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 the so-called primary hypertension. Our country is in 49th place in the world in terms of the number of patients with this disease.
Without treatment, complications of hypertension occur:
- myocardial infarction;
- blow;
- 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 aimed at combating the pathology. New safe drugs are being developed to control blood pressure levels. At the same time, only 1/3 of hypertensives receive adequate therapy and take care of their health.
Doctors around the world believe that every home should have a blood pressure monitor as well as a thermometer. This is especially true for families in which relatives 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 psycho-emotional stress. Other causes of pathology include:
- overweight: when overweight, each kilogram increases blood pressure by two mmHg;
- sedentary way of life;
- eating canned goods, smoked meats, fatty foods, sharp cheeses;
- excessive use of salt in cooking;
- frequent stress;
- smoking - the harmful substances contained in cigarettes contribute to mechanical damage to the artery walls;
- busy work schedule;
- alcohol consumption;
- very tall or too short stature in men;
- physical and nervous fatigue;
- consumption of animal protein, which is not limited.
Risk factors also include hereditary predisposition. High blood pressure in first-line relatives guarantees a high risk of developing the disease.
It is worth paying attention to age, after 35 years men have a greater chance of getting 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 slow heart rate;
- vertigo;
- swelling of the eyelids, legs and hands, puffiness of the face;
- memory impairment;
- numbness of the fingers;
- facial flushing;
- chills;
- increased sweating;
- anxiety;
- internal tension;
- reduced productivity;
- irritability;
- the appearance of "flies" before the eyes.
All these manifestations do not bother patients constantly, but appear 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 on time, then over time the disease will begin to progress and may lead to serious complications. This is why it is important to control blood pressure. For this purpose, there are now many special tonometers, from conventional mechanical devices to fully automated models. Working with 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 anyone can learn this.
Before measuring your blood pressure, you should not smoke, drink alcohol and coffee, it is recommended 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) and automatic devices are used to determine the pressure. In the outpatient setting, 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 forty years, the norm is 120/70 - 130/80;
- from forty to sixty - up to 135/85;
- After sixty years, up to 140/90 is considered normal blood pressure.
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 other symptoms than the data from the device. A competent doctor will give lifestyle recommendations for hypertension at an early stage, which will help to avoid complications.
Hypertension - classification
During the study of the disease, many different classifications were developed with divisions: according to the etiology, the appearance of the patient, the stability and level of pressure, the reasons for the increase, the nature of the course. Some of them are still used by doctors today.
The first classification of hypertension divides it into red and pale. The appearance of the patient plays a crucial role in this division. In the pale variety, the patient had cold extremities and an unhealthy complexion, which was explained by spasm of the vessels. In red hypertension, when the blood pressure rises, the patient's face, on the contrary, becomes red and covered with spots.
In practice, one of the most important classifications is the separation of the disease by origin. It has a primary or essential form, which manifests itself 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 involved in the regulation of vascular tone. These include the kidneys, endocrine and nervous systems.
There is no uniform 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.
- Hypertension in stage 1 is a mild form, characterized by pressure from 140/90 to 159/99 mmHg.
- Hypertension 2nd degree - moderate hypertension, the pressure rises to 79/109 mm Hg. Art. Sometimes doctors diagnose "hypertension stage 2, risk 2", which 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 during the examination the doctor diagnoses "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 from hypertension are:
- brain – DEP, dementia, strokes, memory loss;
- kidneys - development of chronic kidney failure;
- heart - heart failure, heart attack, coronary death;
- vessels;
- eyes.
Doctors classify the disease depending on the damage to the upper organs. Stages of hypertension:
- I stage - the functioning of the cardiovascular system is not disturbed, patients usually do not complain about their condition.
- II stage - enlargement of the left ventricle, increase in blood pressure. Local retinal vessel narrowing may be observed.
- Stage III - signs of organ damage appear: chronic renal failure, angina pectoris, hypertensive encephalopathy, disorders that the ophthalmologist can detect when examining the fundus (edema of the optic nerve, hemorrhages), aneurysm of the aorta.
