Hypersonic disease is the most common disease in the circulation system around the world. About 30% of the world's population suffer from this disease. In recent years, a major "revival" of this disease has been noticed in more and more young and middle-aged patients.
Hypertension is full of heavy disability complications, often leading to death. At the same time, many rules are followed, and the occurrence and development of the disease can be delayed for years. Everyone should be familiar with the risk factors, their symptoms and treatment principles for the development of hypertension.
What is hypertension
Hypertonic disease or arterial hypertension (synonym: essential hypertension, primary hypertension) - Long-term progression, easy to progress, in clinical state, the main symptoms are long-lasting, prolonged elevation of blood pressure (i. e. , arterial hypertension syndrome).
The standard for arterial hypertension is considered to be a systolic pressure (blood pressure) from above or equal to 140 mm Hg. Art. and/or diastolic blood pressure exceeds 90 mm Hg. Art.
Causes of the disease
Hypersonic disease is considered an idiopathic disease and the direct cause of its occurrence has not been determined.
Among the many theories about the emergence and development of primary hypertension, the classical neurosource theory is the most extensive. This concept considers hypertension as a neurotic state of high neural activity. The initiation mechanism is considered as nerve overpressure (acute or prolonged chronic), which can lead to a violation of the nutritional structures responsible for regulating blood pressure. What is particularly important is emotions that have not been implemented in the sporting sphere, the so-called "unreacted emotions".
Genetic susceptibility is tracked when primary hypertension occurs. In 35-50% of patients with hypertension, the family nature of the disease was observed. A specific gene has not been detected and its defects will cause a continuous increase in blood pressure. The disease may have polygenic inheritance.
Pathogenesis of hypertension
The pathogenesis of primary hypertension is complex and has its own characteristics at different stages. According to neurogenic theory, under the influence of nerve overpressure, the inhibitory effect of the brain's major hemisphere cortex on the subcortical (hypothalamus) nutrition center is reduced, resulting in the activation of the sympathetic nervous system of the embossed (vasoconstriction). Adrenaline emission, increased blood volume of heart ejaculation, arterial stenosis (including kidneys), and increased blood pressure. Spasm of the renal artery activates another powerful compression system - nephroprotein - angiotensin - aldosterone, which makes an important contribution to increased blood pressure. Other vasoconstrictors are also linked over time - antidiuretic hormones, prostate fibers, endothelin, thrombotic boxes. They are contrary to the depression system - vascular prostaglandins, Kallikrein-Kinin and sodium inhibitor systems. Long arterial spasms can lead to invasion of its inner shell (endothelium), reorganizing the walls of blood vessels and helping the development of atherosclerosis.
Risk factors
Risk factors are attributed to signs, and the presence in humans increases the likelihood of developing a disease. The multiple risk factors for major hypertension were divided into two groups - modified and unmodified.
Unmodified risk factors (it is impossible to affect them)
These include:
- Men are young and have a higher incidence of hypertension in the middle than gender among men of women of the same age. The protective effect of estrogen explains the low incidence in women. The prevalence of hypertension in the two representatives over the age of 60 is roughly the same.
- Age (over 50-60 years old) - The prevalence of hypertension increases dramatically in old age;
- Genetics - The presence of basic hypertension in the family increases the risk of disease.
Risk factors for modification (affected)
These include:
- Smoking - Nicotine has a powerful vasoconstrictive effect. Active and passive smoking leads to blood vessel cramps and increased blood pressure;
- Obesity - i. e. , body mass index is higher than 30 kg/m2. Clinical studies have shown that as human body weight increases, the incidence of hypertension increases. Deposition of subcutaneous fat in the waist area (abdominal obesity) is particularly dangerous because it is associated with the extremely high risk of primary hypertension. This is due to stimulation of the sympathetic neuroadrenal system in fat people. A woman’s waist over 80 cm and a man’s waist over 94 cm are serious risk factors for hypertension.
