Many people have high blood pressure (BP). This symptom signals hypertension. In almost 90% of patients, this is an independent disease. It is associated with a violation of the cerebral regulation of vascular tone. In all other cases, hypertension appears as a result of a disease of some organ. In this case, it is called symptomatic or secondary hypertension.
What causes hypertension?
There are many pathologies that cause it. For the convenience of diagnosing pathology, a classification of symptomatic arterial hypertension according to the diseases that provoke it has been adopted:
- Renal - occurs when the renal artery narrows. The following conditions contribute to this: the occurrence of a blood clot, inflammation, hematomas, tumors, injuries, congenital artery dysplasia, pyelonephritis, glomerulonephritis.
- Neurogenic - develops as a result of disruptionbrain caused by trauma, stroke, or neoplasm.
- Endocrine - appears due to diseases of the endocrine system: hyperthyroidism, pheochromocytoma, thyrotoxicosis.
- Toxic - this type of symptomatic hypertension occurs when the body is poisoned with toxic substances: alcohol, tyramine, lead, thallium.
- Hemodynamic - begins with the occurrence of pathologies of the cardiovascular system: atherosclerosis, heart valve disease, heart failure.
- Medicinal - is formed when taking certain medications: contraceptives, stimulants of the nervous system, nonsteroidal drugs.
- Stressful - begins after strong psycho-emotional shocks caused by burn injuries, large-scale surgical operations.
To provide full assistance, before prescribing a course of treatment, the cause of high blood pressure is established. To eliminate secondary hypertension, the use of antihypertensive drugs is not enough; therapy of the underlying disease is necessary.
Classification by severity
According to the severity of the course and depending on the magnitude of left ventricular hypertrophy and changes in the vessels of the fundus, there are the following types of symptomatic hypertension:
- Transient - a slight increase in pressure. It is provoked by: stress, sedentary lifestyle, excess weight, excess s alt intake, bad habits. In this case, there is no enlargement of the left ventricle and changes in the fundus. With timelytreatment, the problem disappears.
- Labile - periodic increase in pressure. Medicines are used to reduce Possible hypertrophy of the left ventricle and a slight narrowing of the vessels of the inner surface of the eyeball. Pressure surges may occur.
- Stable - constantly high blood pressure. Occurs with pathologies of the vessels of the fundus and an increase in the myocardium of the left ventricle.
- Malignant - persistently high blood pressure, poorly reduced by drugs. There is a high risk of strokes and heart attacks, as well as complications associated with the fundus.
This classification of symptomatic hypertension is not complete. Not one disease can lead to hypertension, but combinations of them, for example, atherosclerosis of the aorta and a kidney tumor. In addition, the classification does not include chronic lung diseases, in which there is an increase in pressure.
Signs that distinguish symptomatic from independent hypertension
To determine the correct course of therapy, you must first determine the type of hypertension. If a patient has problems with kidneys, neurological disorders, endocrine disruptions, or diseases associated with the cardiovascular system, it can be assumed that the pressure rises due to the development of symptomatic arterial hypertension. Often the underlying disease occurs with mild symptoms or does not show them at all. Presumably, secondary hypertension can be identified by the following symptoms:
- unexpectedly and steadily elevated blood pressure;
- large or, conversely, small difference between diastolic and systolic pressure;
- rapid progression of signs of hypertension;
- malignant course of the disease;
- Age of the patient - symptomatic hypertension develops in young people or people over the age of fifty;
- no effect from taking antihypertensives;
- emergence of panic crises.
These signs can only suggest the presence of secondary hypertension. To clarify the type, it is necessary to diagnose the disease.
Causes of secondary hypertension
Depending on the presence of a disease that causes an increase in pressure, the causes of symptomatic hypertension are as follows:
- Kidney diseases - circulatory disorders in the kidneys, accumulation of fluid in the body, narrowing of the arteries. With inflammatory processes and circulatory disorders, increased production of renin occurs, which leads to an increase in blood pressure.
- Endocrine diseases - disruption of the adrenal glands, thyroid gland, pituitary gland. With these diseases, the production of hormones increases, which causes hypertension.
- CNS diseases - injuries, increased intracranial pressure, brain tumors, encephalitis. Inadequate blood supply increases blood pressure, which contributes to symptomatic hypertension.
