Hypertension is understood as a chronic disease with a progressive course, a characteristic feature of which is an increase in blood pressure (systolic and diastolic), due to a violation of the central nervous regulation of vascular tone. The term “hypertension” was proposed by G. F. Lang in 1922 and used by G. Bergman in 1924.
The concept of hypertension combines such hypertonic conditions that are primarily not associated with diseases of the kidneys, endocrine organs, with organic lesions of the vessels and central nervous system (A. L. Myasnikov).
In the true sense, hypertension should be distinguished from the so-called symptomatic, or secondary, hypertension, when the increase in blood pressure is only a symptom in various diseases.
Symptomatic hypertension differs from hypertension in etiology, pathogenesis and clinical course and requires completely different measures in relation to prevention and treatment. It is much less common than hypertension. The latter accounts for up to 80% of all hypertonic conditions.
Currently, the following forms of symptomatic hypertension are distinguished (N. A. Ratner).
I. Renal hypertension.
1. Autoimmune – allergic kidney disease.
A. Mostly inflammatory:
- a) diffuse glomerulonephritis (acute, subacute and chronic);
- b) kidney damage with systemic vasculitis; with collagenoses (periarteritis nodosa, systemic lupus erythematosus, scleroderma); with capillarotoxicosis, etc.
- a) renal amyloidosis;
- b) diabetic glomerulosclerosis.
B. Nephropathy of pregnant women (primary, secondary).
2. Infectious interstitial kidney disease (pyelonephritis).
3. Renovascular hypertension – stenosing lesion of the main renal arteries (single and bilateral):
- a) congenital malformations (atresia and hypoplasia of the renal arteries, angiomas and arteriovenous fistulas, aneurysms);
- b) acquired (atherosclerosis, thrombosis, embolism, renal infarction, as well as scars, hematomas, neoplasms, compressing the renal arteries).
4. Urological diseases of the kidneys (usually unilateral):
- a) congenital (abnormalities in the number, position, shape and structure of the kidneys);
- b) acquired (kidney stone disease, tuberculosis, tumors, kidney injuries, etc.).
II. Endocrine hypertension (pheochromocytoma, Cohn’s syndrome, Itsenko-Cushing’s disease; acromegaly).
III. Hypertension due to damage to the large arteries and heart.
A. In case of damage to large arteries:
- a) coarctation of the aorta (regional);
- b) stenotic lesions of the carot >
B. With heart failure.
IV. Centrogenic hypertension – with organic lesions of the central nervous system (encephalitis, tumors, trauma, focal ischemic lesions).
Hypertension is one of the most common diseases and is observed in about 5% of the world’s population. Among men and women, it generally occurs equally often, occurring mainly after the age of 40, but can be observed (and sometimes be transient) in young people and even adolescents (especially males).
Prof. G.I. Burchinsky
“What is hypertension, types of hypertension” – an article from the section Cardiology
Causes and symptoms
There are many reasons for the increase in pressure. An important role in the development of hypertension is played by heredity and regular drinking.
Also provoke an increase in blood pressure can:
- Obesity of varying degrees, overweight.
- Incorrect food.
- Sedentary lifestyle.
- Physical overload.
- Stress, neurosis, depression.
- Age changes.
- Sleep disturbances.
The causes of symptomatic hypertension are various diseases and disorders of certain organs. These include:
Pathologies of the k >
Surgical interventions in the presence of significant lesions can also provoke an increase in blood pressure. Hypertension also develops as a complication after extensive burns.
Over time, in the absence of therapy, the following symptoms occur:
- Throbbing headaches, dizziness.
- Heaviness in the occipital region and orbits.
- The appearance of glare or “flies” in front of the eyes.
- Redness of the skin.
- Numbness or tingling in the limbs.
- Swelling of the face after sleep.
- Chills or sweating.
- Rapid pulse.
