1st degree hypertension

High blood pressure is probably the most common symptom that people go to the doctor with. The reasons for pressure "jumps" are constant stress (at work or at home), poor nutrition, lack of proper rest, and bad habits. Stage 1 hypertension is the initial stage of a serious disease. This is the period when it is still possible to prevent the possible consequences of constant high blood pressure.

Stage 1 hypertension is characterized by a stable or frequent increase in pressure, and not only in a stressful situation, overexcitement or physical overload. In the listed conditions, an increase in pressure is considered a normal variant. But an increase in indicators without apparent reasons to 140/90 mm Hg and higher may indicate the development of a mild stage of stage 1 hypertension.

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Risk options for stage 1 hypertension

The diagnosis of stage 1 hypertension can be established if the systolic pressure increases to 18.7-21.2 kPa (140-159 mm Hg), and the diastolic pressure increases to 12.0-12.5 kPa (90-94 mm Hg).

In addition, another value has been established that characterizes the existing probability of complications and adverse effects of the disease. This value is called risk and is divided into 4 degrees.

1. Stage 1 hypertension, risk 1 – is established when the patient is predicted to have a 15% chance of developing cardiovascular complications within 10 years.
2. Stage 1 hypertension, risk 2 – is established if the patient’s prognosis for the development of cardiovascular complications over the next 10 years is 20%.
3. Hypertension stage 1, risk 3 – is assigned if the expected prognosis of cardiovascular complications over the next decade is up to 30%.
4. There is also a 4th degree of risk, which has the most unfavorable prognosis – more than 30% of possible complications.

The risk percentage is determined not only by blood pressure indicators, but also by the condition of the heart and blood vessels, the presence of other diseases (mainly chronic). Attention is also paid to hereditary predisposition, hormonal imbalance, and diseases of the urinary system.

Symptoms of hypertension stage 1

Stage 1 hypertension is the mildest form of the disease, so there may not be any pronounced symptoms. Moreover, the patient often discovers that he has high blood pressure by chance, during a preventive examination, while noting only periodic malaise and headaches.

There may be no changes in the fundus at this stage, cardiac activity is normal, and there are no urinary disorders. Occasionally, the patient notes headaches, slight dizziness, a feeling of fatigue and exhaustion, and possibly slight nosebleeds and tinnitus.

The main symptom of stage 1 hypertension is headache. The pain is transient, it is inconstant, and is most pronounced in the crown and back of the head. It can be combined with dizziness and rapid heartbeat. During examination, an increase in systolic and diastolic pressure indicators is determined.

More pronounced and serious symptoms appear when hypertension reaches stage 2 or 3 severity.

Diagnosis of hypertension stage 1

Diagnosis of hypertension consists of determining the stability of the increase in blood pressure and assessing the degree of the disease. In addition, a conclusion should be made about hypertension as a primary disease, because high blood pressure can be a sign of some other pathology.

At the first appointment, the doctor should measure the blood pressure on the left and right arm: at subsequent appointments, measurements are taken on the limb where the readings were higher. Sometimes, if necessary, blood pressure measurements are taken on the lower limbs. For a more accurate diagnosis, it is recommended to take two or more measurements with a time interval of one week.

Among the mandatory studies that must be carried out on each patient when high blood pressure is detected, the following can be highlighted:

• medical history (questioning the patient: when did he feel the increase in blood pressure, under what circumstances, does anyone in the family suffer from hypertension, etc.);
• visual inspection;
• conducting a general urine analysis;
• blood test for hemoglobin, hematocrit, creatinine, sugar, potassium and calcium content;
• blood lipid analysis, cholesterol tests;
• electrocardiography;
• X-ray (chest);
• assessment of the condition of the fundus;
• Ultrasound of the abdominal cavity.

If these studies were sufficient to confirm the primary nature of the disease and determine the degree of hypertension, then at this stage the diagnostic measures are completed.

If, during the examination, other pathologies are discovered that can directly influence the increase in blood pressure, then a detailed diagnosis of the already discovered diseases is prescribed.

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Treatment of hypertension stage 1

Usually, stage 1 hypertension is treated without the use of medications, since this stage is the mildest and can be treated by adjusting the daily routine and diet. What are the principles of this therapy?

• Bringing body weight to the physiological norm. Simply put, if a patient is overweight, he should lose weight. It is known that with each kilogram lost, the blood pressure indicator decreases by 2 mm Hg.
• Giving up bad habits (smoking and drinking alcohol).
• Moderate physical activity (not excessive).
• Salt-free diet (no more than 3-5 g of salt per day).
• Elimination of stress and emotional overload.

Additional treatment methods are also very beneficial:

• psychotherapeutic treatment, relaxation;
• acupuncture, manual therapy, massage procedures;
• physiotherapeutic measures (use of diadynamic currents, hyperbaric oxygenation);
• treatment with medicinal herbs and infusions (motherwort, hawthorn, sweet clover, immortelle, etc.).

Tablets that lower blood pressure may be prescribed only if standard non-drug therapy does not produce the expected effect.

