Classification of hypertension

For several years, doctors have been sounding the alarm: in developed countries that have overcome epidemics, arterial hypertension continues to occupy a consistently leading position among the causes of mortality from cardiovascular diseases.In terms of the number of complications and unfavorable prognosis, it competes with diabetes mellitus.At the same time, the disease is becoming younger and younger.A few decades ago, a 35-year-old stroke patient was considered foolish.Lately such a case 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 65 have high blood pressure.

What kind of disease is this?

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

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

Typical blood pressure for young people (may 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 strength of blood pressure when the heart contracts and pushes blood out of the arteries.
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 particularly affected.In advanced cases, it can even lead to heart attack and stroke.

Classification of hypertension

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

1. When creating classifications according to the stages of the development of the disease, doctors thought about the connection between hypertension and risk factors for the development of hypertension.However, they never fully agreed - the debate is still ongoing.
2. Identification of disease variants.The approach delves into the causes of hypertension, its stages and mechanisms of development.

The article will discuss several of the classifications proposed by scientists.

With external signs

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

From origin

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

The specific reasons for the appearance and development of the primary have not yet been found.It has three points.

Arterial hypertension of the 1st degree is called "mild".Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure "jumps", sometimes increases and then returns to normal.Hypertension of the first degree has a borderline subgroup with indicators of 140–149 and 90–94 mm Hg.Art.The probability of seizures (sudden sudden jumps) is small, if they occur they are rare.

But for grade 2 (moderate) hypertension, the risk is greater.The tonometer shows 160–179 and 100–109 mmHg.Art.Hypertension of the second degree is characterized by the fact that the pressure increases continuously.

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

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

1. systolic.The pressure is greater than 140 and less than 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and below 90 mmHg.Art.In this case, the "higher" pressure is 140 mmHg.Art.and higher, while the "bottom" remains normal.Then we are talking about a single systolic form of hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under 35 - in 25%).This type of disease is caused by disease of a specific organ.Most often, such symptomatic hypertension occurs 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 by experts into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects pathologies that appear in the body over the years.

In 1999, scientists decided it would be more accurate to classify the disease by grade.There are three of them and each means a series of changes in the digital blood pressure readings (discussed above).

In some classifications you can find the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist marks the 4th degree of the disease, he means digital pressure indicators, and not the patient's condition, since hypertension is at stage 3. it is also considered severe.

With chronic high blood pressure, the body can't deal with the stress and bad things start happening to the organs.Those affected earlier than others are called target organs by doctors.Along with the heart and brain, these include the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weak points.

In the beginning, in stage 1 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 tolerated and do not interfere much with their lives.Hypertensive crises are the exception rather than the rule.Beginner hypertensive patients ignore health problems in vain, because at this stage the disease is easier to tame.Sometimes treatment for stage 1 hypertension is based more on changing your lifestyle than taking medication.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to contact a specialist.Early treatment will help prevent the progression of the "silent killer".

Stage 2 hypertension is characterized by persistently high blood pressure.The heart is the first to give up - the left ventricle begins to enlarge and "thicken".Some, in addition to abnormalities in heart function, also develop retinal blood vessel defects.A person with hypertension is in stage 2. attacks occur much more often.But the disease is still treatable.If the doctor diagnoses "Stage 2 hypertension", his recommendations should be followed very carefully.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all target organs become known with a host of complications.Pressure increases in hypertension, stage 3. may be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is noted when the patient already has fundus bleeding, heart attack, aneurysms, stroke and other diseases.

Signs of blood pressure problems

Early detection of hypertension and understanding how long a person has had it is the number one problem.Many hypertensive patients learn 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, elevated cholesterol levels, a sedentary lifestyle and old age.

The alarm goes off if you see:

• occasional headache;
• "threat" pain in the back of the head or bangs in the temples.
• you often feel nauseous and dizzy.
• the glow flickers in the eyes or flies "black flies".
• Everything is annoying or covered in apathy.
• fingers tingling or numbness;
• swelling of the hands, feet and/or face.
• a rapid heartbeat appears out of the blue.

