Hypertension (hypertension)

According to statistics, 30% of the adult population experiences periods of high blood pressure, and this is almost always a sign of an independent pathology or 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;
• hypertension crisis.

The insidious nature of the pathology is that in half of the cases patients do not even suspect that they are suffering from a dangerous disease, therefore they do not take any measures and hypertension begins to manifest itself with unpleasant symptoms. Many countries have launched prevention 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 undergo adequate treatment and take care of their health.

Doctors around the world believe that every home should have a device to measure blood pressure, as well as a thermometer. This is especially true for families whose loved ones have previously suffered from cardiovascular disease.

Causes of hypertension

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

• excess weight: in case of excess weight, each kilogram increases blood pressure by two mmHg;
• sedentary lifestyle;
• eat canned foods, smoked meats, fatty foods, strong cheese;
• excessive use of salt in cooking;
• frequent stress;
• smoking - harmful substances contained in cigarettes contribute to mechanical damage to the walls of the 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, men have an increased risk 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 heart rate;
• dizziness;
• swelling of the eyelids, legs and arms, swelling of the face;
• memory impairment;
• numbness of fingers;
• facial redness;
• chills;
• increased sweating;
• anxiety;
• internal tensions;
• decreased performance;
• irritability;
• the appearance of "midges" before the eyes.

All these manifestations do not constantly bother patients, but occur only for a certain time. This is the insidious nature of the disease, so if the above symptoms appear, you should consult a doctor for advice. If treatment is not started on time, the disease will begin to progress over time and can lead to serious complications. It is therefore important to control blood pressure. Today there are many special tonometers available for this purpose, from conventional mechanical devices to fully automated models. The operation of tonometers with a phonendoscope is more difficult, it is not always possible to distinguish pulsation sounds, 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) and automatic devices are used to determine pressure. In the outpatient setting, devices are used to monitor pressure changes throughout the day.

Each age has its own blood pressure standards:

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

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

Hypertension - classification

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

The very first classification of hypertension divided it into red and pale. The patient's appearance played a determining role in this division. With the pale variety, the patient had cold extremities and an unhealthy complexion, which is explained by vasospasm. With red hypertension, when blood pressure rises, the patient's face, on the contrary, turns red and becomes 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 which 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 the pathology of the organs participating 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 increase in pressure.

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

The organs most susceptible to complications of hypertension are:

• brain – PED, dementia, stroke, memory loss;
• kidneys – development of chronic renal failure;
• heart - heart failure, heart attack, coronary death;
• ships;
• eyes.

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

• Stage I – the functioning of the cardiovascular system is not impaired, patients usually do not complain about their condition.
• Stage II – hypertrophy of the left ventricle, blood pressure increases. Local narrowing of retinal vessels may be observed.
• Stage III - signs of organ 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 classifying, options for increasing pressure are taken into account. In this case, we distinguish the following forms:

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

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

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

Hypertensive crisis is a condition in which blood pressure reaches critical levels. For this reason, the patient feels 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, from week 20 onwards, some patients may develop gestosis, due to vasospasm. The result is increased blood pressure, swelling and nausea. In severe cases, high blood pressure threatens stroke, this condition is dangerous for the child and woman.

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

If you notice similar symptoms, consult your doctor immediately. It is easier to prevent an illness than to deal with its consequences.

Diagnostic

Depending on the degree and stage of hypertension, treatment is chosen. Before starting treatment, the doctor will certainly 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:

• Physical examination;
• take the history;
• measure body weight and waist circumference;
• measure blood pressure in both arms;
• ECG and FCG;
• fundus examination.

Treatment of hypertension

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 experience headaches, dizziness, tinnitus, and "spots" may appear before the eyes. At the first stage of the disease, the doctor will tell you how to treat hypertension without special medications. The patient must adjust his lifestyle, monitor his weight, stop drinking alcohol and smoking, exercise regularly, but also review his diet and try to avoid stress and excessive physical exertion.

Treatment aids include: reflexology, massage, physiotherapy, herbal medicine.

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

Hypertension 2 degrees, symptoms and treatment

Typically, the disease does not develop within a short period of time. Several years pass before hypertension progresses to stage 2. Symptoms of the pathology include:

• nausea;
• dizziness;
• headache;
• numbness of fingers and toes;
• fatigue;
• cardiofin.

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

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

Drugs that reduce blood viscosity, as well as drugs that reduce cholesterol levels, are used.

A wide selection of drugs makes it possible to choose treatment individually for each patient. At the same time, do not forget about non-drug and auxiliary means. Combined therapy gives positive results.