- A sedentary lifestyle (hypoemia) - Inadequate physical exercise can stimulate the development of obesity;
- Receive overdose of cream with food (more than 5 g per day);
- Overdose of alcohol (more than 30 grams of ethanol per day);
- Diet imbalance (high content, excessive saturated fat) - obesity;
- Very stressed.
Arterial hypertension classification
Primary hypertension is classified according to the level of arterial hypertension, the nature of the lesions of the target organ.
Classification of Arterial Hypertension Levels (AG)
Systolic blood pressure category, MM HG. Art. Diastolic blood pressure, mm mercury. Art.
- Arterial Hypertension I Degree 140-159 90-99
- II degree 160-179 Arterial hypertension of 100-109
- Arterial hypertension with a degree of ≥180≥110
Classification by the nature of defeating the target organ
Mishenian organs are called organs that are mainly pathological changes caused by hypertension. For primary hypertension, the targets are the reticular shells of the heart, kidneys, brain, eyes, and blood vessels.
The 3 stages of major hypertension
The three stages of habits that distinguish between major hypertension are:
Phase 1- Characterized due to the lack of changes in the target organ;
Phase 2- Changes in the target organ show no symptoms:
- Heart: Increase in the left ventricle (according to the results of electrocardiogram or cardiac ultrasound);
- vessel:signs of wall thickening, plaques (according to ultrasound, angiography results);
- kidney:Decreased function, microalbuminuria (detection of a small amount of protein in the urine);
- Retina: Stenosis, blood vessel impregnation;
Stage 3- Symptoms of changes in the target organ:
- Heart: ischemic disease, heart failure;
- brain: Instant interference of cerebral blood flow, stroke;
- kidney:renal failure;
- vessel: Obstruction of peripheral blood vessels and delays aortic aneurysm;
- The blink of an eye:Edema, bleeding, exudate.
Symptoms of hypertension
In some cases, the only symptom of basic hypertension has long been an elevated blood pressure. It can be accompanied by nonspecific complaints of hair pain (occurring in the morning, by the type of "high" positioning within the occipital area), irritability, excessive fatigue, sleep disorders, general weakness, dizziness and rapid breathing.
The hyperosmotic crisis is considered a bright sign of the aggravation of the disease (from 1-2 hours to 2-3 days), which is manifested by a sudden increase in blood pressure. They occur in about one-third of patients.
There are two types of crisis in hypertension: first-order (adrenal glands) and second-order (norepinephrine).
First-order hypertension crisis occurs frequently among middle-aged people. The rise of blood pressure occurs at night, accompanied by headaches, coldness, cooling of limbs, anxiety, anxiety, and a rapid heartbeat.
The second-order hypertension crisis is a characteristic of the elderly. Increased blood pressure is accompanied by obvious headaches, impaired visual perception, inhibition, lethargy, nausea, and vomiting.
In clinical situations, long-term experience in hypertension is occupied by the symptoms of target organ diseases: rag pain with angina pectoris, shortness of breath, swelling of heart failure, symptoms of stroke, etc.
Diagnosis of hypertension
To establish a diagnosis of hypertension in a person, it is necessary to determine the continuous elevation of blood pressure and to exclude the presence of other diseases characterized by arterial hypertension syndrome.
Elevated blood pressure is determined using conventional traditional vocabulary - hell is measured by a doctor or the patient himself. An essential condition is to follow the method of measuring blood pressure - after 3-5 minutes of rest in a comfortable environment, sit, rest, shoulders and heart should be at the same level. Blood pressure level above or equal to 140/90 mm Hg. Art. He said he suspected basic hypertension. In complex cases, daily blood pressure monitoring is used.
