Arterial hypertension: classification, causes, diagnosis
One day you will feel the pressure begins to rise - this is hypertension. Fatal changes can occur for various reasons, often the risk of hypertension linked with the progression of "related" pathologies. Universal treatment of this disease has not yet been developed - you can prescribe special medication or prescribe a rigid diet.
Try to understand the reasons for the growth of AD and to find the optimal solution to resolve the issue.
The nature of the illness and its classification
The essence of hypertension is to increase blood pressure. Threshold values may vary slightly, any person, therefore, to sound the alarm is only in case of sharp deterioration of health. In people suffering from symptomatic arterial hypertension, and increased risk of cardiac, cerebral and renal complications. There is also the probability of death.
Hypertension is diagnosed in cases of exceeding the threshold of HELL 140 over 90. Systolic 140-159 figure stated transit (isolated) type of disease.
This stage is also called hypertension. Decreased elasticity of the aorta, in contrast, leads to an increase in diastolic blood pressure.
The risk is particularly high in the presence of the following diseases:
- insufficiency of the aortic valves;
- anemia (severe);
- patent ductus arteriosus.
Hemodynamic disorders can cause secondary arterial hypertension (symptomatic). The basis of the pathology may lie the nervous and endocrine disorders, and disorders of humoral regulation. Therefore, the classification of hypertension depends on the causes that triggered the development of the disease.
Classification provides the group A (primary form, she is hypertensive heart disease) and group B (the secondary form).
Group B are the following types of symptomatic hypertension:
- hemodynamic (the underlying pathology of heart and aorta);
- neurogenic (caused by encephalitis, traumatic brain injury and brain tumors);
- renal/nephrogenic (occurs in pyelonephritis and nephritis, tumors, paranephritis, bruises, kidney stones);
- endocrinopathies pathology (tumor of the adrenal glands and the pituitary gland, discini, diffuse toxic goiter);
- drug (risk occurs when excessive use glucorticoids, ephedrine, phenacetin orbirth control hormonal methods);
- inopina as a consequence of removal of both kidneys).
The degree of pathology
Now the degree of arterial hypertension classified according to BP level and progression of pathological processes. Doctors are three degrees, which vary greatly.
Do you remember what systolic pressure is considered to be adequate, if kept in the range of 120-129 mm Hg, and the optimal boundaries diastolic blood pressure 80-84. Treatment is required if these indicators significantly exceeded.
Consider all three degrees:
- Easy. Limits are 140/90 or 160/100. Arterial hypertension of 1 degree does not require emergency treatment - in many cases complete diet and lifestyle change.
- Reasonable. Valid indicators or 160/100 180/110. Hypertension 2 degree should make you go to the doctor. It is an occasion to identify the causes of disease and develop comprehensive treatment.
- Heavy. Any above 180/110 is considered to be severe arterial hypertension and requires urgent medical attention.
Risk factors directly affect the development of pathology. Risk is the potential for cardiovascular complications. Based on potential complications, doctors make a prognosis and prescribe treatment.
Risk factors include:
- the abuse of nicotine;
- age (the risk for women over 60 and men older than 50 years);
- genetic predisposition;
- the high content of cholesterol in the blood;
- lack of exercise;
- diabetes mellitus;
- socioeconomic and ethnic factors.
By identifying the cause and establishing the extent of the disease, doctors can predict the risk of stroke (heart attack) for the next decade. Mild risk is negligible (within 10 years) is 15% probability. Non-drug treatment correct the situation.
A similar figure with an average degree of secondary hypertension is 20%, and severe degree increases the likelihood of heart attack by 30%.
Stage of development
To identify the stage of disease, you need to analyze the status of target organs. A complex of diagnostic studies. We study the hormonal surges. Examines the symptoms and medical history.
There are threestage:
- The first stage. Objective symptoms are completely absent.
- The second stage. Disorders and symptoms not yet recorded, but certain signs can already be seen. In the blood increases the level of microalbuminuria or creatinine. For diagnostic use electrocardiography, echocardiography and x-ray machine.
