Hypertension is one of the most common cardiovascular diseases. According to WHO, more than 1. 1 billion people suffer from this disease. all around the world. High blood pressure increases the risk of developing other heart diseases. Hypertension is one of the leading causes of death, and the disease is rapidly becoming more common among young people. It occurs not only in older people but also in young people. Below you will learn why it appears, how to recognize it and control it.
What is high blood pressure?
This is a chronic condition in which blood pressure is high. It is recorded as two numbers and the optimal value is 120/80 mmHg. Art. The first number is systolic blood pressure, which occurs when blood is pushed from the left ventricle into the aorta during systole (the contraction of the heart's ventricles). The second number represents diastolic blood pressure when the heart muscle relaxes. Blood pressure increases with physical activity and emotional excitement, but its value will be close to normal at rest. If measured multiple times at different times, systolic blood pressure exceeds 139 mmHg. Art. and/or diastolic blood pressure exceeds 90 mmHg. Art. , was diagnosed with hypertension.
Persistent increases in blood pressure are linked to a number of factors, including being overweight and lacking physical activity, poor diet, bad habits, and high stress levels.
Causes and risk factors
Hypertension can be primary or secondary:
- main (essential)Hypertension is more common - according to various estimates, in 85-95% of cases. Its occurrence is not associated with accompanying diseases, pressure increases under the influence of many factors;
- secondary (symptomatic)Hypertension occurs in 5-15%. In this case, high blood pressure is one of the symptoms that can be related to endocrine disorders, kidney disease and abnormalities of large blood vessels.
When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its appearance is often constant nervous tension. When making a diagnosis, it is important to determine as accurately as possible the cause of hypertension, whether it has secondary causes (the presence of diseases that cause hypertension).
There are several risk factors that increase your risk of developing primary hypertension:
- overweight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drinking alcohol and smoking;
- stress, frequent emotional stress;
- lack of sleep, poor quality, insomnia;
- excess salt;
- improper organization of sleep and rest (including due to irregular or too long working hours);
- changes in hormone levels (in women, may be related to taking birth control pills at the onset of menopause);
- genetic factors (a total of more than 20 genes have been identified that determine a predisposition to hypertension);
- age over 65 years old (the disease can also occur in young people; blood pressure needs to be monitored periodically after age 35);
- poor nutrition (lack of vegetables and fruits in the diet, excess of foods rich in trans fats and saturated fats);
- kidney disease, diabetes and a number of other related medical conditions.
Many of these elements are interconnected and mutually reinforcing. Some of them can be controlled (for example, diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is a simple way to reduce your risk of high blood pressure or improve your health if your blood pressure is already high.
Classify
To classify the disease, two methods are used: by degree and stage. Degrees of hypertension differ in the value of increased blood pressure, the difference between stages is in the course of the disease, in the number and severity of concurrent organic lesions.
First level
Systolic blood pressure - more than 139 and less than 159 mmHg. Art. , and diastolic at 90-99 mm Hg. Art. With elevated values, blood pressure can be normalized by adjusting your lifestyle. To do this, you need to increase physical activity, adjust your diet, give up bad habits and reduce stress levels.
Second level
At the second level, blood pressure values become high and reach 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastole. With such values, the load on the heart increases greatly. The blood supply to the brain is impaired, which can cause headaches, dizziness, and decreased performance. Changes occur at the back of the eye. Hardening of the tissues and blood vessels of the kidneys begins, excretory function is impaired, and kidney failure may develop. The condition of blood vessels worsens. For treatment, you need to change your lifestyle and start taking medication.
