Arterial hypertension. What is it, symptoms of the syndrome, classification, stage, Sartana, treatment, diet, clinical guidelines

It is important to know what is hypertension, as it manifests itself and what to do to eliminate the threat to health. The disease is a major precipitating factor for stroke, heart attack, and it threatens the loss of ability to work, disability, death.

What is hypertension

Arterial hypertension - is a disease that is characterized by stable blood pressure above normal. According to statistics, he was exposed to about 30 - 50% of people aged 15 to 64 years. According to experts, hypertension is the most common cardiovascular disease.

The pathological process is characterized by high blood pressure, which affects the work of all internal organs. Indicators of blood pressure in the body are constantly changing. This is due to the time of day, physical exercise, rest, wake, stress, but they always come back to an acceptable level.

The average norm blood pressure (mm Hg. v) in accordance with the age category.:

Age	Pressure Norm
20-30 years	120/80
40 years	130/80
50 years	135/84

If recorded a steady rise in the range of 140/90 mm Hg. Art., it is possible to judge the development of hypertension.

Intrigue of the disease is that it develops gradually and is often asymptomatic, but it negatively affects the work of all internal organs. The disease can be identified by chance during the next medical examination or treatment of the patient to the doctor for another reason.

The causes of hypertension

The main causes of abnormal increase in blood pressure have been identified. This disease is primary that develops against the backdrop of genetic and environmental factors, and secondary, multifactorial. At first we have to share about 90-95% of all diagnosed cases, and the other - 2-10%.

Major risk factors that trigger AG:

• Sexual identity. Men aged 35-50 years have a greater predisposition to the development of hypertension. Women dangerous period occurs during menopause.
• Age. The probability of disease increases significantly after 35 years. And the greater the age, the higher the risk of developing hypertension.
• Hereditary predisposition. If the first line of relatives have the same health problem, there is a high probability that pathology will move to the next generation.
• Psychological and emotional stress. With stress and shocks occur adrenaline, the heart begins to pump blood in a greater amount, which leads to higher performance. With frequent or constant load vessels do not maintain this pace and therefore deformed.
• Alcohol, smoking. Cause vasospasm, leading to their damage. As a result, the deformation appearing at the site of atherosclerotic plaque, blood flow impeding movement. As a result, figures are rising.

• Atherosclerosis. Excess cholesterol in the body contributes to the narrowing of the lumen of blood vessels that affects the blood flow movement.
• Unbalanced diet. Excessive amounts of animal fat and salt in the diet contributes to metabolic disruption in cells that provokes vasospasm and water retention.
• Physical inactivity. Insufficient physical activity results in a slower metabolism. This has a negative impact on the functionality of the cardiovascular system. Sedentary provokes hypertension from 20 to 50% of diagnosed cases.
• Chronic diseases: diabetes, renal diseases, thyroid, pituitary.

Symptoms of hypertension

Blood pressure - the main indicator of human health, and to increase its level of negative impact on overall health.

In hypertension patients complain of:

• headache in the temples, back of the head, in the forehead aching with irradiation in the eye socket;
• fatigue;
• decreased physical activity;
• a heavy feeling in the eye sockets or the nape;
• mood swings;
• noise in ears;
• flies in the eyes;
• decreased visual acuity;
• nausea;
• amplified heartbeats without more frequent rhythm;
• dizziness;
• excessive sweating;
• anxiety;
• sleep disturbance;
• general weakness;
• shortness of breath.

The appearance of one or more features at the same time points to the need to address to the therapist.

The degree of hypertension

Arterial hypertension - is a disease that has several degrees of severity of the pathological process. Each of them has its differences and peculiarities of the course.

• Grade 1 (mild). The upper figures are in the range 130-139 mm Hg. Art and the bottom -. 80-89 mm Hg. Art. Symptoms of the disease are rare, usually after stress or excessive stress. This degree has a clear periods of high blood pressure and improve, when a person feels completely healthy. Timely conduct of therapy can completely get rid of the disease.
• Degree 2 (average). The top rate of blood pressure - 140-159 mm Hg. article, and the bottom -. 90-99 mmHg. Art. Fixed deviation above the norm for a long period and rarely returns to normal. Symptoms occur frequently, which negatively affects the well-being of a person. In the absence of adequate treatment and lifestyle adjustments it is impossible to restore health.
• Grade 3 (severe). Systolic index - 160 and more mm Hg. Art and diastolic -. 100 mm Hg and above. Art. It is a chronic form of the disease, in which the increased rates are fixed permanently and will never return to normal. Pathological changes in this background are already irreversible. The disease encompasses more bodies, leading to serious complications. The person needs constant attention and care on the part of relatives. The patient must take pills continuously to keep blood pressure under control.