- The third stage. Target organs are damaged. Clearly identifiable functional impairment and symptoms.
Causes of pathology
A large part of the reasons underlying the hypertension, we have considered above - the time has come to summarize the acquired knowledge. And yet, there are several theories explaining the occurrence of disease.
Disputes in scientific circles still is no consensus developed.
List the dominant hypotheses:
- Neurogenic theory. According to this theory, hypertension is caused due to multiple stresses that affect nerve endings. Regulatory dysfunction increases the risk of high blood pressure in the region of the hypothalamus.
- Three-salt theory. Water and sodium detained in the body that disrupt the natural functioning of the kidneys. The increase in AD is local self-regulation mechanism. Arterioles constrict, the pressure increases.
- The hyperactivation of the sympathetic-adrenal system. The heart is increased, peripheral vasoconstriction increases. This phenomenon may occur due to genetic disorders or constant stress. Treatment may be required because of age-related neuroendocrine adjustment.
- Symptomatic arterial hypertension. Here, the reasons there may be coarctation of the aorta, renal artery stenosis, hyperaldosteronism, pheochromocytoma, overactive thyroid, use of ethyl alcohol. Separate medicines that are too dangerous is cocaine, with an oral contraceptives and antidepressants.
Does not occur without cause and symptomatic arterial hypertension. The number of diseases we have already listed, but there are States of the organism does not fall under the definition of "disease". The risk of hypertension in these situations is quite high.
- endocrine disorders (Cohn syndrome, illness Itsenko-Kushinga, pheochromocytoma, hyperparathyroidism);
- renal diseases (chronic glomerulonephritis, renal arterial stenosis, diabetic nephropathy);
- cardiovascular disease (aortic valve insufficiency, erythremia, patent ductus arteriosus, coarctation of the aorta);
- alcoholic intoxication.
The clinical picture and symptoms of hypertension
A long time symptoms of missing, which increases the risk of morbidity. The man realizes that he has hypertension after the onset of complications - for example, a sharp rise HELL.
To claim that he developed hypertension doctors are not in a hurry, as the pressure may be unstable, rising only in stressful situations.
If the pressure after stress is not normal, pay attention to the following symptoms:
- Arterial disorders. In arterioles pressure to accumulate body fat. Causes atherosclerosis of the blood vascular, eventually developing into angina. If the arteries are narrowed in the toe area, there is a phenomenon known as intermittent claudication (causes stiffness when walking and pain).
- Thrombosis. The formation of a blood clot in the coronary artery increases the risk of infarct States. If a blood clot formed in cerebral carotid artery, there is a possibility of the coming stroke. Launched hypertension will lead to an aneurysm. The impact of AD on small blood vascular lead to kidney damage, hence full or partial loss of vision.
- Heart disorders. The main target of the pathology is heart. There is a risk of increase of this organ and the following deterioration of the heart muscle. Weakened heart is worse than supplying the body with oxygen, so can occur short-term consciousness loss, dizziness, floaters before the eyes and ringing in the ears.
- Brain disorders. Impaired blood supply and fat deposits in the arterioles causes the brain rushes large amounts of blood (that's a paradox). The risk of stroke in this case increases dramatically. Headache and dizziness - the first bells, indicating that you need treatment. Some patients diagnosed by mini-strokes, lasting less than a minute. Possible memory impairment.
- Kidney failure. Inside a kidney nephron under the influence of HELL destroyed the tiny blood vascular. The filtering ability of the kidneys is deteriorating. The problems begin with urination because protein is excreted from our body.
- Visual disturbances. Blood vascular in the region of the fundus sensitive to increased pressure. Eye the retina undergoes degeneration. Hence numerous visual problems (blurred vision, dimness, before eyes front sights).
Diagnosis of a disease ishow to recognize a threat in time?
The main task of the physicians in the diagnosis of disease - to determine whether arterial hypertension is constant. The identification of the causes of pathology to diagnose diseases, against which the problem originated.