Diseases accompanied by high blood pressure
In addition to hypertension, there are many diseases that are accompanied by elevated blood pressure: nephropathology (chronic adrenal/glomerular nephritis), vascular hypertension (caused by stenosis of renal arteries, adrenal tumors-adrenal cell tumors, aortic symptoms (contributed) fusion (contributed) attachment (contributed) (adrenal tumor disease) (adrenal disorder) (contributed) dependence (contributed) attachment (contributed) (contributed) relevance (contributed) (contributed) reproduction (contributed) syndrome, disease. To rule out the existence of these pathology, doctors stipulate a comprehensive examination.
Additional examinations are designed to detect the pathology of the target organ. It allows you to clarify the stage of high blood pressure and prescribe appropriate treatments.
Diagnostic measures include:
- ECG: There may be signs of left ventricle (hyperplasia), ischemic changes, acute myocardial infarction.
- X-rays of chest organs: Changes in the heart profile (the manifestation of left ventricular hypertrophy);
- Echocardiography (ultrasound of the heart): can be detected by left ventricular hypertrophy, expansion of the heart cavity, and reduced work;
- Fundus study: stenosis of the retina, dilated veins, in the late stages - bleeding, exudate, swelling;
- Blood test: determine the cholesterol content, indicators of kidney (creatinine, urea);
- Urine analysis: Detected renal function, microalbuminuria and other functions.
Treatment of hypertension
In the treatment of primary hypertension, non-pharmaceutical and drug methods that complement each other have been successfully used.
Non-drug treatment of arterial hypertension
Even if a person receives medication to control blood pressure, they will prescribe to all patients with high blood pressure. These measures eliminate risk factors by modifying established lifestyles and human habits. Scientists have shown that in some cases, non-pharmaceutical treatment is no more than drug treatment.
Main directions:
- Limit the amount of milk salt from food (up to 5-6 grams per day). This means rejecting foods completely, such as sausages, sausages, salted cheeses, canned foods, salted fish. It should also be considered that bread products contain a lot of salt;
- The fight against overweight - People with primary hypertension suggest reducing calorie content in their food diet by limiting their use of fat;
- Limit alcoholic beverages - up to 30 grams of ethanol per day;
- Totally strictly refuse smoking - if necessary, resort to the help of an anesthesiologist;
- Regular physical exercise is moderate, preferably for at least half an hour a day. Events in the fresh air are preferred: jogging, walking at an accelerated speed, riding a bicycle.
Drug treatment for arterial hypertension
Implications for medication.
In order to effectively treat primary hypertension, experts recommend several types of drugs that lower blood pressure and affect different stages of the pathogenesis of the disease.
Main categories of drugs:
- ANGIOTENZINZINZINPRODING enzyme inhibitor-IAC;
- angiotensin receptor-Sartans;
- calcium antagonists;
- diuretics;
- blockers;
- Renin inhibitors;
- Drugs that act in the central (brain);
- alpha receptor blocker.
Combination of drugs for treating arterial hypertension
In the treatment of hypertension, combinations of drugs from various groups are widely used, such as IACD + diuretics, calcium antagonists + IACF, -block + Sartan + diuretics. The modern pharmaceutical industry has produced a large number of ready-made drugs, which greatly simplifies the drugs.
It should be noted that hypertension treatment is performed under the continuous control of a doctor's therapist or cardiologist. The doctor determines the amount of medical measures, the time for prescription medication, dose, etc.
Independent prescriptions for antihypertensive drugs are unacceptable. With the development of malignant hypertension (not suitable for the effects of drugs), hypertension can be treated surgically (stimulating carotene sinus pressure receptors, renal denervation therapy, etc. ).
Prevent hypertension
Primary prevention of hypertension must be performed from an early age. Children, adolescents, and young people should take regular blood pressure measurements. Prevention should affect the risk factors of the disease. Showing children's muscle load, overfeeding, and excessive consumption of salt foods is unacceptable. Secondary prevention aims to prevent the development of the disease. People with high blood pressure are accidentally overloaded at night, overtime, and stressful overload.