Arterial hypertension is a disease accompanied by a significant and prolonged increase in pressure. Approximately 30% of the adult population of the country suffers from it. Hypertension is one of the most serious pathologies of the cardiovascular system.
With age, the risk of disease increases more and more. The genetic factor is of great importance, which is why, if there is a predisposition, it is necessary to undergo a periodic examination by a doctor so that treatment can be started in a timely manner.
Feature of the disease
Normal pressure is 120/80 mm Hg. Art. This value may change up or down under the influence of certain factors. If the change occurs within a short period of time, it means that the person is completely he althy. Otherwise, the development of the disease can be suspected. With a primary lesion, the ICD-10 code for arterial hypertension is I10.
With a persistent increase in pressure, negative changes are observed in the internal organs. Basedthese indicators is the classification of this disease. According to ICD-10, symptomatic hypertension, that is, a secondary form of the disease, has the code I15.0.
In addition, there is an uncontrolled form, characterized by the absence of a positive result during therapy. It can be pseudo or true hypertension. Often there is no positive prognosis due to an incorrect dosage of drugs or their regimen.
Classification
The increase in blood pressure occurs due to the narrowing of the lumen of the main arteries, provoked by the flow of complex hormonal and nervous processes. With the narrowing of their walls, the work of the heart increases significantly, and the patient begins to develop primary arterial hypertension, which occurs in almost 90% of patients. It leads to damage to various organs and systems.
In the rest of the patients, a secondary type of disease is observed, which is caused by the course of other pathologies. They can be divided into:
- renal;
- hemodynamic;
- endocrine;
- neurogenic.
If the disease was provoked by impaired functioning of the kidneys, then according to the ICD, arterial hypertension has the code I12.0. The disease develops due to hydronephrosis, pyelonephritis, polycystic kidney disease, radiation sickness.
Endocrine disorders occur with a hormonally active tumor of the adrenal glands, as well as with damage to the thyroid gland. The neurogenic type of the disease is formed with brain damage, as well as a changeacid-base balance. If the violation was provoked by heart disease, then the code in the ICD for arterial hypertension is I13.0. Pathology develops due to aortic valve insufficiency, atherosclerosis, and many other diseases.
In addition, there may be other types of disease that develop with late toxicosis during pregnancy, poisoning with toxic substances, carcinoma, overdose of medications. According to the nature of the course, arterial hypertension can be:
- transient;
- stable;
- labile;
- crisis;
- malignant.
The most dangerous type is malignant, as the pressure rises to very high levels, and the disease progresses very quickly. This form can lead to very dangerous complications and even death of the patient.
Stages of the course of the disease
Specialists identify several degrees of arterial hypertension, differing in the rate of development and the characteristics of the course. Stage 1 is considered the easiest, characterized by slight pressure rises. Its level during the day can be quite unstable, but after a rest, this indicator begins to gradually stabilize.
It is worth noting that the patient does not experience any he alth problems at all. In some cases, the following symptoms may occur:
- headache;
- sleep disorder;
- noise in the head;
- decrease in mental activity.
Sometimes there may be dizziness and nosebleeds. Kidney function is not impaired, and the fundus is practically unchanged.
With 2 degrees of arterial hypertension, there is a steady increase in pressure, which can vary between 180-200 mm Hg. Art. Patients very often complain of headache, dizziness, pain in the heart. This stage is characterized by hypertensive crises. This reveals damage to internal organs.
On the part of the nervous system, manifestations of vascular insufficiency, cerebral ischemia, and strokes are possible. On the fundus, there are signs of compression of the veins. Renal blood flow is greatly reduced, although there are no abnormalities in the analyzes.
With arterial hypertension of the 3rd degree, there is a frequent occurrence of vascular crises, depending on the increase in pressure, which can remain stable for a long time. The clinical picture is determined by the lesion:
- brain;
- heart;
- fundus;
- kidney.
Some patients with grade 3 arterial hypertension, despite the increase in pressure, do not experience severe vascular complications for many years.
Causes of occurrence
Assessing the degree of risk of arterial hypertension, it is necessary to take into account the reasons why such a violation occurs. Vasoconstriction is considered the main factor in the increase in pressure. The blood flow exerts significant pressure on their walls. Among the main reasons for the increase in pressure, it is necessary to highlight the presence ofatherosclerosis. This disease eventually leads to the development of symptomatic arterial hypertension.
