Classification of hypertension

For several years, doctors have been sounding the alarm: in developed countries which have overcome epidemics, high blood pressure continues to systematically occupy a preponderant place among the causes of mortality from cardiovascular diseases.In terms of the number of complications and unfavorable prognosis, it competes with diabetes mellitus.At the same time, the disease quickly rejuvenates.About 20 years ago, a 35-year-old patient suffering a stroke was considered absurd.Lately, such a case will not surprise anyone.

According to the World Health Organization, about a quarter of the world's population suffers from high blood pressure.Half of people over 65 have hypertension.

What kind of illness is this?

Hypertension refers to diseases of the cardiovascular system.Its presence causes persistent high blood pressure in the arteries of the systemic circulation.

In itself, pressure on the walls of blood vessels is a necessary and normal process and is necessary for the circulation of blood through them.During sleep, the pressure drops slightly, and during stress or physical activity, vice versa.

The standard blood pressure for young people (may vary slightly from person to person) is 120/75 mmHg.Art.For those over forty – 130/80, for those over fifty – 135/84.If the pressure often rises to 140/90, doctors speak of hypertension.

Blood pressure is divided into two types:

1. Systolic.The first, highest number indicates the force of blood pressure as the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lowest number indicates the blood pressure when the heart muscle (myocardium) relaxes.

High blood pressure (hypertension) is not without reason called the “silent killer”: it can provoke the appearance of various pathologies.The heart and brain are particularly affected.In advanced cases, it can even lead to heart attack and stroke.

Classification of hypertension

The risks of hypertension are impressive, which is why scientists have been studying it since the beginning of the last century.During this period, the classification changed more than once, but two directions were formed:

1. When creating classifications according to the stages of development of the disease, doctors thought about the connection between hypertension and risk factors for the development of hypertension.However, they never reached a complete agreement and the debate is still ongoing.
2. Identification of disease variants.The approach delves deeper into the causes of hypertension, the stages and mechanisms of its development.

The article will discuss several of the classifications proposed by scientists.

By external signs

This is how a German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when the pressure increases, redness of the face and body is noticeable due to the expansion of the capillaries.Red spots often appear.In the second case, a person suffering from the disease feels a vascular spasm with increased pressure, becomes cold and turns pale.

By origin

Doctors conventionally identified the degrees of hypertension: primary (hypertension) and secondary (symptomatic) hypertension.

The precise reasons for the appearance and development of the primary have not yet been found.It has three diplomas.

1st degree hypertension is called “mild”.Pressure - 140-159 and 90-99 mm Hg. Art.Blood pressure "jumps", sometimes increases, then returns to normal.Hypertension of the first degree has a borderline subgroup with indicators from 140 to 149 and 90 to 94 mm Hg. Art.The likelihood of seizures (sudden jumps) is low, if they occur, it is rare.

But for grade 2 (moderate) hypertension, the risk is greater.The tonometer shows 160-179 and 100-109 mmHg.Art.Second-degree hypertension is characterized by the fact that the pressure constantly increases.

Stage 3 (severe) disease can be life-threatening, especially with concomitant illnesses.This level is characterized by indicators above 180 and above 110 mmHg.Art.

Sometimes a person has problems with only one type of pressure.Hypertension is then called isolated and there are two variants of hypertension:

1. systolic.The pressure is above 140 and below 90 mmHg.Art.;
2. subgroup: limit – 140-149 and less than 90 mmHg.Art.In this case, the “upper” pressure reaches 140 mmHg.Art.and higher, while the “low” remains normal.We then speak of an isolated form of systolic hypertension.

Secondary hypertension is less common and is diagnosed in about 20% of cases (in young people under 35 years old - in 25%).This type of disease is caused by a disease of a specific organ.Most often, such symptomatic hypertension appears due to kidney problems.The division into endocrine, neurogenic, renal and hemodynamic forms was proposed by the professor.Doctors still use it today.

Stages of hypertension

In the recent past, experts have divided high blood pressure into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects the pathologies that appear in the body over the years.

In 1999, scientists decided that it would be more accurate to classify the disease by degree.There are three of them and each means a range of changes in the numerical values of blood pressure (they were discussed above).

In some classifications you can find the fourth degree of hypertension.Its lower limits: systolic indicators - 210, diastolic - more than 110. When a specialist notes the 4th degree of the disease, he is talking about digital indicators of pressure, and not about the patient's condition, since hypertension is stage 3. is also considered heavy.

With chronic high blood pressure, the body cannot cope with the stress and bad things start happening to the organs.Those that are affected earlier than others are called target organs by doctors.Besides the heart and brain, these include the retina and kidneys.The classification of hypertension into stages is based precisely on the impact on these weak points.

At the beginning, in stage 1 of the development of hypertension, the organs are still healthy.Often, people with hypertension do not go to the hospital at first, because it feels tolerable and does not particularly interfere with their life.Hypertensive crises are the exception rather than the rule.Beginning hypertensive patients ignore health problems in vain, because at this stage the disease is the easiest to tame.Sometimes treatment for stage 1 hypertension is more about lifestyle changes than medication.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to consult a specialist.Prompt treatment will help prevent the progression of the “silent killer.”

Stage 2 hypertension is characterized by persistent high blood pressure.The heart is the first to give up - the left ventricle begins to enlarge and "thicken".Some, in addition to abnormalities in the functioning of the heart, also develop abnormalities in the blood vessels of the retina.A person suffering from hypertension is stage 2. Attacks occur much more often.But the disease remains treatable.If the doctor diagnoses “stage 2 hypertension,” his recommendations should be followed with particular attention.Because the disease, with its development, begins to threaten life.

