Hypertension

Hypertension is an extremely common disease, which as a collective definition combines several types of hypertension. Hypertension develops against the background of the narrowing of the lumen of the walls of small vessels and arteries, as a result of which the normal movement of blood flow is disrupted, and the blood accumulating in the narrowed places begins to press on the walls of the vessels.

What is hypertension?

Elevated blood pressure may be a symptom, but it can also be an independent disease. If a person is diagnosed with chronic pathologies of the kidneys, cardiovascular system, thyroid gland, adrenal gland, hypertension is almost inevitable as one of the manifestations of these diseases. Also, increased pressure can be an adaptive, adaptive response of organs and systems to changes as external - excessive physical activity, and internal - psychoemotional factors, stress. Practically all types of hypertension with timely diagnosis are supervised both with the help of drug therapy, and with the help of other, non-medicamentous methods.

Normal blood pressure in a relatively healthy person is fixed within the limits of 100/60 and 140/90 mm of mercury, if the regulatory systems stop working properly, hypertension or hypotension may develop.

Statistics provide information that almost 30% of the world's population suffer from one or another stage of hypertension, and even recently, almost nothing was known about such a disease as hypertension. Only Homo sapiens are characterized by violations in the work of the cardiovascular system, no representative of the animal world is affected by them. Until the nineteenth and twentieth centuries, little was known about hypertension, one of the first cases of a heart attack was reliably confirmed by physicians only in the 30s of the last century in one of the European countries, during the same period there was not one clinically confirmed case Cardiovascular pathologies in African and Asian countries. Only with the development of urbanization and the penetration of modern technology into these countries, the Asian and African populations also became vulnerable to hypertension, the peak of which occurred in the 70s of the XX century.

Since the end of the last century, hypertension is divided into primary and secondary

1. Primary (essential) hypertension is a separate nosological unit, an independent disease that is not provoked by impaired functioning of organs and systems. Arterial pressure rises not because of, for example, kidney disease. Hypertension diagnosed as primary (EG - essential hypertension or GB - hypertonic disease) is distinguished by a persistent clinical sign - increased pressure, both systolic and diastolic. Almost 90% of all patients with persistent high blood pressure have primary hypertension. 
2. Symptomatic hypertension, which is also called secondary, is hypertension provoked by a major disease, for example, inflammatory processes in the renal system - glomerulonephritis, polycystic kidney, or a disorder of the pituitary gland or pancreas. Also, secondary hypertension develops against the background of pathological changes in the vascular system - atherosclerosis, can provoke symptomatic hypertension and neurotic disease. Also, secondary hypertension is quite common in pregnancy and with gynecological diseases - cysts and neoplasms

Hypertension is also classified in degrees, depending on the level of increase in blood pressure. 

• If the blood pressure is fixed within the limits of 140/90 and 159/99 mm of mercury, hypertension is diagnosed as a disease of the 1st degree. At the same time, the pressure can return to normal, but periodically "jump" to the specified boundaries. 
• If the blood pressure is fixed in the range from 160/100 to 179/109 mmHg, hypertension is considered a disease of grade II. There is almost no remission, however, pressure can be managed with medication. 
• The arterial pressure, which is constantly kept within the limits of 180/110 and higher indicators is considered a clinical symptom of stage III hypertension. At this stage the blood pressure does not practically fall to the normal level, and if it decreases, it is accompanied by cardiac weakness, up to heart failure.

Hypertension, in addition to having stages of development of the disease, is divided into separate clinical forms. Hyperadrenergic hypertension is actually the initial stage of the development of the disease, which, however, may last for many years. This form of hypertension is manifested by sinus tachycardia, unstable blood pressure, when the systolic index rises, increased sweating, hyperemia of the skin, head throbbing pain, anxiety. The face and limbs often swell, the fingers become numb, the urination is disturbed. There is also a more serious form - malignant hypertension, which is rapidly progressing. Blood pressure can increase so much that there is a risk of encephalopathy, loss of vision, pulmonary edema, and there is also a risk of kidney failure. Fortunately, this form is practically not found today, since hypertension is most often diagnosed much earlier and its development can be stopped with the help of complex therapeutic measures.

Pressure indicators

Arterial pressure is one of the most important indicators of a person's health status and an indicator of the normal functioning of the cardiovascular system. The pressure has two parameters - systolic and diastolic. The upper figure is systole, this is the index of blood pressure during the contraction of the heart muscle, when blood enters the arteries. The lower figure is the index of blood pressure during the relaxation of the heart muscle. It is believed that hypertension begins when indicators exceed the norm of 140/90 mm Hg. This, of course, is a conditional limit, since there are conditions when the risk of developing myocardial infarction exists even at the figures of 115/75 mm Hg. However, formalization and reduction to the average level of the whole variety of the condition of blood pressure helps clinicians to notice deviations in time and start symptomatic, and then standard treatment.