Hypertension is also accompanied by memory impairment, decreased mental activity, anxiety, irritability, nervousness and the appearance of loud tinnitus.
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In medicine, two types of hypertension are distinguished (they have some differences):
- Essential. It occurs in almost 90% of patients with hypertension. This is the primary form in which vasoconstriction is observed. As a result, diseases of the eyes, heart muscle, kidneys and brain develop.
- Symptomatic Secondary hypertension, when an increase in pressure occurs against a background of diseases of the internal organs.
By the nature of the course, hypertension is divided into the following types:
- Transitory. Exceeding the normal level of pressure is temporary and does not depend on medication. High blood pressure may occur for several hours or days.
- Stable The pressure is increased constantly and for its normalization the patient needs to take medication.
- Labile. Physical and psycho-emotional overvoltages become provocateurs of increased pressure. To restore normal levels, medications should be taken.
- Crisis. It is characterized by the occurrence of hypertensive crises.
- Malignant. The disease progresses quickly enough, causing serious consequences. Pressure rises to high rates.
Depending on the pressure indicators, hypertension is divided into several degrees, but they do not always correctly reflect the patient’s condition and the severity of the pathology:
- 1 degree. Also called border, at which the pressure is at least 140/90, but not more than 159/99.
- 2 degree. Medium or moderate. Blood pressure indicators range from 160/100 to 179/109.
- 3 degree. Severe, at which the pressure rises above 180/110. They also distinguish very severe, the indicators of which are from 210/120.
Other types of hypertension
What types of pressure do people have? Most of our fellow citizens will answer with confidence that there are two main types of blood pressure, namely systolic and diastolic. In fact, there are many more.
Doctors know such types of blood pressure as:
- systolic, which is characterized by a rise in pressure to maximum values during systole;
- diastolic, which is determined by a decrease in indicators to a minimum during diastole;
- pulse, which is the difference between systolic and diastolic pressure, which gives an estimate of the amplitude of fluctuations in blood pressure throughout the cardiac cycle;
- dynamic average, which is a conditional value, which is an indicator of pressure in the vascular bed without its rise in systole and decrease in diastole, that is, the stable operation of the heart muscle;
- lateral or pressure with which blood acts on the vascular wall;
- the final, which is formed as a result of summation of the potential and kinetic energy of the blood moving along the vascular system;
- shock is the difference between the lateral and the final exponent of a quantity.
High or low blood pressure is a sure sign of the pathological process, but it also happens that such changes are diagnosed in healthy people. For example, Blood pressure can fall in the heat or with a sharp change in meteorological conditions in the region of a person’s residence, and increase after physical labor or intense sports training. Naturally, such phenomena do not cause disturbances in the general state of health and do not provoke the appearance of pathological symptoms.
Notes: * blood pressure value is indicated
for persons aged 20 to 60 years. For persons
younger than 20 years old. Blood pressure 10-20 mm Hg. Art.
lower, and for people over 60 years of age – at 10-15 mm Hg. above the given values.
In a number of his works, the German doctor F. Folgard proposed a classification of hypertension, which is considered to be the first. Folgard, on the basis of the patient’s appearance, divided hypertension into red and pale. A German doctor wrote that in case of hypertension is pale, spasm of small vessels occurs.
In medicine, there are two terms for determining the degree of hypertension (hypertension): “primary” (hypertension) and “secondary” (symptomatic) hypertension.
The exact causes of the onset and development of the disease are not known.
Primary hypertension is divided into 3 degrees.
- I degree – pressure indicators – 140–159 / 90–99 mm Hg. Art. Blood pressure “jumps”, that is, from time to time it can return to normal values, then again rise above the norm. There are no lesions of target organs (heart, eyes, kidneys), hypertensive crises rarely develop.
- II degree is established at a pressure of 160–179 / 100–109 mm Hg. Art. The degree of pressure increase is more significant, and periods of remission occur much less frequently and they are short-lived.