When stage 3 hypertension occurs, all target organs manifest with many complications.Pressure surges in hypertension, stage 3. can be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina, kidney failure and other "gifts" often develop.Often, the third stage of hypertension is noted when the patient already has hemorrhages in the fundus of the eye, heart attack, aneurysms, stroke and other ailments.

Signs of blood pressure problems

Identifying hypertension in time and understanding how long a person has been suffering from it is the number one problem.Many hypertensive patients learn the diagnosis 3 years or more after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, being overweight, smoking, frequent stress, high cholesterol levels, a sedentary lifestyle and old age.

Alarm bells are ringing if you see:

• occasional headaches;
• “threatening” pain in the back of the head or beating in the temples;
• you often feel nauseous and dizzy;
• reflections sparkle in the eyes or “black flies” fly;
• everything is boring or covered in apathy;
• tingling or numb fingers;
• swelling of the arms, legs, and/or face;
• out of the blue, a rapid heartbeat appears.

If this sounds like you, you should at least systematically measure your blood pressure.But it is better, of course, to go to the hospital.

Diagnosis of high blood pressure

If chronic hypertension is suspected, doctors use three diagnostic methods.

The first and simplest is to measure your blood pressure.

The second is a complete physical exam.It can only be carried out by a specialist.It carries out palpation and auscultation (analysis of sounds accompanying the work of various organs), percussion (tapping various parts of the body and drawing conclusions based on the sound) and a standard examination.

In the third case, an electrocardiograph allows conclusions to be drawn.

So, what awaits you when you arrive at the hospital with suspected hypertension?

First, the doctor will check your blood pressure using a special device - a tonometer.By the way, in people whose nervous system is easily excitable, blood pressure can increase even with minor emotional upheavals.When visiting a doctor, these patients suffer from “white coat” syndrome: as soon as the doctor starts measuring blood pressure, it increases.But the reason for these fluctuations is stress, not illness.Although such a reaction to shock can in the long term cause disruptions in the normal functioning of the heart and kidneys.In these impressionable patients, the healthcare provider will check the pressure more than once and under different conditions.

• Medical examination.Information about the patient's height, weight, and body mass index is collected.The specialist looks for signs of symptomatic hypertension.
• Medical history.Without asking the patient - nowhere.It is necessary to find out what diseases a person has previously encountered and whether any ailments currently exist.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol levels; we determine if diabetes exists), if the parents were hypertensive.
• Physical examination.First, the doctor will listen to the heart using a phonendoscope.The task is to identify noises, changes in tone or the presence of extraneous sounds, if any.After this study, it is possible to exclude heart defects and draw preliminary conclusions about its condition against the background of hypertension.
• Biochemical blood test.It is necessary to know the level of sugar, cholesterol and lipoproteins and understand how prone a person is to atherosclerosis.
• ECG.An electrocardiogram is an integral part of the diagnostic process.This helps to see irregularities in the heartbeat.Having the results in hand, we can judge the presence of hypertrophy of the wall on the left side of the heart, typical of high blood pressure.
• Ultrasound of the heart.With its help, the doctor can see a picture of changes and malformations of the heart, assess the functioning and condition of the valves.
• X-ray examination. Doctors perform arteriography and aortography.With their help, specialists study the arterial walls and their lumen to exclude the presence of congenital narrowing of the aorta (coarctation) and atherosclerotic plaques.
• Dopplerography.When diagnosing high blood pressure, the doctor examines the condition of the cerebral and carotid arteries.Ultrasound is harmless and does not cause complications, while helping to determine the intensity of blood flow in the arteries and veins.
• Ultrasound of the thyroid gland.Along with other data, the doctor needs the results of a blood test to determine the level of hormones produced by the thyroid gland.Based on the results of the study, it will become clear whether the thyroid gland plays a role in the development of the disease and what treatment to prescribe.
• Ultrasound of the kidneys.These organs and their vessels are very vulnerable to hypertension.The study makes it possible to assess their condition.

Treatment methods

Today there are many methods for treating hypertension.Some come to us from Antiquity;pharmacists and scientists have worked on creating others for years and years.

The most common method is drug treatment.Doctors use several types of medications to normalize blood pressure.

1. Calcium antagonists aim to reduce heart rate.
2. Diuretics, most commonly thiazide diuretics, work to improve urinary production and waste.
3. Adrenergic drugs.
4. Vasodilators dilate blood vessels and thus even out the situation.

In some cases, a surgical method called ablation is used.This procedure is not easy.A catheter with a device that creates radio waves is inserted into the patient's vein.With their help, the nerve network near the renal artery is damaged.To avoid the appearance of scars after the procedure, the entire length of the vein is affected.Carried out under local anesthesia.

Various methods from the past are classified as alternative medicine.This includes leg parkas, vinegar lotions and more.

Non-traditional remedies based on valerian, motherwort, beetroot, lemon, honey and horseradish are also effective in treating high blood pressure.

There are many herbal decoctions for the treatment of high blood pressure.Here is an example:

Take 1 tbsp.L.motherwort, valerian root and caraway.Mix.Pour a tablespoon of this mixture into a glass of boiling water and leave for an hour.Drink the medicine three times a day, 1/3 cup.The course is designed for one month.

There is also monastery tea intended to combat hypertension and homeopathic medicines.However, it is best to consult a specialist before treatment.

High blood pressure is a dangerous disease if left untreated.You need to monitor your health at any age, because the modern pace of life often contributes to the development of the disease.And whatever the stage and degree of hypertension, without treatment it can have fatal consequences.