Headaches, weakness, shortness of breath, palpitations, nosebleeds are common complaints that patients come to see a general practitioner.
Every day, but more than once, a doctor has to deal with such complaints, especially if people over 40 years old prevail in the queue. Some of them already know their diagnosis, while others have yet to learn about it. Be that as it may, people are in no hurry to know the truth about their state of he alth, and therefore they delay the visit to the doctor as long as possible. This is especially true for men. Unfortunately, it so happened that until “the roasted rooster pecks”, until “the bell rings”, you won’t lure and drag them to the clinic, despite frequent headaches, dizziness, shortness of breath and nosebleeds.
Criteria for the diagnosis of arterial hypertension
- When measuring with a tonometer, fixing the numbers of systolic pressure of 140 mmHg and above, diastolic - 90 mmHg and above.
- Threefold change in pressure during the day.
- Double fixation of high blood pressure in a week.
Risk factors for hypertension
Decrease in physical activity is a consequence of total computerization and the widespread use of gadgets. With a sedentary lifestyle, there is no natural training of the cardiovascular system, which would be with an active lifestyle, running, sports and outdoor children's games.
People have forgotten how to relax. After work, it is difficult for many hyper-responsible workers to disconnect from production problems, leave behind the threshold of the house everything that was associated with a busy working day, and tune in to a wave of calm joy from communicating with loved ones. The same applies to holidays. The best option, of course, would be to stay in nature, in the fresh air: on a hike, in the mountains, by the sea, on a river rafting, or just in the country! Active recreation, combined with clean, fresh air and a he althy diet, can work wonders for an organism that has withered away in a bustling urban environment.
After watching ads, many tend to enjoy a cup of fragrant coffee or tonic tea before leaving home or already at work before a working day. Those who have been practicing this way of starting the day for a long time have become accustomed to strong invigorating drinks. Meanwhile, numerous studies have confirmed the effect of caffeine, contained in coffee and tea, to increase blood pressure. This habit is especially harmful in conditions when hypertension is just beginning, and a person does not feel all the negative symptoms that it hides.
Obesity. In recent decades, obesity has become widespread throughout the globe. Obese people make up 20-30% of the world's population.
Of these, only 2% have a burdened heredity, all the rest got extra pounds with food, grossly violating the daily routine, without thinking about the volume and quality of food eaten. There is a category of people who suffer from obesity due to endocrine diseases, but there are not so many of them among the entire mass of overweight individuals. Obesity creates an increased burden on the entire body, including the cardiovascular system. The heart has to make more efforts to provide blood to all organs and tissues, which leads to an increase in the upper value of blood pressure (systolic). A person has pain behind the sternum, often radiating to the left arm or under the shoulder blade, a feeling of lack of air, interruptions in the work of the heart, or, conversely, a strong heartbeat. All this can be accompanied by a fear of death and is a symptom of coronary heart disease, angina pectoris. This is how hypertension develops: coronary artery disease, medical history, hospital ward…
Excessive consumption of s alty foods and water also leads to an increase in blood pressure due to suction of fluid from the tissues surrounding the vessels into the bloodstream. This is what doctors write about in the history of the disease, in which hypertension occupies the mostplaces of honor
Lack of calcium and magnesium in food. Calcium is involved in the contraction of muscle cells, including myocardium and smooth muscles located in the walls of the vessels of the arterial bed, and magnesium relaxes these muscles, increasing the lumen of the vessel and lowering blood pressure. The optimal ratio of calcium and magnesium in food is 2:1. A deficiency of one microelement leads to an excess of another over time, an imbalance in the processes of contraction and relaxation of the vascular walls occurs
Modern features of the course of arterial hypertension
Our life is very dynamic. Some 20-40 years ago, it flowed much more calmly, from the majority of citizens it did not require wear and tear. Now constant stressful situations have become the norm of the workflow. A person stops noticing headaches, malaise, tingling in the heart, so asymptomatic or mild hypertension of the 1st degree passes into the second. If the patient is aware of the danger of his situation, seeks help and regularly follows medical prescriptions, he will be able to equalize the pressure and avoid vascular accidents. If he ignores the symptoms and recommendations of the doctor, he will quickly move into the third degree of the disease. And this has recently happened more and more often due to chronic employment and increased responsibility of people. Therefore, quite often there is such a history of the disease. Therapy: hypertension requires complex treatment aimed at maintaining a normal level of pressure,prevention of vascular accidents and structural changes in internal organs.
