Man is alive as long as his heart beats. The "pump" of the heart ensures the circulation of blood in the vessels. In this regard, there is such a thing as blood pressure. Abbreviation m. X. Any deviations from normal blood pressure levels are fatal.
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Risks of developing hypertension
The risk of developing hypertension or arterial hypertension - high blood pressure - is made up of a number of factors. Accordingly, the more there are, the greater the probability that a person will become hypertensive.
Risk factors for developing hypertension:
- hereditary predisposition. The risk of getting sick is higher for those who have hypertension among first-degree relatives: father, mother, grandmothers, grandfathers, brothers. The more close relatives have high blood pressure, the greater the risk.
- age over 35;
- stress (hypertension) and mental stress. The stress hormone adrenaline increases your heart rate. It immediately tightens the blood vessels.
- taking certain medicines, for example, oral contraceptives and various nutritional supplements (iatrogenic hypertension).
- bad habits: smoking or drinking alcohol. The components of tobacco cause spasms of blood vessels - involuntary contractions of their walls. This restricts blood flow.
- atherosclerosis - blockage of blood vessels with plaques. Total cholesterol should not exceed 6. 5 mmol/l blood.
- kidney failure (nephrogenic hypertension).
- endocrinopathy of the adrenal glands, thyroid gland or pituitary gland;
- too much salt in food. Table salt causes arterial spasm and retains fluid in the body.
- inaction. Physical inactivity is accompanied by slow metabolism - metabolism - and gradually weakens the body as a whole.
- excess body weight. Every extra kilogram increases blood pressure by 2 millimeters of mercury - mmHg.
- sudden change of weather.
- chronic lack of sleep and other "provocateurs".
Most risk factors for developing hypertension are closely interrelated. Thus, heavy smokers in most cases develop atheromatous 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 and degree of manifestation of the above factors, as well as the possibility of cardiovascular complications in the next decade, there are 4 types of risk of arterial hypertension:
- low (risk less than 15%).
- average (from 15 to 20%).
- high (over 20%).
- very high (over 30%).
Risk factors for the occurrence of arterial hypertension are also divided into 2 types based on the possibility of their elimination: correctable (correctable) and non-correctable. For example, a person may well quit smoking, but he is unable to change his background. The level of risk is summarized by a number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will greatly increase the chance of developing complications.
Hypertension is quite treatable. Much here depends on the early diagnosis of the disease, the persistence of the patient and his willingness to radically change his lifestyle.
1st degree hypertension
Arterial hypertension can be primary, i. e. they develop independently, and secondary - be a complication of another disease. In the latter case, the treatment is carried out comprehensively, because it is necessary not only to normalize the pressure, but also to cure the accompanying disease-cause.
A blood pressure reading of 120 per 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is the so-called upper blood pressure or systolic pressure (at the maximum contraction of the heart muscle walls). And 80 is the lowest index or the so-called diastolic pressure (at their maximum relaxation). Accordingly, hypertension is divided into systolic, diastolic and mixed (systolic-diastolic), depending on whether the upper or lower indicators exceed the threshold value.
When the lumen of blood flow narrows, the heart makes more effort to push blood through the vessels, wears out more quickly and begins to work intermittently. An increase in heart rate – heart rate – negatively affects the functioning of the entire body. 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 is preceded by a prehypertensive state - prehypertension.
The degree of severity depends on the stage of development of the disease:
- "soft" or light.
- moderate or borderline;
- very severe or isolated systolic.
Otherwise, stage 1 arterial hypertension is called a mild form of this disease. The upper blood pressure reading ranges from 140 to 159 and the lowest is 90 – 99 mm Hg. Disorders in the functioning of the heart occur spasmodically. Attacks usually pass without consequences. This is a preclinical form of hypertension. Periods of exacerbations alternate with the complete disappearance of the symptoms of the disease. During remission, the patient's blood pressure is normal.
The diagnosis of hypertension is simple: blood pressure measurement with a tonometer. For an accurate diagnosis, the procedure is carried out three times a day in a calm environment and in a relaxed state.
Even people at low risk of developing hypertension should have their blood pressure checked regularly. One potentially dangerous factor is enough to monitor your heart's work more closely. For those who are predisposed to heart disease to a significant degree, it is advisable to buy a cardiopulmonary device - ECG recording device - electrocardiogram at home. Any disease is easier to treat at an early stage.
Symptoms of stage 1 hypertension
Symptoms of stage 1 hypertension include:
- headache that worsens with exercise.
- pain 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 occasionally. If after intense physical activity your pulse quickens or it is difficult to fall asleep because of noisy neighbors, you should not panic and consider yourself hypertensive.
During periods of improvement, the patient feels great. Mild hypertension has all the signs of heart failure. The most severe degrees of the disease differ only in terms of the persistence of symptoms and the appearance of complications.
Complications of grade 1 hypertension
Complications include:
- renal sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most people believe that mild arterial hypertension can be treated without consequences. But the risk of complications with grade 1 is average, i. e. about 15%. The high pressure in the vessels due to the narrowing of their lumen leads to insufficient blood supply to the tissues. The lack of oxygen and nutrients leads to the death of individual cells and entire organs. Necrosis begins with localized, focal lesions. Over time, if left untreated, an ischemic stroke is inevitable.
