The disease refers to pathologies associated with impaired functioning of the heart and blood vessels. These are one of the most important human organs responsible for all ongoing processes in the body. In addition to the fact that with arterial hypertension the cardiovascular system suffers, depending on the severity of the disease, other organs are also affected – the liver, kidneys, brain and others.
Arterial hypertension can occur secretly, which is why you need to control your pressure yourself
Hypertension is almost always accompanied by any symptoms that worsen the quality of life and provoke the emergence of new pathological processes. The lack of proper treatment most often leads to:
- Hypertensive seizure;
- A stroke or myocardial infarction;
- Serious damage to target organs.
If the pathology is accompanied by severe headaches, then this can subsequently lead to cerebral hemorrhage. With visual impairment, retinal detachment may occur.
If hypertensive syndrome affects the kidneys, then acute renal failure can develop at any time. These are far from all the disorders that can occur against the background of arterial hypertension. Therefore, you should consult a doctor as soon as possible.
Cardiologists call hypertension a “silent killer.” It gives almost no symptoms until it leads to complications, such as a stroke. Remember a simple algorithm of actions that will help to identify the disease in time and take it under control.
People over 40 years old need to measure it at least 1 time per month, regardless of health. If at least once the “upper” pressure is equal to or exceeds 140 mm Hg. Art., and the “lower” – 90 mm RT. Art., you need to see a doctor. A visit to it is necessary, even if one indicator is increased.
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- Confirm the diagnosis
- Rate the risk
- Classification of hypertension
- When is diagnosis needed?
- Stages of Hypertension
- Survey Algorithm
- Prehypertension Treatment
- Non-drug therapy.
- Drug therapy.
- Medical history
- Possible complications and consequences
- High blood pressure: does he have external signs
- What about the head?
- Physical examination
- Diagnosis of target organs
Confirm the diagnosis
Examination by a doctor also includes a measurement of pressure. But, in order to confirm the diagnosis, it is necessary to conduct it not once, but at least three – on different days. If all three times the pressure is higher than normal, hypertension is considered confirmed.
Rate the risk
- conduct ECHO cardiography to assess the condition of the heart;
- determine the level of cholesterol in the blood to understand how pronounced atherosclerosis is;
- check urine for albumin and protein, which indicates problems with the kidneys (they can be the cause of hypertension, and the consequence);
- to assess the level of uric acid in the blood – it is noted that people who have it high are often suffering from hypertension and coronary heart disease;
- donate blood for sugar to see if there is diabetes.
After evaluating these and some other indicators, the doctor will decide how great the threat to health is and give recommendations on the treatment of hypertension. Be sure to follow them – this will allow you to live fully and for a long time.
Classification of hypertension
There are several classifications of hypertension.
The disease can take a benign (slowly progressing) or malignant (rapidly progressing) form.
Depending on the level of diastolic blood pressure, hypertension of the lung (diastolic blood pressure less than 100 mm Hg), moderate (100–115 mm Hg) and severe (more than 115 mm Hg) can be distinguished.
Depending on the level of increase in blood pressure, three degrees of hypertension are distinguished:
- 140–159/90–99 mmHg. st .;
- 160–179/100–109 mmHg. st .;
- more than 180/110 mm RT. Art.
When is diagnosis needed?
A one-time increase in pressure can be a consequence of stress, excessive physical exertion, lack of sleep, alcohol intake and other things. In this case, blood pressure, as a rule, normalizes after eliminating the causes of the change in indicators, and diagnosis is not required. An examination is necessary if:
- High pressure lasts for one to two days and after a good rest does not return to normal;
- Often there are headaches, nausea, dizziness and other negative phenomena;
- Swelling of the extremities or throughout the body appeared, while the pressure is above normal;
- Sudden nosebleeds occurred;
- It often darkens in the eyes and tinnitus appears.
In the case of the occurrence of several manifestations at once, it is better to consult a doctor, as this may already indicate the development of arterial hypertension.
Note. If one of the symptoms appears once, then perhaps this is a temporary phenomenon that does not pose a health hazard, but blood pressure control still does not hurt. It is enough to measure the pressure 1-2 times a day to exclude the development of the disease.
