hypertension

Hypertension is an extremely common disease that, as a collective definition, combines several types of arterial hypertension. Hypertension occurs against the background of a narrowing of the lumen of small blood vessels and arteries, as a result of which the normal movement of the blood flow is disrupted, and the blood accumulated in the narrowed areas begins to exert pressure on the vessel walls. vessel.

What is high blood pressure?

High blood pressure can be a symptom, but it can also be a separate disease. If a person is diagnosed with a chronic disease of the kidneys, cardiovascular system, thyroid, or adrenal glands, high blood pressure will almost inevitably be one of the manifestations of these diseases. Furthermore, increased stress may be an adaptive response of organs and systems to external changes (excessive physical activity) and internal psychoemotional factors (stress). Nearly all types of high blood pressure can be controlled with medication and other non-drug methods if diagnosed promptly.Normal blood pressure in relatively healthy people is fixed between 100/60 and 140/90 mmHg; if the regulatory system is not working properly, high or low blood pressure may occur.Statistics show that nearly 30% of the world's population suffers from some stage of hypertension, but until recently, almost nothing was known about conditions like hypertension. Only Homo sapiens is characterized by a dysfunction of the cardiovascular system; no representatives of the animal kingdom are affected by this condition. Until the 19th-20th century, in principle little was known about hypertension; only in the 1930s, in a European country, doctors reliably confirmed the first cases of heart attacks; in the same period, there were nocases of heart attack. Single clinically confirmed cases of cardiovascular disease in African and Asian countries. However, with the development of urbanization and the penetration of modern technology into these countries, Asian and African populations are also prone to high blood pressure, which peaked in the 1970s.Since the end of the last century, hypertension has been divided into primary and secondary forms.

1. Essential (idiopathic) hypertension is an independent nosological unit and an independent disease that is not caused by organ and system dysfunction. For example, blood pressure can be elevated for other reasons besides kidney disease. The diagnosis of essential hypertension (EG - essential hypertension or GB - essential hypertension) is characterized by persistent clinical symptoms - elevated systolic and diastolic blood pressure. Almost 90% of patients with persistently elevated blood pressure have essential hypertension.
2. Symptomatic hypertension, also called secondary hypertension, is high blood pressure caused by an underlying disease, such as an inflammatory process in the renal system - glomerulonephritis, polycystic kidney disease, or diseases of the pituitary or pancreas. Furthermore, secondary hypertension occurs against the background of pathological changes in the vasculature (atherosclerosis) and can trigger symptomatic hypertension and neurological diseases. In addition, secondary hypertension is common during pregnancy and in gynecological diseases (cysts and tumors).

Hypertension is also divided into different levels based on the degree of increase in blood pressure.

• Hypertension is diagnosed as Stage I disease if the blood pressure is fixed between 140/90 and 159/99 mmHg. In this case, the pressure may return to normal but periodically "jump" to the specified limit.
• Hypertension is considered stage II disease if blood pressure is recorded in the range of 160/100 to 179/109 mmHg. There is virtually no relief, but the stress can be managed with medication.
• Persistent blood pressure in the range of 180/110 and above is considered a clinical sign of stage III hypertension. During this stage, blood pressure does not actually drop to normal levels, and if it does drop, it is accompanied by heart weakness and even heart failure.

In addition to the stages of disease progression, hypertension is divided into different clinical forms. Hyperadrenergic hypertension is actually the initial stage in the development of the disease but can persist for many years. This form of hypertension presents with sinus tachycardia, unstable blood pressure with fluctuating systolic blood pressure readings, increased sweating, skin congestion, throbbing headaches, and anxiety. There is often swelling of the face and limbs, numbness of the fingers, and difficulty urinating. There is also a more severe form, malignant hypertension, which progresses rapidly. Blood pressure can rise significantly, leading to risk of encephalopathy, vision loss, pulmonary edema, and risk of kidney failure. Fortunately, this form rarely occurs now, as high blood pressure is usually diagnosed earlier and its progression can be halted with sophisticated treatments.

pressure indicator

Blood pressure is one of the most important indicators of human health and an indicator of the normal function of the cardiovascular system. Pressure has two parameters - systolic and diastolic. The top number is systole, which is a measure of blood pressure during the contraction of the heart muscle as blood enters the arteries. The lower number is an indicator of blood pressure during periods of myocardial relaxation. High blood pressure is thought to occur when readings exceed the normal value of 140/90 mmHg. Of course, this is a qualification, since even at a figure of 115/75 mmHg there is a risk of myocardial infarction. However, normalizing various blood pressure conditions and averaging them helps clinicians detect deviations promptly and initiate symptomatic treatment, followed by standard care.