- Diseases of the cardiovascular system - heart failure, acquired and congenital malformations, aortic lesions. Violation of the work of the heart and blood vessels leads toincreasing pressure.
- Uncontrolled intake of drugs - antidepressants, glucocorticoids, oral contraceptives containing estrogens.
Often secondary hypertension affects people prone to regular consumption of alcoholic beverages. Chronic alcoholism is one of the causes of symptomatic hypertension.
Symptoms of secondary hypertension
The main symptom of secondary hypertension is high blood pressure, and signs of the underlying disease join it. The patient most often complains about:
- noise and ringing in the ears;
- fast pulse;
- episodic dizziness and headaches;
- discomfort and pain in the region of the heart;
- appearance of black flies before the eyes;
- pain in the back of the head;
- swelling of the lower extremities;
- constant fatigue;
- nausea, sometimes vomiting;
- excessive sweating;
- recurring fever from time to time;
- heavy or lethargic after high blood pressure.
In the initial development, secondary symptomatic hypertension may not manifest itself in any way. It will be expressed by a slight malaise, which many take for fatigue. In fact, it indicates the development of a serious disease, which must be treated as soon as possible. When examining a patient by a doctor, vascular changes in the fundus, left ventricular hypertrophy, or an increase in the second tone may be detected.pulmonary artery. An individual with chronic diseases must be aware of the symptoms of secondary hypertension in order to protect themselves from complications.
Dif. diagnosis of essential hypertension and symptomatic hypertension
The following standard procedures are used to diagnose the disease:
- Conversation with the patient - to collect an anamnesis, the doctor listens to complaints, reveals information about previous diseases, hereditary predisposition, injuries.
- Examination - the presence of swelling of the limbs and face is determined, the thyroid gland is palpated.
- BP is being measured. The patient is advised to keep a diary, where he will record the readings of pressure measurements.
- A general analysis of urine is prescribed - a violation of the water and electrolyte balance, the presence of an inflammatory process is determined.
- General and biochemical blood test - helps to detect various diseases of internal organs.
- A blood test for hormones - shows the level of hormones to determine endocrine and hemodynamic disorders.
- CT - performed to detect the condition of blood vessels, tumors, various changes in organs.
- ECG - will help determine changes in the work of the heart muscle.
- Dopplerography - used to assess vascular blood flow.
- Angiography - makes it possible to detect vasoconstriction, the appearance of blood clots and atherosclerotic plaques.
If there is any doubt about the diagnosis, the patient is hospitalized for additional procedures and medicalobservations.
Treatment of disease
Treatment of symptomatic hypertension is to eliminate the cause that contributes to high blood pressure. In all cases, complex long-term therapy is carried out, focused on the underlying disease and measures to reduce pressure. Treatment is carried out in two ways. With atherosclerosis of the renal arteries, the most effective method of treatment is surgery. Often, stenting or balloon angioplasty is used for this. And also surgically solves the issue of eliminating defects of the mitral valve of the heart. Radical surgery for symptomatic hypertension is indispensable for various neoplasms in the kidneys, endocrine glands, and brain.
For drug treatment, the patient will need:
- Selection of drugs, taking into account the etiology of the underlying disease. In each case, they are prescribed by a doctor, taking into account all the characteristics of the body.
- Antihypertensive therapy. For this, calcium channel inhibitors, diuretics, beta-blockers, antihypertensives, ACE inhibitors are used.
- Power correction. Patients are advised to eat more vegetable and dairy foods, to introduce porridge into the diet. Refuse smoked, s alty, canned and fatty foods. Proper nutrition can help reduce the severity and frequency of BP spikes.
- Lifestyle change. To stabilize pressure and prevent dangerous complications, doctors advise to reduce weight, increase time for outdoor activities, and give up bad habits. All these activities contribute to the improvement of oxygen metabolism in tissues and the strengthening of the vascular system, and hence the normalization of pressure.
Properly selected treatment for a certain type of symptomatic arterial hypertension and patient care, especially in the elderly, significantly reduces or completely eliminates hypertension and facilitates the course of the underlying disease. When choosing therapy, the doctor takes into account the specific disease that caused the increase in pressure, the severity of the symptoms of hypertension, the individual characteristics of the patient and his age.
