Today, almost everyone has at least the slightest idea of what hypertension is. As for the factors contributing to the emergence of this pathology, non-specialists know much less about this. At the same time, knowledge of the main causes of arterial hypertension is an important condition for its prevention.
What is hypertension
Let's look at the terminology. Arterial hypertension is a cardiovascular disease, which is characterized by a stable increase in the level of SBP (systolic blood pressure) and / or DBP (diastolic blood pressure) from 140/90 mm. rt. Art. respectively.
The prevalence of this pathology among the adult population of the planet is approximately 25%. At the same time, after the age of 60, 55% of people already know what hypertension is by their own example.
This pathology is very dangerous for the reason that it contributes to damage to blood vessels, the heart, becoming a provoking factor in the formation of serious diseases.
Reason for development
Depending on the mechanism of its formationarterial hypertension today is divided into the following 2 types:
- essential;
- symptomatic.
In order to determine what kind of arterial hypertension a patient has, you will first have to conduct a whole range of diagnostic studies.
Essential hypertension
Essential arterial hypertension occurs in more than 90% of all cases. To date, the specific causes of the development of this pathology cannot be established. At the same time, a large number of factors that contribute to its occurrence are known. Chief among them are the following:
- Increase in body weight (each extra kilogram increases the pressure by at least 1 mmHg).
- Sedentary lifestyle (in the absence of muscle activity, the tone of blood vessels supplying them decreases over time, which leads to an increase in blood pressure).
- Smoking (nicotine, getting into the bloodstream, damages the vascular endothelium, which provokes their reflex narrowing and an increase in peripheral resistance).
- Alcohol abuse (in a person with constant intake of alcoholic beverages, the central mechanisms of pressure regulation are disrupted).
- Age (in men after 45 years, and in women - 55 years, the elasticity of the vascular wall begins to decrease, which leads to an increase in pressure).
- Heredity (persons whose parents suffered from arterial hypertension are much more likely to experience a similarproblem).
- Chronic stress.
- Diabetes mellitus (this disease is accompanied by gradual damage to the vascular wall).
- Abuse of table s alt (according to scientists, no more than 3 g should be consumed per day).
The highest risk of developing hypertension are those patients who have several provoking factors at once. These criteria also play a role in assessing the risk of complications in patients with an already established disease.
What is symptomatic hypertension
This pathological condition develops against the background of other ailments. The most common among them are the following types:
- nephrogenic;
- endocrine;
- neurogenic;
- hemodynamic.
When these causes are eliminated, blood pressure levels usually return to normal levels. The symptomatic form of hypertension reviews from patients suffering from it leaves the most unpleasant. The fact is that without eliminating the cause of the disease, it is practically impossible to reduce the level of pressure.
Nephrogenic arterial hypertension
Few people know what nephrogenic hypertension is. This pathological condition occurs when one or another kidney disease develops. This disrupts the functioning of the renin-angiotensin-aldosterone system. Its work directly depends on the proper functioning of the kidney tissue.
Most often diseases,causing their failure are pyelonephritis and glomerulonephritis. At the same time, the acute course of these diseases causes a significantly greater increase in blood pressure than their chronic form.
Endocrine hypertension
This form of hypertension develops in case of defects in hormone metabolism. This is usually observed in the following diseases:
- Thyrotoxicosis.
- Itsenko-Cushing's disease.
- Pheochromocytoma.
- Aldosteroma.
- Climax.
With thyrotoxicosis, there is an increase in the content of thyroid hormones in the blood. At the same time, increased pressure is only one of the many symptoms of this disease. The patient becomes sweaty, he does not tolerate heat. His emotional sphere also changes. A person begins to get annoyed for almost any reason, he develops tearfulness. On the part of the cardiovascular system, in addition to an increase in blood pressure, there is an increase in the pulse rate of contractions, a feeling of palpitations, the development of arrhythmias and signs of circulatory failure. Patients have reduced muscle tissue, they get tired very quickly when performing simple manipulations, osteoporosis gradually develops, which can lead to accidental fractures.
Itsenko-Cushing's disease, in addition to increased pressure, is also characterized by an increase in body weight and a change in the shape of the face. It becomes somewhat puffy and "moon-shaped".
