Hypertension (hypertension)

According to statistics, 30% of the adult population experience periods of high blood pressure, and almost always it is 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;
• 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 action, and hypertension begins to manifest itself with unpleasant symptoms. Many countries have launched preventive programs that are aimed at combating pathology. New safe medications are being developed to control blood pressure levels. At the same time, only 1/3 of hypertensive patients take adequate therapy and take care of their health.

Doctors all over the world believe that every home must have a device for measuring blood pressure, along with a thermometer. This is especially true for families where relatives have already suffered from cardiovascular diseases.

Causes of hypertension

At present, 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 body weight: with excess weight, every kilogram increases blood pressure by two mmHg;
• sedentary lifestyle;
• eating canned food, smoked meats, fatty foods, sharp 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 chance of acquiring 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 may be observed:

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

All these manifestations do not bother patients constantly, but occur only during a certain period of time. This is the insidiousness of the disease, so if the above symptoms appear, you should consult a doctor for advice. If therapy is not started in time, then 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, there are now many special tonometers, 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 the sounds of pulsation, but after some training and practice, almost everyone can learn this.

Before measuring your blood pressure, you should not smoke, drink alcohol or coffee, it is advisable to spend a few minutes at rest. 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 changes in pressure throughout the day.

Each age has its own blood pressure standards:

• 16-20 years – pressure 100/70 – 120/80;
• up to forty years 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 up to 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 recommendations on lifestyle 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 of the course. 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 decisive 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, becomes 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 occurs 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 organs that take part in regulating 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 that was recommended by the World Health Organization. It is characterized by the degree of pressure increase.

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

The organs that are most susceptible to complications from hypertension are:

• brain – DEP, dementia, strokes, memory loss;
• kidneys – development of chronic renal failure;
• heart - heart failure, heart attack, coronary death;
• vessels;
• eyes.

Doctors classify the disease depending 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 – enlargement of the left ventricle, blood pressure rises. Local narrowing of the 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, the following forms are distinguished:

• diastolic – lower pressure increases;
• systolic – only the upper indicators increase;
• systolic-diastolic;
• 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 hypertensionis arterial hypertension 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 diagnosed incorrectly when the 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, cerebral circulation is impaired, and brain 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, swelling and nausea. In severe cases, high blood pressure threatens a 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 blood pressure increases, you must inform your doctor about this, who will select an adequate treatment for hypertension that is safe during this period.

If you notice similar symptoms, consult your doctor immediately. It is easier to prevent a disease than to deal with the consequences.

Diagnostics

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;
• measuring body weight and waist circumference;
• measuring 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 some time returns to normal on its own. In this case, the patient may feel a headache, dizziness, tinnitus, and "spots" may flash before the eyes. At 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, monitor his weight, stop drinking alcohol and smoking, exercise regularly, and also review his diet and try to avoid stress and excessive physical exertion.

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

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

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

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

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 remove excess fluid from the body.

In some cases, a decision is made 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.

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

A large 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. Combination therapy gives positive results.

Hypertension 3 degrees, symptoms and treatment

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

The reason for the development of this degree of the disease, in most cases, is 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 opportunity to visit 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 organ damage are added to the symptoms of the disease. Most often, damage to the 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 circle occurs. Emerging diseases worsen the course of hypertension; it is difficult to treat.

As in other cases, treatment should consist of several stages. These are dosed physical activities and recreational activities. Patients need to maintain a work and rest schedule, 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 approach to treatment. Drug 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 drugs and tune in to a positive result.

In the case when 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 these medications are much more effective than at an earlier age. It is important to remember that diuretics are prescribed in small doses, since increasing them can cause 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. Also, these drugs are effective remedies for angina pectoris 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 drugs are rarely prescribed because they cause drowsiness, depression and low blood pressure even when standing.

Combination drugs for the treatment of hypertension have been proven to reduce blood pressure more effectively than a single drug at an increased dosage. Therefore, in modern medicine, combinations of drugs 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. Usually 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;
• courses of drug treatment.

As maintenance therapy, patients are recommended to use electrosleep, laser therapy, and electrophoresis. Thanks to 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 patient’s age and stage of the disease.

Folk remedies in treatment

Treatment of hypertension should be comprehensive; along with 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 at night. 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, mash five cloves of garlic and grind one lemon along with the peel. 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 juices. Mix one 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 well-washed, 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 must be strained, then drink one glass throughout the day.
6. Golden mustache. Finely chop the dark purple knee and pour in 0. 5 liters of vodka. Leave for twelve days in a dark place, gently shaking the contents every three days. Take one 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 peels. 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 through a meat grinder). Add the mixture to one glass of honey and take one tablespoon in the morning and evening.
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 constantly stirred. Let it brew. For the second composition, you need to brew a pinch of the following herbs in one liter of water: chamomile, cudweed, valerian, knotweed, motherwort. Let the broth brew, 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, a tablespoon, until the decoction runs out. Treatment in this way is long-term, with breaks of 7–10 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 every extra kilogram increases the numbers on the tonometer. The main task is to reach the optimal weight if it does not meet the standards. To normalize blood pressure, the following recommendations must 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 about 4 grams. Ideally, there is no need to add additional salt to food during cooking.
• To normalize metabolism, you need to drink a sufficient amount of liquid, about 1. 5 liters per day. It is necessary to give preference to clean water, rosehip decoction, as well as "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 even portions five to eight times a day.
• Reduce the amount of meat and animal fats you consume. 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 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 rich in potassium and magnesium consumed: cereals, beets, carrots, dried apricots, cabbage.
• It is recommended to avoid eating confectionery products with high amounts of sugar; preference is given to dried fruits, honey, and whole grain products.
• Patients with hypertension should not fast. Strict fasting and diets are contraindicated.

Disability due to hypertension

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

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

When determining disability, a special medical commission evaluates 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 a malignant disease; in most cases it is non-working.

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

• steady progression;
• severe heart failure;
• severe disturbances in the functioning of organs;
• the patient cannot care for himself and is limited in movement and communication.

Prevention of hypertension

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

• maintaining normal body weight;
• limiting 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 of selecting medications that stabilize blood pressure, as well as choosing a set of supportive measures.