A person lives as long as his heart beats. The heart "pump" provides blood circulation in the veins. In this regard, there is something like blood pressure. As abbreviated AD. Any deviation from the normal blood pressure level is fatal.
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Risks of developing hypertension
The risk of developing hypertension or arterial hypertension - high blood pressure - consists of a number of factors. Accordingly, the more it is, the more likely a person is hypertensive.
Risk factors for the development of hypertension:
- hereditary predisposition. The risk of getting sick is higher for those who suffer from hypertension among first-degree relatives: father, mother, grandmother, grandfather, brother. The more close relatives have high blood pressure, the greater the risk;
- Age over 35 years;
- stress (stress hypertension) and mental stress. The stress hormone adrenaline increases your heart rate. It immediately constricts blood vessels;
- taking certain medications, for example, oral contraceptives and various dietary supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. The components of tobacco cause spasms of blood vessels - involuntary contraction of their walls. It narrows the blood flow;
- atherosclerosis - blockage of blood vessels with plaques. Total cholesterol in the blood should not exceed 6. 5 mmol/l;
- kidney failure (nephrogenic hypertension);
- endocrinopathy of the adrenal glands, thyroid gland or pituitary gland;
- excessive salt in food. Table salt provokes arterial spasm and retains fluid in the body;
- immobility. Physical inactivity is accompanied by slow metabolism and gradually weakens the body as a whole;
- excess body weight. Each additional kilogram increases blood pressure by 2 millimeters of mercury - mmHg;
- sudden change of weather;
- chronic lack of sleep and other "provocateurs".
Most of the risk factors for the development of hypertension are closely related to each other. Thus, heavy smokers often develop atherosclerotic plaques, and physically inactive and malnourished people quickly gain excess weight. Such combinations of factors significantly increase the risk of pathological abnormalities in the heart.
Depending on the combination of the above factors and the degree of manifestation, as well as the probability of the occurrence of cardiovascular complications in the next decade, 4 types of risk of developing arterial hypertension are distinguished:
- low (risk less than 15%);
- medium (15-20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the appearance of arterial hypertension are also divided into 2 types according to the possibility of their elimination: correctable (correctable) and not. For example, a person can quit smoking, but he is not able to change his generation. The amount of risk is summarized from a number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will significantly increase the risk of developing complications.
Hypertension is quite treatable. Here, a lot depends on the timely diagnosis of the disease, the determination of the patient and the desire to radically change his lifestyle.
Hypertension 1st degree
Arterial hypertension can be primary, i. e. develops independently and is secondary - a complication of another disease. In the latter case, the treatment is comprehensive, because it is necessary not only to normalize the pressure, but also to treat the cause of the accompanying disease.
A pressure reading of 120 for 80 mm Hg is considered normal. This is, as they say, the "ideal" value for astronauts. 120 is called the upper blood pressure or systolic pressure (during the maximum contraction of the walls of the heart muscle). And 80 is the low indicator or the so-called diastolic pressure (at maximum relaxation). Accordingly, hypertension is divided into systolic, diastolic and mixed (systolic-diastolic) depending on the exceeding of the upper or lower indicators.
When the lumen of the blood flow narrows, the heart spends more effort to push blood into the vessels, wears out more quickly and begins to work intermittently. An increase in heart rate - heart rate - has a negative effect on the work of the whole body. The air and nutrients contained in the blood do not have time to enter the cells.
Like any disease, hypertension progresses if left untreated. The appearance of the first hypertensive symptoms occurs with a prehypertensive state - before prehypertension.
The degree of severity depends on the stage of development of the disease:
- "soft" or light;
- middle or border;
- very severe or isolated systolic.
Otherwise, arterial hypertension in the 1st stage is called a mild form of this disease. The upper blood pressure indicator ranges from 140 to 159, and the lower one is 90-99 mm Hg. Violations in the work of the heart occur spasmodically. Attacks are usually unsuccessful. This is a preclinical form of hypertension. Periods of exacerbation are replaced by the complete disappearance of symptoms of the disease. During remission, the patient's blood pressure is normal.
Diagnosis of hypertension is simple: blood pressure measurement using a tonometer. For an accurate diagnosis, the procedure is carried out three times a day in a quiet environment and in a comfortable position.
