Arterial hypertension of degree and stage and risk

Violation of blood pressure provokes malfunctions of the whole organism. Despite the fact that it is completely impossible to recover from this disease, the course of the disease can be made less noticeable and problematic for the patient.

Arterial hypertension is a chronic ailment that is associated with increased pressure inside the vascular walls.

In this case, it is very important to distinguish between rare situations when a person’s blood pressure rises and the real manifestation of this disease.

A one-time increase can occur for various reasons, and often does not recur soon. The cause may be a person’s excitement, hormonal disruptions or trauma.

When wondering what arterial hypertension is, it is necessary to understand the term “hypertension”. This is a temporary increase in blood pressure over 140/90. But hypertension in medicine is called a condition in which a person has consistently high rates. They rarely fall below the indicated numbers on their own.

The negative side of this disease is that not only the cardiovascular system suffers from chronically high pressure. In medicine, there is such a thing as target organs.

The essence of the problem lies in the fact that constantly increased blood pressure has a negative effect on a number of organs – the heart, kidneys, brain and retina. The disease will adversely affect the entire body, but they suffer in the first place.

Even the principle of classification of an ailment depends on which organ was adversely affected.

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Stage of the disease

The disease has various forms, which depend on the principle by which to classify. They may depend on the origin, on the course and on the level of blood pressure. The last form of arterial hypertension is most easily determined, since patients can also find out their pressure at home.

Like other ailments, the development of hypertension has several degrees, which, without the necessary treatment, are only exacerbated. There are norms that help determine the stage of the disease.

It is impossible to draw conclusions after one or two measurements of human pressure, since such an approach can give incorrect indicators.

Do not confuse high blood pressure, which is within normal limits, with how hypertension manifests itself.

A pressure of 120/80 is considered normal for the human body, but pressure up to 129/84 can also be considered normal.

Increased pressure is considered to be 139/89, but it is not classified as the degree of hypertension. Hypertension is considered a pressure that exceeds 140/90.

Table 1. Degrees of Hypertension and Pressure Level

The degree of hypertension
Normal value120/80 to 139/89
1 degree of hypertension140/90 to 159/99
2 degree of hypertension160/100 to 179/109
3 degree of hypertensionFrom 180/110 and above

In addition to the definition of “hypertension” and the classification of the disease according to the degree of development, there is also a division into primary and secondary hypertension.

Primary develops as an independent pathology, and often other problems in the human body in this case are not detected.

If we are talking about secondary hypertension, then it becomes the result of existing diseases in the human body.

First degree

It is considered to be a mild form of the disease, while blood pressure indicators do not exceed 160/100, and seizures are mainly without serious consequences.

Arterial hypertension of the 1st degree is characterized by spasmodic disorders that occur in the work of the heart. Exacerbation periods can hardly be called rare, but due to the minor manifestation and chronic course of the disease, they are easily tolerated by the patient.

An exacerbation alternates with normal indicators, during this period the patient does not feel the symptoms of the disease.

In order to adequately assess the situation, it is necessary to carry out pressure measurements using a tonometer several times a day. This is usually done three times a day in the absence of emotional outbursts or other causes that may affect a short-term change in blood pressure.

Arterial hypertension of the 1st degree has its own symptoms, which often patients may not take seriously. The disease can manifest itself as a headache, heart palpitations or pains on the left side in the sternum. Often patients are confused by the fact that first-degree hypertension is characterized by rarely occurring symptoms.

But even a mild degree of hypertension can have its own complications, which are fraught with serious disorders in the human body. It:

  • microinfarction of the brain;
  • hypertrophy of the heart muscle;
  • nephrosclerosis.

It is a mistake to assume that grade 1 arterial hypertension can pass without a trace if treated with medication. It can be argued that a patient suffering from first-degree hypertension has a risk of developing complications. Statistics indicate approximately 15% of this probability.

When a patient was diagnosed with grade 1 hypertension, the situation is as follows: high pressure can be triggered by narrowed gaps in the vessels, which leads to insufficient nutrition of body tissues.

