Hypertension with predominant heart damage

Diagnosis of the disease focuses on such methods that will help identify the main causes. Based on the results of a general blood test, ultrasound and ECG of internal organs, an x-ray of the heart and blood vessels, MRI, the doctor prescribes an individual treatment, the guideline of which is pressure stabilization.

Typically, treatment is as follows:

  • Recommendations for eliminating stressful situations, proper sleep and rest, a special diet with the exception of fat, salt, sugar.
  • The use of drugs of various mechanisms of influence, which affect the endurance of the heart muscle and vascular tone.
  • Diuretics.
  • Herbal teas with a sedative effect or stronger medicines.

In the modern world, there are many medications aimed at treating hypertensive disease. Medicines not only help reduce pressure, but also protect internal organs from harmful transformations.

The main categories of drugs include the following:

  1. Diuretics.
  2. ACE inhibitors.
  3. Sartans.
  4. Beta blockers.
  5. Calcium channel blockers.

Heart failure is treated with drugs that stabilize the functioning of the heart muscle.

Treatment with diuretics helps to reduce the amount circulating in the blood vessels, which leads to normalization of pressure. As a rule, they are first-line drugs for hypertension.

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ACE inhibitors prevent the formation of a substance called angiotensin-2. This substance is a powerful agent that constricts blood vessels. Drugs in this category contribute to vasodilation, and blood pressure decreases.

Sartans block receptors for angiotensin, as a result of which its vasoconstrictor ability is lost.

Beta-blockers help reduce the frequency of contraction of the heart muscle, as a result, the minute volume of blood flow decreases and blood pressure decreases.

Calcium antagonists dilate peripheral vessels, decrease peripheral vascular resistance and normalize blood pressure.

It is worth noting that only a doctor prescribes treatment with medications, because all drugs have their contraindications and side effects.

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As a rule, the doctor prescribes a comprehensive treatment regimen, which includes several drugs of different mechanisms of exposure.

In some situations, diuretics are prescribed that help to remove excess fluid, and also have the following effects on the patient’s body:

  • Beneficial effect on the filtering renal tubules of the cells.
  • Reduce the volume of fluid inside the vessels.
  • Reduce the sensitivity of arterial walls. Due to this, the walls are not so sensitive to hormones, which can contribute to their narrowing.

Diseases characterized by high blood pressure

After diagnosis, the patient is assigned an individual course of treatment, which will be aimed at stabilizing blood pressure and the work of the heart muscle. For this, the doctor prescribes medication, which include:

  • diuretic drugs;
  • pressure reducing agents;
  • statins against high cholesterol;
  • blockers to lower blood pressure and reduce the amount of oxygen that the heart uses;
  • aspirin against blood clots.

In parallel with the course of drug therapy, it is important to adhere to a therapeutic diet, which should reduce the burden on the heart. The main rules of such a diet are the following items:

  • Limit or completely eliminate salt intake.
  • Replace animal fats with vegetable fats.
  • Fatty foods in the form of meat and fish should be replaced with dietary types.
  • Exclude spicy foods, canned foods and marinades.
  • Stop smoking and drinking.

Treatment involves eliminating the underlying cause of the pathology, getting rid of negative symptoms, improving the functioning of the cardiovascular system and normalizing blood pressure. Medicines are prescribed individually, since there is no specific treatment regimen. Depending on the clinical picture, the cardiologist may prescribe a combination of such drugs as:

  • ACE inhibitors;
  • Diuretics (diuretics);
  • Sedatives (sedatives);
  • Calcium antagonists;
  • Beta blockers.

Depending on the symptoms present, tranquilizers, drugs for arrhythmias/tachycardia, antispasmodics, drugs to normalize sleep, and other medications can be prescribed.

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Any medication is prescribed by the attending physician. Do not self-medicate – it may cost you your life

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Hypertension is characterized by a persistent increase in blood pressure (BP). With the progression of the disease, vision is impaired, the brain, kidneys and other important organs of the human body suffer. Hypertensive disease, in which the heart muscle is predominantly affected, is a form of hypertension.