The degree of cardiovascular risk

Any deviation from normal performance is more a cause for concern. This negatively affects the work of all organs. Therefore, when you install the card in the diagnosis of the patient indicates the degree of cardiovascular risk.

The indicator is based on many factors. It takes into account the sex of the patient, lifestyle, age group, hereditary factors, cholesterol, comorbidities, the presence of bad habits, the degree of obesity.

The diagnosis also indicates the degree of organ damage, failure of which takes place before the rest of the function:

• kidneys - disturbed body bandwidth;
• heart - increases the load that provokes a hypertrophy of the left ventricle muscle;
• bodies of - disturbed metabolism, which leads to insufficient nutrition retina;
• brain - against the backdrop of the failure of blood supply to the body gradually decreases, resulting decline in intellectual activity, a partial memory impairment;
• containers - cross flow is reduced, the elasticity of the wall is lost, frequent cramps.

Availability and a set of trigger factors determine the degree of disease risk:

degree of risk	The probability of developing complications
1st (low)	15%
2nd (middle)	15-20%
Third (highest)	20-30%
4-I (very high)	over 30%

Each unit of blood pressure above the normal is equal to 1% risk of developing serious complications.

Stage of hypertension

Increase in blood pressure has a negative impact on the internal organs. Assessment of the level of destruction is indicated in medicine 3 stages.

• 1st. Adverse changes in organ function were not identified.
• 2nd. Malfunction occurs in one or two organs. This is expressed by the hypertrophy of the left ventricle of the heart muscle, retina power failure, increased protein content in the urine and the creatine in blood (1.2 to 2 mg%).
• 3rd. In this case, the organ damage increases, and in addition to these complications appear, and other clinical symptoms. On the part of the heart is evident: rapid heart rate, angina pectoris, myocardial infarction. In the brain: stroke, encephalopathy, malnutrition cells. The retinal hemorrhage is manifested. In the kidney - creatine levels greater than 2.0 mg. The vessels - aortic aneurysm, occlusive arterial disease.

When a progressive form of the lack of adequate treatment of hypertension leads to death after 6-12 months. against the background of the development of cardiac or renal failure acute form, and as a result of a heart attack or stroke.

Diagnosis of hypertension

When you install the diagnosis the doctor takes into account the testimony of the 3 main methods: examination and the patient survey, the measurement of blood pressure, a comprehensive survey of the major organs. When a plurality of data doctor confirms or denies the development of hypertension, and also fixes the level of risk and the degree of disease neglect.

Basic Diagnostic Methods:

• Measurement of blood pressure. The method involves the use of a tonometer. But often the data are distorted due to the patient's subconscious fear of "white coat", which causes an increase in performance. In this case, the doctor conducts measurement is not less than 3 times in a certain period. And sometimes advises the patient to take measurements at home and keep track of the dynamics of change in a relaxed atmosphere.
• The survey and examination of the patient. The doctor sets the age, weight and presence of signs of hypertension. It refines the presence of bad habits, concomitant diseases and hereditary factors.
• Blood analysis. Determines the degree of probability of atherosclerosis.
• ECG. It helps to identify cardiac dysfunction characteristic of hypertension.
• Physical examination. To obtain the data used stethoscope. The device detects the presence of noise, uncharacteristic sound, change the tone of the heart muscle.
• X-ray. It helps to identify the degree of deformation of the vessel wall, as well as to confirm or refute the formation of atherosclerotic plaques, provoking pressure surges.
• Ultrasound of the kidneys, heart, thyroid gland. It reveals the possible disruption of the main bodies that can trigger hypertension.
• Doppler. Based on the measurement of the movement of blood flow by ultrasound, is used for carotid and cerebral artery.