Having dealt with this issue, physicians build long-term prognosis and plan treatment.
Applied diagnostics following types:
- repeated measurements of blood pressure;
- laboratory research;
- instrumental methods;
- examination of the physical nature.
Collecting medical history, the doctors considered the main indicator of the age of the patient, who had developed hypertension. The secondary type of disease is often seen in patients 30 to 40 years. Patients older than 50 suffer essential form of hypertension.
We should not forget about the harmful habits - alcohol and tobacco use.
The next stage is a physical examination of the patient. Identified risk factors, secondary symptoms, all sorts of complications. The main method of diagnosis of the patient is sphygmomanometry. It is the repeated measurement of blood pressure, which is essential for the final diagnosis.
Skin pallor and hyperemia, a sure indication that you need treatment. You may experience swelling and changes in the Constitution.
Redness usually affects the upper body and face is evidence of hypertensive crisis. Likely will prescribe specialized medications and develop additional non-drug therapy.
Monitoring daily pressure is another cornerstone of diagnosis. This information helps to make a conclusion about cardiovascular processes developing in the body.
Some drugs are more effective at night, so the dynamics of the disease is necessary to determine clearly.
Here is a list of key studies:
- biochemical analysis of blood;
- the General analysis of urine.
How to cure hypertension
Long time hypertension was treated for a salt-free dietary practices. In the middle of last century there was a bunch of specialized medicines, so the medical Arsenal has expanded. Successful therapy has helped to reduce mortality among patientshypertension several times.
The leading role is now assigned drug therapy - treatment with diuretics and various beta-blockers has yielded substantial results.
Patients traditionally are concerned that the drugs against hypertension, it will cause a lot of unwanted side effects. Among the "horror stories" - impotence and depression. Note that the side means have any medications, even familiar aspirin. It is better to take medications than to bring the case before surgery.
Just note: when detecting the first stage of hypertension no drugs you do not prescribe. Re-measuring blood pressure, doctors will focus on non-pharmacological therapy. Every three months the measurements are repeated.
If the pressure continues to grow, can be discharged the following medications:
- Diuretics. The pressure reduction is carried out by retrieving from the body of water and salt. Treatment diuretics are often combined with other therapeutic techniques.
- Beta-blockers. These drugs are created to influence the nervous system. By reducing the heart rate decreases and blood pressure. On the peripheral blood vascular beta blockers have a narrowing effect. These funds are strictly prohibited to patients-disease and asthma.
- Blockers of receptors of angiotensin. These drugs are based on the Angiotensin II. Contribute to the production of aldosterone and narrows the vascular, reducing AD.
- Calcium channel blockers. Limit the influx of calcium into muscle cells. Are appointed it is not always because the desired effect is achieved in 30-40% of cases.
- The ACE inhibitors. These substances are assigned to patients in whom hypertension developed on the background of cardiovascular disease, and renal pathologies.
- The drugs of the Central action. Prescribed in combination with other drugs. Treat moderate hypertensive forms.
- Alpha blockers. These substances affect the CNS and contribute to the narrowing of arterioles. The effectiveness of these products is extremely low.
Non-pharmacological therapeutic methods
Reducing the salt content in food, you significantly reduce the likelihood of disease. Treatment may not be required in the normal way of life - avoiding harmful habits, proper nutrition and active sports (swimming, walking, Jogging, gym).
To stabilizepressure through special breathing exercises. It is worth spending half an hour a day for exercise, to subsequently die from a stroke.
Doctors advise not to drink more than 80 grams of alcohol a day. Exceeding the rate, you significantly increase the risk of developing hypertension. Subsequent treatment will be long, costly and not always effective. In some cases, required surgical intervention.
Eliminate from your diet fatty and spicy foods. Clean the refrigerator from canned goods, sausages and smoked meat, fill it with vegetable products (fruits and vegetables). Try to obtain from the ambient positive emotions, walk on foot or to start a jog in the Park. All these measures will allow to avoid death.