Hypertension (hypertension)

According to statistics, 30% of the adult population experiences periods of high blood pressure, and it is almost always a sign of an independent pathology or the so-called primary hypertension. Our country ranks 49th in the world in terms of the number of patients with this disease.

Without treatment, complications of hypertension occur:

• myocardial infarction;
• stroke;
• acute heart failure;
• hypertensive crisis.

The insidiousness of the pathology is that in half of the cases, patients do not even suspect that they have a dangerous disease, so they do not take any measures and hypertension begins to manifest itself with unpleasant symptoms. Many countries have launched preventive programs aimed at combating the pathology. New safe medications are being developed to control blood pressure levels. At the same time, only 1/3 of hypertensive patients receive adequate therapy and take care of their health.

Doctors around the world believe that in every home there should be a device for measuring blood pressure, in addition to a thermometer. This is especially true for families where family members have already suffered from cardiovascular diseases.

Causes of hypertension

Currently, the exact causes of hypertension have not been established. The main risk factor is prolonged or severe psychoemotional stress. Other causes of pathology include:

• excess body weight - with excess weight, each kilogram increases blood pressure by two mmHg;
• sedentary lifestyle;
• eat canned foods, smoked meats, fatty foods, spicy cheeses;
• excessive use of salt when cooking;
• frequent stress;
• smoking - harmful substances contained in cigarettes contribute to mechanical damage to the walls of arteries;
• busy work schedule;
• alcohol consumption;
• very tall or too short stature in men;
• physical and nervous fatigue;
• consumption of animal proteins, which is not limited.

Risk factors also include hereditary predisposition. High blood pressure in first-degree relatives guarantees a high risk of developing the disease.

It is worth paying attention to age, after 35 years of age men have a greater chance of contracting this disease. In women, the pathology is associated with the onset of menopause.

Symptoms of hypertension

Often there are no signs of pathology, but sometimes the following symptoms can be observed:

• headache;
• fast or weak heartbeat;
• dizziness;
• swelling of the eyelids, legs and arms, swelling of the face;
• memory impairment;
• numbness of fingers;
• facial redness;
• shaking chills;
• increased sweating;
• anxiety;
• internal tension;
• decreased performance;
• irritability;
• the appearance of "mosquitoes" before the eyes.

All these manifestations do not constantly bother patients, but occur only for a certain period of time. This is the insidious disease, so if the above symptoms appear, you should consult a doctor. If therapy is not started on time, over time the disease will begin to progress and can lead to serious complications. Therefore, it is important to control blood pressure. For this purpose, today there are many special tonometers, from conventional mechanical devices to fully automated models. The operation of tonometers with a stethoscope is more complicated, it is not always possible to distinguish sounds from pulsations, but after a little training and practice, almost everyone can learn it.

Before measuring your blood pressure you should not smoke, drink alcohol or coffee, it is advisable to spend a few minutes resting. The measurement is carried out in a sitting position, the cuff should be fixed slightly above the elbow, where the pulse is best felt. Most often, aneroid (lever and inflatable type) and automatic devices are used to determine pressure. In outpatient settings, devices are used that can monitor pressure changes throughout the day.

Each age has its own blood pressure standards:

• 16-20 years – pressure 100/70 – 120/80;
• up to the age of forty the norm is 120/70 – 130/80;
• from forty to sixty – up to 135/85;
• After sixty years, normal blood pressure is considered to be 140/90.

In cases where the readings exceed the norm for several days in a row, this is a mandatory reason to visit a doctor, even if there are no symptoms other than the data from the device. A competent doctor will give you lifestyle recommendations for hypertension at an early stage, which will help avoid complications.

Hypertension - classification

During the study of the disease, many different classifications with divisions were developed: according to etiology, the appearance of the patient, the stability and level of pressure, the causes of the increase and the nature of the course. Some of them are still used by doctors today.

The first classification of hypertension divided it into red and pale. The patient's appearance played a decisive role in this division. In the pale variant, the patient had cold extremities and a sickly complexion, which was explained by vasospasm. With red hypertension, when blood pressure increases, the patient's face, on the contrary, becomes red and covered with spots.

In practice, one of the most important classifications is the division of the disease by origin. There is a primary, or essential, form that presents as an isolated pathology. At the same time, there are no diseases of other organs and systems.

The secondary form is a symptom of pathology of the organs involved in the regulation of vascular tone. These include the kidneys, endocrine and nervous systems.

There is no unified systematization of hypertension, but, as a rule, doctors use the classification recommended by the World Health Organization. It is characterized by the degree of pressure increase.