This is the most serious complication of hypertension, in which the power of the heart decreases, so the blood passes through the cameras more slowly. As a result, the body is not sufficiently saturated with nutrients and oxygen. Hypertensive disease with predominant heart damage has several stages of development:

  1. In the first stage, left ventricular hypertrophy occurs due to an increase in the load on the heart muscle.
  2. The second stage is characterized by the development of diastolic dysfunction (a violation of the ability of the myocardium to completely relax in order to fill up with blood).
  3. In the third stage, systolic dysfunction of the left ventricle occurs (a violation of its contractility).
  4. The fourth stage proceeds with a high probability of developing complications.

Hypertension with predominant heart damage (ICD code: I11) develops mainly against the background of the patient’s psychoemotional state, because stress often acts as a trigger (trigger) to start the pathological process in the arteries. Often, the development of the disease is associated with atherosclerotic changes in the vessels, due to the high level of bad cholesterol in the blood. It accumulates on the walls of arteries, forming plaques that interfere with normal blood flow.

The exact reasons for the development of the disease by doctors have not been established. It is believed that hypertensive disease is due to the action of a combination of several factors, among which:

  • Obesity. Excessive accumulation of adipose tissue in the body accelerates the development of cardiovascular diseases, worsens the effectiveness of antihypertensive drugs (lowering blood pressure).
  • Heart failure. Pathology is characterized by the impossibility of a full blood supply to the body due to a failure of the pumping function of the heart. Reduced blood outflow rate causes high blood pressure.
  • Bad habits. Regular smoking, taking large doses of alcohol or drugs cause a sharp narrowing of the lumen of the vessels with cholesterol plaques, which contributes to the development of hypertensive disease and other cardiovascular diseases.

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Symptoms

In approximately 35% of patients, a hypertensive heart produces no symptoms at all. Patients for a long period may continue to lead a habitual life, until at some point they encounter acute heart pain, which is already accompanied by the third stage of the disease. In other cases, the disease is manifested by the following symptoms:

  • shortness of breath;
  • migraine
  • hyperemia of the face;
  • chills;
  • increased heart rate;
  • anxiety or fear due to increasing pressure in the chest;
  • dizziness;
  • pain in the heart and/or sternum;
  • irregular blood pressure.

Diagnostics

Since at the initial stage of the disease any changes in the heart are advised, the patient is diagnosed with arterial hypertension. Doctors talk about hypertensive heart during the development of the disease, when during examination, arrhythmia or hypertrophy of the left ventricle is clearly expressed. The following diagnostic methods are performed to detect hypertensive disease with heart damage:

  • Physical examination. The doctor performs percussion, palpation and auscultation. On palpation, a pathological cardiac impulse is determined. With percussion, the doctor draws attention to the expansion of the relative and absolute boundaries of the heart, which indicates its hypertrophy. During auscultation, various pathological sounds in the organ are detected.
  • Electrocardiogram of the heart. Using an ECG, the doctor assesses the contractile function of the myocardium, its conductivity and rhythm. By deflecting the axis on the tape, ventricular hypertrophy is diagnosed.
  • Echocardiographic examination of the myocardium. Stagnation in the heart muscle, expansion of the cavities, and the state of the valves are detected.
  • Ultrasound of the carotid arteries and cervical plexus. The intima-media complex (CIM) is evaluated (heterogeneity, surface roughness of arteries, differentiation of layers).

Therapeutic techniques are aimed at correcting the diet and lifestyle (eliminating bad habits, physical inactivity, stress), normalizing blood pressure.

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Additionally, medications are used to treat heart failure. There are no universal therapeutic regimens.

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Treatment is selected individually, taking into account the age of the patient, the values ​​of his blood pressure, disorders of the cardiovascular system.

Diet for hypertension of the heart muscle includes a salt restriction (up to 5 g/day). It is forbidden to eat fatty, spicy, fried foods, pickled products, pastry. A sufficient amount in the diet should include vegetables, grain bread, low-fat varieties of fish, meat, poultry. Each specific menu should be coordinated with the attending physician.