Circulatory disorders inevitably lead to metabolic disorders. This has a detrimental effect on the respiration and nutrition of cells of any type. Pathological changes are inevitable, for example, hardening - replacement by connective tissue. With nephrosclerosis, the walls of the kidney become pathologically thicker and the organ "shrinks". In this regard, the excretory function is disturbed and urea enters the bloodstream.
If the blood vessels become narrowed, the heart works harder to push blood through them. This leads to pathological enlargement of the heart muscle. This hypertrophy is called true or functional. 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 him to push harder. It seems, how could this be dangerous? An "enlarged" heart can compress adjacent vessels, and uneven muscle growth can block the left ventricular output. Cardiac hypertrophy sometimes leads to sudden death.
Complications from grade 1 hypertension occur extremely rarely. To avoid them, it is enough to minimize the risk of arterial hypertension, i. e. eliminate its conditions and causes.
Treatment of stage 1 hypertension
First, the doctor will advise the patient to change his lifestyle. The patient will be advised to have restful sleep, avoid stress, targeted relaxation exercises, special diet, exercise, etc. If these measures are not enough, drug therapy 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 drugs is influenced by the age of the patient and the drugs he uses.
If it is possible to stop the disease at the initial stage and get rid of it completely, prevention cannot be neglected in the future. Its principle is simple - it is the avoidance of all risk factors for hypertension. Thanks to a healthy lifestyle, you can prevent the appearance of even hereditary pathologies.
Hypertension 2 degrees
This is hypertension in moderate form. Upper blood pressure is 160 - 179 mm Hg and lower blood pressure is 100 - 109 mm Hg. At this stage of the disease, the periods of increased pressure are longer. Blood pressure rarely returns to normal.
Depending on the speed of transition of hypertension from one stage to another, benign and malignant arterial hypertension are distinguished. In the second, the disease progresses so rapidly that it is often fatal. Hypertension is dangerous because the increase in the speed of blood circulation through the vessels leads to thickening of their walls and even greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Typical signs of arterial hypertension appear even in mild forms of the disease.
In the second stage, they are accompanied by the following symptoms:
- throbbing sensation 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 attacks - sudden increases in pressure (sometimes by 59 units at once);
- the appearance or worsening of signs of target organ damage.
Fatigue, lethargy and swelling occur because the kidneys are involved in the pathological process. A hypertensive crisis can be accompanied by vomiting, difficulty urinating and bowel movements, shortness of breath and tears. Sometimes it lasts for several hours. Complications of a hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neuroblastic (increased heart rate, hyperarousal, hand tremors, unmotivated panic, dry mouth).
- edematous (lethargy, swelling of the eyelids, suspension of consciousness).
The symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of hypertension. The disease at this stage reluctantly subsides and often returns.
Complications of grade 2 hypertension
Complications of stage 2 hypertension include the following diseases: aortic aneurysm - pathological protrusion of its wall.
To target organs i. e. Internal organs affected due to hypertension include:
- Bleeding in various organs occurs because the walls of the blood vessels thicken more and more, lose their elasticity and become fragile. Increased blood flow easily damages such vessels. The reverse process occurs with the development of aneurysms. Here the walls are stretched and thinned due to increased blood circulation. They are so weakened that they tear easily.
- An abnormally narrow lumen increases the likelihood of developing atherosclerosis - fatty deposits in the walls - and thrombosis - blocking them with a blood clot. Hemorrhage of brain cells leads to oxygen starvation and their death. This phenomenon is called encephalopathy. Ischemia is the oxygen starvation of the heart. Angina is constant chest pain.
In connection with this, pathological processes related to the underlying disease develop. Consequently, if you do not start treatment in time or violate medical prohibitions, there will be more and more target organs and it will be almost impossible to restore health.
2nd degree hypertensive disability
Hypertensive patients are continuously monitored in the clinic and periodically examined. In addition to daily blood pressure measurements, they are regularly prescribed an EKG. In some cases, ultrasound - an ultrasound examination of the heart, urine tests, blood tests and other diagnostic procedures may be required. Hypertensive patients with a moderate form of the disease are less productive than healthy ones.
If there is a persistent decline in body functions caused by hypertension, the patient is sent to the office for examination to obtain a medical and social examination report. In rare cases, hypertensive patients are examined at home, in a hospital or even in absentia. Sometimes an additional exam schedule is drawn up. For people with disabilities, specialists from the Office of Medical and Social Expertise develop a mandatory program of individual rehabilitation.
To determine the disability group, the expert committee, along with the degree of hypertension, takes into account the following factors:
- information from medical history about hypertensive attacks;
- working conditions of the patient.
The process of setting up a disability group is essential for proper employment. Whether it will be easy to find an employer willing to tolerate the work of an "inferior" worker is another question. If a job applicant submits documents confirming his disability, then, according to federal law, he must be provided with the necessary working conditions.
