Hypertension is one of the most common cardiovascular diseases. According to the WHO, more than 1. 1 billion people suffer from it. worldwide. High blood pressure increases the risk of developing other heart diseases. Hypertension is among the leading causes of death and the disease is becoming increasingly younger. It occurs not only in the elderly, but also in young people. Below you will discover why it appears, how to recognize it and control it.
What is hypertension?
This is a chronic condition in which blood pressure is high. It is noted as two numbers and the ideal value is 120/80 mmHg. Art. The first number is the systolic pressure, which occurs when blood is ejected from the heart's left ventricle into the aorta at the time of systole (contraction of the heart's ventricles). The second number indicates the diastolic pressure when the heart muscle is relaxed. Blood pressure increases during physical activity and emotional excitement, but its value should be close to normal at rest. If, with multiple measurements taken at different times, the systolic pressure exceeds 139 mmHg. Art. and/or diastolic pressure exceeds 90 mmHg. Art. , diagnosed with hypertension.
A persistent increase in blood pressure is associated with several factors, including being overweight and lacking physical activity, poor diet, bad habits and high levels of stress.
Causes and risk factors
Hypertension can be primary or secondary:
- primary (essential)hypertension is more common - according to various estimates, in 85-95% of cases. Its appearance is not associated with concomitant diseases, pressure rises under the influence of a complex of factors;
- secondary (symptomatic)hypertension occurs in 5-15%. In this case, hypertension is one of the symptoms that may be associated with endocrine disorders, kidney disease and large vessel anomalies.
When the regulation and maintenance of ideal blood pressure is impaired, primary hypertension occurs. The cause of its occurrence is usually constant nervous tension. When diagnosing, it is important to establish as accurately as possible what causes hypertension, whether it has secondary causes (the presence of diseases that cause an increase in blood pressure).
There are several risk factors that increase the chances of developing primary hypertension:
- overweight (obesity);
- insufficient activity, physical inactivity, lack of physical activity;
- drinking alcohol and smoking;
- stress, constant emotional tension;
- lack of sleep, poor quality, insomnia;
- excessive salt intake;
- poorly organized sleep and rest patterns (including due to irregular or very long working hours);
- changes in hormonal levels (in women, these may be associated with the use of oral contraceptives, the onset of menopause);
- hereditary factors (in total, more than 20 genes have been identified that determine the predisposition to hypertension);
- age over 65 years (the disease can also occur in young people; it is worth periodically monitoring blood pressure from the age of 35);
- poor diet (lack of vegetables and fruits in the diet, excess foods rich in trans fats and saturated fats);
- kidney disease, diabetes mellitus and some other related conditions and diseases.
Many of these factors are interconnected and mutually reinforcing. Some of these can be controlled (e. g. food and nutrition, sleep, physical activity, weight, alcohol consumption, smoking). This is a simple way to reduce your risk of high blood pressure or improve your well-being if your blood pressure is already high.
Classification
To classify the disease, two approaches are used: by degrees and stages. The degrees of hypertension differ in the values at which blood pressure rises, the difference between the stages lies in the course of the disease, the number, the severity of concomitant organic lesions.
First degree
Systolic blood pressure - greater than 139 and less than 159 mmHg. Art. , and diastolic is at the level of 90-99 mm Hg. Art. With high values, blood pressure can be normalized by adjusting your lifestyle. To do this, it is necessary to increase physical activity, adjust your diet, abandon bad habits and reduce stress levels.
High school
In the second degree, blood pressure values become high and reach 160-179 mm Hg. Art. for systolic and 100-109 mm Hg. Art. for diastolic. With these values, the load on the heart increases significantly. The blood supply to the brain deteriorates and this can cause headaches and dizziness, as well as decreased performance. Changes occur in the back of the eye. Sclerosis of the tissues and blood vessels of the kidneys begins, excretory function is impaired and renal failure may occur. The condition of the blood vessels worsens. For treatment, you need to change your lifestyle and start taking medication.