• Stage 1 hypertension is a mild form, characterized by a pressure of 140/90 to 159/99 mmHg.
• Second degree hypertension - moderate hypertension, pressure increases to 79/109 mm Hg. Art. Sometimes doctors diagnose "hypertension stage 2 risk 2", this means that one or two risk factors exist and the possibility of complications has arisen.
• Third degree hypertension is characterized by a severe course, the pressure increases to 180/110 mm Hg. Art. and even higher. If, during the examination, the doctor diagnosed "hypertension, stage 3, risk 4", then you should immediately start treatment and seek help in a hospital. In this case, the probability of complications increases to 30%.

The organs most susceptible to complications of hypertension are:

• brain – DEP, dementia, stroke, memory loss;
• kidneys – development of chronic kidney failure;
• heart: heart failure, heart attack, coronary death;
• boats;
• eyes.

Doctors classify the disease based on damage to the organs mentioned above. Stages of hypertension:

• Stage I - the functioning of the cardiovascular system is not affected, patients usually do not complain about their condition.
• Stage II: enlargement of the left ventricle, blood pressure increases. Local narrowing of the retinal vessels may be observed.
• Stage III: signs of organic damage appear: chronic renal failure, angina pectoris, hypertensive encephalopathy, disorders that an ophthalmologist can detect when examining the fundus (swelling of the optic nerve, hemorrhages), aortic aneurysm.

When sorting, options for increasing pressure are taken into account. In this case, the following forms are distinguished:

• diastolic - lower pressure increases;
• systolic – only the upper indicators increase;
• diastolic systolic;
• labile form - in this case, the pressure rises briefly and returns to normal without special medications.

There are certain types of hypertension that are not included in any of the classifications. These are refractory hypertension and hypertensive crises.

Refractory hypertensionIt is high blood pressure that is not corrected with medications. The pressure does not decrease even when using more than three drugs. Sometimes this form of the disease is incorrectly diagnosed when medications are chosen incorrectly or even the diagnosis is incorrect.

Hypertensive crisis is a condition in which blood pressure rises to critical levels. Because of this, the patient experiences dizziness, severe headaches, impaired cerebral circulation, and cerebral hyperthermia may occur.

Hypertension during pregnancy

In a healthy woman, blood pressure should remain within normal limits throughout pregnancy. However, starting from week 20, some patients may develop Gestosis, which occurs due to vasospasm. The result is increased blood pressure, bloating and nausea. In severe cases, high blood pressure threatens stroke; This condition is dangerous for both the child and the woman.

Therefore, it is important for pregnant women to constantly monitor their blood pressure. If your blood pressure increases, you should inform your doctor, who will select an appropriate hypertension treatment that is safe during this period.

If you notice similar symptoms, see your doctor immediately. It is easier to prevent a disease than to face its consequences.

Diagnosis

Depending on the degree and stage of hypertension, treatment is selected. Before starting therapy, the doctor will definitely prescribe diagnostic tests that should confirm the presence of the disease.

Laboratory tests include: general blood and urine analysis, urine analysis according to Nechiporenko, biochemical blood test and bacterial culture.

The mandatory diagnostic program includes:

• Clinical examination;
• taking anamnesis;
• measure body weight and waist circumference;
• measure blood pressure in both arms;
• ECG and FCG;
• fundus examination.

Hypertension treatment

Stage 1 hypertension, symptoms and treatment.

Stage 1 hypertension is characterized by a periodic increase in pressure, which after a while returns to normal on its own. In this case, the patient may feel headache, dizziness, tinnitus, and "spots" may appear before the eyes. In the first stage of the disease, the doctor will tell you how to treat hypertension without special medications. The patient needs to adjust his lifestyle, control his weight, stop drinking alcohol and smoking, exercise regularly, as well as review his diet and try to avoid stress and excessive physical exertion.

Treatment aids include: reflexology, massage, physiotherapy and herbal therapy.

Medications are rarely prescribed, only in cases where other therapeutic methods have proven to be ineffective and the disease goes to the next stage of development.

Hypertension 2 degrees, symptoms and treatment.

As a rule, the disease does not develop in a short period of time. It takes several years before hypertension progresses to stage 2. Symptoms of the pathology include:

• nausea;
• dizziness;
• headache;
• numbness in the fingers and toes;
• fatigue;
• cardiopalm.

When a persistent increase in blood pressure develops, the doctor prescribes special medications to treat hypertension. They must be used continuously, regardless of the tonometer readings. It is recommended to take diuretics, which help eliminate excess fluid from the body.