Stages of Hypertension
For the correct diagnosis, doctors need to determine the stage of hypertension in the patient and make an appropriate entry in his medical record. If hypertension is diagnosed late in the patient, i.e.
at the 2nd or 3rd stage, the consequences for his body will be more serious than if the treatment of hypertension began at the first stage of the disease.
Nevertheless, few people with hypertension at the initial stage go to the doctor or at least measure their blood pressure.
This is due to the fact that hypertension in many patients proceeds without pronounced symptoms until the transition to the second or even third stage.
|1||No signs of target organ damage|
|2||There are objective signs of target organ damage, without impairing their functions or subjective symptoms in the patient:|
- Hypertrophy of the left ventricle of the heart (according to electro- and echocardiography, radiography)
- Retinal artery narrowing
- The appearance of protein in the urine or a significant increase in the creatine content in blood plasma (177 μmol/L or 2 mg/dl)
- Myocardial infarction
- Heart failure stage II A-III
- Transient ischemic attack
- Acute hypertensive encephalopathy
- Chronic stage III encephalopathy caused by hypertension
- Vascular dementia (progressive dementia)
- Retinal hemorrhages and exudates with or without optic edema
- plasma creatine gt; 177 μmol/L (2 mg/dl)
- Exfoliating Aortic Aneurysm
In the clinical picture of hypertension, depending on the defeat of target organs and the development of concomitant pathological processes, three stages are distinguished:
- Preclinical, or stage of mild to moderate hypertension.
- Stage of common arterial changes, or severe hypertension.
- Stage changes in target organs, which are caused by changes in arteries and impaired intraorgan blood flow, or very severe hypertension.
Diagnosis is carried out in several stages using various techniques designed to study the condition of the heart, blood vessels, brain and other organs. After passing all the recommended procedures, the doctor decides on the appointment of a particular medication.
Blood pressure endangers target organs, it is they that require special attention in the diagnosis
Sometimes two or three procedures are enough to make an accurate diagnosis, and in some cases several diagnostic methods may be required. In this case, it all depends on the physiological characteristics of the patient and on the severity of the pathology.
The modern medical community does not have an unequivocal opinion regarding the feasibility and necessary volume of therapy for prehypertension. Some experts consider lifestyle changes to be sufficient, while others insist on early prescribing. By analyzing and summarizing the recommendations for the management of patients with elevated normal blood pressure, non-drug and drug treatment principles can be distinguished.
Wellness measures are recommended for all patients who have a persistent increase in pressure greater than 120/80 mm Hg. They are designed to prevent the transition of pre-pathology into a disease, to influence the existing risk factors. The main measures include quitting smoking and alcohol, normalizing body weight, increasing physical activity (aerobic exercise 30 minutes 3-4 times a week). It is important to correct the diet, reduce the intake of salt and fatty foods, increase the proportion of fresh vegetables and fruits, fish.
The use of drugs for prehypertension is usually considered appropriate only if there are concomitant factors, signs of damage to target organs. Medical correction can prevent or significantly delay the development of stable hypertension. It is possible to use monotherapy or combinations of drugs in small doses against the background of regular self-monitoring of blood pressure. The first-stage drugs include inhibitors of the renin-angiotensin-aldosterone system (enalapril, lisinopril), calcium antagonists (amlodipine, nifedipine), thiazide, potassium-sparing diuretics.
Chronic hypertension is a common medical problem of the st century, with which people of different ages turn to specialists in developed countries.
Specialists at the Yusupov hospital diagnose and treat patients with arterial hypertension. The onset of symptoms of hypertension should be the reason for going to the doctor.
Doctors have at their disposal modern methods of treating hypertension. Achieving a positive result in the treatment of hypertension is possible only with an integrated approach and careful observance of the instructions of a specialist.
A timely examination can save your life and health.
With arterial hypertension, a person constantly has high blood pressure. This condition occurs due to spasm of the vessels, as a result of which the blood flow through them is impeded. The diagnosis of arterial hypertension is made by a specialist with a stable increase in systolic pressure above 140 mm RT. Art.
To determine the pressure, at least three measurements must be taken at different times. The patient should be in a calm state and not take medications that lower or increase blood pressure.