Stages of disease progression
- Under the influence of increased pressure, small vessels come into a state of spasm. The kidneys suffer the most, in which blood is filtered through a small capillary network. The kidneys receive less blood and oxygen, and a state of ischemia occurs.
- In response to ischemia, the renin complex is activated: the kidneys begin to produce substances that increase blood pressure, and fluid is retained in the vascular bed, aggravating the condition and closing the vicious circle.
Classification by degrees of arterial hypertension
Degrees of disease are characterized by blood pressure numbers.
- 1st degree - 140 to 160 systolic pressure and 90 to 100 mmHg. Art. diastolic pressure.
- 2nd degree - from 160/100 to 179/109 mm Hg. post.
- 3rd degree - above 180/110 mm Hg. post.
Classification by stages
Staging of the process reflects the occurrence of pathological changes in organs and tissues.
- 1st stage - no complications of the disease and structural changes.
- 2nd stage - there are signs of functional and structural changes in the internal organs (enlargement of the left parts of the heart; the kidney shrinks due to the growth of the connective tissue) and blood vessels (dyscirculatory encephalopathy, changes in the fundus vessels, and so on).
- 3rd stage - occurrence of vascular accidents (stroke and heart attack).
Classification by factorsrisk of hypertension
In addition to the degree and stage of hypertension, there are also risk factors. They mean the risk of developing complications of hypertension in each of the patients in particular. This risk stratification is designed to provide better control for those patients who need to take special care of their he alth due to the greater likelihood of developing complications. It includes all the factors that affect the course of the disease, as well as the prognosis of the disease.
- Low risk (less than 15%) occurs in men and women under the age of 55 who have first-degree hypertension and no associated organ or heart damage.
- A moderate risk (15-20%) is typical for patients with hypertension of 1-2 degrees with the simultaneous presence of 1-2 risk factors and the absence of changes in the structure of internal organs under the influence of the disease.
- High risk (from 20% to 30%) is typical for patients with 1-2 degrees of hypertension, with 3 or more risk factors, structural changes in internal organs, tissues, blood vessels, characteristic of grade 2 hypertension.
- Very high risk (over 30%) is typical for patients with hypertension of the 2nd degree, many risk factors that caused the onset of the disease, and the presence of structural changes in organs and tissues of the body under the influence of high pressure.
Examples of diagnoses
Let's analyze what the diagnoses that the medical history contains mean. "Hypertension stage 2, degree 2, risk 3". To understand this notation, let's remember the classification.
This diagnosis is made to a person over 55 years old, whose blood pressure figures several times a week exceed 160/100 mm Hg, for example, reach 170/120 mm. He has a pronounced enlargement of the left parts of the heart, in particular, the ventricle, discirculatory encephalopathy, obesity of the 1st-2nd degree. Such a person occupies a leadership position for a long time, is nervous a lot, smokes, occasionally abuses alcohol, eats irrationally, loves s alty and spicy food. These are the facts that a medical history can hide (hypertension stage 2, degree 2, risk 3). Other options are possible.
Case records. Hypertension at a young age
Every year, experts observe a steady rejuvenation of diseases of the cardiovascular and nervous systems. Already in the last century, cardiovascular pathology was called the scourge of the century. In the coming century, the negative trend continues to gain momentum. Now it is already difficult to surprise someone with 30-year-old hypertensive patients, some people already have their own “experience” by the age of 20. Each of them has their own medical history. Hypertension can develop very quickly, in weeks, or maybe very slowly, gradually, acquiring concomitant pathology or manifesting itself as one of the symptoms of the disease. Given the trend towards rejuvenation, 16-18-year-old people also suffer from this ailment.
Case history. Young people
In medical practice, there is such a case history of therapy: hypertension developed inyoung man aged 15 years. In the anamnesis of life, several factors attract attention:
- Hereditary predisposition on the father's side, grandparents on his side and on the maternal side of the grandfather.