Pressure increase options are taken into account when classifying. In this case, the following forms are distinguished:
- diastolic - lower pressure rises;
- systolic - only the above indicators increase;
- systolic-diastolic;
- labile form - in this case, the pressure rises for a short time and normalizes without special drugs.
There are certain types of hypertension that are not included in any of the classifications. These are refractory hypertension and hypertensive crises.
A hypertensive crisis is a condition in which blood pressure rises to critical levels. Because of this, the patient experiences dizziness, severe headache, cerebral blood circulation is impaired and cerebral hyperthermia may occur.
Hypertension during pregnancy
In a healthy woman, blood pressure should remain within normal limits throughout pregnancy. However, starting from the 20th week, some patients may develop preeclampsia, which occurs due to vasospasm. The result is increased blood pressure, swelling and nausea. In severe cases, high blood pressure threatens with a stroke, this condition is dangerous for both the child and the woman.
That is why it is important for pregnant women to constantly monitor their blood pressure. If the blood pressure rises, you should inform your doctor about it, who will choose an adequate treatment for hypertension that is safe during this period.
If you notice such symptoms, consult your doctor immediately. It is easier to prevent a disease than to deal with the consequences.
Diagnosis
Treatment is selected depending on the degree and stage of hypertension. Before starting the therapy, the doctor will definitely prescribe diagnostic tests that should confirm the presence of the disease.
Laboratory tests include: general blood and urine analysis, Nechiporenko urinalysis, biochemical blood test and bacterial culture.
The mandatory diagnostic program includes:
- clinical examination;
- history taking;
- measuring body weight and waist circumference;
- measuring blood pressure in both arms;
- ECG and FKG;
- fundus examination.
Treatment of hypertension
Hypertension in the first stage, symptoms and treatment
Hypertension of the 1st stage is characterized by a periodic increase in pressure, which after some time normalizes on its own. In this case, the patient may feel headache, dizziness, tinnitus and "spots" may flash before the eyes. In the first stage of the disease, the doctor will tell you how to treat hypertension without special drugs. The patient should adjust his lifestyle, monitor 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, herbal medicine.
Medicines are rarely prescribed, only in cases when other methods of treatment 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;
- vertigo;
- headache;
- numbness in fingers and toes;
- tiredness;
- cardiopalmus.
When a constant increase in blood pressure develops, the doctor prescribes special drugs for the treatment of 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, 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 are used, as well as drugs that reduce cholesterol levels.
A large selection of drugs allows you to choose an individual treatment for each patient. At the same time, do not forget about non-medicinal and auxiliary 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 medication today, 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 the late visit to the doctor and the lack of adequate treatment. Modern diagnostic capabilities make it possible to detect even the most insignificant changes in the functioning of the cardiovascular system. Often patients themselves neglect the opportunity to visit a specialist. Taking drugs (pills) for hypertension at certain stages of the disease helps to achieve the level of the physiological norm, not just "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. Damage to blood vessels and structures of the central nervous system is most often diagnosed in the brain. The risk of myocardial infarction and development of hemodynamic instability increases significantly. The kidneys suffer, problems related to damage to the retina appear.
It is important to understand that when the organs are damaged, a vicious cycle occurs. The emerging diseases worsen the course of hypertension, they are difficult to treat.
As in other cases, the treatment should consist of several stages. These are dosed physical exertion and recreational activities. Patients should maintain a regime of work and rest, establish a healthy diet and do not forget about drug therapy.
Treatment of hypertension in the elderly
Elderly people suffering from this disease are a separate group of patients that require a special approach to treatment. Drug reduction of blood pressure in the elderly has its own characteristics.
Standard therapy is not always suitable for patients over 60, but this is not a reason to give up treatment. Here it is important to individually choose effective drugs and set yourself up for a positive result.
If the elderly 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 drugs are much more effective than at an earlier age. It is important to remember that diuretics are prescribed in small doses, as their increase can lead to an increase in cholesterol. If the patient has low potassium or sodium levels, potassium-sparing agents are recommended.