The causes of arterial hypertension, specialists cannot establish in 90% of cases. In 10% of cases, the disease can develop as a complication of another disease or as a result of taking medications. The risk of developing hypertension syndrome may increase due to some factors:
- hereditary predisposition;
- age and gender of a person;
- frequent stressful situations;
- high alcohol use;
- excessive salt intake;
- low mobility and obesity;
- kidney disease;
- metabolic disorders;
The classification of hypertension is based on various parameters, one of which is the origin. By origin, the patient can be diagnosed with:
- primary arterial hypertension is caused by many factors, the clarification of which is carried out by specialists all over the world. However, it has been reliably established that the basis of this disease is unfavorable heredity in conjunction with factors acting on it. The vast majority of patients – about 90% – suffer from this type of arterial hypertension. This disease has a second name – essential hypertension;
- secondary arterial hypertension manifests itself in lesions of organs involved in the regulation of blood pressure, so the disease is otherwise called symptomatic arterial hypertension.
With this disease, irreversible changes occur in the body that require immediate treatment. Diagnosis takes place in several stages and includes a specialist examination and collection of materials for diagnosis.
Diagnosis of the patient begins with a measurement of blood pressure, in order to confirm the diagnosis, at least three measurements are required. Upon obtaining high rates, the patient is sent to laboratory and instrumental studies:
- general and clinical analysis of urine;
- biochemical detailed blood test;
- Ultrasound of the heart and internal organs.
The examination scheme is selected by the doctor individually for each patient. If the doctor suggests that the patient has secondary hypertension, the classification of which is extensive, additional studies of organs are carried out, the violation of which could cause arterial hypertension.
During the study of arterial hypertension, specialists developed several classifications on various grounds: etiology, causes of increased pressure, degree of damage to systems and organs, stability and level of pressure, the nature of the development of the disease. Some classifications over time have not lost their relevance: according to the stages and degree of the disease.
Based on the recommendations of the World Health Organization, a classification is developed according to the level of pressure that is of practical importance, the following conditions and degrees of arterial hypertension are distinguished:
- optimal blood pressure is at a level of 120/80 mm RT. st .;
- normal blood pressure does not exceed 120/80 – 129/84 mm RT. st .;
- border blood pressure is in the range 140/90 – 159/99 mm RT. st .;
- hypertension of the 1st degree is diagnosed with a pressure level of 140/90 to 159/99 mm RT. Art. In international practice, risk factors are taken into account when making a diagnosis. So, in a person with these indicators of blood pressure and in the absence of aggravating factors, the diagnosis can be made: arterial hypertension, degree 2, risk 1;
- grade 2 arterial hypertension is characterized by blood pressure in the range 160/100 – 179/109 mm RT. Art. With one or two aggravating factors, there is an arterial hypertension of degree 2 risk 2;
- grade 3 arterial hypertension is observed in a patient with a pressure of 180/110 mm Hg. Art. and higher. Under the action of more than three aggravating factors, arterial hypertension of degree 3 is diagnosed, risk 3. If organ damage is observed, then a diagnosis of arterial hypertension of degree 3 risk 4 is established;
- isolated arterial hypertension is characterized by systolic blood pressure equal to or greater than 140, and diastolic – below 90 mm Hg.
Classification of the disease is important in the diagnosis of hypertension, determining treatment options depending on the degree and stage. So, arterial hypertension of the 1st degree risk 2 and arterial hypertension of the 2nd degree risk 3 suggest various methods of treating hypertension.
Currently, doctors use a classification according to the nature of organ damage, in which 3 stages of arterial hypertension are distinguished:
- arterial hypertension of the 1st stage. At this stage, the patient has an unstable and slight increase in blood pressure, there are no complaints. The functioning of the cardiovascular system is not impaired.
- arterial hypertension 2 stages, in particular 2 degrees, is characterized by an increase in blood pressure. At this stage of the development of the disease, the left ventricle increases, and narrowing of the vessels of the retina of the eye can also be noted.
- arterial hypertension 3 stages. The following patient conditions are characteristic of this stage: angina pectoris, heart failure, heart attack, stroke, renal failure, disturbances in the blood supply to the brain and eyes.
The choice of treatment for hypertension is carried out by specialists on the basis of research data. Methods of treating arterial hypertension are divided into non-drug and drug.