Third degree
Systolic blood pressure value above 180 mm Hg. Art. , diastolic - above 110 mm Hg. Art. With hypertension, the load on the heart becomes too high and causes irreversible changes. Blood pressure must be continuously reduced with medication. Without this there is a risk of acute heart failure, arrhythmia, angina, myocardial infarction and other serious conditions. Patients with stage 3 hypertension need to be continuously monitored by a doctor. Continuous use of antihypertensive drugs is necessary.
| Arterial pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Strong | < 130 | < 85 |
| Usually so-called prehypertension | 130–139 | 85–89 |
| 1 - mild hypertension | 140–159 | 90–99 |
| 2 - moderate degree of hypertension | 160–179 | 100–109 |
| 3 - severe hypertension | ≥ 180 | ≥ 110 |
Stages of hypertension
The disease develops gradually. There are three stages in total.
- First stage:moderate hypertension. Blood pressure is unstable and can fluctuate throughout the day. At this stage, the condition of internal organs and the central nervous system remains normal, with no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
- Second stage:severe hypertension. In the second stage, blood pressure increases significantly, health often worsens, and hypertensive attacks become severe. At this stage, changes in internal organs begin due to persistently high blood pressure. Vascular disorders appear and blood supply to the brain decreases. The retinal arteries are narrowed. Hypertrophy of the left ventricle of the heart develops and this increases the risk of serious heart pathologies. Signs of kidney dysfunction appear (increased albumin concentration in urine, increased creatinine concentration in serum)
- Third stage:very severe hypertension. Blood pressure becomes extremely high - above 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastole. Organic lesions increase, heart failure, cerebral thrombosis, aneurysm, renal failure and other serious conditions develop. Severe hypertensive crisis often occurs.
Symptom
Even when blood pressure increases significantly, hypertension may remain asymptomatic for a long time. For this reason, you should have your blood pressure measured periodically (monitoring is especially important for people over 35). You can measure blood pressure with an automatic electronic sphygmomanometer - such devices are sold in pharmacies.
The main symptoms of hypertension include headache, dizziness and head heaviness. These manifestations are related to vasospasm and impaired blood supply to the brain. May cause nosebleeds, tinnitus, decreased vision, and heart rhythm disturbances. In severe hypertension, muscle weakness, chest pain, nausea, vomiting and tremors may occur. Other symptoms include blurred or dark spots before the eyes, difficulty sleeping, palpitations and tinnitus.
As the disease progresses, vision gradually decreases, the sensitivity of the arms or legs may decrease, and in severe cases, paralysis may occur. During times of stress, due to nervous tension or physical activity, symptoms may increase. They often appear in middle-aged and elderly people. The disease will be worse if you are overweight, have bad habits, tend to overeat or have high stress levels.
You should consult a therapist or cardiologist if you have frequent headaches, dizziness, or vision problems, or if your blood pressure is often elevated when you measure your blood pressure yourself.
Diagnose
Usually, diagnosis is carried out in three directions:
- blood pressure.Done over a period of several hours or over 2-3 days to determine the degree of hypertension and its stage;
- determine the cause of the disease.It is important to determine whether hypertension is primary or secondary (caused by other diseases). In the latter case, specific treatment may be required;
- Monitor general health.During the examination, the condition of the heart, cerebral vessels, fundus and kidneys is monitored. Due to high blood pressure, the function of these organs is impaired. When making a diagnosis, it is important to evaluate their condition.
At the first appointment, the doctor will conduct a survey and collect detailed medical history related to the disease. Information will be needed about how long the patient has had high blood pressure, what the blood pressure level is, whether there are symptoms of heart disease, apnea, heavy snoring, and whether the person or their relatives have had a stroke. stroke, peripheral artery disease or not, gout, diabetes, kidney disease. The doctor will certainly ask questions about lifestyle: physical activity, bad habits, diet, taking medications.
For patients with arterial hypertension, the following examinations are performed:
- blood pressure.It is measured several times at rest (physical activity, caffeine consumption, smoking are excluded half an hour before measurement), measurements are taken at different times of the day;
- General examination:measure height, weight, waist circumference, palpate the abdomen, evaluate the pulse of peripheral arteries;
- Urine analysis.Albumin and creatinine levels are important - deviations from normal levels indicate kidney dysfunction and require an ultrasound;
- blood analysisTo monitor the concentration of potassium, creatinine, lipids, renal ultrasound is indicated. Assessment of lipid levels is necessary to control lipid metabolism to eliminate the risk of complications on the cardiovascular system;
- ECGperformed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiovascular, neurological or respiratory examination.