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

Diagnosis of arterial hypertension

If chronic hypertension is suspected, doctors use three diagnostic methods.

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

The second is a complete physical examination.It can only be performed by a specialist.Performs palpation and listening (analysis of sounds accompanying the work of various organs), percussion (hitting various parts of the body and drawing conclusions based on sound) and a standard examination.

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

So what awaits you when you arrive at the hospital with suspected high blood pressure?

First, the doctor will check your blood pressure using a special device - a tonometer.Incidentally, in people who have an easily excitable nervous system, blood pressure numbers can rise even with minor emotional upheavals.When visiting a doctor, these patients experience "white coat" syndrome: as soon as the doctor starts measuring the blood pressure, it rises.But the reason for these fluctuations is stress, not disease.Although such a reaction to a shock in the long term can cause disturbances in the normal functioning of the heart and kidneys.In such impressionable patients, the health care provider will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight and body mass index is collected.The specialist looks for evidence of symptomatic hypertension.
• Medical history.No patient interview - nowhere.It is needed to find out what diseases a person has faced in the past and if there are any diseases at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level, diabetes is established), if the parents were hypertensive.
• Physical examination.First, the doctor will listen to the heart using a stethoscope.The task is to detect noises, changes in tones or the presence of extraneous sounds, if any.After this study, it is possible to rule out heart defects and draw preliminary conclusions about his condition in the context of hypertension.
• Biochemical blood test.It is needed to find out the level of sugar, cholesterol and lipoproteins and to understand how prone a person is to atherosclerosis.
• EKG.The electrocardiogram is an integral part of the diagnostic process.It helps to see heart rhythm abnormalities.With the results in hand, we can judge the presence of hypertrophy of the wall of the left side of the heart, typical of arterial hypertension.
• Heart ultrasound.With its help, the doctor can see a picture of changes and heart defects, evaluate the function and condition of the valves.
• x-ray.Doctors perform arteriography and aortography.With their help, specialists study the arterial walls and their lumen to rule out the presence of congenital narrowing of the aorta (joints) and atheromatous plaques.
• Dopplerography.When diagnosing arterial hypertension, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while it helps to determine the intensity of blood flow through the arteries and veins.
• Ultrasound of the thyroid gland.Along with other data, the doctor needs the results of a blood test to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will become clear whether the thyroid gland plays any role in the development of the disease and what treatment should be prescribed.
• Kidney ultrasound.These organs and their vessels are very vulnerable to hypertension.The study helps to assess their situation.

Treatment methods

Today there are many methods for the treatment of hypertension.Some came to us from ancient times.pharmacists and scientists worked to create others for years and years.

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

1. Calcium antagonists aim to reduce the heart rate.
2. Diuretics, most commonly thiazide diuretics, improve urine production and waste.
3. Adrenergic drugs.
4. Vasodilators dilate the blood vessels and thus normalize the condition.

In some cases, a surgical method called ablation is used.This process is not easy.A catheter with a device that generates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is destroyed.To prevent scars from appearing after the intervention, the entire length of the vein is affected.It is performed with local anesthesia.

A variety of methods derived from the past are classified as alternative medicine.This includes foot parks, vinegar lotions and more.

Non-traditional remedies based on valerian, motherwort, beets, lemon, honey and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal teas for treating high blood pressure.Here's an example:

Take 1 tbsp.large.motherwort, valerian root and cumin.Mixture.Pour a tablespoon 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 is also monastery tea meant to help with hypertension and homeopathic remedies.However, it is better to consult a specialist before treatment.

Arterial hypertension is a dangerous disease if left untreated.You need to monitor your health at any age, because the modern pace of life often contributes to the development of the disease.And whatever the stage and degree of hypertension, without treatment it can lead to fatal consequences.