Hypertension 3 degrees, symptoms and treatment

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

The cause of the development of this degree of the disease is, in most cases, late access to a doctor and lack of adequate treatment. Modern diagnostic capabilities make it possible to detect even the most minor changes in the functioning of the cardiovascular system. Often, patients themselves neglect the possibility of consulting a specialist. Taking medications (pills) for hypertension at certain stages of the disease helps to achieve 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 development of hemodynamic instability increases significantly. The kidneys suffer, problems linked to retinal damage 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 include several stages. These are dosed physical activities and recreational activities. Patients should maintain a work and rest schedule, establish a healthy diet and not forget about drug treatment.

Treatment of hypertension in the elderly

Elderly people suffering from this disease are a separate group of patients who require a special approach to treatment. Drug reduction of blood pressure in the elderly has its own characteristics.

Standard treatment is not always suitable for patients over 60, but this is not a reason to abandon treatment. Here it is important to individually select effective drugs and achieve a positive result.

In cases where older people do not have complications, it is recommended to start treatment with a thiazide diuretic. Their effectiveness increases with the age of the patient, so after 55 years of age, these drugs are much more effective than at an earlier age. It is important to remember that diuretics are prescribed in small doses, since their increase 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, then beta-blockers become the drugs of choice.

In the low-renin form of hypertension, calcium antagonists are prescribed to support 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 drugs above, but they can be used when other drugs do not produce the desired effect. Strong medications are rarely prescribed because they cause drowsiness, depression and hypotension, even when standing.

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

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

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

• physiotherapy;
• dietary nutrition;
• medicinal baths;
• hardware physiotherapy;
• herbal medicine;
• aromatherapy;
• oxygen cocktails;
• drug treatment course.

As maintenance treatment, 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 sulfide 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 age of the patient and the stage of the disease.

Folk remedies in treatment

Treatment of hypertension should be comprehensive, and in addition to traditional dosage forms, you can use traditional medicine, which contains many effective recipes.

1. Red clover decoction. The plant is brewed in the same way as regular tea, then consumed half a glass in the evening. It is advisable to use only fresh decoction, but you can store the medicine in the refrigerator for up to three days.
2. Honey and garlic. You need to take half a glass of honey, crush five cloves of garlic and grind one lemon with the zest. Mix everything well and put it 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 juice. Mix a glass of carrot, black radish and beet juice with a glass of honey and the juice of a 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 filtered, then drink 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 pre-crushed lemon zest. Close the container in which the infusion will be stored tightly and place it in a dark place. Take the infusion one teaspoon after meals, two to 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 morning and evening.
8. Dear. 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 constantly stirred. Leave to infuse. For the second composition, you need to infuse a pinch of the following herbs in a liter of water: chamomile, cudweed, valerian, knotweed, motherwort. Let the broth infuse, then filter it and mix it 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 decoction is exhausted. Treatment in this way is long-term, with breaks of 7-10 days.

Diet for hypertension

An adequate and balanced diet for hypertension is the key to a successful fight against the disease. It is worth remembering that each additional 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 salt intake. 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 approximately 4 grams. Ideally, there is no need to add additional salt to foods while cooking.
• To normalize metabolism, you need to drink a sufficient amount of fluid, approximately 1. 5 liters per day. You should give preference to clean water, rosehip decoction, as well as "healthy" soups.
• Eliminate coffee, strong tea and alcohol from your diet.
• Split meals. It's important to portion out your diet so that you eat equal portions five to eight times a day.
• Reduce the amount of meat and animal fats you eat. Patients are advised to choose lean meat - turkey, veal, chicken, rabbit. It is best to cook without oil; If the meat seems bland, you can add herbs and lemon juice to replace the salt. You should include smoked meats, sausages and butter in your diet as rarely as possible.
• It is important to increase the amount of vegetables and foods consumed rich in potassium and magnesium: cereals, beets, carrots, dried apricots, cabbage.
• It is recommended to avoid eating confectionery products high in sugar, with preference given to dried fruits, honey and whole grain products.
• Hypertensive patients should not fast. Strict fasting and diets are contraindicated.

Disability due to hypertension

Hypertension is a serious illness and in some cases patients are considered disabled. It is usually given to patients who have the second or third stage of the disease or are steadily progressing.

In case of hypertension at stage 1, the medical labor commission should assist in employment, as increased stress, night work and work associated with contact with hazardous substances should be avoided.

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

Disability of the second group can be obtained by patients with malignant disease; in most cases it is not work.

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

• steady progress;
• severe heart failure;
• serious disorders in the functioning of organs;
• the patient cannot take care of himself and is limited in movement and communication.

Prevention of hypertension

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

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

Secondary prevention involves selecting drugs that stabilize blood pressure, as well as choosing a set of support measures.