Classification of hypertension

For several years now, doctors have been sounding the alarm: in developed countries that have overcome epidemics, arterial hypertension continues to consistently take the leading place among the causes of death from cardiovascular diseases.It competes with diabetes mellitus in terms of the number of complications and unfavorable prognosis.At the same time, the disease is rapidly rejuvenating.A few decades ago, a 35-year-old stroke patient was considered nonsense.Recently, such a situation will not surprise anyone.

According to the World Health Organization, about a quarter of the world's population suffers from arterial hypertension.Half of people over the age of 65 are hypertensive.

What disease is this?

Hypertension refers to diseases of the cardiovascular system.Its presence causes persistent high blood pressure in the vessels of the systemic circulation.

In itself, pressing on the walls of blood vessels is a necessary, normal process and is necessary for the movement of blood through them.During sleep, the pressure decreases slightly, and during stress or physical activity - on the contrary.

The standard blood pressure for young people (which can vary slightly from person to person) is 120/75 mmHg.Art.For those over forty – 130/80, for those over fifty – 135/84.If the pressure often rises to 140/90, doctors speak of hypertension.

Blood pressure is divided into two types:

1. Systolic.The first, top number shows the force of blood pressure at the moment when the heart contracts and pushes blood through the veins.
2. Diastolic.The second, lower number shows the blood pressure when the heart muscle (myocardium) relaxes.

Arterial hypertension (hypertension) is not called the "silent killer" without reason: it can cause the appearance of various pathologies.The heart and brain are especially affected.In advanced cases, it can even cause heart attack and stroke.

Classification of hypertension

The risks of hypertension are impressive, so scientists have been studying it since the beginning of the last century.During this time, the classification changed more than once, but two directions were formed:

1. When creating classifications according to the stages of development of the disease, doctors thought about the relationship between hypertension and risk factors for the development of hypertension.However, they never fully agreed - the dispute is still ongoing.
2. Identification of disease variants.This approach examines the causes, developmental stages and mechanisms of hypertension.

The article will discuss several classifications proposed by scientists.

With external signs

This is how a German doctor classified the disease.F. Volgard, who looked after the patient, divided the disease into red and pale.In the first case, when the pressure increases, reddening of the face and body is noticeable due to the expansion of capillaries.Red spots often appear.In the second case, a person suffering from the disease experiences vascular spasm with increased pressure, becomes cold and pale.

By origin

Doctors conventionally defined the degrees of hypertension: primary (hypertension) and secondary (symptomatic) hypertension.

The specific reasons for its initial appearance and development have not yet been found.There are three degrees.

Arterial hypertension of the 1st degree is called "mild".Pressure - 140-159 and 90-99 mm Hg.Art.Blood pressure "jumps", sometimes rises, then returns to normal.First-degree hypertension has a borderline subgroup with indicators of 140-149 and 90-94 mm Hg.Art.The probability of a crisis (sharp sudden jumps) is low, if it occurs, it is rare.

But the risk is greater for type 2 hypertension (moderate).Tonometer shows 160-179 and 100-109 mmHg.Art.Secondary hypertension is characterized by a constant increase in blood pressure.

Stage 3 disease (severe) can be life-threatening, especially with comorbidities.This level is characterized by indicators of more than 180 and more than 110 mmHg.Art.

Sometimes a person has problems with only one type of pressure.Then hypertension is called isolation, and there are two variants of hypertension:

1. systolic.The pressure is more than 140 and less than 90 mmHg.Art.;
2. subgroup: border - 140-149 and less than 90 mmHg.Art.In this case, the "upper" pressure creeps up to 140 mmHg.Art.and higher, and "lower" remains normal.Then we talk about the isolated systolic form of hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under 35 years old - 25%).This type of disease is caused by the disease of a certain organ.Often, such symptomatic hypertension appears due to kidney problems.The division into endocrine, neurogenic, renal and hemodynamic forms was proposed by the professor.Doctors still use it today.

Stages of hypertension

In the recent past, arterial hypertension was divided into three stages by experts.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the section reflects the pathologies that have appeared in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease according to the degree.There are three of them, and each of them means a number of changes in digital blood pressure values (they were discussed above).

In some classifications, you can find the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110.When the specialist mentions the 4th degree of the disease, he does not mean the patient's condition, but the digital pressure indicators, because hypertension is the 3rd stage.is also considered heavy.

With chronic high blood pressure, the body cannot cope with stress and bad things start to happen to the organs.Those affected earlier than others are called target organs by doctors.These include the heart and brain, as well as the retina and kidneys.The classification of hypertension into stages is based on the effect on these weak points.

Initially, in the 1st stage of the development of hypertension, the organs are still healthy.Often, people with hypertension do not go to the hospital at first, because they feel tolerable and do not particularly interfere with their lives.Hypertensive crises are not the rule, but the exception.Patients who start hypertension do not ignore their health problems in vain, because at this stage the disease can be controlled most easily.Sometimes the treatment of stage 1 hypertension starts with lifestyle changes rather than medication.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to consult a specialist.Timely treatment will help prevent the development of the "silent killer".