What causes hypertension?

Hypertension is considered a multi-ethical, multifactorial disease, the real causes of which are not fully understood. More specific factors provoking secondary hypertension, as the cause is the underlying disease. The final diagnosis of essential hypertension is made after a comprehensive examination by excluding the presence of provoking diseases. Primary hypertension, expressed in medical terms, is a genetic imbalance of regulatory mechanisms in the body (imbalance of pressor and depressor systems of blood pressure).

Of the reasons that the clinicians described and carefully studied, we can name the following:

• The pathology of the kidneys is nephritis and more often glomerulonephritis. The factor that provokes secondary hypertension.
• Stenosis (constriction) of the renal arteries.
• Congenital pathology, in which the renal artery is impassable (coarctation).
• Neoplasms of the adrenal glands - pheochromocytosis (disruption of norepinephrine and adrenaline production).
• Increased production of aldosterone - hyperaldosteronism, which happens when the tumor process in the adrenal glands.
• Dysfunction of the thyroid gland.
• Alcoholism.
• Overdose or constant use of drugs, especially hormonal, antidepressants.
• Addiction.

Factors that are considered provocative in the sense of a violation of the normal level of pressure can be divided into nutritional, age and pathological:

• Age over 55 years for men and 65 years for women.
• An increase in the level of cholesterol in the blood (above 6, 6 mmol).
• Hereditary predisposition, family history.
• Obesity, especially abdominal, when the waist is more than 100-15 cm in men and 88-95 in women.
• Diabetes, a change in the normal level of glucose tolerance.
• Hypodinamy, osteochondrosis.
• Chronic stress, increased anxiety.

The mechanism of development of hypertension in brief is as follows:

With spasmodic arthritis - the arteries of the organs, most often the kidneys, under the influence, for example, of the stress factor, there is a disturbance in the nutrition of the kidney tissue, ischemia develops. The kidneys try to compensate for the impairment by developing renin, which in turn provokes an activation of angiotensin, narrowing the blood vessels. As a result, the pressure rises, and hypertension develops.

Symptoms of hypertension

The primary symptom of hypertension, and sometimes the main one, is a persistent excess of indices of 140/90 mm of mercury. Other signs of hypertension are directly related to the parameters of blood pressure. If the pressure rises slightly, a person simply feels an ailment, a weakness, a pain in the head.

If the pressure exceeds the norm by 10 units, the headache becomes intense, constant, most often it is localized in the occiput and temples. A person is sick with nausea, sometimes there is vomiting. The face turns red, the sweating rises, the tremor of the fingers is noticeable, often their numbness.

If hypertension lasts for a long time, then the pathological processes in cardiac activity develop, the heart begins to ache. The pain can be piercing, acute, it can irradiate into the hand, but more often the heart pain is localized to the left in the chest, without spreading further. Against the background of constantly high blood pressure, anxiety and insomnia develop.

Hypertension is also characterized by dizziness and decreased vision.

Ophthalmic signs - shroud or spots, "flies" before the eyes. Often, the code pressure rises sharply, there may be bleeding from the nose.

Another symptom of hypertension is dizziness. Vision worsens.

The terminal stage, when hypertension passes to the third degree, neurosis or depression will join the typical symptomatology. Often, hypertension in this form occurs in a pathological "union" with coronary heart disease.

The most dangerous manifestation of hypertension is a crisis - a state with a sharp increase, a jump in blood pressure. Cryptic condition is fraught with a stroke or a heart attack and is manifested by such symptoms:

• A sudden, sudden or rapidly growing headache. 
• Parameters of blood pressure up to 260/120 mm of mercury. 
• Pressure in the heart, aching pain. 
• Severe shortness of breath. 
• Vomiting, starting with nausea. 
• Increased pulse, tachycardia. 
• Loss of consciousness, cramps, paralysis.

Hypertension in a crisis stage is a threatening condition, which can result in a stroke, a heart attack, therefore, at the slightest, alarming signs, you should call for emergency medical attention. The hypertensive crisis is stopped with the help of diuretics, cardiac and hypertensive drugs injected. A hypertonic who knows about his problem must constantly take prescribed medications to prevent a crisis state.

Treatment of hypertension

Hypertension in the initial stage, when blood pressure indicators do not often exceed the norm, can be treated with non-medicament means. The first method is to control body weight and observe a low-carb and lean diet. Diet in hypertension also involves limiting the intake of salty foods, the control of the use of liquid - no more than 1.5 liters per day. Also effective is psychotherapy, autogenic training, which removes the level of general anxiety and tension. These methods are effective for the first stage of hypertension, although they can be used as auxiliary and additional elements to the main therapy of the II and III stage of hypertension.