Employers are reluctant to hire people with disabilities because. . . Working hours for them have been reduced while maintaining full wages (for groups 1 and 2). In addition, they are forced to go on sick leave more often than other workers, while their annual leave has increased. In this regard, most people with group 3 disabilities hide their illnesses in order to get a well-paid position. Violation of medical instructions regarding working conditions leads to worsening of the disease over time.
Disabled people of Group 3 receive cash benefits and are allowed to engage in professional activities with certain restrictions:
- Strong vibrations and noise are contraindicated.
- You may not work overtime, weekends or night shifts without the employee's consent.
- Constant physical or emotional stress is not allowed.
- prohibition of work at high altitudes, in hot shops, near dangerous mechanisms.
- reducing the duration of work that involves a high concentration of attention;
- seven hour workday.
A special case is malignant arterial hypertension stage 2. Its development is so rapid and the patient's condition is serious, that the committee assigns him a group 2 disability. This is no longer a working group. For 2 and 3 degrees of disability, a medical and social examination is carried out annually. Persons with disabilities in the following categories are excluded from the review:
- men over 60;
- women over 55;
- people with irreversible anatomical defects.
The disability group assignment is caused by the need for social protection of hypertensive patients. His ability to engage in work activity is limited.
Treatment of stage 2 hypertension
At this stage of the disease, there is no way to do without drugs. Tablets are taken regularly, if possible at the same time of day. The patient should not think that to get rid of the disease it will be enough just to take medicine. If he does this while at the same time being seduced by, for example, fatty foods and alcohol, then the positive effect of the treatment will quickly disappear. The disease will move to the next stage, in which any treatment is no longer effective.
Hypertension 3 degrees
Why are doctors concerned about deviations in blood pressure readings from the norm, even by one? 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 the blood pressure deviates from the normal 120 to 80 mm Hg. by 39 units, then there is a very high probability of pathological abnormalities in various organs (39%). What can one say about the 3rd degree of the disease, in which 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 falls to the normal 120/80. Pathological changes are already irreversible.
Symptoms of stage 3 hypertension
Symptoms of stage 3 hypertension include:
- impaired coordination of movements.
- persistent visual impairment.
- paresis and paralysis due to disorders of cerebral circulation.
- prolonged hypertensive attacks with speech disorders, blurred consciousness and sharp pain in the heart.
- significant limitation of 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 signs of hypertension indicate that the patient's well-being is gradually deteriorating, the disease is spreading to new organ systems, and there are more and more complications.
Complications of grade 3 hypertension
Complications of grade 3 hypertension include the following diseases:
- myocardial infarction - the middle muscle layer of the heart.
- cardiac asthma - suffocation attacks.
- peripheral arterial damage;
- Hypertensive retinopathy affects the retina of the eyes.
- Scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of grade 3 arterial hypertension are otherwise called associated clinical conditions. When cerebral circulation is impaired, a stroke develops, accompanied by loss of sensation in the extremities and fainting. Heart failure is a whole complex of heart pathologies. The kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes mellitus, then nephropathy is inevitable.
The more advanced the disease, the more dire and serious its consequences. The circulatory system is so important to the life of the body that the slightest deviation in its functioning has a powerful destructive effect.
3rd degree hypertensive disability
In severe cases of the disease, disability group 1 is established. 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.
But even with the most severe degree of disability, the patient must undergo rehabilitation procedures. In this situation, this is necessary to prevent death.
Treatment of stage 3 hypertension
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 therapy is minimal. Chronic hypertensive patients are doomed to take pills for life.
When the disease becomes severe, surgery may be required. The operation is indicated for certain pathologies of the blood vessels and the heart. The stem cell treatment method for stage 3 arterial hypertension is considered innovative.
Hypertension 4 degrees
Some experts also identify stage 4 of the disease, which is very serious. In most cases, death is near. They try to relieve the patient's suffering as much as possible and provide first aid in every hypertensive crisis. The patient is lying down, raising his head. He is urgently given medication that sharply lowers his blood pressure.
Without treatment, new complications appear. Some of them cause others, and diseases overcome a person more and more. To stop this destructive process in time, you just need to monitor the dynamics of changes in your blood pressure, using at least a regular tonometer.
Example of risk calculation depending on the stage of hypertension
Hypertension Stages Other Risk Factors, POM or Disease BP (mmHg)
| High normal | Degree 1 | Degree 2 | Degree 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 more 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) |
moderate / High Risk |
High Risk (risk 3) |
|
| ≥3 FR | Short / moderate risk (risk 1) |
moderate / High Risk |
High Risk (risk 3) |
High Risk (risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without organ damage |
moderate / High Risk |
High Risk (risk 3) |
High Risk (risk 3) |
tall / too high danger |
| Stage III | Established cardiovascular disease, 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 identify factors that can be influenced to reduce it. Among these modifiable features:
- Obesity (with a BMI over 30), as well as central or visceral obesity, which is determined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, severe heart rhythm disorders such as atrial fibrillation, and others may also increase the risk.