Classification of arterial hypertension is a system used to evaluate the severity and stage of development of arterial hypertension.
attention!In the International Classification of Diseases in the Tenth Revision (ICD-10), arterial hypertension of inorganic properties is represented by code i10.
Hypersonic disease: definition, description and cause
About 50% of people suffer from high blood pressure (GB).About half of the high blood pressure is unaware of the pain of the disease.More than 50% of patients with known hypertension have not received treatment or received ineffective medications.The main cause of mortality in adult patients with hypertension is brain or heart infarction.
The prevalence of arterial hypertension increases with age and weight.Men at young age are usually sicker than women.Postmenopausal women suffer from high blood pressure more often than men.
Arterial hypertension can be divided into primary (essential) and secondary (organic).
The vast majority (>90%) of hypertension have primary hypertension, defined as idiopathic.Primary hypertension is diagnosed by excluding organic pathology.
Some risk factors may increase the risk of developing the disease in childhood.In medicine, the modification of disease formation and unmodified factors are distinguished.These include:
- obesity;
- Excess salt, alcohol in the diet;
- Smoking cohabitants (because the patient becomes passive smokers involuntarily, it poses a risk);
- pressure;
- Hypoemia (the patient lacks exercise in life);
- Smoking;
- Circulatory system diseases (small or large circles);
- Old age;
- Low social status.
Secondary (symptomatic) hypertension is due to another disease in dreams - aortic abbreviation or apnea syndrome in aortic sclerosis.Neurogenic, psychological and mature forms are also known.The final form includes ovulation inhibitors and NSAID.Drugs and toxic substances, as well as very high consumption of licorice, may lead to secondary forms of hypertension.Renal hypertension caused by renal artery stenosis and thyroid, pheochromocytoma, Cushing's disease or hyperthyroidism are secondary forms of hypertension.
Another type of arterial hypertension occurs in hypertension in hypertension.Risk factors include the mother's age and multiple pregnancy.Various forms are known, including, for example, gestational hypertension with or without proteinuria.
Pathophysiology
Arterial hypertension occurs due to an increase in peripheral resistance, an increase in cardiac output, or a combination of both.There are several adaptation mechanisms during this process, so blood pressure continues to keep rising levels.To maintain the heart's ejaculation, the heart becomes hypertrophy and can withstand a constant load under pressure.
The kidneys also play an important role in the pathogenesis of hypertension.Although renal blood flow and glomerular filtration rate remain largely constant, sodium excretion also increases.For example, the effect of renin secretion or reabsorption of sodium on pressure is discussed.
symptom
Usually, the symptoms of arterial hypertension are too late.In most cases, the disease is asymptomatic.
High blood pressure is characterized by the following symptoms:
- Headache in the early morning;
- Sleep disorders, dizziness;
- epistaxis;
- tinnitus;
- nonspecific heart disease;
- The heart is trembling.
In the case of secondary hypertension, the symptoms of the underlying disease are increased.Special forms of hypertension are hidden hypertension (SG) and white gown syndrome (SBC).
Using SBC, blood pressure increased by ≥140/90 mm Hg.Art.When taking measurements in the doctor's office.Record normal blood pressure values at home and when monitoring blood pressure.
Using hidden hypertension, the doctor's blood pressure value is within the normal range.House measurement or blood pressure monitoring shows an increase in the value of ≥140/90 mm Hg.Art.This form can be associated with factors such as male and young age, as well as smoking, drinking and stress.
Due to the hypertension crisis, it is necessary to prescribe the correct treatment plan to prevent pathological processes in the organs.Patients with this disease need to cause urgent help or bring it to the clinic on their own.Lack of treatment can threaten the patient's life and lead to irreversible consequences.Progress in blood pressure can be malignant, which will lead to unreasonable risks.If any vascular symptoms occur, it is recommended to see a doctor immediately, as the crisis can lead to lifelong disability.
Classified by degree of hypertension
The stages of arterial hypertension are distinguished by WHO.Increased blood pressure (for example, after body stress) is not considered hypertension.
The high level of blood pressure under low load is called unstable hypertension.The dangerous form of arterial hypertension is associated with diastolic pressure above 120 mm Hg.Art, drops less than 10% at night.