As for drug treatment, at the initial stage of the disease, monotherapy with angiotensin-converting enzyme inhibitors is prescribed. With the further development of hypertension with a predominant damage to the heart muscle, combination therapy is practiced, which includes the following groups of drugs:

  • Diuretics. Reduce the amount of circulated fluid in the body, which leads to a decrease in blood pressure (Furosemide, Hypothiazide, Amyloride).
  • ACE inhibitors. They block the enzyme that forms active angiotensin, which causes a persistent increase in blood pressure (Metiopril, Ramipril, Enam).
  • Sartans. The active substances of the drugs block receptors that contribute to the transformation of inactive angiotensinogen into angiotensin (Losartan, Valsartan, Eprosartan).
  • Calcium antagonists. Decrease the intake of calcium in the cells, affect its intracellular movement, lowering blood pressure (Verapamil, Diltiazem, Amlodipine).
  • Beta blockers. Beta-adrenoreceptors bind, inhibits the effects of catecholamine mediating hormones (Acebutolol, Pindolol, Bisoprolol) on them.

Treatment

Hypertension and Complications

Hypertensive heart disease is the cause of the following complications:

  • kidney failure;
  • heart failure;
  • cerebrovascular insufficiency;
  • coronary artery damage (myocardial infarction);
  • ischemic and hemorrhagic stroke;
  • hemorrhage;
  • aortic aneurysm;
  • impaired vision.

Heart failure is a condition of the heart in which the pumping function of an organ is disrupted, it does not provide normal blood flow in the body. The wall of the heart loses its elasticity or the heart muscle (myocardium) is weakened. Slowed outflow of blood through the vessels leads to an increase in pressure. The heart is unable to deliver oxygen, nutrients to tissues and organs. Trying to compensate for the flaw, the heart begins to work more intensively, as a result of which it quickly becomes “unusable”.

How is hypertension with heart damage manifested and treated

Hypertensive heart disease is a lesion that occurs due to abnormal blood pressure in the circulatory system. There are left ventricular and right ventricular forms of the disease. This is due to the presence of general hypertension of the arteries or only pulmonary hypertension.

Causes of pathology

Left ventricular hypertensive heart disease will be diagnosed along with arterial hypertension. There is working hypertrophy of the left ventricular myocardium with a deviation from the norm by 1,2 cm.

The concentric, and then the eccentric type of cardiac hypertrophy begins to progress. With a concentric type of hypertrophy, thickening of the left ventricular walls begins, due to which the rhythm of contraction increases, that is, the frequency of the heart rhythm will be increased.

This also increases the ratio of the radius of the left ventricular cavity and its thickness.

However, in any case, the compensatory capabilities of the myocardium will be exhausted, its fatty degeneration will begin to progress, which will contribute to a decrease in the tone of the muscles of the heart in the presence of a cavity expansion of the flabby heart, which is increased in size.

With excessive muscle mass, stretching of the walls of the heart chambers with an increased amount of blood contained, an additional load volume will be created, myocardial hypoxia will increase, the force of its contractions will decrease, due to which there will be left ventricular failure and pulmonary edema, and in chronic course their violent induction will also occur.

In some cases, the only manifestation of hypertensive heart disease for many years is high blood pressure, which makes early diagnosis of the disease difficult.

Complaints of patients who are presented at an early stage of the disease have a rather nonspecific characteristic.

This is fast fatigue, insomnia, a person feels weak and becomes irritable, there is a rapid heartbeat.

Later, a periodic and then almost constant headache begins to appear (most often in the morning), which is localized in the back of the head and intensifies when a horizontal posture is taken, decreases after walking or drinking tea or coffee. Such a headache, which characterizes hypertensive heart disease, is also diagnosed in patients who have blood pressure within normal limits.

The course of hypertensive heart disease is divided into several stages. With this in mind, various clinical classifications have been created, which are based on the dynamics of one or more symptoms of high blood pressure (stages of labile and stable types of hypertension are distinguished), as well as on a set of signs correlated with the appearance and development of complications.

The main task in the treatment of hypertensive heart disease is bringing the blood pressure level to normal, as well as preventing future relapses and preventing the progression of complications. Hypertensive heart disease has a fairly large number of complications. This can be a defeat of the myocardium, ocular retina and even male infertility.

Hypertensive heart disease is treated with the use of various medications. In the case of secondary hypertension, the main cause of the onset of the disease is treated first, and antihypertensive drugs will only need to be used to alleviate the symptoms.

Patients with hypertension present must completely change their lifestyle. In medicine, this treatment is called non-drug therapy. At the initial stage of the disease, carrying out these measures will be enough. Necessary:

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It is worth remembering that only a qualified doctor should deal with the appointment of drug therapy.