The data obtained in the diagnosis allow the physician to evaluate the severity of the disease and prescribe appropriate therapy, depending upon the detected deviations.

drug therapy selection principles

Arterial hypertension - is a disease that must be treated in a timely manner and as long as it did not lead to irreparable consequences. Treatment may occur for each patient is different, so the choice of drugs should be carried out physician based on the established diagnosis, any self leads to a significant deterioration It is.

To understand the principle of selection of medicines, it is to understand, thereby increasing blood pressure.

• The renin-angiotensin system. Prorenin formed in the kidneys, if it enters the bloodstream is converted to renin. It is in contact with blood protein forms angiotensin I (inactive substance). Under the action of glycoprotein it is converted into the active ingredient of angiotensin II, provoking a rise in blood pressure, as has vasoconstrictor effect.
• Calcium channels. Calcium in the body is present in bound form. But protein (actomyosin) formed on admission it through certain channels in the cell. This is the trigger mechanism for narrowing the lumen of blood vessels, which triggers an enhanced functioning of the heart, and as a consequence - the pressure increases.
• Adrenergic receptors. Some bodies are equipped with specific receptors, irritation of which causes an increase in pressure. These include alpha- and beta-receptors present in the kidneys, arterioles, heart.
• Urinary organs. Violation of their function leads to urinary retention in the body, thereby increasing blood pressure levels.
• Nervous system. Vasomotor centers are present in the brain also affect blood pressure levels. Stress leads to the excitation of the nervous system, which causes a deviation from the norm indicators.

Based on the revealed violations in the body, appointed by the treatment. In hypertension, one type of medication is not used and combined with other simultaneously. The treatment regimen prescribed by the physician on the basis of the survey. Drug selection is performed in accordance with the individual patient.

Treatment is carried out using:

• beta-blockers;
• ACE inhibitors;
• diuretics;
• calcium channel blockers;
• angiotensin receptor antagonists (ARA Sartai);
• imidazoline receptor agonists and agonists of alpha2 adrenergic receptors of the brain;
• neurotransmitters;
• Combined drugs.

drug therapy

Antihypertensive drugs differ in their effect. Initially, the doctor selects one medicine at minimal dosage and subsequently enters and other drugs. To achieve the best results of therapy, you should use the method of selection of active agents.

Beta-blockers

This group of drugs prevents the formation of prorenin. This feature allows you to block the renin-angiotensin system, and thus causes the blood pressure to normal levels. Use of beta-blockers are prohibited in bronchial asthma, diabetes mellitus.

Common drugs:

• metoprolol;
• nebivolol;
• carvedilol;
• Bisoprolol.

Beta andrenoblokatory prescribed for associated diseases: arrhythmia, and angina pectoris.

diuretics

The diuretic therapy combined with other drug groups. Promote the excretion of excess water and prevent the absorption of sodium ions. But the reverse effect of their action is the elimination of potassium. It is therefore important to take diuretics to drugs, sparing this component. Drink diuretics should be daily in the morning.

The main types of diuretics:

• Klopamid;
• benzthiazide;
• hydrochlorothiazide;
• Spironolactone.

Drugs that quick action (Lasix, Furosemide), are used only as an ambulance in an emergency. But they can not take a long time.

Calcium channel blockers

Means active components are attached to the cell walls and block the calcium influx channel. This feature allows the drug to prevent the formation of actomyosin. As a result, expanded lumen of the vessels, at the heart load decreases, the pressure decreases.

Dihydropyridine drugs in this group are assigned with hypertension, arrhythmia, angina pectoris.

Often these diseases are combined simultaneously. A pulsurezhayuschie blockers are used for arrhythmia. The dosage of medication prescribed by a doctor. The regularity of reception - 1-2 times per day. Side effects - swelling, headache, who independently tested 7 days after initiation of therapy.

Common medications:

• dihydropyridine - (Nifedipine, Nimotop, Latsipil, Lercanidipine);
• pulsurezhayuschie - (verapamil, diltiazem).

inhibitory

Drug Group prevents transition inactive component (angiotensin I) to active (angiotensin II). As a result, the concentration of this component in the plasma is reduced lumen of the vessels increases. Inhibitors have a quick, but short-lived effect, so their reception takes place twice a day. Side effect - irritation of the bronchial tubes, which provokes a dry cough.

Representatives inhibitors:

• captopril;
• ramipril;
• quinapril;
• perindopril;
• fosinopril;
• Zofenopril.

