High blood pressure is the most common cardiovascular disease, with symptoms affecting a significant portion of the population after the age of 60-65 years. The diagnosis has several names, including essential hypertension (AH), arterial hypertension (AH). The disease is chronic, the main task of all patients is to avoid exacerbations and prolong the period of remission (disappearance of symptoms) by pharmacological and non-pharmacological methods.
What is high blood pressure
Arterial hypertension is a persistent rise in blood pressure above acceptable levels (starting at 140/90 mmHg) due to provocative factors. This diagnosis is called a "silent killer. "The pathological process is asymptomatic for a long time, but during a seizure it significantly increases the risk of stroke, heart attack and other dangerous diseases. The potential complications of GB can be life-threatening and require timely diagnosis and appropriate treatment.
Hypertensive disease is caused by dysfunction of the higher centers of neurohumoral regulation, the kidneys and the blood vessels. In the absence of timely treatment, the pathological process leads to organic and functional disorders of the heart, central nervous system organs, and kidneys. Improperly selected therapy can lead to disease progression with increased pain.
Classification of high blood pressure
In 2003, a uniform classification of hypertension was determined according to the severity of the disease. The determining factor in this division is the true measure of blood pressure, which is determined by the tonometer in a given clinical case. Hypertension is also classified according to origin (primary, secondary), stages (transient, stable, sclerotic), and risk level of cardiovascular pathologies. This classification simplifies the diagnosis and helps to define more precisely the treatment regimen for each hypertensive patient.
Degrees of arterial hypertension
With an increase in blood pressure (BP), there is a suspicion that arterial hypertension is progressing, especially if this health problem cannot be solved with drug-free methods. It is important to know that the optimal blood pressure is 120/80 mmHg. Art. , Normal - 120-129 mmHg. Art. (systolic pressure - SBP) and 80-84 mmHg. Art. (diastolic - DBP), high normal - 130-139 mm. rt. Art. (SAD) and 85-89 mm. rt. Art. (APU). Deviation from this indicates severe pathologies of the body. Doctors distinguish between 3 degrees of GB:
- Grade 1 (mild) hypertension is characterized by unstable pressure ranging from 140/90 to 159/99 mm Hg for several days. Art. The risk of developing a hypertensive crisis is minimal, and there are no symptoms of organ damage to the internal organs or the central nervous system. In order to suppress a painful attack, in addition to medication, the patient needs good rest and the exclusion of stressful situations. Positive emotions, walks in the fresh air are especially helpful.
- Grade 2 arterial hypertension develops rapidly. The blood pressure index varies between 160/100 and 179/109 mmHg. Art. , There are symptoms of hypertensive crisis (cold sweat, goosebumps, flushing). The patient is worried about migraine attacks, dizziness, poor sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischaemia (decreased blood flow to the organ), increased blood creatinine, narrowing of the retinal arteries, left ventricular hypertrophy (increased size), microalbuminuria (detection of protein in the urine). Normalization of the condition is not possible without medication.
- Grade 3 (severe) hypertension is accompanied by a sharp decrease in visual acuity, poor memory, and tachycardia attacks (increased heart rate). A hypertensive crisis develops. BP indicator - from 180/110 mmHg. Art. and higher. Possible complications include hypertensive encephalopathy, cerebral vascular thrombosis and aneurysm (abnormal dilation of the blood vessel), left ventricular heart and kidney failure, bleeding (bruising) and swelling of the optic nerve. The pathological lesions are irreversible.
The degree of cardiovascular risk
The first step in predicting the likelihood of complications of progressive arterial hypertension is to determine the cardiovascular risk index. This requires expert advice and complex diagnostics. They take into account the degree of high blood pressure, the conditions that trigger relapse (physiological and abnormal). Common risk factors include:
- smoking, other bad habits;
- high cholesterol in the blood;
- sedentary lifestyle;
- obesity, including abdominal obesity (most of the fat is deposited in the abdomen);
- age (women over 65, men over 55);
- fasting sugar index 5. 6-7. 0 mmol / l;
- impaired glucose tolerance as determined by a special test;
- the presence of cardiovascular disease in relatives;
- man.
A patient has a high risk of cardiovascular disease in addition to high blood pressure:
- diabetes;
- heart failure;
- violation of lipid (fat) metabolism;
- bronchial asthma;
- extensive damage to the retina;
- coronary artery disease;
- Stage 4 renal failure;
- suffered a stroke;
- cerebrovascular disease (damage to the blood vessels in the brain);
- signs of destructive disease of the peripheral arteries of the lower extremities (atherosclerosis);
- damage to other internal organs.
Such information helps the physician predict the clinical outcome of the disease. To determine your cardiovascular risk score, you should read the table below for each degree of high blood pressure:
| General Risk Factors (RFR) | Blood pressure | Risk of high blood pressure of 1 degree | degree of arterial hypertension, risk | Risk of grade 3 hypertension |
|---|---|---|---|---|
| there are no risk factors | ordinary risk | short | moderate | high |
| 1-2 | short | moderate | Medium high | high |
| Above 3 | low to medium | Medium high | high | high |
| damage to other internal organs, stage 3 kidney disease, diabetes mellitus | Medium high | high | high | Very high |
| CVD, stage 4 chronic kidney disease with involvement of other organs or common risk factors | Very high | Very high | Very high | Very high |
Treatment of high blood pressure
Classification of GB by stage and risk will help to correctly define drug therapy, quickly stop the painful seizure, and prolong the remission period. In the case of the development of primary arterial hypertension (isolated), the prognosis is favorable depending on medical recommendations. The secondary form of the disease is often complicated.
If the disease is not cured in time, high blood pressure is difficult to stabilize even with medication. The following are general recommendations for specialists who are diagnosed with grade 1, 2, or 3 hypertension. . It should be supplemented with the medication prescribed by your doctor:
- Adherence to a therapeutic diet. It is important to reduce the dose of table salt, enrich the daily diet with foods containing potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and cereals, greens).
- Rejection of bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, abandon a "sedentary" lifestyle, and take walks in the fresh air.
- Weight control. If a patient with arterial hypertension is obese, they should skip fatty, fried and smoked foods and fast regularly.
- Physiotherapy. To prevent and prolong the remission period of GB, it is recommended to perform moderate-intensity physical exercise 5 times a week for 30 minutes.
- Receiving multivitamin complexes. The composition of such drugs should contain potassium, magnesium, iron and other trace elements that are important for the body.
Medical therapy
Oral administration depends on the degree of hypertension and associated symptoms. The optimal regimen for the conservative treatment of arterial hypertension is presented below:
- In the mild phase of the disease, the patient prescribes angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
- The development of grade 2 arterial hypertension 4 requires an integrated approach to the problem, bringing together several representatives of different pharmacological groups in a conservative treatment regimen. These are the above medicines in combination with thiazide diuretics.
- In addition to the above medications, doctors recommend alpha or beta blockers during the complex course of the disease. This is necessary if the weakened body does not tolerate high-dose diuretics).