Causes of pathology

Diuretics

Heart disease is treated with the following drugs:

  1. Thanks to diuretics, you can eliminate edema and normalize the functioning of blood vessels. Using “Hydrochlorothiazide”, “Indapamide”, “Chlortalidone”, “Veroshpiron”, “Metoclopramide”, “Furosemide” congestion in the circulatory system and kidneys are eliminated, toxins and toxins are removed from the body, blood pressure is normalized.
  2. Using Bisoprolol, Carvedilol, Betaxolol, you can normalize the functioning of the heart.
  3. Thanks to angiotensin-converting enzyme inhibitors, the functioning of blood vessels and their expansion can be improved. The use of Metoprolol, Captopril, Berlipril, Kapoten, Trandolapril, Lisinopril is aimed at restoring the full functioning of the heart and blood vessels.
  4. Reduce the burden on the heart with Amlodipine, Corinfar, Nifedipine, Verapamil and Diltiazem. These drugs are called calcium channel blockers.
  5. Effective angiotensin receptor blockers include: “Losartan”, “Valsartan”, “Telmisartan”, “Mikardis”.

If hypertension arose due to a violation of the regulation of blood pressure by the centers of the brain, then treatment is carried out with the use of “Klofelin”, “Andipal”, “Moxonitex”, “Physiotensa”.

When edema occurs, doctors often prescribe diuretics – diuretics. These include Furosemide. The drug is recommended for edema caused by:

  • pathology of the kidneys;
  • hypertension;
  • cerebral edema;
  • hypercalcemia.

The dose is prescribed by a strictly attending physician. Veroshpiron is a potassium-sparing drug that prevents calcium from leaving the body. Assign for the prevention of edema, as well as:

  • with essential hypertension;
  • cirrhosis of the liver;
  • ascites;
  • nephrotic syndrome;
  • hypomagnesemia;
  • hypokalemia.

And thanks to “Indapamide” you can increase the elasticity of blood vessels. The drug does not harm the general state of health and does not affect the level of glucose in the blood. With the help of the drug, hypertrophy of the left ventricle of the heart is reduced. Assign with hypertension of moderate severity and chronic heart failure.

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Degrees and stages of the disease

The disease varies in degrees and stages:

  1. The first degree is characterized by an increase in blood pressure to 90-100 by 140-160 mm. RT Art.
  2. In the second degree, diastolic indicators, as a rule, are kept at the same level as in the first, and systolic indicators increase to 180 mm. RT Art.
  3. The third degree is characterized by excessively high blood pressure – 120 to 180 mm. RT and above.

Also, the disease is divided into several stages. They are determined by the degree of damage to the heart muscle.

Stage Feature
First (initial)It may be asymptomatic or with minor manifestations (weakness, fatigue, apathy). The heart is affected at this stage, but timely treatment usually brings positive results.
Second (moderate)This stage occurs with damage to the left ventricle of the heart. Symptoms begin to appear in the form of loss of coordination, nausea, headaches (pain is usually localized in the neck and crown).
Third (heavy)The most severe and dangerous stage in which heart failure develops. Most often, the pathology is accompanied by cardiac arrhythmias and regular headaches. The danger lies in the fact that at any time a hypertensive attack can occur. Treatment should be comprehensive and urgent.

Hypertensive disease with predominant heart damage is a progressive disease. Three degrees are distinguished according to the degree of change in blood pressure, three stages are distinguished according to the nature of the violation of the heart.

The first degree of the disease is a moderate increase in blood pressure in the range of 140-160 mm Hg. The boundaries of the lower pressure in this case are from 90 to 100 mm Hg.

The second degree is characterized by an increase in pressure to 180 mmHg, the third – over 180 to 120. Since the violation is accompanied by heart failure, it is possible to increase systolic pressure while maintaining the diastolic index within normal limits. This indicates a violation in the work of the heart muscle.

According to the degree of pathological disorders of the heart, three stages of the disease are distinguished:

  • Stage 1 – there are no violations, or they are insignificant;
  • Stage 2 is accompanied by severe hypertrophy of the left ventricle of the heart;
  • Stage 3 is coronary heart disease and heart failure.

As a rule, at stage 1, moderately elevated blood pressure is noted, which is quite effectively normalized when taking antihypertensive therapy. In the second stage of the disease, pressure often jumps, a high probability of developing a crisis. Antihypertensive therapy may not be effective enough due to left ventricular hypertrophy, so treatment is supplemented by taking medications to normalize heart function.