Third degree
The systolic pressure value is above 180 mm Hg. Art. , diastolic - above 110 mm Hg. Art. In hypertension, the load on the heart becomes very high and causes irreversible changes. Blood pressure must be constantly reduced with medication. Without this, there is a risk of acute heart failure, arrhythmia, angina pectoris, myocardial infarction and other serious conditions. Patients with stage 3 hypertension need to be constantly monitored by a doctor. Continuous use of medications to lower blood pressure is necessary.
| Blood pressure | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Fine | <130 | <85 |
| Typically, so-called prehypertension | 130–139 | 85–89 |
| 1 – mild hypertension | 140–159 | 90–99 |
| 2 - moderate degree of hypertension | 160–179 | 100–109 |
| 3 - severe hypertension | ≥ 180 | ≥ 110 |
Stages of hypertension
The disease develops gradually. There are three stages in total.
- First step:moderate hypertension. Blood pressure is unstable and can fluctuate throughout the day. At this stage, the state of internal organs and the central nervous system remains normal, there are no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
- Second stage:severe hypertension. In the second stage, there is a significant increase in blood pressure, the state of health usually worsens and hypertensive crises become severe. At this stage, changes in internal organs begin due to constantly high blood pressure. Vascular disorders appear and the blood supply to the brain deteriorates. The retinal arteries narrow. Hypertrophy of the left ventricle of the heart develops and this increases the risk of serious cardiac pathologies. Signs of kidney dysfunction appear (increased levels of albumin in urine, increased levels of creatinine in blood serum)
- Third stage:very severe hypertension. Blood pressure becomes critically high - above 200 mm Hg. Art. for systolic and 125 mm Hg. Art. for diastolic. Organic lesions intensify, heart failure, thrombosis of cerebral vessels, aneurysms, kidney failure and other serious conditions develop. Severe hypertensive crises often occur.
Symptoms
Even with a significant increase in blood pressure, hypertension may not present symptoms for a long time. For this reason, you should periodically measure your blood pressure (monitoring is especially important for those over 35). You can measure your blood pressure with an automatic electronic tonometer - these devices are sold in pharmacies.
The main symptoms of hypertension include headache, dizziness and heaviness in the head. These manifestations are associated with vasospasm and deterioration of blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, cardiac arrhythmias. In severe cases of hypertension, weakness, chest pain, nausea, vomiting and tremors ("trembling" muscles) may appear. Other symptoms include cloudy or black spots before the eyes, difficulty sleeping, palpitations and tinnitus.
As the disease progresses, visual acuity gradually decreases, sensitivity in the arms or legs may decrease, and in severe cases, paralysis is possible. During periods of stress, in a context of nervous tension or physical activity, symptoms may increase. They most often appear in middle-aged and elderly people. The disease is more serious if you are overweight, have bad habits, tend to overeat or have a high level of stress.
You should see a therapist or cardiologist if you experience regular headaches, dizziness, or vision problems, or if your blood pressure is frequently elevated when you measure your blood pressure yourself.
Diagnosis
Typically, diagnosis is carried out in three directions:
- blood pressure measurement.Carried out at intervals of several hours or over 2-3 days to determine the degree of hypertension and its stage;
- identify the causes of the disease.It is important to determine whether hypertension is primary or secondary (caused by other diseases). In the second case, specific treatment may be necessary;
- monitoring general health.During the examination, the condition of the heart, cerebral vessels, fundus and kidneys is monitored. Due to hypertension, the functioning of these organs is impaired. When diagnosing, it is important to assess your condition.
At the first consultation, the doctor will carry out a survey and collect details of the medical history related to the disease. Information will be needed about how long the patient has suffered from hypertension, what the blood pressure level is, whether there are symptoms of heart disease, apnea, heavy snoring, whether the person or their close relatives have had a stroke, peripheral arterial disease, gout , diabetes, kidney disease. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, medication use.
For patients with high blood pressure, the following tests are performed:
- blood pressure measurement.It is measured several times at rest (physical activity, caffeine consumption, smoking are excluded half an hour before measurement), measurements are taken at different times of the day;
- general exam:measure height and weight, waist circumference, palpate the abdomen, assess the pulsation of peripheral arteries;
- Urine analysis.Albumin and creatinine levels are important - deviations from the norm indicate renal dysfunction and require ultrasound;
- blood analysisTo monitor the levels of potassium, creatinine, lipids, ultrasound of the kidneys is prescribed. Assessment of lipid levels is necessary to control lipid metabolism and eliminate the risk of cardiovascular system complications;
- ECGperformed when left ventricular hypertrophy is detected to monitor the condition of the heart.