In some cases, it is decided to prescribe ACE inhibitors, which affect the narrowing of blood vessels. They can enhance the effects of diuretics by reducing the ability to produce aldosterone.

Medications that reduce blood viscosity are used, as well as medications that lower cholesterol levels.

A large selection of medications allows you to choose treatment individually for each patient. At the same time, do not forget about auxiliary and non-drug means. Combined therapy gives positive results.

Hypertension 3 degrees, symptoms and treatment.

A doctor can diagnose stage 3 hypertension when there is target organ damage. Since blood pressure levels can be successfully adjusted with medications today, less attention is paid to the magnitude of blood pressure readings.

The cause of the development of this degree of the disease, in most cases, is late access to the doctor and the lack of adequate treatment. Modern diagnostic capabilities make it possible to detect even the smallest changes in the functioning of the cardiovascular system. Often, patients themselves miss the opportunity to visit a specialist. Taking medications (pills) for hypertension at certain stages of the disease helps to reach the level of physiological norm, not limited to "working blood pressure". This allows patients to avoid the third stage of the disease and significantly improve their quality of life.

Signs of organic damage are added to the symptoms of the disease. Most often, damage to blood vessels and structures of the central nervous system is diagnosed in the brain. The risk of myocardial infarction and the development of hemodynamic instability increases significantly. The kidneys suffer, problems associated with damage to the retina appear.

It is important to understand that when organs are damaged, a vicious cycle occurs. Emerging diseases worsen the course of hypertension, it is difficult to treat.

As in other cases, treatment must consist of several stages. These are dosed physical activities and recreational activities. Patients should observe a schedule of work and rest, establish a healthy diet and not forget about drug therapy.

Treatment of hypertension in older people.

Older people suffering from this disease constitute a separate group of patients who require a special treatment approach. Pharmacological reduction of blood pressure in older people has its own characteristics.

Standard therapy is not always suitable for patients over 60 years of age, but this is not a reason to abandon treatment. Here it is important to individually select effective medications and tune in to a positive result.

In the event that older people do not present complications, it is recommended to start treatment with a thiazide diuretic. Their effectiveness increases with the age of the patient, so from the age of 55 these medications are much more effective than at a younger age. It is important to remember that diuretics are prescribed in small doses, since increasing them can lead to an increase in cholesterol. In the event that a patient has low potassium or sodium levels, potassium-sparing agents are recommended.

If the patient, for objective reasons, cannot take diuretics, beta blockers become the drug of choice.

In the low-renin form of hypertension, calcium antagonists are prescribed to promote cerebral and renal blood flow. Additionally, these medications are effective remedies for angina and can reduce the risk of cardiovascular complications.

Angiotensin II receptor blockers and ACE inhibitors are not as effective as the above drugs, but they can be used when other drugs do not provide the desired effect. Strong medications are rarely prescribed because they cause drowsiness, depression, and low blood pressure even while standing.

Combination medications for the treatment of hypertension have been shown to lower blood pressure more effectively than a single medication at higher doses. Therefore, in modern medicine, drug combinations are prescribed:

• diuretic and calcium antagonists;
• beta blockers with diuretic;
• ACE inhibitor with calcium antagonist;
• ACE inhibitor diuretic.

When a hypertensive crisis occurs, the patient needs rehabilitation. Normally this problem is solved in a sanatorium. The following measures are recommended for patients:

• physiotherapy;
• dietary nutrition;
• medicinal baths;
• hardware physiotherapy;
• Phytotherapy;
• aromatherapy;
• oxygen cocktails;
• pharmacological treatment courses.

As maintenance therapy, patients are recommended to use electrosleep, laser therapy and electrophoresis. Thanks to the electrical impulses, blood pressure decreases and the kidneys and heart become healthier.

With the help of sulfur and carbon dioxide baths, the functioning of the immune system is improved and blood pressure is normalized. The choice of procedures is determined by the patient's age and the stage of the disease.

Folk remedies in treatment

The treatment of hypertension must be comprehensive; Along with traditional dosage forms, traditional medicine can be used, which contains many effective recipes.