Renal hypertension
According to medical statistics, it is believed that most of all cases of secondary hypertension occur in pathologies associated with kidney disease. These include acquired or congenital pathologies of the structure of the kidneys and the arteries that feed them. The severity of the disease depends on the speed of blockage of the renal vessels. At the beginning of the development of renal pathology, the patient's pressure does not change.
Symptomatic renal hypertension begins to manifest itself when the tissues of the organ are already significantly affected. The disease is especially dangerous for patients who have been diagnosed with pyelonephritis. Inflammatory processes in the renal pelvis create a significant risk of high blood pressure. Another kidney infection called glomerulonephritis also causes secondary hypertension. It is noted that renal hypertension is often found in young people whocareless about their he alth. Symptomatic arterial hypertension in infectious diseases of the kidneys often has a malignant course.
Hypertension in children
With arterial hypertension, an increase in blood pressure in children can be persistent or manifest in the form of crises. Children of the first years of life rarely suffer from this disease. More often it develops in adolescents as a secondary sign of another disease, during puberty. This is due to the restructuring of the body, passing with hormonal and vegetative failures. The occurrence of childhood and adolescent hypertension depends on the age and pathologies of the internal organs. The most common causes of hypertension in age groups are:
- In infants - narrowing and blood clots in the renal arteries, congenital defects in the structure of the kidneys, lungs, heart defects.
- In preschool children - inflammation in the tissues of the kidneys, narrowing of the aorta and renal vessels, malignant Wilms tumor.
- In schoolchildren under the age of 10 - inflammation of the kidneys, structural kidney disease.
- Children older than ten years of age have primary arterial hypertension, inflammation of the kidney parenchyma.
There are other anomalies that cause an increase in pressure:
- endocrine diseases;
- systemic vasculitis;
- brain pathologies;
- connective tissue diseases;
- uncontrolled medication.
In the absence of the above reasons, the diagnosis is primary hypertensivedisease, symptomatic hypertension - otherwise. Causes of primary hypertension in a child can be:
- overweight;
- heredity;
- constant emotional stress;
- temperament;
- too much s alt.
Clinical presentation of childhood secondary hypertension
Moderate hypertension is characterized by the absence of clinical manifestations, so parents and the child may not be aware of the occurrence of the disease. Complaints about fatigue, headache and irritability are usually attributed to the age characteristics of the child and a large study load. A thorough examination reveals autonomic dysfunctions, anomalies in the structure of the kidneys or heart. The child's well-being worsens and becomes stable with a pronounced form of hypertension. He begins to feel dizzy, palpitations, heart pain appears, memory decreases. At the doctor's appointment, tachycardia, left ventricular hypertrophy, and vasoconstriction of the fiber are detected.
The malignant form of symptomatic arterial hypertension and caring for a sick child requires special attention from parents. The pressure can take on high values, and the ongoing therapeutic measures have little effectiveness. In this case, there is a high lethal outcome. The following complications are typical for a hypertensive crisis:
- Acute hypertensive encephalopathy, accompanied by visual impairment, headache, nausea, vomiting, convulsions, impaired consciousness.
- Left ventricular failure withpain in the heart, shortness of breath, pulmonary edema.
- Renal failure with high protein excretion, blood in the urine, decreased urine output.
Symptomatic hypertension in children must be diagnosed early to avoid irreversible consequences.
Disease prevention
Preventive measures to prevent secondary arterial hypertension include the following activities:
- Follow the rules of a he althy diet. This measure prevents the appearance of excess weight and provides the body with useful substances. You should increase the consumption of seafood, citrus fruits, dried fruits, honey, greens, reduce animal fats, which increase cholesterol levels and clog blood vessels. Meat for cooking use only low-fat varieties. In the diet, increase the amount of foods rich in potassium, reduce s alt intake.
- Apply vitamin-mineral complexes periodically.
- Constantly engage in physical exercise and sports. A feasible load helps to strengthen the vascular system.
- Stop smoking.
- Avoid stressful situations. Observe the regime of the day: sleep for at least eight hours, take daily walks.
In addition to these recommendations, you should not abuse alcohol. People who are overweight must follow a special diet. To strengthen the nervous system, use products containing B vitamins:legumes and any nuts. If you follow the recommendations, it will not be difficult to prevent hypertension.