Patients who are diagnosed with mild hypertension, in particular arterial hypertension of 1 degree 1 stage, can be exempted by the doctor from taking special medications. The main method of non-drug treatment is to change the patient’s lifestyle:
- rejection of bad habits;
- weight control;
- regular moderate physical activity. Effective are daily activities such as moderate walking or light weight training;
- stress reduction. During stressful situations, a person may increase pressure, it is possible to lower it through massage, breathing exercises or meditation;
- the inclusion in the diet of foods rich in macro- and micronutrients, and a decrease in salt intake.
Medicines for hypertension are prescribed to patients in the event that non-drug therapy has been ineffective for 3-4 months, and there are also risk factors. So, arterial hypertension 2 risk 3 requires the use of special drugs. The number of drugs is determined by blood pressure and the presence of concomitant diseases.
Modern doctors prescribe drugs for the treatment of hypertension in accordance with one of the strategies: monotherapy or combination therapy. When drawing up a treatment plan, the question of the admissibility of using one drug is most relevant for a specialist.
With monotherapy, a patient with degree I is prescribed one drug at the beginning of the course of treatment. An important factor in the appointment of the drug is its effectiveness in reducing the risk of complications.
Currently, doctors use the most studied drugs belonging to two groups to control blood pressure: thiazide-like and thiazide diuretics, which have a diuretic effect.
Before prescribing diagnostic measures, the doctor must collect complete information about the patient. This will help most accurately build a phased survey plan. Information that may be useful to the doctor is as follows:
- Are there family members with a similar diagnosis to rule out/identify a genetic predisposition.
- When the patient showed the first signs of the disease, with what frequency does blood pressure rise, to what limits, and which drugs were taken.
- What specific symptoms appeared – headache, dizziness, nausea, sexual problems and more. This will help to approximately guess the form and stage of the pathology and to understand what diagnostic measures should be carried out in the first place.
- In what conditions does the patient live and work, how often is he exposed to stress, physical overload, lack of sleep and mental stress. Also important information is what food the patient most often consumes, and what kind of diet.
- If the pathology has arisen in a woman, then the doctor needs to know about the frequency of the menstrual cycle, whether there is a menopause at the moment and whether any contraceptives or other hormonal medications have been taken.
Also, the doctor needs to know the patient’s age, whether there have ever been any cardiac arrhythmias, increased pressure due to weather events, etc.
True and accurate answers will allow the specialist to prescribe effective treatment
Possible complications and consequences
With a prolonged course of hypertension in the absence of treatment or in the case of a malignant form of the disease, the blood vessels of the target organs (brain, heart, eyes, kidneys) are damaged. Unstable blood supply to these organs leads to the development of angina pectoris, cerebrovascular accident, hemorrhagic or ischemic stroke, encephalopathy, pulmonary edema, cardiac asthma, retinal detachment, aortic dissection, vascular dementia, etc.
High blood pressure: does he have external signs
It is generally accepted that red-faced people who are overweight and prone to sweating have high blood pressure. But is everything as simple as we think? The BBC Future correspondent found out that science knows about this, and whether we can rely on this knowledge.
You must have seen more than once some agitated stranger mincing along the street – puffy, roaring and with a red face. This spectacle inevitably makes you think that the unfortunate must suffer from high blood pressure. Maybe looking at him, you even promise yourself more often to appear in the gym.
If we are talking about your friend or colleague, who, moreover, begins to complain of headaches and nosebleeds, then you may be worried that these symptoms would not be harbingers of a heart attack or stroke. But is it really possible to recognize the signs of high blood pressure by simply looking at the person?
A person turns red when blood vessels located close to the skin expand to let in more blood. Sometimes a blush appears on the face suddenly, and a person suddenly becomes hot – for example, from shame or embarrassment.
And sometimes the face turns red gradually – this process takes up to 20 minutes, and its cause can also be embarrassment or heat, cold and great physical exertion. In all these cases, a person’s blood pressure temporarily rises, but the blush caused by cycling uphill, walking in frosty weather or unexpected meeting with a former life partner is not a sign of persistent hypertension.
If facial redness persists, it could be a sign of rosacea, a skin disease associated with chronic inflammation of small blood vessels. High blood pressure can complicate the course of this disease, but people with rosacea are not always hypertensive.