Stage 2 hypertension is characterized by persistent high blood pressure.The heart is the first to give in - the left ventricle begins to grow and "thicken".Some develop defects in the vessels of the retina, along with abnormalities in the work of the heart.Hypertensive patient is stage 2.crises occur more frequently.But the disease is still being treated.If the doctor diagnoses "Hypertension stage 2", his recommendations should be followed especially carefully.Because the disease develops further and begins to threaten life.

When stage 3 hypertension occurs, all target organs present themselves with many complications.Pressure increase in hypertension, stage 3. can be accompanied by heart failure and cardiac asthma attacks.Atherosclerosis, angina pectoris, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is noted when the patient already has fundus hemorrhages, heart attacks, aneurysms, strokes and other diseases.

Symptoms of blood pressure problems

Identifying hypertension in time and understanding how long a person has had it is the number one problem.Many hypertensive patients receive information about the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, being overweight, smoking, frequent stress, high cholesterol levels, a sedentary lifestyle and old age.

Alarm bells ring when you see:

• occasional headache;
• pain in the back of the head "threats" or throbbing in the temples;
• often feels nauseous and dizzy;
• glimmer flickering or flying "black flies" in the eyes;
• everything is covered with annoyance or apathy;
• tingling or numbness in the fingers;
• swelling of the arms, legs and/or face;
• A rapid heartbeat is visible from the sky.

If you know yourself, you should at least measure your blood pressure systematically.But of course it is better to go to the hospital.

Diagnosis of arterial hypertension

If you suspect chronic hypertension, doctors use three diagnostic methods.

The first, simplest method is to measure your blood pressure.

The second is a complete physical examination.It can only be done by a specialist.He conducts palpation and auscultation (analysis of sounds accompanying the work of various organs), percussion (tapping on different parts of the body and drawing conclusions based on sound) and standard examination.

In the third case, the electrocardiograph helps to draw conclusions.

So what awaits you when you come to the hospital with suspected hypertension?

First, the doctor will check your blood pressure using a special device - a tonometer.By the way, in people with an easily excited nervous system, blood pressure numbers can rise even with small emotional shocks.When visiting a doctor, such patients develop the "white coat" syndrome: as soon as the doctor starts measuring blood pressure, it increases.However, the cause of these fluctuations is usually not disease, but stress.Although such a reaction to shock over a long period of time can cause disturbances in the normal functioning of the heart and kidneys.In such impressionable patients, the health care provider will check the blood pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight, body mass index is collected.The specialist looks for evidence of symptomatic hypertension.
• Medical history.Without talking to the patient - nowhere.It is necessary to find out what diseases a person has faced before and whether he currently has any diseases.Risk factors and lifestyle (the presence of bad habits, diet, cholesterol level; the presence or absence of diabetes mellitus), the presence or absence of hypertensive parents are analyzed.
• Physical examination.First, the doctor will listen to the heart using a stethoscope.The task is to determine the presence of noises, changes in tone or extraneous sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about its condition against the background of hypertension.
• Biochemical blood test.It is necessary to study the level of sugar, cholesterol and lipoproteins and understand how a person is prone to atherosclerosis.
• EKG.Electrocardiogram is an integral element of the diagnostic process.It helps to detect irregularities in the heart rhythm.Having the results in hand, we can judge the presence of hypertrophy of the wall of the left side of the heart, which is characteristic of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see the picture of changes and heart defects, evaluate the function and condition of the valves.
• X-ray examination.Doctors perform arteriography and aortography.With their help, specialists study the arterial walls and their lumen to rule out congenital narrowing of the aorta (coarctation) and the presence of atherosclerotic plaques.
• Dopplerography.When arterial hypertension is diagnosed, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, and at the same time helps to determine the intensity of blood flow through veins and arteries.
• Ultrasound of the thyroid gland.Among other information, the doctor needs blood test results to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will be clear whether the thyroid gland plays any role in the development of the disease, and what treatment will be prescribed.
• Ultrasound of the kidneys.These organs and their vessels are very sensitive to hypertension.Research helps to assess their situation.

Treatment methods

Today, there are many ways to treat hypertension.Some have come down to us from ancient times;pharmacists and scientists worked for years to create others.

The most common method is drug treatment.Doctors use several types of drugs to normalize blood pressure.

1. Calcium antagonists are aimed at reducing the heart rate.
2. Diuretics, most commonly thiazide diuretics, work to improve urine production and excretion.
3. Adrenergic drugs.
4. Vasodilators widen blood vessels and thereby correct the condition.

In some cases, a surgical method called ablation is used.This procedure is not easy.A catheter, a device that generates radio waves, is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.After the intervention, the entire length of the vein is affected so that scars do not appear.It is performed under local anesthesia.

Various methods from the past are classified as alternative medicine.This includes foot parks, vinegar lotions and more.

Alternative remedies based on valerian, mother beet, beetroot, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal decoctions for the treatment of arterial hypertension.An example:

Take 1 tbsp.l.motherwort, valerian root and cumin.Mix it up.Pour a spoonful of this mixture into a glass of boiling water and leave it for an hour.Drink the medicine three times a day, 1/3 cup.The course is designed for one month.

There are also monastic teas and homeopathic remedies designed to help with hypertension.But it is better to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if not treated.It is necessary to monitor your health at any age, because the modern rhythm of life often contributes to the development of the disease.Regardless of the stage and degree of hypertension, it can lead to fatal consequences without treatment.