ICD-10 code

I10 Essential hypertension.

What causes high blood pressure?

Hypertension is considered a multi-causal, multi-factorial disease, and its true causes are not fully understood. What triggers secondary hypertension is more specific because the cause is an underlying medical condition. The final diagnosis of essential hypertension is made after a thorough examination to exclude predisposing conditions. Essential hypertension, in medical terms, is a genetic imbalance of the body's regulatory mechanisms (an imbalance in the blood pressure-raising and blood-pressure-lowering systems).The reasons described and carefully studied by clinicians are as follows:

• Kidney disease - nephritis, the most common is glomerulonephritis. Factors inducing secondary hypertension.
• Renal artery stenosis (narrowing).
• Congenital pathology of renal artery obstruction (coarctation).
• Adrenal gland tumors - chromocytosis (impaired production of norepinephrine and epinephrine).
• Increased aldosterone production, called hyperaldosteronism, occurs during adrenal tumors.
• Impaired thyroid function.
• alcoholism.
• Excessive or continued use of medications, especially hormonal antidepressants.
• addiction.

Factors considered irritating in terms of disrupting normal blood pressure levels can be divided into nutritional, age-related and pathological factors:

• Age: Men are over 55 years old, women are over 65 years old.
• Increased blood cholesterol levels (more than 6. 6 mmol).
• Genetic predisposition, family history.
• Obesity, especially abdominal obesity, has a waist circumference of more than 100-15 cm for men and 88-95 cm for women.
• Diabetes, changes in normal glucose tolerance levels.
• Lack of physical activity, osteochondrosis.
• Chronic stress, increased anxiety.

The mechanism of hypertension is briefly described as follows:When arterioles (the arteries of an organ, most commonly those of the kidneys) spasm under the influence of stress factors, the nutrition of the kidney tissue is destroyed and ischemia occurs. The kidneys try to compensate for the disturbance by producing renin, which in turn triggers the activation of angiotensin, which constricts blood vessels. As a result, blood pressure increases and hypertension develops.

Symptoms of high blood pressure

The main symptom (sometimes the main symptom) of high blood pressure is considered to be a sustained increase above 140/90 mmHg. Other symptoms of hypertension are directly related to blood pressure parameters. If the pressure rises even slightly, the patient will only experience discomfort, weakness, and headaches.If the pressure is 10 units above normal, headaches can become severe and persistent, most commonly occurring at the back of the head and temples. Patients feel nauseous and sometimes vomit. The face becomes red, sweating increases, the fingers tremble obviously, and there is often numbness.If high blood pressure persists for a long time without treatment, pathological processes will occur in the heart's activity, and pain in the heart will begin. The pain may be stabbing, sharp, or may radiate to the arm, but most often, heart pain is localized to the left side of the chest and does not spread further. Against the background of persistently elevated blood pressure, anxiety and insomnia arise.Another hallmark of high blood pressure is dizziness and decreased vision.Ophthalmic symptoms - "gauze" or "spots" and "floaters" appear in front of the eyes. Typically, nosebleeds may occur when pressure rises sharply.Another symptom of high blood pressure is dizziness. Vision worsens.In the final stages, when hypertension reaches the third stage, neurosis or depression joins the classic symptoms. This form of hypertension is often pathologically "combined" with coronary heart disease.The most dangerous manifestation of high blood pressure is a crisis - a sudden increase or jump in blood pressure. Crisis situations are fraught with stroke or heart attack and manifest with symptoms such as:

• Severe, sudden, or rapidly worsening headache.
• Blood pressure readings as high as 260/120 mmHg.
• There is pressure and pain in the heart area.
• Severe shortness of breath.
• Vomiting, starting with nausea.
• Increased heart rate, tachycardia.
• Loss of consciousness, convulsions, paralysis.

High blood pressure in the crisis stage is a threatening condition that can lead to stroke or heart attack, so you should seek emergency medical help at the slightest alarming sign. Hypertensive crises can be controlled with injections of diuretics, heart disease medications, and high blood pressure medications. People with high blood pressure who are aware of their problem must continue to take prescribed medications to prevent a crisis state.

Who to contact?

Cardiologist.