- Funnel chest since childhood, not corrected by either therapeutic exercises or surgery.
- An additional factor provoking the disease is smoking, starting from adolescence and periodically moderate alcoholism.
From the history of the disease: in adolescence, headaches, chest pains appear and gradually become more frequent and increased blood pressure numbers are recorded: systolic rises to 130-140 mm Hg, and diastolic - up to 90-110 mm Hg. The patient does not pay attention to these “calls”, takes analgesics and does not seek medical help, therapy is not carried out, the condition worsens, and by the age of 18 he is hospitalized. Such is the history of the disease. Hypertension stage 2, hypertensive crisis, first appeared in life by adolescence.
The following is an example of another young man. He has a standard medical history. Hypertensive disease of the 2nd stage developed as a result of a negligent attitude towards one's he alth. This is a case history for therapy. IHD: hypertension 1 tbsp. was diagnosed in a patient aged 14 years. By this time, he already had obesity (body mass index reached 31), shortness of breath with little physical exertion, and pathological changes in the knee joints. By the way,the whole family suffered from obesity, so the child began to get sick from childhood. The recommendations of pediatricians on nutrition correction, maintaining a he althy lifestyle, increasing mobility, the need to visit the pool or other sports and fitness activities, according to age, were ignored by parents. With a set of body weight, the state of he alth of the child worsened. At the age of 15, blood pressure reached 150 mm Hg, visual impairment, chest pain, severe shortness of breath during physical exertion. Here is a case history of therapy. Hypertension is an insidious thing and you should not start it. Of course, everyone wants to recover without much effort, therefore, neglecting the doctor's prescriptions for the daily intake of drugs that maintain normal blood pressure, they get a hypertensive crisis. Some people's medical history begins with him.
All the negative trends in the state of he alth did not alert young people, did not make them think about the normalization of their lifestyle. Unfortunately, without correction, the state of he alth will not improve, and the prognosis for the development of pathology is unfavorable.
Many obese people believe that by smoking they will lose weight and everything will be fine, but this opinion is wrong. Smoking only aggravates the course of the disease. So far, he has a diagnosis (which contains a medical history of therapy) - hypertension of the 2nd degree, 2 stages. Without systematic treatment, which most people consider optional, the patient will receive a "bouquet" of comorbidity. And it will containthe diagnosis of his medical history for therapy: hypertension grade 3, stage 3. Isn't it worth considering?
Hypertension. Medical history academic
A 58-year-old patient was delivered to the emergency department of the therapeutic building of the city hospital with complaints of severe chest pain, shortness of breath, and palpitations. Pain does not go away after taking nitroglycerin. BP measured at 185/110 mmHg.
When collecting an anamnesis, it turns out that similar pain attacks appeared in him more than 20 years ago, high blood pressure has been noted since the age of 35. During this time, a hypertensive crisis occurred 2 times with an increase in pressure up to 210 mm Hg. st.
8 years ago was treated in a hospital for high blood pressure. There was such a history of the disease: hypertension of the 2nd degree. The pills prescribed at discharge from the hospital, including Enap, are taken irregularly. Before a real attack, I did not take them for a week due to good he alth. He works as a technical director in a large construction company, the work is associated with psycho-emotional stress. Bad habits - smoking.
At the last medical examination, there was a decrease in vision by 0.4 units, protein, erythrocytes in the urine, an increase in voltage on the ECG, a shift in the electrical axis of the heart to the left. Sent for additional examination and treatment at the place of residence, but did not reach the doctor - business, work.
During the examination in the hospital found: acute myocardial infarction, numerousstructural changes in the internal organs, blood vessels, ECHO - CG - dilatation of the left parts of the heart, ultrasound of the internal organs - revealed "wrinkled kidneys".
After the treatment, he was discharged in a satisfactory condition. Here is an example, when even after a vascular accident the situation was successfully resolved (case history - hypertension grade 3, stage 3).
Conclusion
Note the slow, gradual in most cases, development of hypertension. Make it a habit to measure your blood pressure several times a week, especially when you are not feeling very well, and do not neglect prevention: an active lifestyle, proper nutrition, avoiding stress will help you stay he althy and happy for a long time!
