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Hypertension

Hypertension is the causes of the appearance of which diseases arise, diagnosis and treatment methods.

According to world statistics, cardiovascular diseases are first among all causes of mortality.

Hypertension is one of the most common diseases of the circulatory system, which also acts as a factor in the development of other heart disease and blood vessels such as coronary heart disease, chronic heart failure, hemorrhagic and ischemic stroke.

Arterial hypertension is a persistent increase in systolic (upper) blood pressure above 140 mm Hg.Art.and/or diastolic (lower) above 90 mm hg.Art.According to the recommendations of the European Society of Hypertension and the European Society of Cardiologists, the criterion of arterial hypertension from 135/85 mm Hg is adopted for domestic pressure measurement.Art.And above.

The main symptoms that accompany an increase in blood pressure include headache, nausea, ear ears, palpitations, decreased visual acuity, irritability, sweating.

Sometimes an increase in blood pressure can be asymptomatic.In this case, blood pressure control is required.

Varieties of arterial hypertension

Before talking about increased blood pressure (blood pressure), one should understand how normal pressure should be.For each person, blood pressure values are individual.However, there is a generally accepted classification of blood pressure.

  • Ideal, where systolic blood pressure is less than 120 mm hg.Art. And the diastolic blood pressure is less than 80 mm hg.Art. 
  • Normal, where the upper blood pressure values are 120 to 129 and lower values from 80 to 84 mm hg.Art.
  • High normal, where the upper blood pressure values are 130 to 139 mm hg in the interval.Art.and inferior at the interval of 85 to 89 mm hg.Art.

Arterial hypertension is divided according to degrees, depending on the maximum values obtained by measuring the pressure.

1st degree systolic blood pressure 140-159 mm Hg.Art.and/or diastolic blood pressure 90-99 mm hg.Art.

2nd degree systolic blood pressure 160-179 mm Hg.Art.and/or diastolic blood pressure 100-109 mm hg.Art.

3rd degree systolic blood pressure 180 and more mm Hg.Art.and/or diastolic blood pressure 110 and more mm Hg.Art.

Separately isolate isolated arterial hypertension when only systolic blood pressure increases more than 140 mm Hg.ST and diastolic remains within normal values.

Causes of increased blood pressure

It is believed that most patients with high pressure suffer Primary Hypertension, whose development cannot be associated with specific causes.This is essential arterial hypertension, which occurs more often in age -related patients.

In other cases, when a certain cause of pressure is revealed, they mean secondary Hypertension.

Among the main causes that lead to secondary arterial hypertension, they distinguish:

  1. Kidney and Blood Vessels.These pathologies lead to a decrease in the intensity of blood flow to the kidneys and, as a result, to the release of sprouts of substances that contribute to increasing blood pressure and compensation for impaired renal blood flow.Chronic kidney disease, chronic glomerulonephritis, urolithiasis - these diseases can lead to the development of hypertension.Among the diseases of blood vessels, the narrowing (stenosis) of the renal arteries is observed, which may be congenital pathology or occurs with atherosclerosis in adulthood. 
    2. reducing blood flow due to atherosclerosis
  2. Different Endocrine diseases lead to the development of hypertension and other related symptoms.For example, with thyreotoxicosis, the production of thyroid hormones is improved, accompanied by the appearance of a goiter (an increase in the gland itself), an increase in systolic blood pressure, a heartbeat, increased excitability and a decrease in body weight.With hypothyroidism, thyroid hormones are reduced.Pathologies are accompanied by endothelial dysfunction and impaired relaxation of smooth muscle cells of blood vessels, which leads to an increase in peripheral resistance of blood vessels.This helps to increase blood pressure.These patients are characterized by an increase in diastolic blood pressure, a deceleration in the pulse, weakness and rapid fatigue.With pheochromocytoma (adrenal glands), catecholamine release (adrenaline, norepinephrine) increases in the blood, which leads to accentuated heels in blood pressure at very high values.Hypertension is a frequent satellite of obesity.Adipose tissue cells (adipocytes) produce biologically active substances that affect the whole body as a whole and, in particular, in the vessels.Also, do not forget that the "extra" tissue also needs to be blood supply, and this leads to an additional load in the cardiovascular system. 
  3. Different heart disease and blood vessels They can lead to high blood pressure.For example, aortic coarctation is a local narrowing of the aorta lumen, more often congenital pathology;Atherosclerotic narrowing of the vessels. 
  4. Pregnancy (pre -acclaimsia). 
  5. Hypertension when taking a little medication: Oral contraceptives, anabolic steroids, glucocorticosteroids, antidepressants.

