Hypertension

Hypertension is a systemic disease with a persistent increase in blood pressure above 140/90 mmHg.Art.

Causes of hypertension

In clinical cardiology, hypertension is classified as an independent disease and a secondary one that develops as a complication of other pathologies.

The causes of primary hypertension can be the following factors:

• dysregulation of blood pressure;
• Excessive cardiogenic reactivity (sudden changes in blood pressure against the background of external stimuli);
• increased arteriolar tone;
• Disturbance of the process of sodium excretion by the urinary system.

Secondary hypertension develops as a complication in certain pathologies, including:

• Diseases of the kidneys and adrenal glands - chronic glomerulonephritis, pyelonephritis, tumors of the kidneys and adrenal glands, blockage of the renal artery, etc.
• Endocrinological diseases - diabetes mellitus, hyxedema, myxedema, tumors, metabolic disorders, hormonal imbalance, etc.
• Cardiovascular pathologies - atherosclerotic narrowing of blood vessels, aortic lumen, valve defects, etc.

In addition, provoking factors:

• A diet with excessive consumption of fats, salt, sugar and a sufficient amount of plant-based products;
• Age over 55 years;
• hereditary tendency;
• physical inactivity;
• Smoking, alcohol abuse;
• chronic stress.

Hypertension can also develop when taking certain drugs (glucocorticosteroids, anabolic steroids, antidepressants).

Types of disease

Depending on the cause and nature of the lesion, the following are distinguished:

• Primary hypertension;
• Hypertensive disease, which is the main damage of the heart;
• hypertension with predominant renal damage;
• Arterial hypertension with a preference for the heart and kidneys;
• secondary hypertension.

Taking into account the degree of pathology in the internal organs, the following are diagnosed:

• Stage i (Independent) - there is no damage to the target organs, but there is a continuous increase in blood pressure;
• Stage II (asymptomatic) - characterized by damage to the target organs, but there are no signs of the pathological process;
• III - organ damage accompanied by severe clinical symptoms occurs.

According to severity, hypertension is classified as:

• Mild - moderate - increased blood pressure in the range of 140 / 90-159 / 99 mm HG.Art.;
• Average - moderate - indicators within 160 / 100-179 / 109 mm HG.Art.;
• Severe - blood pressure more than 180/110 mm Hg.Art.

Isolated hypertension is also distinguished, the peculiarity of which is only an increase in systolic pressure.

Symptoms

Clinical manifestations of hypertension depend on the cause of the pathology and the degree of increase in blood pressure.In the initial stages, the disease may be asymptomatic, then patients complain:

• headache, dizziness;
• noise, ringing in the ears;
• the appearance of "flies" and spots in front of the eyes;
• active heartbeat, a feeling of trouble in the temples, at the back of the head;
• blushing;
• To suppress pain in the heart region;
• shortness of breath;
• swelling of the face, hands;
• Excessive sweating;
• Loss of appetite, nausea.

Other manifestations depend on the form and presence of complications of hypertension.This includes blurred vision, tremors, numbness in the limbs, impaired coordination, fine motor skills, etc.It can be included.

Often, with a long course of the disease, the patient is first bothered by the above symptoms, but then they go away.This is due to the loss of sensitivity of the receptors and the adaptation of the body to the parameters of increased blood pressure.However, it is necessary to measure blood pressure regularly, record indicators and follow medical recommendations.

Possible complications of hypertension

In advanced forms of the disease, for example, complications:

• Hypertensive crisis;
• stroke;
• myocardial infarction;
• encephalopathy (reduced cognitive abilities with the subsequent development of vascular dementia);
• Kidney, chronic heart failure;
• atherosclerosis;
• Aortic aneurysm rupture;
• hypertensive retinopathy (damage to the retina);
• nephrosclerosis (primarily kidney).

The risk of complications depends on a combination of various inciting factors, but even a slight increase in blood pressure can lead to negative consequences.

Diagnosis of the disease

If symptoms of hypertension appear, you should consult a doctor or cardiologist.During the consultation, the doctor examines the detailed information of the medical history to determine the complaints, their characteristics, their characteristics, factors in the development of the disease.After that, the specialist conducts an examination, including a general examination, auscultation, percussion, palpation, heart rate and blood pressure measurement. 

A minimum of 3 isolated blood pressure measurements (on different days in a medical facility) or Abpm data (24-hour blood pressure monitoring) are required to confirm the diagnosis. 

As part of the initial diagnosis, the patient is prescribed:

• clinical analysis of blood, urine;
• Blood test for the content of hormones and glycated hemoglobin.

In order to clarify the delayed factors and detect pre-existing pathological processes, the patient can undergo the following diagnostic methods:

• Electrocardiography;
• echocardiography;
• Duplex examination of brachiocephalic, renal and iliofemoral vessels;
• Ultrasound of the heart, urinary system;
• Ophthalmological examination.

Depending on the causes of the disease, the general practitioner may refer the patient to a cardiologist, endocrinologist, nephrologist, neurologist or ophthalmologist for further treatment and diagnostic measures.

Treatment of hypertension

The goal of hypertension treatment is to normalize heart function, eliminate the symptoms of the disease and prevent the development of complications.The treatment regimen is selected individually.

Non-drug therapy

It means a change in lifestyle.To do this you need:

• regularly engage in therapeutic exercises;
• control weight;
• give up bad habits and coffee drinks;
• excluding fatty, spicy, canned foods, fast food and sweets from the diet;
• minimize salt and sugar consumption;
• More seasonal vegetables, fruits, fish, low-fat dairy products;
• Normalize the drinking regime (daily liquid volume should be 1-1.5 liters).

Drug therapy

Several drug groups are used in the treatment of hypertension:

• diuretics;
• Beta-blocker drugs;
• angiotensin-converting enzyme inhibitors;
• Antagonists of calcium channels, as well as Angiotensin II receptors;
• central action items. 

According to indications, renin inhibitors, vasodilators, lipid-lowering drugs, sedatives, etc.Can be undefined.Specific drugs, dosage and frequency of administration are determined by the doctor.

Prevention of hypertension

There is no specific prevention of the disease.To minimize the risk of developing hypertension and dangerous complications, it is necessary to follow a general set of preventive measures:

• maintain optimal body weight;
• exercise regularly;
• adhere to dietary nutrition;
• give up bad habits;
• urgently treat endocrine, nephrological and heart diseases;
• minimize stressful situations;
• Manage blood pressure levels.

It is also important to undergo regular preventive examinations and follow all medical recommendations.If your blood pressure rises, you should make an appointment with your doctor.

You can get advice from highly qualified specialists in a multidisciplinary medical center.Experienced therapists and cardiologists will conduct a proper examination and select an effective treatment for each patient.