Eccrine sweat glands are found in especially large numbers on the face, as well as on the palms, feet, and armpits. Their work is regulated by the sympathetic nervous system, which is also responsible for the body’s response to the detected danger and for our decision on whether to join the fight or better to run away. Excessive sweating, or hyperhidrosis, can be hereditary or indicate a number of other diseases – but not hypertension.
The body reacts in a certain way, even in cases where a stressful situation does not imply a threat to life. If you rush to the bus in a hurry to get home, or if you have a fight with one of your friends, this can also cause a strong heartbeat and increased pressure. However, once you get home and make peace with a friend, these symptoms quickly disappear.
The relationship between stress and increased pressure is very complex, and if pressure often jumps under the influence of stressful situations, this can contribute to the development of hypertension. But if a person is angry from time to time, this does not betray hypertension in him.
What about the head?
But what about headaches associated with pressure? Previously, doctors thought they were due to hypertension, but recent evidence suggests the opposite is true. When measuring pressure, two indicators are always taken into account.
The upper of them – systolic pressure – is the pressure in the arteries during contraction of the heart muscle. According to the results of scientific studies, it was found that people with high systolic pressure are much less prone to headaches, and those who have a higher difference between the upper and lower indicators (pulse pressure) are also less likely to suffer from headaches. And Brazilian scientists have found that people with high blood pressure are less likely to develop migraines.
By the way, this applies not only to headaches and migraines. Recently, a study was conducted in Norway with more than 17 people – for several years, scientists have observed which of them develop back pain. A third of the participants encountered this problem, but it was noticed that the higher their systolic and pulse pressure, the lower the risk of pain.
This reduced sensitivity to pain as a result of high pressure is called hypalgesia due to hypertension. This phenomenon also makes it possible to understand why some women in late pregnancy cease to have migraines – during this period they naturally increase pressure.
No one knows for sure the mechanism of hypalgesia in hypertension, but according to one version, the compaction of the walls of blood vessels due to increased pressure interferes with the normal activity of nerve endings, and the pain becomes dull.
This does not mean that hypertension is useful, but it seems that some symptoms, including headaches, are more likely a sign of normal, not high blood pressure.
If a headache is not an indicator of high blood pressure, then what about nosebleeds? The research results on this subject are contradictory. So, Austrian scientists found that the patients who were admitted to the emergency department of the Vienna hospital complaining of persistent nosebleeds had indeed a higher pressure than the rest. However, studies conducted in Brazil have not established any connection between these phenomena.
However, these studies were aimed exclusively at people suffering from nosebleeds. But in order to find out whether this problem really indicates high blood pressure, you need to understand how often it occurs among hypertensive patients.
In Greece, a study was conducted among patients admitted to a hospital in an acute condition caused by high blood pressure. It turned out that constant nosebleeds are observed only in 17% of them. Apparently, in some patients, bleeding may be a sign of increased pressure, but in most people this relationship is not observed.
The simplest answer to all these questions is that hypertension can often be asymptomatic – with one important caveat. If the pressure rises sharply to a dangerous level, a person, as a rule, experiences severe anxiety, acute headache and dizziness, he suddenly does not have enough air. These symptoms may indicate a serious health problem and should not be ignored.
However, this is rare. In 90% of cases, the exact cause of hypertension is unknown. The only way to diagnose persistent hypertension is to regularly measure blood pressure. So if at the sight of red-faced, sweaty, and excited friends or strangers you feel a sense of pride in the state of your own vessels, remember: high pressure is not in vain called the “silent killer”.
High blood pressure in women and men characterizes the signs of hypertension, which in recent years has developed at a relatively young age. The disease is dangerous, prone to a chronic course.
In order to exclude secondary hypertension, it is required to timely proceed to intensive care.
It is important to know the main signs of pressure, so that at the first changes in overall health you should immediately contact your doctor or cardiologist.
Arterial hypertension is a vascular disease in which the blood pressure rises above the allowable limit of 140/90 mm Hg. Art. More often, a characteristic ailment progresses in older men, but is also found in young people over the past decade.
After the occurrence of hypertension, it is necessary to control the blood pressure index, since the number of relapses is significantly reduced.