- III degree – pressure level – 180/110 and higher mm RT. Art.
Often, grade II and III hypertension is complicated by atherosclerosis, heart failure, and may also be accompanied by attacks of cardiac asthma and a tendency to pulmonary edema.
It must be remembered that if hypertension is not treated, then its stages will increase. And then the prospects are even darker: if you continue to also be irresponsible with your own health, then the risk of developing a hypertensive crisis increases. In the absence of proper treatment, hypertensive crises can recur, and in some cases lead to a heart attack or stroke.
To diagnose high blood pressure, it is enough to fix the high blood pressure figures three times at different times in a calm environment, observing the condition: on the day of measurement, you can not take any drugs that affect blood pressure, as this can lead to its increase.
It is important to remember that blood pressure rises:
- after taking coffee;
- after smoking;
- after drinking alcohol;
- with a full bladder.
Secondary hypertension makes up about 20% of cases of high blood pressure, and in the age group under 35 years old – 25%, the most common arterial hypertension of renal origin. Renal, endocrine, hemodynamic and neurogenic forms of secondary hypertension are distinguished. This division of symptomatic hypertension into four main groups, developed back in Soviet times by Professor A. L. Myasnikov, is still relevant today.
The most common is renal (renovascular) hypertension, which is caused by damage to the kidneys or arteries that feed the kidneys.
In some cases, the occurrence of renal hypertension is due to the narrowing of one or two arteries from birth (congenital dysplasia of the renal artery). Renal hypertension can also develop as a result of kidney diseases such as pyelonephritis, chronic glomerulonephritis, and renal amyloidosis.
The development of such arterial hypertension mainly depends on how the underlying disease proceeds, how quickly and to what extent blockage of the renal artery occurs. (It should be noted that patients with renal arterial hypertension often feel good.)
Renal arterial hypertension, as a rule, is difficult to treat with antihypertensive drugs.
Let us consider in more detail some diseases that can become the trigger for the development of renal arterial hypertension.
Chronic pyelonephritis. This is an infectious inflammation of the renal pelvis and kidney tissue. This disease is one of the most common factors in increasing blood pressure. All kinds of microbes can cause chronic pyelonephritis, such as Escherichia coli, streptococcus, staphylococcus, etc. These microbes get into the kidneys with blood in case of angina, and lymph in colitis.
In some cases, the cause of chronic pyelonephritis is an ascending infection from the lower urinary tract. Stones in the renal pelvis and ureter, prostatic hypertrophy, compression of the ureter by an enlarged uterus during pregnancy make urine outflow difficult, which also contributes to the development of pyelonephritis.
According to statistics, women often suffer from pyelonephritis. This is explained by the anatomical structure of the urethra, which is straight, short and wide in women, which facilitates the penetration of an ascending infection, especially with inflammation in the female genital organs or irregular hygienic care of the urogenital organs.
Acute pyelonephritis is accompanied by fever, pain, frequent urination, lower back pain. In some cases, the disease proceeds almost imperceptibly: the temperature rises slightly, pain in the lumbar region is weak, urination is frequent. In children, pregnant women and the elderly, acute and especially chronic pyelonephritis can be asymptomatic, and, of course, most often patients do not attach particular importance to unpleasant sensations and do not rush to the doctor for help.
Diffuse glomerulonephritis. Another of the most common kidney diseases, which leads to hypertension, which most often develops after repeated sore throats. The emergence and development of this disease contribute to hypothermia, the common cold, and a deficiency of vitamins in the body. The capillaries of the glomeruli (or glomeruli) of the kidneys are affected by the inflammatory process, protein and red blood cells (red blood cells) enter the urine from the blood. Water and sodium are poorly excreted from the body. A delay in sodium and increased production of vasoconstrictor substances in the kidneys lead to the development of hypertension.