Under the influence of atherosclerosis, the walls of the arteries begin to thicken, and the vessels lose their former elasticity. In addition, they are covered with atherosclerotic plaques from the inside. This poses a threat to life, as it significantly increases the risk of a heart attack or stroke.
Among the main factors provoking the development of arterial hypertension, it is necessary to highlight:
- excessive weight;
- bad habits;
- excessive consumption of table s alt.
Knowing exactly what causes the disease, you can prevent the risk of its development. In addition, people who have a predisposition to high blood pressure should undergo periodic examinations with a doctor and strictly follow his recommendations.
Main symptoms
When arterial hypertension occurs, clinical signs may not be observed for a long time, so if you do not use a tonometer, you may not even know about the presence of problems, which greatly interferes with timely therapy. The most important symptom may be persistent high blood pressure. However, not all of us control its level. That is why you need to pay attention to symptoms such as:
- headache;
- pain in the heart;
- tinnitus;
- strong heartbeat;
- visual impairment;
- arterial damage;
- shortness of breath;
- puffinessfeet.
Headache is often localized in the temples, the back of the head or the parietal region. Discomfort may occur at night or immediately after waking up. As a rule, the pain increases with physical and mental stress.
When the first signs of the course of the disease occur, you should immediately consult a doctor for a comprehensive diagnosis, as this will make it possible to diagnose and prescribe treatment in a timely manner in order to avoid the development of a hypertensive crisis.
Diagnostics
When the level of pressure rises, you should immediately consult a doctor. At the initial stage, the diagnosis is a study of the history of the course of the disease, as well as the existing symptoms.
In addition, laboratory and instrumental studies such as:
- blood and urine test;
- electrocardiogram;
- biochemical study;
- ultrasound.
It is also important to control blood pressure by using a special device - a tonometer. The patient must acquire it in order to be able to respond in a timely manner to the course of negative changes in the body. A physical examination is required, which includes examining the patient with a stethoscope. It helps to determine the presence of heart murmurs and many other characteristic changes in the body.
To get complete information about the state of the walls of blood vessels,you need to undergo arteriography, which is an x-ray method of examination. In addition, an ultrasound examination of the blood flow of the vessels is carried out.
Feature of treatment
Treatment of arterial hypertension should be carried out comprehensively, as well as strictly follow all the recommendations of the attending doctor, so as not to provoke a deterioration in well-being. When conducting therapy, it is imperative to eliminate such risk factors as:
- tobacco smoking and alcohol consumption;
- excessive weight;
- sedentary lifestyle.
In addition, it is imperative to normalize the level of lipids in the blood. This can be achieved through drug therapy or through proper nutrition. The diet for arterial hypertension implies a reduction in the amount of s alt consumed, as well as the introduction of seaweed, potatoes, legumes into the usual diet.
Drug therapy is required if blood pressure remains at 140 or more for a long time despite lifestyle changes. When arterial hypertension occurs, clinical recommendations must be followed very strictly. The patient is treated by a cardiologist. If a secondary form has been identified, then the patient is referred to a nephrologist or endocrinologist.
In addition, it is recommended to undergo an additional examination by a neurologist and an ophthalmologist to determine the condition of the internal organs. Following simple recommendations leads to a fairly good result.
Medicationtherapy
Drug treatment of arterial hypertension consists in the use of drugs such as:
- antihypertensive drugs;
- diuretics;
- blockers;
- ACE inhibitors;
- calcium antagonists.
Treatment should begin with the introduction of the minimum dosage of antihypertensive drugs and increase it only if there is no desired result. To prevent the risk of complications, medications must be taken throughout life, as they will allow you to constantly maintain optimal pressure. When choosing drugs, preference should be given to long-acting drugs, as this will allow organizing only a single dose in the morning.
Start treatment of symptomatic hypertension with monotherapy and gradually move to a combination of drugs from different groups. For the elderly, calcium channel blockers should be used initially. It is undesirable that they contain components that change the metabolism of insulin and glucose. The main goal of therapy is to prevent death in patients.
Diuretics have a positive effect on the heart muscle and are well tolerated by most patients. They are used to treat hypertension only in the absence of gout and diabetes. Diuretics are often prescribed along with other blood pressure medications.