A detailed diagnosis of the disease is carried out by the attending physician in a hospital setting, however, there are symptoms with high pressure, which the patient is difficult to ignore.
With this disease, pronounced violations of blood pressure are observed. Ideally, the normal figure is 120/80 mm. Hg. Art.
Small jumps do not cause increased anxiety for their own health, since they do not indicate the development of serious diseases.
It is possible that this is a consequence of a change in weather (signs of changes in atmospheric pressure), the result of stress and poor mood. Manifestations of hypertension occur if blood pressure exceeds the limits of 140/90 mm RT. Art.
The patient experiences weakness, internal discomfort, after the onset of the disease there are complaints of bouts of headache, which are temporary.
Other initial symptoms of high blood pressure in men and women are presented below:
- decreased performance, increased drowsiness;
- reduced concentration;
- the appearance of flies in the eyes;
- loss of appetite;
- increased sweating;
- nasal bleeding;
- unexpected blanching of the face;
- feeling of anxiety;
- chronic insomnia;
- signs of memory impairment.
High blood pressure in the weaker sex is preceded by hormonal imbalances, therefore, such a health problem more often occurs in the menopause. Dangerous attacks can be caused by diseases of the cardiovascular system, extensive kidney pathologies. The characteristic symptoms of hypertension in women are presented below:
- migraine attacks;
- increased blood pressure;
- angina attacks;
- spasms of blood vessels;
- hot flashes to the face;
- sleep disturbance;
- peripheral edema.
The intensity of the clinical symptoms of hypertension in the stronger sex also reduces the quality of life, and hypotonic crises are observed more often after 40-45 years. Arterial hypertension is caused by kidney disease and not only does not exclude the development of dangerous complications. To avoid this, it is important to know the main signs and manifestations of primary hypertension. It:
- numbness of fingers;
- decreased visual acuity;
- noise in ears;
- nose bleed;
- myocardial pain;
- increased sweating;
- decline in performance.
The outcome depends on the presence of predisposing factors and their number, the presence of associated conditions. In the vast majority of cases, the prognosis remains favorable if prehypertension does not go directly into the disease. Prevention is closely intertwined with non-drug therapy, includes general health measures (correction of diet and body weight, rejection of bad habits, moderate physical activity). Regardless of the presence of complaints, it is recommended that you visit a therapist once a year, undergo a medical examination or a routine medical examination.
Timely correctly selected treatment of hypertension can slow the progression of the disease and prevent the development of complications. In the case of the debut of hypertension at a young age, the rapid progression of the pathological process and the severe course of the disease, the prognosis worsens.
In this case, a complete examination of the patient is carried out with the determination of blood pressure, body temperature and skin condition. Also, during the diagnosis, the doctor palpates (palpates) the thyroid gland, takes measurements of the borders of the heart and conducts a visual examination of the vessels that are visible through the skin.
Physical examination is an integral part of the diagnosis of hypertension
If a physical examination revealed:
- Heart murmur;
- Increased or decreased heart rate;
- Increase in heart size;
- Swelling in the limbs or throughout the body;
- Heart rhythm disorders.
That, most likely, this indicates the development of arterial hypertension or other pathology associated with the cardiovascular system.
This diagnostic measure allows you to determine the condition of the heart. The examination is carried out using special equipment that detects the degree of damage to the heart muscle, determines the heart rate and whether there are violations. An electrocardiogram also helps to identify pathologies associated with thickening of the walls and a change in heart size. The decryption of the data is made by a cardiologist who can make an approximate forecast.
The duration of the electrocardiogram is not more than 10 minutes
Diagnosis of target organs
Since the disease leads to disruption of the target organs, a complete differential diagnosis of arterial hypertension is needed, including an examination:
- Kidney (urinalysis and ultrasound);
- Vessels (dopplerography);
- Thyroid gland (ultrasound).
If these measures are not enough, then the doctor may prescribe an ultrasound of the adrenal glands, a biochemical analysis of urine and blood, as well as consultations of narrow specialists.
Diagnostic methods for hypertension by and large depend on the characteristics of the pathology, the age of the patient and other factors. When diagnosed with arterial hypertension, treatment should be comprehensive and urgent. Therefore, no matter what studies are assigned, they must be completed completely.