity of the disease, a person can feel quite normal and not lose efficiency even with very high blood pressure. Patients note that the pressure jump is preceded by a characteristic lower back pain. This form is difficult to treat; in order to cope with the disease, it is necessary to cure the primary disease.

• Endocrine. In accordance with the name, it occurs in diseases of the endocrine system, among them: pheochromocytoma - a tumor disease in which the tumor is localized in the adrenal glands. It is relatively rare, but causes a very severe form of hypertension. It is characterized by both sudden jumps in blood pressure and persistent high blood pressure. Patients complain of visual impairment, headache, and heart palpitations.

  Another cause of the endocrine form of hypertension is Conn's syndrome. It manifests itself as hyperplasia or tumor of the adrenal cortex and is characterized by excessive secretion of aldosterone, which is responsible for renal function. The disease provokes an increase in blood pressure, accompanied by headache, numbness in various parts of the body, weakness. Kidney function is gradually disrupted.

  Itsenko-Cushing's syndrome. The disease develops due to the increased content of glucocorticoid hormones produced by the adrenal cortex. Also accompanied by increased blood pressure.

• Hemodynamic. It can manifest itself in the late stage of heart failure and congenital partial narrowing (coarctation) of the aorta. At the same time, the blood pressure in the vessels extending from the aorta above the narrowing site is significantly increased, below it is reduced.
• Neurogenic. The reason is atherosclerotic lesions of cerebral vessels and brain tumors, encephalitis, encephalopathy.
• Medicinal. Some medications that are taken on a regular basis have side effects. Against this background, arterial hypertension may develop. The development of this form of secondary hypertension can be avoided if you do not self-medicate and carefully read the instructions for use.

Essential arterial hypertension

This type can be combined with primary hypertension, since its only clinical sign is long-term and persistent high blood pressure in the arteries. Diagnosed by the exclusion of all forms of secondary hypertension.

Hypertension is based on dysfunctions of various systems of the human body that affect the regulation of vascular tone. The result of this effect is arterial spasm, a change in vascular tone and an increase in blood pressure. Lack of treatment leads to sclerosis of arterioles, making the high blood pressure more persistent. As a result, organs and tissues do not receive enough nutrition, which leads to disruption of their functions and morphological changes. In different periods of the course of hypertension, these changes appear, but first of all, they always relate to the heart and blood vessels.

The disease is formed definitively when depletion of depressive renal function occurs.

Pulmonary arterial hypertension

This type of hypertension is very rare, the incidence is 15-25 people per million. The cause of the disease is high blood pressure in the pulmonary arteries that connect the heart and lungs.

Through the pulmonary arteries, blood, containing a low proportion of oxygen, flows from the right ventricle of the heart (lower right part) into the small vessels and arteries of the lungs. Here it is saturated with oxygen and goes back, only now into the left ventricle, and from here it spreads throughout the human body.

In PAH, blood is not able to circulate freely through the vessels due to their narrowing, increases in thickness and mass, edema of the vascular walls caused by inflammation, and the formation of clots. This disorder leads to damage to the heart, lungs and other organs.

In turn, LAS is also subdivided into types:

• Hereditary type. The disease is caused by genetic problems.
• Idiopathic. The origin of this type of PAH has not yet been established.
• Associate. The disease develops against the background of other diseases such as HIV, liver disease. It may occur due to the abuse of various pills to normalize body weight, drugs (amphetamines, cocaine).

Persistent elevated blood pressure significantly increases the load on the heart, the affected vessels interfere with normal blood circulation, which, over time, can cause the right ventricle to stop.

Labile arterial hypertension

This type of hypertension is referred to as the initial stage of hypertension. Actually, this is not a disease yet, but rather a 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.

In principle, people with labile hypertension are considered quite healthy (provided that the pressure returns to normal without intervention), but they need to closely monitor their condition, since blood pressure is still not stable. In addition, this type can be a harbinger of a secondary form of hypertension.

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Diagnosis of arterial hypertension

The diagnosis of hypertension is based on three main methods:

• The first is blood pressure measurement;
• The second is a physical examination. Comprehensive examination carried out directly by the doctor. These include: palpation, auscultation (listening to sounds that accompany the work of various organs), percussion (tapping different parts of the body, followed by sound analysis), routine examination;
• The third is an electrocardiogram.

Now let's proceed to the description of all diagnostic measures for suspected arterial hypertension:

Blood pressure control. The first thing the doctor will do is measure your blood pressure. It makes no sense to describe the method of measuring pressure using a tonometer. This technique requires special training, and the amateurish approach will give distorted results. But we recall that the permissible limits of blood pressure for an adult fluctuate between 120-140 - the upper pressure, 80-90 - the lower.

In people with an "unstable" nervous system, blood pressure indicators increase with the slightest emotional outbursts. When you visit a doctor, you may experience a "white coat" syndrome, that is, during the control measurement of blood pressure, a rise in pressure occurs. The reason for these surges is stress, this is not a disease, but such a reaction can cause disruption of the heart and kidneys. In this regard, the doctor will measure the pressure several times, and in different conditions.