In the absence of a normal amount of nutrients and oxygen in the cells, necrosis develops. Initially, this process is not noticeable, but over time, necrosis of some organs in the patient’s body, and not just certain cells, can occur.

Lack of treatment provokes an ischemic stroke.

If the patient has high blood pressure, then even grade 1 hypertension gives a very high risk of developing heart problems.

Changing the indicators upwards gives an additional burden on the heart, which, trying to push the blood through the narrow lumens of the vessels, is overstrained.

Everyone knows that with an additional load, the muscles begin to grow, this also happens with heart tissues. It may seem that hypertension of the 1st degree is more likely to reduce the risk, because the heart can pump blood more efficiently, but this is not entirely true.

Cardiomyopathy can compress blood vessels in the immediate vicinity, and even provoke death.

Second degree

In the second degree of arterial hypertension in a patient, the pressure will be at a level of up to 180/110 mm Hg. In this case, patients have much more reasons for concern than with grade 1 hypertension, the risk of complications in which occurs less often.

The second degree of hypertension is characterized by the fact that pressure comes extremely rarely, it can decrease and increase, but not reach acceptable limits.

Usually hypertension of the 1st degree has a risk of passing into the same disease of the 2nd degree, then the appearance of benign or malignant hypertension can be determined.

In patients, vascular insufficiency, pulsation in the head, hyperemia, problems with clarity of vision and hypertensive crises are added to the already familiar symptoms. The problem of the latter is that the pressure can change dramatically by 59 units, which negatively affects the patient’s body. With the second degree of hypertension, complications are possible:

  • brain thrombosis;
  • aortic aneurysm;
  • atherosclerosis;
  • angina pectoris;
  • encephalopathy.

A feature of this degree of development of hypertension is that the target organs are affected. In patients with this diagnosis, hemorrhages in one of the organs are possible.

This is due to the fact that, at a later degree of arterial hypertension, blood vessels lose their former elasticity and can be much more easily destroyed.

There are also serious risks of blood clots on the walls of blood vessels, the clearance of which is already reduced.

Due to serious problems that may occur in the second degree of hypertension, the patient may be disabled. Most often give 3 group.

But this does not mean that it is enough for the patient to measure his pressure several times and show that it exceeds the permissible norm.

The commission takes into account the complications that arose against the background of this disease, collects information about hypertensive crises, as well as about the patient’s working conditions – only after that we can talk about receiving a cash allowance.

The paradox of the situation is that some patients at the first symptoms try to get this help, while others, on the contrary, hide their disease.

Most often this is done by employees who can be fired because of the working conditions that they will be entitled to after this (more sick leave, increase in annual leave).

But we must not forget that in the second degree of hypertension, an additional load can have serious consequences that will rapidly aggravate the disease.

Men over 60 years old, women over 55, as well as patients who have found irreversible defects, are given disability for life.

This means that there will be no need to annually pass a commission to confirm the status.

Third degree

By the pressure of a person, the degree of the disease can be determined. When the indicators begin to reach extremely high indicators – from 180/110 mm Hg, the patient will be diagnosed with a third, severe degree of hypertension.

Complications are very serious, most of them with untimely provision of medical care can be fatal.

It can be a stroke, cardiac asthma, myocardial infarction, renal failure and other diseases.

Assessing the severity of this degree, patients are assigned 1 group of disabilities. Assessing the risk of developing diseases, the patient must undergo rehabilitation. There is no need to talk about the treatment of this degree, but this approach will help to avoid premature death.

Hypertension classification and development risk stratification
cardiovascular complications

Hypertension, hypertension is a chronic pathology. This is the name for the defeat of the cardiovascular system, which develops as a result of a violation of the functions of the central mechanisms of regulation of vascular tone, as well as renal and neurohumoral regulation. Often this disease is accompanied by dysfunctions of the so-called target organs.