Pheochromocytoma is a neoplastic diseaseadrenal glands. With its development, blood pressure may not be constantly elevated, but when it increases, it reaches very impressive numbers and practically does not decrease when using antihypertensive drugs.
Aldosteroma or Conn's disease is a tumor pathology. As a result of its development, the level of production of the hormone aldosterone increases. This active substance delays the excretion of sodium ions from the body, which leads to dysregulation of blood pressure levels.
Menopause in women usually develops at the age of 50-55 years. It is accompanied by periodic "hot flashes", during which the patient's pressure level, the frequency of cardiovascular contractions increases, a feeling of heat develops, sweating, emotional disturbances and anxiety occur.
Degrees of hypertension
Diagnosis of arterial hypertension is made in cases where the patient has a 2-fold measurement of the pressure level, this indicator exceeds 139/89 mm. rt. Art. In this case, the interval between measurements should be at least 2 weeks. In cases where the pressure is in the range of 130/85 mm. rt. Art. up to 139/89 mm. rt. Art., speak of a highly normal level of this indicator.
Currently, there are 3 main degrees of arterial hypertension:
- 1st - the pressure level is set from 140/90 mm. rt. Art. up to 159/99 mm. rt. st.
- 2nd - the pressure level is determined in the range from 160/100 and up to a maximum of 179/109 mm. rt. st.
- 3rd - the pressure level is between 180/110 mm. rt. Art. and above.
The degree of arterial hypertension is determined by the highest index. If the patient has a pressure of 135/100, then he is given the 2nd degree of this pathology. In such situations, we speak of isolated arterial hypertension. More often it is observed in persons belonging to the older generation.
Main symptoms of the disease
Hypertension has quite characteristic manifestations. The main signs of this disease are:
- Persistent increase in blood pressure.
- Headaches, mainly in the occipital region.
- Decrease in visual acuity (with a long-term illness).
- "Sparks" before the eyes (manifested at sufficiently high blood pressure).
- Nausea, which may lead to vomiting.
- General weakness.
- Discomfort, pain in the heart area.
It is important to consult a doctor immediately after the first symptoms of hypertension appear, as arterial hypertension can lead to such severe complications (myocardial infarction and stroke).
Diagnosis of disease
In order to establish the diagnosis of "arterial hypertension", as well as to clarify the degree of its severity, doctors use the following methods:
- Collection of anamnestic data (allows you to clarify the possible causes of the development of the disease, as well as determinerisk level).
- Common blood and urine tests (to rule out comorbidity or establish the fact of its presence).
- Blood chemistry (used here to measure electrolytes, including sodium and potassium, which affect blood pressure).
- Thyroid imaging with ultrasound.
- Ultrasound of the heart.
- Ultrasound of brachycephalic arteries.
- Ultrasound of the kidneys.
- 24-hour blood pressure monitoring.
- A blood test for hormone levels.
Thanks to these diagnostic measures, the doctor receives information that allows him to judge the appropriateness of establishing a diagnosis, the severity of the disease, as well as the causes of its occurrence, which helps determine the tactics of further patient management.
Treatment of disease
Hypertension is a rather dangerous disease, the negative impact of which, with proper therapeutic action, can be, if not eliminated, then significantly reduced. Treatment of hypertension involves the patient being prescribed antihypertensive drugs. The most commonly used drugs are from the following groups:
- Angiotensin-converting enzyme inhibitors ("Captopril", "Lisinopril", "Enalopril", "Ramipril").
- Beta-blockers ("Metoprolol", "Bisoprolol", "Carvedilol").
- Angiotensin II receptor blockers("Lazartan", "Valsartan").
- Diuretics ("Hypothiazid", "Furasemide", "Indapamide", "Spironalactone").
- Calcium channel antagonists ("Amlodipine", "Diltiazem", "Verapamil").
Each drug for hypertension, depending on its severity, the cause and the presence of concomitant pathology, can be prescribed as monotherapy or in combination with other drugs. In addition, the patient is advised to eliminate such risk factors as being overweight, eating excessive amounts of s alt, coffee, alcohol and quit smoking.
