Arterial hypertension belongs to the most common diseases of heart and blood vessels, affecting about 25% of the adult population.No wonder it is sometimes mentioned as a non -infectious epidemic.High blood pressure with its complications significantly affects the mortality of the population.Estimates show that up to 25% of deaths of people over 40 are directly or indirectly caused by hypertension.The probability of complications determines the stages of hypertension.How many steps have hypertension, how are they classified?Look below.
Important!According to the latest estimates of the 1993 World Health Organization, adult hypertension is a constant increase in blood pressure to 140/90 mm Hg.Art.
Classification of hypertension, determination of the degree of risk of the disease
In whom, according to etiology, hypertension is classified into primary and secondary.
With primary hypertension (essential) (GB), the main organic cause of increased blood pressure (blood pressure) is unknown.A combination of genetic factors, external influences and violations of internal regulatory mechanisms is taken into consideration.
External factors:
- environment;
- Excessive use of calories, development of obesity;
- Increased salt consumption;
- Lack of potassium, calcium, magnesium;
- excessive drink;
- Repeating stressful situations.
Primary hypertension is the most common hypertension in approximately 95% of cases.
3 hypertension stages are separated:
- Stage I - Increased blood pressure without alterations in organs;
- Stage II - an increase in blood pressure with organs changes, but without impairing its function (left ventricular hypertrophy, proteinuria, angiopathy);
- Step III - The organs accompanied by the impaired function (left heart failure, hypertensive encephalopathy, stroke, hypertonic retinopathy, renal failure).
Secondary (symptomatic) hypertension is an increase in blood pressure as a symptom of the underlying disease with the identified cause.The classification of secondary arterial hypertension is as follows:
- Renoparecimal hypertension - occurs due to kidney disease;Reasons: Renal Parenchimate Disease (glomerulonephritis, pyelonephritis), tumors, kidney damage;
- Renovascular hypertension - narrowing of renal arteries with fibromoscular dysplasia or atherosclerosis, renal vein thrombosis;
- Endocrine hypertension - Primary hyperaldosteronism (Conn syndrome), hyperthyroidism, feochromocytoma, kushing syndrome;
- Hypertension caused by medicines;
- Gestational hypertension - high pressure during pregnancy, after delivery, the condition is often normalized;
- Coarctation of the aorta.
Gestational hypertension can lead to congenital child diseases, in particular retinopathy.2 phases of retinopathy (premature and complete term children) are separated ::
- Active - Consists of 5 stages of development, can lead to vision loss;
- Rubtes - leads to the cloudy of the cornea.
Important!Both stages of retinopathy of premature and total term children lead to anatomical disorders!
Hypertensive disease according to the international system (according to ICD-10):
- Primary form - I10;
- Secondary Form - I15.
Hypertension degrees also determine the degree of dehydration - dehydration.In this case, the classifier is a lack of water in the body.
Share 3 degrees of dehydration:
- Grade 1 - Light - Lack of 3.5%;Symptoms - dry mouth, severe thirst;
- Grade 2 - Average - Disability - 3-6%;Symptoms - sharp fluctuations in pressure or pressure reduction, tachycardia, oliguria;
- Grade 3 - The third degree is the most severe, characterized by 7 to 14% of water;It is manifested with hallucinations, delirium;Clinic - Coma, hypovolemic shock.
Depending on the degree and stage of dehydration, the decompensation is performed by the introduction of solutions:
- 5% glucose + isotonic NaCl (lightweight);
- 5% NaCl (average grade);
- 4.2% Nahco3(severe degree).
GB stages
Subjective symptoms, especially with mild, moderate stage of hypertension, are usually absent, so an increase in blood pressure is often found at the level of hazardous indicators.The clinical picture is divided into 3 stages.Each stage of hypertension has typical symptoms, of which GB classification comes.
Stage I
At the 1 stage of hypertension, the patient complains of headache, fatigue, rapid heartbeat, disorientation, sleep disturbance.In the 1st GB stage, objective heart detection, ECG, eye fund, in laboratory studies, are present within the normal range.
Stage II
In the two stages of AH, subjective complaints are similar;At the same time, there are signs of left ventricular hypertrophy, there are signs of hypertensive angiopathy in the retina, microalbuminuria or proteinuria in the urine.Sometimes there is a multiplication of red blood cells in urine precipitation.In 2 stages of hypertension, the symptoms of renal failure are absent.
Stage III
With stage III hypertension, functional disorders are diagnosed in organs belonging to an increase in the degree of risk of hypertension:
- Damage to the Heart - In the beginning, the shortness of breath is manifested and then symptoms of cardiac asthma or pulmonary edema;
- Vascular complications - damage to peripheral and coronary arteries, the risk of brain atherosclerosis;
- Background changes - have the nature of hypertensive retinopathy, neuroretinopathy;
- Changes in brain blood vessels manifest themselves by transient ischemic struggles, typical thrombotic or hemorrhagic vascular traits;
- In stage III, a stroke, brain lesions are diagnosed in almost all patients;
- Benign nephrosclerosis of renal vessels - leads to limiting glomerular filtration, an increase in proteinuria, red blood cells, hyperuricemia and later chronic renal failure.