Even people at low risk of hypertension should have their blood pressure checked regularly. One potentially dangerous factor is enough to keep a closer eye on your heart. It is recommended to buy a home cardiovisor - ECG - electrocardiogram device for those who are prone to heart disease. It is easier to treat any disease at an early stage.
Symptoms of hypertension in the 1st stage
Symptoms of stage 1 hypertension include:
- headache that persists with exercise;
- aching or stabbing pain in the left side of the chest, radiating to the shoulder blade and arm;
- black spots in front of the eyes.
We must not forget that in mild forms of hypertension, all these symptoms appear from time to time. If the pulse quickens after vigorous physical activity or it becomes difficult to fall asleep due to noisy neighbors, you should not panic and consider yourself hypertensive.
During periods of improvement, the patient feels great. Mild hypertension has all the symptoms characteristic of heart failure. More severe degrees of the disease differ only in the persistence of symptoms and the occurrence of complications.
Complications of 1st degree hypertension
Complications include:
- kidney sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most people believe that mild arterial hypertension can be treated ineffectively. However, the risk of complications with the 1st degree is moderate, i. e. about 15%. Due to the narrowing of the lumen, the high pressure in the vessels causes insufficient blood supply to the tissues. Lack of oxygen and nutrients causes the death of individual cells and entire organs. Necrosis begins with local, focal lesions. If left untreated over time, ischemic stroke is inevitable.
Disruption of blood circulation inevitably leads to disruption of metabolism. This has a harmful effect on the respiration and nutrition of any type of cells. Pathological changes are inevitable, for example, sclerosis - replacement by connective tissue. With nephrosclerosis, the walls of the kidney become pathologically denser, and the organ "shrinks". In this regard, the excretory function is disturbed, urea enters the bloodstream.
If the blood vessels constrict, the heart strains to push blood through them. This causes pathological enlargement of the heart muscle. This hypertrophy is called true or working. The volume and mass of the left ventricle increases due to the thickening of its walls. This pathology is otherwise called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows it to tighten even more. Apparently, how can it be dangerous? A "swollen" heart can compress adjacent vessels, and uneven muscle growth can block the outflow from the left ventricle. Cardiac hypertrophy sometimes causes sudden death.
Complications of hypertension of the 1st degree occur extremely rarely. To prevent them, it is enough to minimize the risk of developing arterial hypertension, i. e. to eliminate its preconditions and causes.
Treatment of hypertension in the 1st stage
First, the doctor advises the patient to change his lifestyle. Restful sleep, stress avoidance, purposeful relaxation exercises, special diet, sports, etc. are given to the patient. If these measures are not enough, drug treatment is used.
The cardiologist prescribes the following drugs: sedatives and other antihypertensive drugs.
Medicines are selected strictly individually, because many hypertensive patients have concomitant diseases. The choice of drug depends on the age of the patient and the drugs used.
If it is possible to stop the disease at the initial stage and get rid of it completely, prevention in the future should not be neglected. Its principle is simple - to avoid all risk factors for hypertension. Thanks to a healthy lifestyle, you can even prevent the occurrence of hereditary pathologies.
Hypertension 2 degrees
This is moderate hypertension. Upper blood pressure is 160 - 179 mm Hg, and lower blood pressure is 100 - 109 mm Hg. At this stage of the disease, periods of increased pressure are longer. Blood pressure rarely normalizes.
Benign and malignant arterial hypertension are distinguished depending on the speed of transition of hypertension from one stage to another. Second, the disease progresses so rapidly that it is often fatal. Hypertension is dangerous because the increase in the speed of blood flow through the vessels causes their walls to thicken and the lumen to narrow further.
Symptoms of stage 2 hypertension
Typical symptoms of arterial hypertension appear even in mild forms of the disease.
In the second stage, the following symptoms are added to them:
- sensation of pulsation in the head;
- hyperemia - overflow of blood vessels, for example, redness of the skin;
- microalbuminuria - the presence of albumin proteins in the urine;
- numbness and tingling of the fingers;
- fundus pathologies;
- hypertensive crises - sudden increases in pressure (sometimes 59 units at once);
- appearance or worsening of signs of target organ damage.
Because the kidneys are involved in the pathological process, fatigue, lethargy and swelling appear. A hypertensive attack can be accompanied by vomiting, difficulty in urination and bowel movements, shortness of breath and tears. Sometimes it lasts for several hours. Complications of hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, excessive excitement, trembling hands, unexplained panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, impaired consciousness);
Symptoms of hypertension in the 2nd stage are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of high blood pressure. At this stage, the disease regresses reluctantly and often returns.