Adrenergic blockers have a very good effect on the lipid composition of the blood. They are not at allchange glucose levels, reduce blood pressure without increasing heart rate. It is worth noting that at the first use of such drugs, there may be some deterioration in well-being, and a person may even lose consciousness. To avoid this, you need to follow certain rules. Diuretics must be discontinued before taking this remedy, and the first dose should be in the evening.
ACE inhibitors block the formation of hormones that cause vasoconstriction. Due to their effect on the patient's body, a significant decrease in pressure is observed. In addition, their use reduces the risk of developing nephropathy in diabetes. It is worth noting that their use is indicated primarily for chronic heart failure.
Hormone antagonists are prescribed if for some reason the use of inhibitors is contraindicated. In the treatment of arterial hypertension, clinical recommendations must be followed very strictly, since the success of recovery largely depends on this. The doctor may prescribe one or more drugs for medical treatment.
Even after normalization of pressure, treatment should not be stopped without consulting a doctor, as this can provoke the development of a hypertensive crisis.
Non-pharmaceuticals
When arterial hypertension occurs, the doctor's recommendations must be followed very strictly, since self-medication can provoke various complications. Non-drug methods of therapy are widely used, which are well combined with various medicinaldrugs.
Be sure to give up smoking, as it has a very bad effect on the state of the cardiovascular system. In addition, it is imperative to monitor your weight, as weight loss has a beneficial effect on lowering blood pressure and helps to eliminate the main risk factors for developing disorders.
It is worth increasing the consumption of fruits and vegetables rich in potassium and magnesium, as well as limiting animal fats in your diet. Be sure to try to avoid stress, mental and physical strain. Doctors recommend increasing physical activity. For example, brisk walking and swimming will be useful. It is worth noting that some types of loads, on the contrary, contribute to an increase in the level of pressure.
Consequences of the course of the disease
It is worthwhile to understand exactly what the risks of arterial hypertension may be. With a prolonged increase in pressure, the walls of blood vessels thicken significantly and lose their ability to relax. As a result, the process of saturation of tissues and organs with oxygen is disrupted, which leads to a decrease in their activity. Among the main risks of hypertension are the following:
- hypertensive crisis;
- stroke;
- heart attack;
- angina;
- heart failure;
- ischemic disease;
- kidney failure;
- visual impairment.
Among the most frequent risks of the course of the disease, one can single out the occurrence of a hypertensive crisis. It can be observed atrelatively satisfactory condition of the patient. This is one of the most common risks of arterial hypertension of the 2nd degree. It can be provoked by the psychophysical stress of the patient. It develops very quickly, and at the same time it is observed:
- pressure surge;
- severe headache;
- nausea;
- arrhythmia or tachycardia.
The risk of grade 3 hypertension is the occurrence of myocardial infarction. This complication proceeds for several minutes and can lead to the death of the patient. The main symptom is a prolonged pain attack.
Hypertensive crisis
Hypertensive crisis is a condition requiring urgent care. It implies a sharp increase in pressure to very high levels. In this case, there is a violation of the blood supply to internal organs, including vital ones. It occurs when the body is exposed to adverse factors.
Hypertensive crisis is very dangerous because it is completely impossible to predict. In the absence of timely assistance, a fatal outcome is possible. To provide emergency care, the patient must be urgently taken to the hospital, where his pressure will be reduced by the use of special medications.
Influence on internal organs
Arterial hypertension is quite acute, as a constant increase in pressure leads to damage to many internal organs and systems. In particular, these include:
- brain;
- heart;
- vessels;
- kidneys.
The symptoms of the course of the disease largely depend on which of the organs are affected in the first place. Pathological changes in the vessels concern, first of all, their walls, as their thickening, narrowing of the lumen and damage by plasma proteins occur. This leads to disruption of the functioning of blood vessels and hypoxia of organs.
Changes in the heart muscle begin with myocardial hypertrophy. Subsequently, heart failure occurs and the risk of sudden death increases. In the kidneys, important mechanisms are inhibited at the very beginning. Then degenerative and structural changes occur in the renal arteries, and kidney atrophy occurs.
The same degenerative changes occur in the brain as in the vessels of the kidneys. This leads to encephalopathy, hemorrhagic stroke, and ischemia.
Hypertension leads to high blood pressure and increased stress on the heart. This provokes thickening of the myocardium and the development of heart failure.