Treatment of high blood pressure

In the early stages of hypertension, blood pressure readings usually do not exceed normal levels and can be treated with non-drug treatments. The first way is to control your weight and follow a low-carb, low-fat diet. A high blood pressure diet also includes limiting the intake of salty foods and controlling fluid intake - no more than 1. 5 liters per day. Psychotherapy and autogenic training to relieve general anxiety and tension are also effective. These approaches are effective in stage I hypertension, although they can be used as adjunctive and additional elements in the primary treatment of stage II and III hypertension.Medications involving the treatment of high blood pressure are prescribed on a "step-by-step" basis. They are used sequentially, targeting different organs and systems, until blood pressure is completely stable.Stage I hypertension involves the use of diuretics (diuretics), beta-blockers, and adrenergic blockers to stop the rapid heartbeat. The dosage of beta-blockers is calculated based on the patient's medical history, weight, and condition. If blood pressure returns to normal after two to three days, the dose will be reduced, usually every other day. As diuretics, thiazides are effective in doses of 25 milligrams, alternated every one or two days to avoid weakening the heart muscle. If high blood pressure begins to subside, a diuretic may be taken once a week. In some cases, diuretics and beta-blockers cannot be used due to possible side effects (diabetes, gout, or asthma); in this case, antispasmodics are needed. Throughout treatment, you will need to monitor your blood pressure levels three times a day. Stage II hypertension requires complex treatment, including beta-blockers, diuretics, antispasmodics, ACE inhibitors (angiotensin-converting enzyme inhibitors), and potassium preparations. Among beta-blockers, effective drugs are those that control rapid heartbeat and reduce peripheral vascular resistance. These drugs are also effective in diagnosed bradycardia when the heart rate is reduced. Angiotensin-converting enzyme inhibitors may neutralize the increase in renin production, which increases blood pressure. These drugs activate the work of the left ventricle, reduce hypertrophy, dilate coronary vessels, thereby helping to normalize peripheral blood flow. Calcium antagonists are designed to block calcium conduits in blood vessel walls, increasing their lumen. Calcium antagonists should only be prescribed by a doctor or cardiologist because all of these drugs can cause swelling, dizziness, and headaches. Choose a group of medications taking into account all possible side effects and contraindications. It should also be noted that long-term use of diuretics can lead to a decrease in potassium levels in the body (hypokalemia), so diuretics should be taken with potassium supplements.Stage III hypertension is a serious condition characterized by the body becoming resistant to traditional medications. Therefore, treatment options must be chosen carefully, taking into account all individual characteristics of the patient. Therapeutic complexes include diuretics, most commonly potassium-sparing agents, and may also require the use of peripheral vasodilators. Today's pharmaceutical industry produces many combinations of effective drugs. These drugs are used in patients whose bodies have become accustomed to the monotherapy and have stopped responding, or in patients who have significant contraindications to standard treatments for stage I and stage II hypertension.Severe grade III hypertension also requires monitoring with vasodilators. Vasodilators are increasingly being replaced by alpha-blockers. Combination drugs that combine the properties of alpha and beta blockers may also be effective. This drug, combined with a diuretic, can replace three or even four other less effective medications. ACE inhibitors are prescribed to improve peripheral circulation and control renin levels. The drug, taken three to four times a day in combination with a diuretic, can reduce blood pressure to normal after a week.Degrees I and II hypertension can be treated at home and do not require hospitalization. In rare cases, hospitalization may be required for analytical examination and monitoring of health conditions. Severe hypertension can only be treated in the cardiology department of a hospital; the length of stay depends on the blood pressure status and the performance of the body's organs and systems.

How to prevent high blood pressure?

Unfortunately, high blood pressure, if it has developed, will always be with a person. Prevention in this sense simply involves preventing crisis situations through regular use of prescribed medications, daily blood pressure monitoring, feasible physical activity, and weight loss.However, if a relative has a family history of hypertension but the condition has not yet manifested itself, preventive measures can be taken. The rule is simple - maintain a healthy lifestyle and physical activity, since one of the causes of high blood pressure is lack of physical activity. High blood pressure can also be prevented by eating a normal diet, keeping cholesterol and salty foods to a minimum.High blood pressure is also a bad habit, so if a person does not want to join the ranks of those with high blood pressure, he or she needs to quit smoking and limit alcoholic beverages. In addition, positive emotions and attitudes help to cope with any disease, and hypertension "loves" pessimists. The secret is simple - enjoy life, stay calm, take care of your nerves, and your heart and blood vessels will run "like clockwork" and your stress will, as the proverbial saying goes, "run like an astronaut. "