It should be remembered about the factors that contribute to the development of arterial hypertension: hereditary predisposition, excess prolonged nerve strength, frequent stressful situations, excessive physical activity, smoking, alcohol and coffee abuse, consumption of a large amount of salt and greasy foods.

What diseases occur hypertension?

Arterial hypertension is divided according to degrees, depending on the maximum values obtained by measuring the pressure.

Let's indicate some of them.

  • Atherosclerosis, including the renal arteries. 
  • The injury of the renal vessels (thrombosis, embolism, stenosis, renal vessel compression with a tumor or organ). 
  • Chronic pyelonephritis. 
  • Chronic glomerulonephritis. 
  • Chronic kidney disease. 
  • Thyroid diseases (hypo and hyperthyroidism). 
  • Izenko-Cush's disease and syndrome. 
  • Feochromocytoma. 
  • Primary hyperaldosteronism.
  • Metabolic syndrome. 
  • Coarctation of the aorta. 
  • Pre -ECLAMPSIA.

Which doctors contact us by increasing blood pressure?

To identify the causes of pressure increase, you should initially contact the therapist.The doctor will conduct an exam and prescribe the necessary amount of expert exams and consultations.Among them may be:

  • Cardiologist; 
  • Endocrinologist; 
  • neurologist; 
  • surgeon; 
  • ophthalmologist.

Diagnosis and examination with increased blood pressure

First of all, the self -control of blood pressure at home is necessary to maintain a diary, where all measures of pressure in time, taking drugs and episodes of stress should be fixed, which could cause an increase in blood pressure.

The following laboratory studies are prescribed for all patients in the first stage of the exam:

  • Clinical blood test;
  • General urine analysis;
  • Biochemical blood test (cholesterol control; lipoproteins is very low; and high density to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium; creatinine levels; blood glucose levels);
  • blood test for the level of glycated hemoglobin; 
  • A blood test for hormone content (th4 - t4; triiodothyronine - t3; thyrotropic hormone - TSH; thyroid antibodies - peroxidase; antibodies for thyroidoglobulin).

If necessary, the doctor can prescribe a complex of laboratory and instrumental examination methods:

  • daily monitoring of blood pressure; 
  • Electrocardiographic study; 
  • echocardiography; 
  • Holter's daily monitoring; 
  • duplex scanning brachiocephalas, 
  • Renal/iliac and lamp arteries; 
  • Ultrasound study of adrenal kidneys and glands; 
  • Eye bottom study.

Hypertension Treatment

Hypertension is a disease, whose development depends on many factors and, therefore, the first recommendation in high pressure correction is a change in lifestyle.

Firstly, they make changes in the diet: limit the consumption of canned and finished products, sauces and mayonnaise and gradually reduce the amount of salt added to food.

The menu should include more fresh vegetables, fruits and dairy products.Alcohol and smoke should also be limited.

In the presence of overweight and absence of contraindications, a diet is used.Regular moderate physical exertion of at least half an hour a day contributes to the normalization of vascular tone.

We should not expect a quick effect of diet and physical education.However, at the beginning of the disease, it is these actions that can play a positive role.

Depending on the stage and degree of the disease, drug therapy is prescribed.In clinical practice, several groups of medicines are used to treat hypertension:

  • diuretics (diuretics); 
  • Betabloquers; 
  • Calcium channel antagonists; 
  • Inhibitors of the enzyme angiotenzinzinzinproding (IAC); 
  • Anatagonists of the receptor of angiotensin II; 
  • Central drugs.

Depending on the cause of the development and course of the disease, as well as related diseases, the doctor prescribes an individual treatment regime.The therapy selected by the assistant doctor, the constant use of drugs and a change in lifestyle will help normalize blood pressure.

What to do with high pressure?

The pressure should not be reduced quickly: in the first two hours when helping, blood pressure should decrease by no more than 20% of the initial high level.

When blood pressure has increased moderately, but the overall stable good (there are no other symptoms), you should try to fall asleep or lie down with your eyes closed.If after rest the pressure remains high, it is necessary to take medications recommended by the assistant doctor.

If an increase in blood pressure is accompanied by severe headache, dizziness, shortness of breath, visual impairment, pain, nausea or vomiting, it is necessary to cause an ambulance.