High blood pressure is the most common cardiovascular disease, the symptoms of which affect a large proportion of the population after the age of 60 to 65. The diagnosis goes by several names including essential hypertension (AH), arterial hypertension (AH). The disease is chronic, the main task of each patient is to avoid exacerbations and prolong the period of remission (disappearance of symptoms) using drug and non-drug methods.
What is high blood pressure
Arterial hypertension is a steady increase in blood pressure above an acceptable level (from 140/90 mm Hg) under the influence of provoking factors. This diagnosis is called the "silent killer". The pathological process proceeds asymptomatically for a long time, but during an attack it significantly increases the risk of stroke, heart attack and other dangerous diseases. Possible complications of GB can threaten the life of the patient, so the disease mustdiagnosed in a timely manner and treated appropriately.
Hypertensive disease develops as a result of dysfunction of the higher centers of neurohumoral regulation, the kidneys and blood vessels. Without timely treatment, the pathological process leads to organic and functional disorders of the heart, organs of the central nervous system and kidneys. Incorrectly selected therapy can lead to the progression of the disease with increased pain.
Classification of hypertension
In 2003, a uniform classification of high blood pressure according to the severity of the disease was defined. The determining factor in this subdivision is considered the actual indicator of blood pressure, determined by the tonometer in a specific clinical case. Hypertension is also classified according to its origin (primary, secondary), stages (transient, stable, sclerotic) and the degree of risk of cardiovascular pathologies. This classification simplifies the diagnosis and helps to more accurately determine the treatment regimen for each hypertensive patient.
degrees of arterial hypertension
With an increase in blood pressure (BP), there is a suspicion that arterial hypertension is progressing, especially if it is not possible to solve this health problem with non-drug methods. It is important to know that the optimal blood pressure is 120/80 mmHg. Art. , normal - 120-129 mm Hg. Art. (systolic pressure - SBP) and 80-84 mm Hg. Art. (diastolic - DBP), high normal - 130-139 mm. rt. Art. (SAD) and 85-89mm. rt. Art. (DAD). A deviation from these numbers indicates serious pathologies of the body. Doctors distinguish 3 degrees of GB:
- Grade 1 (mild) hypertensive disease is characterized by unstable pressure that ranges from 140/90 to 159/99 mm Hg for several days. Art. The risk of developing hypertensive crisis is minimal, there are no symptoms of organic damage to internal organs and the central nervous system. In order to suppress a painful attack, in addition to taking medication, the patient needs a good rest, the exclusion of stressful situations. Positive emotions, walks in the fresh air are especially useful.
- Arterial hypertension of the second degree develops rapidly. The blood pressure index varies from 160/100 to 179/109 mm Hg. Art. , there are symptoms of hypertensive crisis (cold sweat, goose bumps, flushing of the face). The patient is worried about migraine attacks, dizziness, sleep disturbances, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decrease in blood flow in the organ), increase in blood creatinine, narrowing of the retinal arteries, hypertrophy (increase in size) of the left ventricle, microalbuminuria (detection of protein in urinalysis). ). Normalization of the condition is not possible without medication.
- Grade 3 (severe) hypertensive disease is associated with a sharp decline in visual acuity, poor memory, and attacks of tachycardia (increased heart rate). A hypertensive crisis develops. BP indicator - from 180/110 mm Hg. Art. and higher. Possible complications include hypertensive encephalopathy, cerebral vascular thrombosis and aneurysm (abnormal enlargement of the vessel), left ventricular heart and kidney failure, hemorrhage (bruise), and optic nerve swelling. Pathological changes are irreversible.
Degree of cardiovascular risk
To predict the likelihood of complications from progressive arterial hypertension, the first step is to determine the index of cardiovascular risk. This requires expert advice and complex diagnostics. The degree of hypertension, provoking relapse circumstances (physiological and pathological) are taken into account. Common risk factors are:
- smoking, other bad habits;
- high blood cholesterol;
- sedentary lifestyle;
- obesity, including abdominal (most fat is deposited in the abdomen);
- age (women over 65, men over 55);
- fasting glucose index 5. 6-7. 0 mmol/L;
- impaired glucose tolerance, determined using a special test;
- the presence of diseases of the cardiovascular system in relatives;
- male.
The patient has a high cardiovascular risk if, in addition to high blood pressure, there are chronic comorbidities:
- diabetes mellitus;
- heart failure;
- violation of lipid (fat) metabolism;
- bronchial asthma;
- extensive damage to the retina;
- coronary heart disease;
- renal failure stage 4;
- suffered a stroke;
- cerebrovascular diseases (damage to the vessels of the brain);
- Signs of obliterating diseases of the peripheral arteries of the lower extremities (atherosclerosis);
- Damage to other internal organs.
Such information will help the doctor to predict the clinical outcome of the disease. To determine the indicator of cardiovascular risk for each degree of hypertension, you need to familiarize yourself with the following table:
| General Risk Factors (RFR) | blood pressure | High blood pressure 1 degree risk | Arterial hypertension grade 2, risk | Hypertension grade 3 risk |
|---|---|---|---|---|
| no risk factors | ordinary risk | short | moderate | high |
| 1-2 | short | moderate | medium high | high |
| over 3 | low-moderate | medium high | high | high |
| Damage to other internal organs, stage 3 kidney disease, diabetes mellitus | medium high | high | high | very large |
| CVD, stage 4 chronic kidney disease with other organ involvement or common risk factors | very large | very large | very large | very large |
treatment of high blood pressure
Classification of GB by stages and risks will help to correctly determine the drug therapy regimen, quickly stop a painful attack and increase the period of remission. If primary arterial hypertension (isolated) develops, then subject to medical recommendations, the prognosis is favorable. The secondary form of the disease often occurs with complications.
If the disease is not cured in time, it is difficult to stabilize high blood pressure even with medication. General recommendations from specialists when diagnosing grade 1, 2 or 3 hypertension are given below. . Should be supplemented by taking medications as prescribed by the attending physician:
- Adherence to a therapeutic diet. It is important to reduce portions of table salt and enrich the daily diet with foods containing potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and grains, vegetables).
- rejection of bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, to leave behind a "sedentary" lifestyle and to go for walks in the fresh air.
- weight control. If a patient with arterial hypertension suffers from obesity, it is necessary to abandon fatty, fried and smoked foods and regularly arrange fasting days.
- Physical therapy. To prevent and prolong the remission period of GB, it is recommended to do 30 minutes of moderate-intensity physical exercise five times a week.
- Reception of multivitamin complexes. The composition of such drugs should include potassium, magnesium, iron and other trace elements important for the body.
Medical therapy
Oral medication depends on the degree of hypertension and associated symptoms. The following are the optimal regimens for conservative treatment of arterial hypertension:
- In the mild stage of the disease, the patient is prescribed angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
- If grade 4 arterial hypertension develops, an integrated problem treatment is required that combines several representatives of different pharmacological groups in a conservative treatment scheme. These are the drugs mentioned above in combination with thiazide diuretics.
- With the complicated course of this disease, in addition to the above drugs, doctors recommend taking alpha or beta blockers. The need for this arises when high-dose diuretics are poorly tolerated by a weakened body).