In addition, the doctor may refer the patient for a cardiological or neurological examination or examination of the respiratory system.
Treatment of hypertension
High blood pressure is a disease that cannot be completely cured, but can be controlled. Therapy and lifestyle changes can stop the development of high blood pressure, reduce the frequency and severity of attacks, and eliminate symptoms. But the most important thing is to reduce the risks to the cardiovascular system, brain and kidneys.
Treatment begins with lifestyle adjustments:
- stop smoking;
- refusal to drink alcohol or significantly limiting the amount of alcohol;
- diet: the diet is adjusted, salt intake is reduced (less than 3. 75 g per day), the amount of vegetables and fruits is increased (ideally you need 5 servings per day), whole grains, dairy products, products with low fat and calorie intake is limited. If there are no contraindications or kidney diseases, increase your consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others);
- increased physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.
During treatment, blood pressure is reduced to target values (below 130/80 mmHg) to reduce the risk of complications. With this decrease, constant monitoring by a doctor is necessary. A tonometer used for home measurements must be calibrated regularly. For patients with diabetes, pregnant women, the elderly and debilitated people, the use of antihypertensive medications requires special caution.
The following may be used to treat high blood pressure:
- adrenergic modifiers.They reduce the activity of the sympathetic nervous system and lower blood pressure, but can cause drowsiness and lethargy and are therefore rarely used;
- ACE inhibitors.Reduce peripheral vascular resistance, often prescribed for patients with diabetes;
- angiotensin II receptor blockers.They have a similar effect to ACE inhibitors and are therefore not prescribed together with them. Not prescribed during pregnancy;
- beta blockers.Provide a decrease in blood pressure, reducing heart rate;
- calcium channel blockers.They reduce total peripheral vascular resistance and can cause reflex tachycardia;
- direct vasodilators.They have a direct effect on blood vessels and are used for severe hypertension;
- diuretics.They reduce blood plasma volume, which lowers blood pressure, but can also cause hyperkalemia.
Important!A therapist or cardiologist should prescribe medications and their dosages after the examination. Taking medicines without a prescription can be dangerous.
If your doctor prescribes medication, you will need periodic follow-up exams to assess the effectiveness of your treatment and adjust it. It is important to adjust your lifestyle and restore normal health so that a minimum amount of medication is needed to control the course of hypertension.
Possible complications
Due to the increase in blood pressure, the walls of the arteries lose their elasticity and the heart muscle works a lot. This increases the risk of angina, acute heart failure and heart attack. Due to impaired blood supply to the brain, transient ischemic attacks and strokes are possible. The severity of hypertension will increase without treatment and lifestyle correction: pressure will continue to increase and this will cause damage to internal organs and worsen overall health and well-being. Smoking, alcohol consumption, overeating, lack of physical activity and high levels of stress accelerate the development of hypertension and make its course more complex.
Consequences
Without treatment, high blood pressure causes serious consequences. Constant spasm of cerebral vessels leads to ischemia and stroke. They are dangerous with serious disabilities and even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia and heart failure occur. Without treatment, myocardial infarction is possible.
The severity of hypertensive crises increases, they become complicated, life-threatening and can be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life against the background of hypertension without adequate therapy and restoration of a normal state of health decreases sharply, even with severe disability.
Forecast
The prognosis is good if the patient consults the doctor on time and takes measures to control blood pressure and factors that affect hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its severe course. Even with severe high blood pressure, it is necessary to undergo treatment and adjust your lifestyle.
Prevention
To prevent hypertension, self-monitoring of blood pressure is recommended from the age of 35 or when symptoms of hypertension appear. It is important to eliminate the effects of factors that cause an increase in blood pressure: control your diet, eliminate smoking and alcohol consumption, reduce stress levels, dedicate more time to physical activity: in short, lead a healthy lifestyle.
Conclusion
Hypertension is a dangerous disease, but it can be controlled by maintaining normal health and reducing the risk of complications. To achieve this, it is important to monitor blood pressure levels, control weight, lead a healthy lifestyle and undergo preventive exams with a therapist or cardiologist.