• Inspection. Height, weight, body mass index are specified, signs of symptomatic hypertension are revealed.
• Medical history. Any doctor's visit usually begins with a doctor's interview with a patient. The task of a specialist is to find out from a person the diseases that he suffered before and has at the moment. Analyze risk factors and assess the lifestyle (whether the person smokes, how he eats, whether he has high cholesterol levels, does he suffer from diabetes), whether the first-line relatives had hypertension.
• Physical examination. First of all, the doctor examines the heart for murmurs, changes in tones and the presence of uncharacteristic sounds using a phonendoscope. Based on these data, preliminary conclusions can be drawn about changes in heart tissue due to high blood pressure. And also to exclude vices.
• Blood chemistry. The results of the study allow to determine the level of sugar, lipoproteins and cholesterol, on the basis of which, it can be concluded that the patient is prone to atherosclerosis.
• ECG. The electrocardiogram is an indispensable diagnostic method for detecting heart rhythm disturbances. In addition, echocardiogram results indicate the presence of hypertrophy of the wall of the left side of the heart, characteristic of hypertension.
• Ultrasound of the heart. With the help of echocardiography, the doctor receives the necessary information about the presence of changes and defects in the heart, the function and condition of the valves.
• X-ray examination. In the diagnosis of hypertension, arteriography and aortography are used. This method allows you to explore the arterial walls and their lumen, to exclude the presence of atherosclerotic plaques, congenital narrowing of the aorta (coarctation).
• Doppler ultrasonography. Ultrasound examination to determine the intensity of blood flow through the arteries and veins. When diagnosing arterial hypertension, the doctor is primarily interested in the state of the cerebral and carotid arteries. For this purpose, it is ultrasound that is most often used, since it is completely safe, and after its use there are no complications.
• Ultrasound of the thyroid gland. Simultaneously with this study, the doctor needs the results of a blood test for the content of hormones produced by the thyroid gland. Based on the results, the doctor will be able to determine what role the thyroid gland plays in the development of hypertension.
• Ultrasound of the kidneys. The study makes it possible to assess the condition of the kidneys and renal vessels.

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Hypertension treatment

Non-drug treatment is prescribed to all patients with hypertension, without exception, as it increases the effect of drug therapy and significantly reduces the need for taking antihypertensive drugs.

First of all, it is based on changing the lifestyle of a patient suffering from arterial hypertension. It is recommended to refuse:

• smoking if the patient smokes;
• the use of alcoholic beverages, or a reduction in their intake: for men up to 20-30 grams of ethanol per day, for women, respectively, up to 10-20;
• increased consumption of table salt with food, it must be reduced to 5 grams per day, preferably less;
• using drugs containing potassium, magnesium or calcium. They are often used to lower high blood pressure.

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In addition, your doctor will strongly recommend:

• overweight patients to normalize their body weight, for which it is sometimes better to consult a nutritionist for a diet that allows you to eat a balanced diet;
• increase physical activity through regular exercise;
• Introduce more fruits and vegetables into your diet, while reducing your intake of foods rich in saturated fatty acids.

With "high" and "very high" risks of cardiovascular complications, the doctor will immediately begin to use drug therapy. The specialist will take into account the indications, the presence and severity of contraindications, as well as the cost of drugs when they are prescribed.

As a rule, drugs with a daily duration of action are used, which makes it possible to prescribe one, two times a day. To avoid side effects, taking medications begins with a minimum dosage.

Let's list the main medications for hypertensive drugs:

There are six groups of hypertensive drugs that are currently in use. Beta-blockers and thiazide diuretics are leading among them in terms of effectiveness.

Again, drug treatment, in this case, thiazide diuretics, should be started with small doses. If the effect of admission is not observed, or the patient does not tolerate the drug well, the minimum doses of beta-blockers are prescribed.

Thiazide diuretics are marketed as:

• first-line drugs for the treatment of hypertension;
• the optimal dose is minimally effective.

Diuretics are prescribed for:

• heart failure;
• arterial hypertension in the elderly;
• diabetes mellitus;
• high coronary risk;
• systolic hypertension.

Diuretics are contraindicated for gout and, in some cases, for pregnancy.

Indications for the use of beta-blockers:

• combination of angina pectoris with hypertension and with myocardial infarction;
• the presence of an increased coronary risk;
• tachyarrhythmia.

The drug is contraindicated in:

• bronchial asthma;
• obliterating vascular diseases;
• chronic obstructive pulmonary disease.

In drug therapy of hypertension, doctors use combinations of drugs, the appointment of which is considered rational. In addition, according to the indications, it can be assigned:

• antiplatelet therapy - for the prevention of stroke, MI and vascular death;
• taking lipid-lowering drugs, in the presence of multiple risk factors;
• combined drug treatment. It is prescribed in the absence of the effect expected from the use of monotherapy.

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Prevention of arterial hypertension

It is easier to prevent hypertension than to cure it. Therefore, it is worth thinking about preventive measures while still young. This is especially important for people with relatives suffering from hypertension. Prevention of hypertension is designed to eliminate factors that increase the risk of developing this formidable disease. First of all, you need to get rid of addictions and change your lifestyle in the direction of increasing physical activity. Sports activities, jogging and walking in the fresh air, regular swimming in the pool, water aerobics significantly reduce the risk of developing hypertension. Your heart will gradually get used to the stress, blood circulation will improve, due to which the internal organs will receive nutrition, and the metabolism will improve. In addition, it is worth protecting yourself from stress, but if you fail, then at least learn how to respond to them with a grain of healthy skepticism. On the subject: How to get rid of pressure once and for all? If possible, it is worth purchasing modern devices for monitoring blood pressure and heart rate. Even if you do not know what high blood pressure is, it should be measured periodically as a preventive measure. Since the initial (labile) stage of hypertension may be asymptomatic. People over the age of 40 should undergo preventive examinations by cardiologists and therapists annually.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".