1. Red clover decoction. The plant is brewed in the same way as regular tea and then half a glass is consumed at night. It is advisable to use only fresh decoction, but the medicine can be stored in the refrigerator for up to three days.
2. Honey and garlic. It is necessary to take half a glass of honey, crush five cloves of garlic and grind one lemon together with the peel. Mix everything well and put in a dark place for a week, after which the composition should be stored in the refrigerator, in a closed jar (you can wrap it in a cloth or foil). Take one teaspoon three times a day.
3. Vegetable juices. Mix a glass of carrot, black radish and beet juice with a glass of honey and the juice of one lemon. Take one tablespoon three times a day before meals. The duration of the course is one and a half months.
4. Rosehip infusion can be drunk without restrictions.
5. Seeds. Pour the well-washed and unpeeled sunflower seeds into the pan. Pour one and a half liters of cold water and boil for about two hours over low heat. The broth should be strained and then drunk a glass throughout the day.
6. Golden mustache. Finely chop the dark purple knee and pour 0. 5 liters of vodka. Leave for twelve days in a dark place, gently shaking the contents every three days. Take a dessert spoon half an hour before meals.
7. Lemon Mix 1 glass of white onion juice and 1 glass of honey and add 50 grams of previously crushed lemon peels. Close the container in which the infusion will be stored tightly and place it in a dark place. Take the infusion a teaspoon after meals, two or three hours later. Or mix a tablespoon of grated lemon 1: 1 with chopped cranberries, add half a tablespoon of fresh rosehip (you can grind it in a meat grinder). Add the mixture to a glass of honey and take a tablespoon in the morning and at night.
8. Honey. Mix five hundred grams of May honey with half a liter of vodka and heat until foam appears. In this case, the mixture must be stirred constantly. Let it rest. For the second composition, it is necessary to prepare a pinch of the following herbs in a liter of water: chamomile, cudweed, valerian, knotweed, motherwort. Let the broth rest, then strain it and mix with the first mixture. Place the tincture in a dark place for three days. In the first week, the composition is taken twice a day, one teaspoon, the next week, one tablespoon, until the broth runs out. Treatment in this way is long-term, with breaks of 7 to 10 days.

Diet for hypertension

Proper and balanced nutrition for hypertension is the key to a successful fight against the disease. It is worth remembering that each extra kilogram increases the numbers on the tonometer. The main task is to achieve the optimal weight if it does not meet the standards. To normalize blood pressure, the following recommendations should be followed.

• Reduce the consumption of salt. Since sodium retains water in the body, the volume of circulating blood increases, which affects the increase in blood pressure. The amount of salt will be about 4 grams. Ideally, it is not necessary to add additional salt to foods during cooking.
• To normalize metabolism, it is necessary to drink a sufficient amount of fluid, about 1. 5 liters per day. It is necessary to give preference to clean water, rosehip decoction and "healthy" soups.
• Eliminate coffee, strong tea and alcohol from your diet.
• Fractional meals. It is important to distribute your diet in such a way that you eat equal portions five to eight times a day.
• Reduce the amount of meat and animal fats you consume. Patients are recommended to choose lean meats: turkey, beef, chicken, rabbit. It is best to cook without oil, if the meat seems soft to you, you can add herbs and lemon juice instead of salt. You should include smoked meats, sausages and butter in your diet as little as possible.
• It is important to increase the amount of vegetables and foods rich in potassium and magnesium consumed: cereals, beets, carrots, dried apricots, cabbage.
• It is recommended to avoid the consumption of confectionery products with large amounts of sugar, preference is given to nuts, honey and whole grain products.
• Patients with hypertension should not fast. Strict fasts and diets are contraindicated.

Disability due to hypertension.

Hypertension is a serious disease, and in some cases, patients are considered disabled. It is generally administered to patients with the second or third stage of the disease or with constant progression.

In case of stage 1 hypertension, the medical-labor commission should help with employment, since increased stress, night work and work associated with contact with dangerous substances should be avoided.

When determining disability, a special medical commission evaluates deficiencies, the presence of complications and a history of hypertensive crises. Sometimes, already in the second stage of hypertension, the third group can be diagnosed.

The disability of the second group can be obtained by patients with a malignant disease; In most cases it doesn't work.

In patients with grade 3 hypertension, the first group of disability can be established in the case of:

• constant progression;
• severe heart failure;
• serious disturbances in the functioning of organs;
• The patient cannot care for himself and has limitations in movement and communication.

Prevention of hypertension

Primary prevention must eliminate the risk factors that contribute to the appearance of hypertension:

• maintain a normal body weight;
• limit the use of table salt;
• elimination of bad habits: smoking, alcohol;
• try to avoid physical and nervous stress;
• prevention of physical inactivity;
• treatment of chronic diseases.

Secondary prevention consists in selecting drugs that stabilize blood pressure, as well as choosing a set of supportive measures.