Which stage or degree of hypertension is the most dangerous?Despite various symptoms, all stages and degrees of hypertension are dangerous, they require appropriate systemic or symptomatic treatment.
Degree
According to blood pressure (blood) indicators, determined at the time of the diagnosis, 3 degrees of hypertension are distinguished:
- light;
- average;
- heavy.
There is also a fourth concept to resistant (persistent) hypertension, in which, even with the proper choice of a combination of antihypertensive drugs, blood pressure indicators are not reduced below 140/90 mm hg.Art.
A clearer overview of the degrees of arterial hypertension is presented in the table.
AG Classification and Normal Blood Pressure Stratification according to the ESH/ESH 2007 guidelines.
| Category | Sistolic pressure, mm Hg.Art. | Diastolic pressure, mm Hg.Art. |
|---|---|---|
| Ideal | <120 | <80 |
| Normal | 120–129 | 80–84 |
| Normal increase | 130-139 | 85–89 |
| 1 degree | 140–159 | 90–99 |
| 2 degree | 160–179 | 100-109 |
| 3 degrees | More than 180 | More than 110 |
| Isolated systolic hypertension | More than 140 | less than 90 |
The patient's difficulties vary according to the separation of hypertension into degrees.The choice of disease treatment regime depends on the determination of the degree.
I Diploma
The disease can only be detected with regular blood pressure measurement.Measurements should be performed in a relaxed environment, at least three times in a certain period.
This is the only way to evaluate the presence or absence of hypertension.Depending on the degree of increased blood pressure, the clinical image of the disease differs.
II degree
The second degree of hypertension is characterized by periods of increased alternate pressure with a decrease in indicators or an increase in diastolic value.To this extent, hypertension, increasing pressure cases in certain circumstances are typical, particularly in patients with an unstable nervous system.
III degree
III The degree of AG is characterized by a critical increase in blood pressure.
GB grade III is characterized by severe complications that arise as a result of the harmful effects of high blood pressure on all organs and systems.First of all, the heart, the kidneys, the eyes, the brain are affected.With grade III hypertension, symptoms and treatment are closely associated - insufficient or inadequate treatment, the disease can lead to serious consequences: stroke, encephalopathy, renal failure, irreversible eye injuries, blood vessels.Lack of treatment for III degree of hypertension increases the risk of isolated systolic hypertension.
In this phase of hypertension, the degree of risk increases significantly!Memory disorders, mental activity, frequent loss of consciousness manifest themselves.
The hypertonic crisis emerges as a complication of the third century and is considered art.GB.
Risks
According to hypertension classification due to stages and degrees, patients are divided into risk groups, depending on the severity of ag. 4 categories are distinguished (ie there are as many as hypertension degrees), which are determined by the principle of probability of damage to internal organs in the future.
Risks in the degree of disease:
- risk less than 15%;
- risk of up to 20%;
- risk of 20 to 30%;
- The risk is above 30%.
Low, insignificant
A low -risk group includes men up to 55 and women at 65 years old in I Art. Hypertension.In this group, the risk of cardiovascular pathology within 10 years is less than 15%.People belonging to a low -risk group are recommended to change the lifestyle.If, within 6 to 12 months, non -Drug therapy does not show effectiveness, it is advisable to prescribe medications.
Average
The average risk group includes people from I -II art.Hypertension, provided there are 1-2 risk factors.The risk increases with high body weight, smoking, an increase in cholesterol, a violation of glucose tolerance, lack of movement.Hereditary factors are also important.The risk of cardiovascular complications in these people is higher and is 15 to 20% for 10 years.People related to this group are recommended to fulfill a healthy lifestyle.If a decrease in pressure does not occur within 6 months, pharmacotherapy will be prescribed.
High
The high -risk group includes people from the first century - II.Hypertension, subject to the presence of at least three risk factors, which include:
- diabetes;
- defeat of the organs -Alv;
- atherosclerotic vascular diseases;
- Left ventricular hypertrophy;
- Increased creatinine;
- changes in eye vessels.
This group also includes hypertension of the 3rd century, which have no risk factors (the risk of cardiovascular disease is 20 to 30% for 10 years).Representatives of this group are under the supervision of a cardiologist.
Tall
A group of hypertension with a very high risk of cardiovascular disease (over 30% for 10 years) includes people with art III.Hypertension, provided there are at least 1 risk factor.In addition, this group includes patients with AH I - II Art. In the presence of a violation of brain circulation, ischemia, nephropathy.This group is controlled by cardiologists, requires active therapy.
Conclusion
The problem of arterial hypertension is that the disease has no typical symptoms, it is characterized by a variety of clinical pictures.Therefore, a person often does not know the presence of the disease.Therefore, high pressure is detected by accident during inspection or manifestation of complications.By diagnosing hypertension, it is important to correctly inform the patient that he can widely affect the course of his illness after a healthy lifestyle.