It is caused by a disease of the endocrine glands. This form develops in diseases: thyrotoxicosis, pheochromocytoma, Itsenko-Cushing’s syndrome, hyperthyroidism.
Thyrotoxicosis. Thanks to the thyroid gland, the hormone thyroxine enters the bloodstream. If this hormone is released in excess in the blood, then the metabolism is accelerated, the person’s body temperature rises, he loses weight, becomes irritable, fingers tremble, and eyecup may occur. The heartbeat becomes more frequent, as a result of which more blood is ejected into the vascular system, the systolic blood pressure rises, but the diastolic remains normal.
Thyrotoxicosis can also occur as a result of nervous overstrain or mental trauma.
Pheochromocytoma. Pheochromocytoma is a tumor of the adrenal medulla in which blood pressure rises. Moreover, the pressure rises either in fits or stays high. Typical crises are frequent, accompanied by palpitations, dilated pupils, and pale skin.
Itsenko-Cushing’s syndrome. The characteristic symptoms of the disease are a specific increase in body weight (the face becomes puffy, acquires a moon shape, the body becomes thicker, but the limbs remain thin).
Primary aldesteronism (Conn syndrome). With this disease, aldosterone is released – a hormone that inhibits sodium. Since sodium retention in the kidneys is accompanied by increased excretion of potassium in the urine, a number of symptoms associated with potassium loss develop: palpitations, severe muscle weakness, numbness in various parts of the body, headaches, weakness, and fatigue. The activity of the tubules of the kidneys also worsens, the reabsorption of water decreases, therefore, the amount of urine excreted in patients increases.
With hypertension, headaches, dizziness and sleep disturbances occur, which indicates a violation of blood circulation in the brain. In the absence of medical care, pathology can cause a stroke.
To exclude complications, experts recommend drugs such as Vazobral. Active components help restore metabolism, improve the condition of blood vessels. They also have the effects of oxygen deficiency and have a stimulating effect. Regular use of the drug reduces the risk of heart attacks and strokes.
The basis of treatment for hypertension is compliance with a number of rules. They are recommended for all patients, regardless of the degree, form and stage of development of the pathology. Non-drug therapy includes:
- Exclusion of bad habits. Smoking, taking alcohol, taking drugs negatively affect blood vessels. Over time, they become thinner, blood clots form.
- Weight Loss. One of the reasons for the increase in pressure is obesity and extra pounds. Such patients need to follow a diet and control their weight. In addition, proper nutrition helps to improve the general condition of diabetes.
- A decrease in the amount of salt. According to studies, it was found that reducing the amount of salt consumed to 4 g per day helps to reduce pressure to 6 mm Hg.
- Compliance with the diet. With hypertension, it is important to abandon various fast-food dishes, fried, salted and smoked. The diet should include fruits, vegetables, seafood. Limit should be the use of animal fats.
An important role in maintaining normal pressure is played by an active lifestyle. Patients are recommended to walk 3-4 times a week for 30 minutes. The main condition is not to overload yourself. Daily outdoor walks are also helpful.
The prognosis for hypertension is poor. Most often, the disease causes disability or death.
Among the possible complications are observed:
- Heart attack.
- Hypertensive crisis .
- Erectile disfunction.
- Brain stroke.
- Decreased vision quality.
- Heart muscle disease.
Only with timely contact with a specialist is it possible to slow down or stop the progression of the disease and avoid the development of serious consequences.
For this reason, in the event of the first signs of hypertension, it is necessary to consult a doctor without delaying the next day.
How to get rid of high blood pressure
This can be done in various ways, for example, taking drugs or being treated with alternative methods. In any case, the course of treatment should be prescribed by a doctor.
Hypertension is important to remember that potassium removes fluid from the body that can cause high blood pressure. Potassium is found in large quantities in:
One of the most effective high-pressure foods is garlic. Thanks to it, you can effectively reduce high blood pressure. Doctors recommend using two cloves of garlic daily for prevention.
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