Complications of hypertension 2 degree
Complications of the 2nd stage of hypertension include the following diseases: aortic aneurysm - pathological protrusion of its wall.
To target organs, that is. Internal organs affected by hypertension include:
- Hemorrhages occur in various organs due to the fact that the walls of the vessels become more and more thickened, lose their elasticity and become fragile. Increased blood flow easily destroys such vessels. The reverse process occurs with the development of aneurysms. Here, due to increased blood circulation, the walls are stretched and thinned. They are so weak that they tear off easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis - fat deposits in the walls - and thrombosis - their blockage with a blood clot. Bleeding of brain cells leads to oxygen starvation and their death. This phenomenon is called encephalopathy. Ischemia is oxygen starvation of the heart. Angina pectoris is constant chest pain.
Pathological processes associated with the main disease develop in connection with it. Accordingly, if you do not start treatment on time or violate medical prohibitions, there will be more target organs and it will be almost impossible to restore health.
Hypertension is a disability of the 2nd degree
Hypertensive patients are under constant dispensary control and are periodically examined. In addition to daily blood pressure measurement, an ECG is regularly prescribed. In some cases, ultrasound may be required - ultrasound examination of the heart, urine tests, blood tests and other diagnostic procedures. Hypertensive patients with an average form of the disease are less productive than healthy people.
If there is a persistent violation of body functions caused by hypertension, the patient is sent to the office for examination to get a medical-social expertise opinion. Rarely, hypertensive patients are examined at home, in the hospital, or even in absentia. Sometimes an additional exam program is drawn up. Specialists of the Bureau of Medical and Social Expertise for the disabled prepare a mandatory individual rehabilitation program.
To determine the disability group, the expert commission takes into account the following factors, in addition to the degree of hypertension:
- information from the medical history about hypertensive crises;
- working conditions of the patient.
A procedure for creating a disability group is necessary for proper employment. Another question is whether it will be easy to find an employer willing to tolerate the work of an "inferior" employee. If an applicant for employment provides documents confirming his disability, he must be provided with the necessary working conditions in accordance with federal law.
Employers are reluctant to hire people with disabilities because. . . working hours are shortened for them (for groups 1 and 2) while maintaining full wages. In addition, they are forced to take sick leave more often than other workers, and their annual leave has been increased. In this regard, most of the 3rd group of disabled people hide their illness in order to get a well-paid position. Violation of medical prescriptions related to working conditions leads to worsening of the disease over time.
Group 3 disabled people receive cash benefits and are allowed to engage in professional activities with some restrictions:
- strong vibration and noise are contraindicated;
- You cannot work overtime, weekends or night shifts without the consent of the employee;
- Constant physical or psycho-emotional stress is not allowed;
- prohibition of work at high altitude, in hot workshops, near dangerous mechanisms;
- reduction of working time due to high concentration of attention;
- seven-hour workday.
A special case is stage 2 malignant arterial hypertension. Its development is so fast and the patient's condition is serious that the commission assigns him a disability of the 2nd group. This is no longer a task force. For 2nd and 3rd degrees of disability, a medical and social examination is conducted every year. Disabled people from the following categories are exempt from re-examination:
- Men over 60 years of age;
- Women over 55 years old;
- people with irreversible anatomical defects.
Designation of the disability group stems from the need for social protection of hypertensive patients. His ability to work is limited.
Treatment of hypertension in the 2nd stage
At this stage of the disease, it is impossible to do without medication. Tablets are taken regularly, if possible at the same time of day. The patient should not think that just taking medicine is enough to get rid of the disease. If he does this at the same time, for example, while taking fatty foods and alcohol, the positive effect of therapy will quickly disappear. The disease will progress to the next stage, when any treatment will no longer be effective.
Hypertension 3 degrees
Why are doctors worried about blood pressure readings that deviate from the norm, even once? The fact is that when the pressure increases by several units, the risk of developing cardiovascular complications increases by the same percentage. For example, if a person has mild hypertension and blood pressure exceeds 120 mm Hg. 39 units, then there is a very high probability of pathological abnormalities occurring in various organs (39%). Then what about the 3rd degree of the disease, where the deviation is at least 60 units?