These are the most frequently asked questions about hypertension:

  1. What triggers hypertension? The reasons for it can not be listed, you can only talk about provoking factors. There is still no consensus on what triggers the disease. Scientists are seriously considering a version of the viral nature of the disease, in particular, they are talking about cytomegalovirus, the frequency of occurrence of which is very high. But it is clear that low mobility, obesity, poor nutrition, frequent stress, bad habits will increase the risks of developing hypertension. As, unfortunately, their genetic component and advanced age increase.
  2. Why is pressure measured in two numbers? There is a concept of upper / i.e. systolic pressure and lower / i.e. diastolic. Systole is the pressure of the blood on the arterial walls at the time of contraction of the heart muscle, diastole is the pressure on the same walls between contractions. Measuring blood pressure is taken in millimeters of mercury.
  3. What is ideally considered normal pressure? It is possible that one doctor will tell you that there is no such concept at all, you can only talk about working pressure. The other will answer clearly – 120/80 mmHg. Art. And the third will say that he cannot give a monosyllabic answer. The Joint National Committee for the Prevention, Evaluation, Diagnosis and Treatment of Hypertension established clear categories of norm: optimal blood pressure is really 120/80 mmHg. Art., prehypertension is 120-139 / 80-89 mm Hg. Art. But the pressure, for example, 110/70 mm RT. Art. it is not always possible to consider reduced – the stability of indicators, the patient’s well-being at these values ​​and the objective state of his health are important.
  4. What diseases can cause hypertension? Firstly, atherosclerosis – plaques and fat deposits in the arteries, dangerous “clogging” of blood vessels. Secondly, the development of renal pathologies, as well as heart diseases, eye diseases, and stroke, is not ruled out.
  5. How to understand that I have hypertension? Sometimes the disease does not have clear symptoms, but even in this context, the patient understands that something is wrong with him. But he may not attach importance to his malaise, weakness, tinnitus, facial flushing, or dizziness. More than just often, hypertension is detected at a doctor’s appointment, planned or related to a completely different problem.

If the disease is found, the doctor will tell you what diagnostic measures you need to undergo, based on the results they will draw up an individual treatment regimen for you.

In addition to degrees and risks, doctors also distinguish stages of hypertension. There are three of them – first / easy, second / medium, third / heavy.

At the first stage, the pressure does not rise very high, but its level is unstable. When the patient goes to rest, Blood pressure itself can return to normal. But if the disease is fixed by doctors, the increase in pressure will inevitably recur again. A certain percentage of patients do not experience any ailments at this stage.

The first stage is almost always not burdened by complications, it does not affect the work of internal organs – but already at this stage prerequisites are created for that. Pressure rises for a short time, returns to normal without drugs. The disease at this stage is not so difficult to control – proper nutrition, physical education, giving up bad habits, a positive worldview will do the trick. If you are overweight, it’s time to say goodbye to him. For many patients, it is enough to lose excess so that the pressure returns to normal.

The pressure rises and can reach up to 170-180 mm RT. Art. In such patients, headaches and dizziness become more frequent, they complain of heartaches. Signs of damage to target organs are already being recorded: hypertrophy of the left heart ventricle is observed, ischemic manifestations are visible on the ECG. The CNS also noted negative changes – cerebral strokes are not ruled out. An ophthalmologist will detect vascular compression in the fundus. Renal blood flow is reduced, although urine tests may not show this.

Serious treatment is required – only lifestyle correction no longer helps. Mandatory drug therapy, which will be aimed at stabilizing indicators.

Severe stage, since it is already characterized by vascular catastrophes. It depends on how high the pressure rises and how long this indicator lasts. Blood pressure is very high, and spontaneous stabilization is simply not possible. The heart, as a rule, is already affected at this stage, the brain is also under great threat.

This is the most severe stage of hypertension, it is called the advanced form of the disease. At this stage, situations are possible where the pressure cannot be normalized. The patient often needs hospitalization, he should receive therapy constantly.

European Society of Hypertension experts retained the classification of blood pressure levels and the definition of hypertension and recommend that blood pressure be classified as optimal, normal, high normal and grade 1, 2, and 3 are hypertension (recommendation class I, level of evidence C) (Table 1).

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.