Pharmacological means, which involves the treatment of hypertension, are prescribed according to the "stepwise" principle. They are used consistently, directing to various organs and systems, until the blood pressure is completely stabilized.

Hypertension in the first stage involves the use of diuretics (diuretics), beta-adrenoblockers, adrenergic receptor blockers for the management of tachycardia. The dose of anaprilin is calculated on the basis of anamnesis, weight and condition of the patient, as a rule, it is 80 milligrams per day. If the arterial pressure is normalized after two or three days, the dose of anaprilin is reduced, and the administration is often given every other day. As a diuretic, hypothiazide is effective, which is prescribed 25 mg once, alternating after one or two days, in order not to weaken the heart muscle. If hypertension begins to recede, a diuretic can be administered once a week. It is not uncommon for diuretics and beta-blockers to be used in connection with possible side effects (diabetes, gout or asthma), in such situations, the reception of antispasmodics is indicated. During the entire course of treatment, you need to monitor the blood pressure level three times a day.

Stage II hypertension is supervised by complex therapy, including both beta-blockers and diuretics, and antispasmodics, ACE inhibitors (angiotensin-converting enzyme inhibitors), and potassium preparations. Of the b-blockers, atenolol, lokren, vetchin are effective, which are able to control the rapid heart rate, reduce the vascular resistance at the periphery. Also, these drugs are effective in diagnosed bradycardia, when the heart rate is reduced. Angiotensin-converting enzyme inhibitors can neutralize the increased production of renin, which increases blood pressure. These are spirapril, ethanolol, methiopril, hood, and other drugs of this group. These funds activate the left heart ventricle, reducing hypertrophy, dilate the coronary vessels, thereby contributing to the normalization of peripheral blood flow. Calcium antagonists are designed to block calcium channels in the vascular walls, increasing their lumen. This is Corinfar, Amlodipine, Felodipine and other substances in this category of drugs. Calcium antagonists should be prescribed only by a therapist or cardiologist, since all these drugs can provoke swelling, dizziness and verbal pain. The complex of medicines is selected taking into account all possible side risks and contraindications. It should also be noted that long-term use of diuretics can cause a decrease in the level of potassium in the body (hypokalemia), so diuretics should be taken with panangin or asparcum. Diabetics, hypothiazide is not prescribed, it is replaced with veroshpiron.

Hypertension III stage - a severe form of the disease, which is characterized by resistance to traditional drugs. Therefore, treatment should be carefully selected taking into account all the individual characteristics of the patient. The therapeutic complex includes diuretics, most commonly potassium-sparing, such as amiloride or spironolactone, in addition, the use of peripheral vasodilators is shown. The pharmaceutical industry today produces a variety of combined effective drugs such as adelphan, brineridine, triresite. These drugs act on those patients whose body is either accustomed to monotherapy and stopped responding to it, or has significant contraindications to the use of standard treatment used for hypertension I and II stages.

Hypertension III severity is also controlled by vasodilators, such as phenygidine or corinfar, which is prescribed three times a day for 10 milligrams. Increasingly, vasodilators began to be replaced by alpha-adrenergic blockers - pratziol, fentalomine. Also, a combined agent combining the properties of alpha and beta-blockers - trandate (labetalol hydrochloride) can also be effective. This drug in combination with a diuretic is able to replace three or even four other less effective drugs. From the ACEI, captopril is indicated, which improves peripheral circulation and controls the level of renin. Captopril is taken three to four times a day, combining with a diuretic, which allows you to reduce blood pressure to the norm after a week.

Hypertension I and II degree is treated at home and does not require hospitalization. In rare cases, inpatient treatment is possible, in order to conduct analytical surveys and monitor health status. Hypertension, taking place in severe forms, is treated only in the hospital, in the cardiology department, the length of stay depends on the condition of the blood pressure and the performance of organs and systems of the body.

How is hypertension prevented?

Hypertension, if it has already developed, unfortunately, remains with the person forever. Prevention in this sense refers only to the prevention of crisis situations through regular intake of prescribed medications, daily monitoring of blood pressure, physical activity and weight loss.

However, if in a family history a person has relatives with hypertension, but the disease has not yet manifested, precautionary measures can be taken. The rules are quite simple - keeping a healthy lifestyle and motor activity, because one of the reasons that provoke hypertension is hypodynamia. Hypertension is also prevented by a normal diet, where cholesterol and salty foods are minimized.

Hypertension is also a bad habit, so if a person does not want to join the ranks of hypertensive patients, he should stop smoking and limit the use of alcoholic beverages. In addition, a positive mood and mood help to cope with any disease, and hypertension "likes" pessimists. The recipe is simple - enjoy life, stay calm and take care of your nerves, then your heart and blood vessels will work "like a clock," and pressure will be, according to a well-known saying "like an astronaut."