Stage 3 hypertension is a severe, chronic form of the disease. Blood pressure rises above 180/110 mm Hg, never falling to the normal 120/80. Pathological changes are irreversible.
Symptoms of hypertension in the 3rd stage
Symptoms of stage 3 hypertension include:
- violation of coordination of movements;
- persistent visual impairment;
- paresis and paralysis due to impaired cerebral circulation;
- long-term hypertensive crises with speech disorder, blurred consciousness and sharp pain in the heart;
- significantly limiting the ability to move independently, communicate and care for oneself.
In severe cases, hypertensive patients can no longer cope without external help, they need constant attention and care. The above symptoms of hypertension indicate that the patient's well-being is getting worse, the disease is spreading to new organ systems, and there are more and more complications.
Complications of 3rd degree hypertension
Complications of 3rd degree hypertension include the following diseases:
- myocardial infarction - the middle muscle layer of the heart;
- cardiac asthma - suffocation attacks;
- peripheral artery damage;
- hypertensive retinopathy affects the retina of the eyes;
- A scotoma ("darkness") defect is a blind spot in the field of vision.
Complications of 3rd degree arterial hypertension are otherwise called associated clinical conditions. When cerebral blood circulation is disturbed, a stroke develops, accompanied by loss of sensation in the limbs and loss of consciousness. Heart failure is a whole complex of heart pathologies. Kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes, nephropathy is inevitable.
The more advanced the disease, the more terrible and severe its consequences. The circulatory system is so important for the life of the body that the slightest deviation in its activity has a powerful destructive effect.
3rd degree hypertensive disability
In severe cases of the disease, group 1 disability is assigned. At this stage, patients are practically unable to work. Sometimes they are recognized as partially able to work and continue to work, but only at home or in special circumstances.
However, even with the most severe degree of disability, the patient must undergo rehabilitation procedures. In this case, this is necessary to prevent death.
Treatment of hypertension in the 3rd stage
As the course of the disease worsens, more and more powerful drugs are prescribed or their list remains the same, but the dosage increases. At this stage of hypertension, the effect of drug treatment is minimal. Chronic hypertensive patients are doomed to take pills for life.
If the disease worsens, surgery may be required. The operation is indicated for certain pathologies of blood vessels and heart. The method of stem cell therapy for the 3rd stage of arterial hypertension is considered innovative.
Hypertension 4 degrees
Some experts also identify the 4th stage of the disease, which is very severe. In most cases, death is imminent. They try to alleviate the patient's suffering as much as possible and provide first aid with every hypertensive crisis. The patient is placed on the floor with his head raised. He is urgently given antihypertensive drugs.
In the absence of treatment, new complications arise. Some of them provoke others, and diseases gradually conquer a person. To stop this destructive process in time, it is enough to at least monitor the dynamics of changes in your blood pressure using an ordinary tonometer.
An example of risk calculation depending on the stage of hypertension
Stages of hypertension Other risk factors, POM or disease BP (mmHg)
| High normal | Level 1 | Level 2 | Level 3 | ||
| GARDEN 130-139 DBP 85-89 |
GARDEN 140-159 DBP 90-99 |
GARDEN 160-179 DBP 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FRs | Low risk (risk 1) |
Low risk (risk 1) | Moderate risk (risk 2) |
High risk (risk 3) |
| 1-2 FR | Low risk (risk 1) |
Moderate risk (risk 1) |
Average / high risk |
High risk (risk 3) |
|
| ≥3 FR | short / medium risk (risk 1) |
Average / high risk |
High risk (risk 3) |
High risk (risk 3) |
|
| Stage II | Without POM, CKD stage 3 or DM organ damage |
Average / high risk |
High risk (risk 3) |
High risk (risk 3) |
High / very tall risk |
| III stage | Defined CVD, CKD stage ≥4 or diabetes with organ damage |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
GB - hypertension
SBP - systolic blood pressure
DBP - diastolic blood pressure
RF is a risk factor
CVD - cardiovascular disease
CKD - chronic kidney disease
DM - diabetes mellitus
POM - target organ damage
Once the risk category is determined, the doctor can determine the factors that can affect its reduction. Among these modifiable features are:
- Obesity (with BMI over 30), as well as central or visceral obesity defined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, severe heart rhythm disorders such as atrial fibrillation, and others can also increase the risk.