The third stage of hypertensive heart disease is accompanied by severe hypertension and heart failure. Monotherapy is ineffective, there are frequent crises, accompanied by pain in the heart and a violation of its rhythm.

This stage progresses rapidly and, if the patient neglects treatment, can lead to the development of a fatal heart attack.

Heart failure is accompanied by a violation of blood circulation, that is, a weakening of the pumping function of the muscle. The development of such a violation is due to myocardial weakness, loss of elasticity of the walls of the heart.

Due to the fact that blood flow in arteries and blood vessels decreases, blood pressure increases directly in the heart, which exacerbates the violation of its work. Blood circulation and oxygen supply to the whole body is disturbed, as well as heart nutrition. Due to a lack of oxygen, the heart is forced to work in an accelerated mode, in order to avoid the development of hypoxia of the brain. This further depletes the heart muscle, so over time, hypertension progresses, and the risk of heart attack increases many times.

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With heart failure, a high probability of myocardial infarction

Stages of the development of pathology

All factors directly depend on a person’s lifestyle. No one thinks about the dangers of a particular habit and addiction, but they can adversely affect health.

Hypertensive heart disease is a violation of the cardiovascular system due to the narrowing of the blood arteries and increased pressure.

According to the symptoms and signs, this form of the disease completely repeats hypertension. There is only one difference – in hypertensive heart disease, it is this organ that acts as a target.

According to statistics, this form of the disease occurs in 20% of cases of sustained increase in pressure.

The reasons for the development of the disease are not exactly identified, it is believed that hypertension is due to the action of a combination of factors, among which:

  • obesity;
  • heart failure;
  • stress;
  • bad habits;
  • unbalanced diet.

Doctors believe that heart damage due to high blood pressure is largely due to the patient’s psychoemotional state, and it is stress that acts as a trigger to begin the development of the pathological process in arteries and vessels.

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Among the triggering factors are excessive emotionality and stress.

Often the development of hypertensive disease with predominant heart damage is associated with atherosclerotic changes in the vessels. This is due to the high level of “bad” cholesterol in the blood, which accumulates on the walls of blood vessels, forming plaques that impede normal blood flow.

One of the main and primary causes is heart disease and the vascular system. The second most popular reason is obesity, especially of an increased degree of risk.

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Obesity May Cause Hypertensive Heart Disease

Also, the causes of the development of the disease can be:

  • Excessive consumption of alcoholic beverages;
  • Improper nutrition (a large amount of salt in the diet, fatty, fried and smoked foods);
  • Sedentary lifestyle;
  • Hard work in hazardous work;
  • Frequent stress and nervous strain;
  • Lack of rest and sleep;
  • Atherosclerotic vascular disease;
  • Disorders of the endocrine system.

Also, the cause may be a genetic predisposition, serious hormonal disruptions and disorders in the endocrine system.

Hypertensive disease is dangerous in that it can progress. Given the changes in blood pressure, doctors divided the process of disease development into several degrees. The nature of the disruption of the cardiovascular system is taken into account.

  1. In the first degree of hypertensive (hypertonic) disease with a primary lesion of the heart, the systolic (upper) value of blood pressure moderately increases – within 135-159 mm. Hg. Art., the border of the diastolic (lower) value is from 89 to 99 mm. Hg. Art.
  2. The second stage of the development of the disease, when the pressure can rise to 179 mm. Hg. Art.
  3. The third is over 181 mm. Hg. Art.

There are several stages of hypertensive (hypertensive) disease with predominant heart damage. Namely:

  1. At the first stage, a slight violation occurs.
  2. In the second, pronounced hypertrophy of the left ventricle of the heart can be detected.
  3. The third stage is characterized by the occurrence of coronary heart disease and heart failure.

In hypertensive disease with predominant heart damage (111.9 code according to ICD 10), there are no stagnation phenomena. At the initial stage of the development of the disease, pressure can be normalized with the help of antihypertensive drugs. At the second stage of the disease, the pressure can fluctuate, so health complications often arise.

In some cases, antihypertensive treatment is ineffective. For this reason, therapy is carried out with the use of drugs that normalize the functioning of the heart. At the last stage of the development of the disease, the functioning of the heart is disrupted. In patients, overall health worsens and pain appears in the affected organ.

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.

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