Treatment of hypertension
Arterial hypertension is a disease that cannot be completely cured but can be controlled. Therapy and lifestyle changes can prevent the development of hypertension, reduce the frequency and severity of attacks, and eliminate symptoms. But the most important thing is to minimize risks to the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle adjustments:
- Quit smoking;
- refuse to drink alcohol or significantly limit the amount of alcohol;
- diet: adjusted diet, reduced salt intake (less than 3. 75 g per day), increased vegetable and fruit intake (ideally you need 5 servings per day), whole grains, dairy products, low-fat products and limited calorie intake. If there are no contraindications or kidney disease, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increase physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is reduced to the target value (below 130/80 mmHg) to reduce the risk of complications. With such a decrease, constant monitoring by a doctor is required. A tonometer used for home measurements must be calibrated regularly. For diabetics, pregnant women, the elderly and debilitated people, the use of antihypertensive drugs should be especially cautious.
The following may be used to treat hypertension:
- adrenergic modulator.They reduce sympathetic nervous system activity and lower blood pressure, but can cause drowsiness and coma so are rarely used;
- ACE inhibitor.Reduces peripheral vascular resistance, often prescribed for diabetics;
- angiotensin II receptor blockers.They have similar effects to ACE inhibitors and therefore should not be prescribed with them. Not prescribed during pregnancy;
- beta blockers.Reduces blood pressure by slowing the heart rate;
- Calcium blockers.They reduce total peripheral vascular resistance and may cause reflex tachycardia;
- direct vasodilator.They have a direct effect on blood vessels and are used in severe hypertension;
- diuretic.They reduce plasma volume, reduce blood pressure, but can also cause hyperkalemia.
Important!A therapist or cardiologist should prescribe medication and dosage after examination. Taking medication without a doctor's prescription can be dangerous.
If your doctor prescribes medication, you will need to have regular follow-up exams to evaluate treatment effectiveness and make adjustments. It is important to adjust your lifestyle and restore normal health so that a minimum amount of medication is needed to control the process of hypertension.
Complications may occur
Due to increased blood pressure, the artery walls lose their elasticity and the heart muscle has to work too hard. This increases the risk of angina, acute heart failure and heart attack. Due to reduced blood supply to the brain, transient ischemic attacks and strokes can occur. The severity of hypertension will increase without treatment and lifestyle adjustments: pressure will continue to increase and this will lead to damage to internal organs and deterioration of overall health. Smoking, drinking alcohol, overeating, lack of physical activity and high stress levels accelerate the development of hypertension and make the course of the disease more complicated.
Consequence
If left untreated, arterial hypertension will cause serious consequences. Continuous cerebral vasospasm leads to ischemia and stroke. They are dangerous with severe disability and even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia, and heart failure occur. If left untreated, a heart attack can occur.
The severity of hypertensive attacks is increasing, they become complex, life-threatening and can be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life in the context of hypertension, if not adequately treated and restored to a normal state of health, will decrease sharply, even leading to severe disability.
Forecast
The prognosis is good if the patient is promptly consulted by a doctor and takes measures to control blood pressure as well as factors affecting hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its serious course. Even if you have severe arterial hypertension, you still need treatment and lifestyle adjustments.
Prevent
To prevent high blood pressure, self-monitoring of blood pressure is recommended over the age of 35 or when symptoms of high blood pressure appear. It is important to eliminate the impact of factors that cause hypertension: control your diet, quit smoking and drinking alcohol, reduce stress levels, spend more time on physical activity: saysIn short, have a healthy lifestyle.
Conclusion
Hypertension is a dangerous disease but can be controlled by maintaining normal health and reducing the risk of complications. To do this, it is important to monitor blood pressure levels, control weight, lead a healthy lifestyle and undergo preventive examinations with a therapist or cardiologist.