New (2017) Classification of hypertension by stage and degree: the table is as follows.
| Stage AG | Systolic blood pressure in MM HG.Art. | Diastolic blood pressure in MM Hg.Art. |
|---|---|---|
| The best | <120 | <75 |
| Ordinary | 120-125 | 75-79 |
| High normal | 126-129 | 80-85 |
| Stage 1: Starting Hypertension | 130-150 | 85-99 |
| Stage 2: Moderate hypertension | 160-179 | 100-109 |
| Stage 3: Severe hypertension | ≥180 | ≥110 |
| Isolated systolic hypertension | ≥130 | <90 |
Arterial hypertension by degree
Hypertension can be classified according to damage to blood vessels, eyes, heart, and kidneys.According to who has the advice, there are 3 high blood pressure.At first level, there are no clinical signs of organ damage.To a second extent, the target organ is affected and atherosclerosis of the blood vessels is detected.Third level, obvious cardiovascular complications can occur with chest toads, heart and brain heart attacks, and transient ischemic attacks.
The risk of stratification with obvious arterial hypertension determines the possibility of complications.The risks may vary widely depending on the stage of arterial hypertension.
Important!Only doctors can determine the correct diagnosis, namely risk categories, to provide certain types of advice for prevention and treatment.It is not recommended to independently calculate the risk of the unverified scale and try to treat the disease.Treatment for children and teenagers may vary.The doctor chose various treatments based on his medical history.
complication
The problem with arterial hypertension is that it is often undiagnosed or is not well treated.The lack of symptoms forces patients not to seek medical help.This causes complications usually occur in the heart, kidney, central nervous system and blood vessels in the eyes or lower limbs.Often, significant atherosclerosis develops.
Heart and insufficiency and coronary heart disease are important consequences of cardiac hypertension.The heart increases to bear the increased load.The result is a failure in the Levo-room.
Coronary reserves are so limited due to atherosclerosis that a slight increase in cardiac output during stress can also lead to angina, myocardial infarction, or sudden coronary death.
Hypersoporotic nephropathy - kidney damage caused by hypertension.It can occur due to endothelial damage.Years of exposure to hypertension can lead to significant renal severity and final stages of renal failure.
AG can cause transient ischemic attacks (TIA), brain and heart attacks, hyperosmotic mass bleeding, or acute encephalopathy.The risk of stroke can be greatly reduced through antihypertensive treatment.
Typically, hypertonic retinopathy occurs due to the spread of atherosclerosis in the retinal blood vessels.Vascular diseases caused by hypertension are OZPA, aneurysms of abdominal aorta and aortic dissection.
Treatment method
Hypertension treatment begins with non-pharmacological intervention.The main non-pharmacological treatments for the disease:
- According to BMI, weight is reduced to 25 units;
- 从每天<5-6 g NaCl过渡到低盐饮食（建议选择破折号饮食）；
- Refuse to smoke, alcohol;
- Limit caffeine consumption.
If you have hypertension, you also need to limit the use of hypertensive drugs.Patients are advised to receive 3-4 times a week for the end-to-water type training, timid or cycling.
In addition to these general measures, diseases that cause secondary hypertension must also be treated.According to data from the European Hypertension Association, the target value of blood pressure should be > 140/90 mm Hg.Suitable for patients under 80 years of age, > 150/90 mm Hg.- For elderly patients.
Medical therapy begins with a monotherapy that chooses drugs.At values of strong deflection with normal blood pressure values (> 20/10 mm Hg) or with primary treatment, with concomitant disease.
Select Preparation:
- beta blockers;
- ACE inhibitors;
- Thiazide diuretics;
- AT1 receptor antagonist;
- Long-acting calcium blocks.
As a dual combination, you can use diuretics in combination with beta blockers, long-acting calcium antagonists, ACE inhibitors, or AT1 receptor blockers.
Non-methylpyridin type calcium antagonists should not be prescribed with beta blockers as they contribute to the development of bradycardia or ventricular disorders.
Depending on the disease associated with it, no prescription can be prescribed.It is recommended to use diuretics in combination with heart failure.ACE inhibitors can be used in heart failure and diabetic nephropathy.In the case of myocardial insufficiency, beta blockers can also be used.
As for the use of a single drug, factors such as side effects, side effects, individual tolerance and interaction with other drugs used by the patient are added.If the double combination does not provide the desired effect, three combinations can also be performed.