Treatment of hypertension stage 1 with tablets

To treat stage 1 hypertension, sedatives and hypotensive drugs are used, as well as medications that have a positive effect on tissue metabolism.

According to the mechanism of action, antihypertensive drugs are divided into several categories:

1. Neuro- and psychotropic drugs that have a calming and antidepressant effect. These drugs include tranquilizers (diazepam, trioxazine, chlordiazepoxide), sedatives (bromide drugs, valerian, magnesium preparations, sleeping pills), antidepressants (amitriptyline, etc.).
2. Agents that affect the sympathetic-adrenal system. These agents include centrally acting drugs (guanfacine, methyldopa, clonidine), peripherally acting drugs (sympatholytic drugs such as guanethidine, or ganglionic blockers: pyrilene, imekhin, dimecolin, etc.), as well as combination drugs: reserpine, inderal, trazicor, phentolamine, labetalol, etc.
3. Diuretics, which reduce plasma volume and remove sodium salts and water. These medications include thiazide group agents (hypothiazide, indopres, hydrochlorothiazide), ethacrynic acid and furosemide, as well as potassium-sparing "loop" diuretics (veroshpiron, amiloride, mannitol, lasix, spironolactone).
4. Vasodilators of peripheral action that affect the smooth muscle structures of the vessels of the systemic circulation (apressin, sidnopharm, vasonite, molsidomine, etc.).
5. Medicines that can specifically influence the renin-angiotensin system (berlipril, captopril, diovan, captopril, enap, prestarium, ramizes, etc.).

The dosage of tablets is selected individually for each patient. As a rule, the intake begins with the lowest possible dosage - ¼ or ½ tablet once a day or one-time. The scheme of intake and dosage should be calculated by the doctor at an individual appointment. Self-medication with antihypertensive drugs is unacceptable!

Nutrition for hypertension stage 1

An integral part of the treatment for stage 1 hypertension should be nutrition, with a restriction of salt, liquid and animal fats. Animal fats can provoke atherosclerotic changes in the vessels, which negatively affects their lumen. Fats are sharply limited in the diet, and preference is given to vegetable crops, dietary lean meat and fish, dairy products, and greens.

The amount of salt consumed is limited to 3-5 g/day, or eliminated altogether. The amount of liquid consumed should be limited to 0.8-1 liter/day.

The main focus of dietary changes is to reduce the amount of cholesterol in the bloodstream, reduce the volume of circulating blood and prevent fluid retention in the body's tissues.

Proteins in the diet should be reduced to 90 g, fats – to 70 g (giving preference to vegetable fats), carbohydrates – to 400 g/day.

It is advisable to eat products stewed, boiled, or cooked in a steamer. It is recommended to eat small portions six times a day. All products should be fresh, without preservatives and stabilizers.

Diet for stage 1 hypertension

What foods should not be included in the diet for stage 1 hypertension:

• fatty foods (lard, fatty meats and fish, including fish oil, fatty dairy products);
• alcoholic beverages;
• desserts with butter cream, sweet dishes, including pure sugar, bee products, jam, candies;
• coffee, cocoa, strong black tea, cola;
• pickles, smoked products, canned and marinated dishes, hot seasonings and spices.

What foods should be consumed with stage 1 hypertension:

• greens (dill, cilantro, parsley);
• vegetables, including potatoes, carrots, cabbage;
• cereals (rice, buckwheat, millet, etc.);
• berries (rose hips, raspberries, blueberries);
• fruits (bananas, apricots, peaches, citrus fruits, pineapples, etc.);
• vegetable oils;
• garlic, onion;
• vegetable soups and side dishes;
• low-fat dairy products.

You can have fasting days once a week: vegetable, kefir, watermelon.

A properly selected diet will ensure that the body receives all the necessary substances and microelements, which will have a positive effect on stabilizing blood pressure and improving the patient’s quality of life.

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Stage 1 hypertension and the army

Many conscripts are interested in the question: are people with stage 1 hypertension taken into the army?

As a rule, if the medical commission at the military registration and enlistment office finds that a conscript has high blood pressure corresponding to stage 1 hypertension (systolic - not less than 140 mm Hg, and diastolic - not less than 90 mm Hg), then in most cases he is assigned the category "fit with restrictions". This means that the young man will most likely not be called up for this draft in peacetime. But from the next draft, he will again be sent to the medical commission, where his blood pressure will be checked again. If the diagnosis is confirmed again, the conscript will be sent to the reserve and issued a military ID. If the diagnosis is not confirmed, he will have to serve.

The category "fit with restrictions" may not provide for military service only in peacetime. In wartime, such a conscript will be called up to the army even with hypertension of the 1st degree.

Conscripts with stage 2 and 3 hypertension are unconditionally not subject to military service.

Stage 1 hypertension is an insidious disease that requires careful attention. It is quite difficult to get rid of persistent high blood pressure, so you should make every effort to pacify the disease at its mildest stage. Therefore, it is important to regularly visit a doctor, monitor blood pressure indicators and lead a healthy lifestyle and diet. A comprehensive and competent approach to the problem will allow you to maintain normal blood pressure for many years.