If the patient cannot take diuretics for objective reasons, 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. In addition, these drugs are effective agents 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 to treat hypertension have been shown to reduce blood pressure more effectively than a single drug at an increased dose. That is why combinations of drugs are prescribed in modern medicine:
- diuretics and calcium antagonists;
- beta-blockers with a 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:
- physical therapy;
- dietary nutrition;
- medicinal baths;
- apparatus physiotherapy;
- phytotherapy;
- aromatherapy;
- oxygen cocktails;
- drug treatment courses.
As a supportive therapy, patients are recommended to use electrosleep, laser therapy and electrophoresis. Thanks to the electrical impulses, the blood pressure decreases, and the kidneys and heart become healthier.
With the help of sulfide and carbon 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
The treatment of hypertension should be comprehensive, along with traditional medicinal forms, you can use traditional medicine, which contains very effective recipes.
- Decoction of red clover. The plant is prepared in the same way as regular tea, then half a cup is consumed at night. It is recommended to use only fresh decoction, but you can store the medicine in the refrigerator for up to three days.
- Honey and garlic. You need to take half a cup of honey, crush 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 towel or foil). Take one teaspoon three times a day.
- Vegetable juices. Mix one cup of carrot, black radish and beetroot juice with one cup of honey and the juice of one lemon. Take one tablespoon three times a day before meals. The duration of the course is a month and a half.
- Rosehip infusion can be drunk without restrictions.
- seeds. Pour well-washed, unpeeled sunflower seeds into the pan. They are poured with a liter and a half of cold water and boiled for about two hours on low heat. The broth should be strained, then drink one cup throughout the day.
- A golden mustache. The dark purple knee is finely chopped and poured with 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 a meal.
- Lemon Mix 1 cup of white onion juice and 1 cup of honey and add 50 grams of pre-crushed lemon peel. Tightly close the container in which the tincture will be stored and put it in a dark place. Take the infusion one teaspoon after a meal, after two or three hours. Or mix a tablespoon of grated lemon 1: 1 with chopped blueberries, add half a tablespoon of fresh rose hips (you can grind them through a meat grinder). Add the mixture to a glass of honey and take one tablespoon in the morning and evening.
- 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 boil. For the second composition, you need to boil a pinch of the following herbs in one liter of water: chamomile, winnow, valerian, nettle, lemon balm. Bring the broth to a boil, then strain it and mix with the first mixture. Put the tincture in a dark place for three days. During the first week, the composition is taken twice a day, one teaspoon, the next week, one tablespoon, until the decoction is finished. Treatment in this way is prolonged, with interruptions of 7-10 days.
Diet for hypertension
Proper and balanced nutrition in hypertension is the key to successfully fighting 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 should be followed.
- Reduce your salt intake. Since sodium retains water in the body, the volume of circulating blood increases, which has the effect of raising blood pressure. The amount of salt will be about 4 grams. Ideally, there is no need to add extra salt to the food during cooking.
- To normalize the 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, decoction of rose hips, as well as "healthy" soups.
- Eliminate coffee, strong tea and alcohol from your diet.
- Small 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 fat you consume. Patients are advised to choose lean meat - turkey, beef, chicken, rabbit. It is best to cook without oil; if the meat seems soft, you can add herbs and lemon juice instead of salt. Smoked meat, sausages and butter should be included in your diet as rarely as possible.
- It is important to increase the amount of consumed vegetables and foods rich in potassium and magnesium: cereals, beets, carrots, dried apricots, cabbage.
- It is recommended to avoid the consumption of confectionery products with a high sugar content, prefer 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 prescribed to patients with the second or third stage of the disease or with constant progression.
In the case of stage 1 hypertension, the medical commission of labor should help in employment, as increased stress, night work and work related to contact with dangerous substances should be avoided.
When determining the disability, a special medical committee evaluates the disabilities, the presence of complications and the 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 received by patients with malignant diseases, in most cases non-working.
In patients with hypertension of the 3rd degree, the first group of disability can be established in case of:
- steady progression;
- severe heart failure;
- severe disorders in the functioning of the organs;
- the patient cannot take care of himself and is limited in movement and communication.
Prevention of hypertension
Primary prevention should eliminate the risk factors that contribute to the appearance of hypertension:
- maintaining a 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 in the selection of drugs that stabilize blood pressure, as well as in the selection of a set of supportive measures.