Angiotensin receptor antagonists

Group is an innovative drug in the treatment of hypertension. The main function - blocking angiotensin receptor with subsequent isolation of Angiotensin II. This allows you to expand the lumen of blood vessels, and the level of pressure to return to normal. The maximum treatment effect is achieved after 1-2 weeks after the start. Drinking cure - 1 times per day. Dry cough is observed.

Representatives of the group:

• valsartan;
• losartan;
• irbesartan;
• telmisartan;
• Olmesartan.

agonists

Hypertension caused by stress, a group treated with drugs that affect the nervous system. Such therapy has a calming effect. Active ingredients of these drugs reduce the tone vasomotor center present in the brain. Receiving funds held 1 time per day.

The first representative of the drug group was Clonidine, wherein the rapid action. But while taking the drug often recorded critical decrease while ignoring the daily dosage, which caused the patient to whom. Therefore, at this time, prescription drug doctor.

Drugs in this group:

• rilmenidine;
• moxonidine;
• Methyldopa.

combined type

In the treatment of hypertension medications used and combined, combining drugs from two different groups. This makes it possible to deal not only with a high level of pressure, but also to provide treatment based on comorbidities in the body. Selection of drugs carries the attending physician taking into account the individual patient. Self-conduct strictly prohibited.

The most common combination of drugs:

• inhibitor + diuretic: Co-renitek, Enziks duo, Iruzid, Akkuzid;
• angiotensin receptor blocker + diuretic: Teveten Plus, Co-diovan, Atacand Plus, Mikardis Plus;
• ACE inhibitor + calcium channel blocker: Tarka, Equator;
• a beta-blocker + diuretic: Aritel plus Lodoz.

invasive therapy

Innovative treatment is renal denervation. It is effective when multi-component therapy does not give a positive result, and the criticality of the situation requires drastic measures. During the procedure, the puncture is performed renal artery and introduce a special catheter at its mouth through which an electric current discharge is weak.

As a result, neutralized by body cells, causing the pressure level of deviation from the norm. Surgery takes place on an outpatient basis under local anesthesia. According to studies, this method gives a long positive effect and reduces the pressure of the top at 30 mm Hg. Art, and the bottom -. 12 mm Hg. Art.

Renal denervation enables to depart from the daily administration of drugs, and to switch to exchange treatment in acute periods. this method safety is confirmed by clinical studies of the leading countries of the world.

neurotransmitters

medicines for hypertension group helps to improve the effectiveness of therapy. Receiving neurotransmitters held in said doctor dosage.

Main products:

• acetylcholine;
• aldosterone;
• Norepinephrine.

hypertension diet

Hypertension - This is a disease that can not be removed without the correct nutrition. The main condition is a fractional dieting food intake restriction potentially dangerous consumer products.

The basic rules of supply:

• Limiting salt. Component retains water, which on the background of the volume of blood in the vessels increases, which affects the pressure. The daily rate of consumption should be 3-4 grams of salt. This volume is already present in the products.
• Avoiding alcohol, coffee, strong tea. Drinks cause spasm of blood vessels, which increases the workload on the heart muscle.
• Correct diet. In hypertension, it is important to eat small meals, but 5-6 times a day.
• To give up smoking. Tobacco has vasoconstrictor properties.
• Limiting animal fats. Fatty foods contribute to cholesterol increase, provoking the formation of atherosclerotic plaques, which contributes to clogging of blood vessels.
• More vegetables. This rule will not only help reduce cholesterol in the body, but also helps to strengthen the heart, as the potassium and magnesium to improve its functionality. The diet should enrich cabbage, carrots, beets.
• Less sugar. It is to abandon cakes, pastries, chocolates, that is, from those products, which include those present easily digestible carbohydrates. They contribute to the emergence of extra kilos.

In the treatment of hypertension it should be understood that this is a disease where you can not starve.

Therefore, any strict diet, as well as the posts are strictly forbidden. Any restriction in the diet the body sees as a threat and as a consequence the pressure rises. Therefore, to cope with the disease, you need to be attentive to their health and to carry out all the doctor's recommendation.

Videos about hypertension, its symptoms and treatments

Classification of hypertension:

Causes and treatment of arterial hypertension: