A person is alive as long as their heart beats. The cardiac "pump" ensures blood circulation in the vessels. In this regard, there is such a thing as blood pressure. Abbreviated as AD. Any deviation from normal blood pressure levels is fatal.
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Risks of developing hypertension
The risk of developing hypertension or high blood pressure – high blood pressure – includes a number of factors. Accordingly, the more of them, the greater the likelihood that a person will become hypertensive.
Risk factors for developing hypertension:
- hereditary predisposition. The risk of getting sick is higher in people with hypertension among first-degree relatives: father, mother, grandmothers, grandfathers, brothers and sisters. The more relatives suffer from high blood pressure, the greater the risk;
- age over 35;
- stress (stress hypertension) and mental stress. Adrenaline, a stress hormone, increases your heart rate. It instantly tightens blood vessels;
- taking certain medications, for example oral contraceptives and various food supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. Tobacco components cause spasm of blood vessels - involuntary contractions of their walls. This restricts blood flow;
- atherosclerosis – blockage of blood vessels by plaques. Total cholesterol should not exceed 6. 5 mmol/l of blood;
- renal failure (nephrogenic hypertension);
- endocrinopathy of the adrenal glands, thyroid gland, or pituitary gland;
- excess salt in food. Table salt causes arterial spasms and retains fluids in the body;
- inactivity. Physical inactivity is accompanied by a slow metabolism - metabolism - and gradually weakens the body as a whole;
- excess body weight. Each extra pound increases blood pressure by 2 millimeters of mercury – mmHg;
- sudden change in weather;
- chronic lack of sleep and other "provocateurs".
Most risk factors for developing hypertension are closely related. Thus, heavy smokers in most cases develop atherosclerotic plaques, and physically passive and malnourished people quickly gain weight. Such combinations of factors significantly increase the risk of cardiac pathological abnormalities.
Depending on the combination and degree of manifestation of the above factors, as well as the likelihood of cardiovascular complications in the next decade, there are 4 types of risk of developing high blood pressure:
- low (risk less than 15%);
- medium (15 to 20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the occurrence of high blood pressure are also divided into 2 types depending on the possibility of their elimination: correctable (correctable) and not. For example, a person may very well quit smoking, but they are not able to change their ancestry. The amount of risk is summarized based on a certain number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will significantly increase the percentage of chances of developing complications.
Hypertension is completely treatable. Much depends on the timely diagnosis of the disease, the patient's perseverance and willingness to radically change his lifestyle.
1st degree hypertension
Arterial hypertension can be primary, that is, develop independently, and secondary - be a complication of another disease. In the latter case, treatment is carried out comprehensively, since it is necessary not only to normalize the pressure, but also to cure the concomitant cause of the disease.
A blood pressure of 120 per 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is what is called upper blood pressure or systolic pressure (during maximum contraction of the walls of the heart muscle). And 80 is the lower indicator or the so-called diastolic pressure (at their maximum relaxation). Accordingly, hypertension is divided into systolic, diastolic and mixed (systole-diastolic), depending on whether the upper or lower indicators exceed the threshold value.
When the lumen of blood flow narrows, the heart puts more effort into pushing blood through the vessels, it wears out faster and begins to work intermittently. An increase in heart rate – heart rate – negatively affects the functioning of the entire body. The air and nutrients contained in the blood do not have time to penetrate the cells.
Like any disease, hypertension progresses if left untreated. The appearance of the first hypertensive symptoms is preceded by a prehypertensive state - prehypertension.
The degree of severity depends on the stage of development of the disease:
- "soft" or light;
- moderate or borderline;
- very severe or isolated systolic.
Otherwise, stage 1 high blood pressure is called a mild form of this disease. The upper value of blood pressure ranges from 140 to 159, and the lower value is 90 to 99 mm Hg. Disorders in the functioning of the heart occur spasmodically. The attacks generally take place without consequences. This is a preclinical form of hypertension. Periods of exacerbations alternate with the complete disappearance of symptoms of the disease. During remission, the patient's blood pressure is normal.
Diagnosing hypertension is simple: measure blood pressure using a tonometer. For an accurate diagnosis, the procedure is performed three times a day in a calm and relaxed environment.
Even people at low risk of developing hypertension should check their blood pressure regularly. One potentially dangerous factor is enough to more closely monitor the work of your heart. For those who are significantly predisposed to heart disease, it is advisable to purchase a cardiovisor - a device for performing an ECG - an electrocardiogram - at home. Any disease is easier to treat at an early stage.
Symptoms of stage 1 hypertension
Symptoms of stage 1 hypertension include:
- headache that progresses with exercise;
- aching or stabbing pain on the left side of the chest, radiating to the shoulder blade and arm;
- black spots before the eyes.
It should be remembered that in mild forms of hypertension, all of these symptoms appear occasionally. If, after intense physical activity, your pulse accelerates or it is difficult to fall asleep due to noisy neighbors, do not panic and do not consider yourself hypertensive.
During periods of improvement, the patient feels good. Mild hypertension has all the characteristic signs of heart failure. More serious degrees of the disease differ only in the persistence of symptoms and the occurrence of complications.
Complications of 1st degree hypertension
Complications include:
- renal sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most believe that mild high blood pressure can be cured without consequences. But the risk of grade 1 complications is average, that is, around 15%. High pressure in the vessels due to narrowing of their lumen leads to insufficient blood supply to the tissues. Lack of oxygen and nutrients leads to the death of individual cells and entire organs. Necrosis begins with local and focal lesions. Over time, if left untreated, an ischemic stroke is inevitable.
Circulatory disorders inevitably lead to metabolic disorders. This has a detrimental effect on respiration and nutrition of cells of any type. Pathological changes are inevitable, for example sclerosis - replacement with connective tissue. With nephrosclerosis, the walls of the kidney become pathologically denser and the organ "shrinks". In this regard, the excretory function is disrupted and urea enters the blood.
If the blood vessels are narrowed, the heart struggles to circulate blood through them. This leads to pathological hypertrophy of the heart muscle. This hypertrophy is called true or functional. The volume and mass of the left ventricle increase due to the thickening of its walls. This pathology is otherwise called cardiomyopathy. The heart adapts its structure to the needs of the body. The extra muscle tissue allows it to squeeze harder. It would seem, how could this be dangerous? A "swollen" heart can compress adjacent vessels, and uneven muscle growth can close the left ventricular outlet. Cardiac enlargement sometimes leads to sudden death.
Complications of grade 1 hypertension occur extremely rarely. To avoid them, it is enough to minimize the risk of developing high blood pressure, that is, eliminate its prerequisites and causes.
Treatment of stage 1 hypertension
Initially, the doctor will advise the patient to change their lifestyle. The patient will be advised to have restful sleep, avoid stress, targeted relaxation exercises, special diet, exercise, etc. If these measures are not enough, drug treatment is used.
The cardiologist prescribes the following medications: sedatives and other antihypertensives.
Medicines are selected strictly individually, becauseMany hypertensive patients suffer from concomitant diseases. The choice of medications is influenced by the age of the patient and the medications they use.
If it is possible to stop the disease at the initial stage and completely get rid of it, then prevention cannot be neglected in the future. Its principle is simple: it involves avoiding all risk factors for hypertension. Thanks to a healthy lifestyle, you can prevent the appearance of even hereditary pathologies.
Hypertension 2 degrees
This is moderate hypertension. The upper blood pressure is 160 to 179 mm Hg, and the lower blood pressure is 100 to 109 mm Hg. At this stage of the disease, the periods of increased pressure are longer. Blood pressure rarely returns to normal.
Depending on the speed of transition of hypertension from one stage to another, benign and malignant arterial hypertension are distinguished. In the second case, the disease progresses so quickly that it is often fatal. Hypertension is dangerous because an increase in the speed of blood circulation in the vessels leads to thickening of their walls and even greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Typical signs of high blood pressure appear even in mild forms of the disease.
In the second stage, they are accompanied by the following symptoms:
- throbbing sensation in the head;
- hyperemia - overflow of blood vessels, for example redness of the skin;
- microalbuminuria – presence of albumin proteins in urine;
- numbness and chills in the fingers;
- fundus pathologies;
- hypertensive crises - sudden increases in pressure (sometimes by 59 units at a time);
- the appearance or worsening of signs of damage to a target organ.
Fatigue, lethargy and swelling appear because the kidneys are involved in the pathological process. A hypertensive attack may be accompanied by vomiting, difficulty urinating and defecating, shortness of breath and tears. Sometimes it lasts several hours. Complications of a hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, overexcitement, hand tremors, unmotivated panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, inhibition of consciousness);
The symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of high blood pressure. At this stage, the disease reluctantly recedes and often returns.
Complications of hypertension 2 degrees
Complications of stage 2 hypertension include the following diseases: aortic aneurysm - a pathological protrusion of its wall.
Target organs i. e. internal organs affected due to hypertension include:
- Hemorrhages in various organs occur because the walls of blood vessels become increasingly thickened, lose their elasticity and become brittle. Increased blood flow easily destroys these vessels. The opposite process occurs with the development of aneurysms. Here, the walls stretch and thin due to increased blood circulation. They are so weakened that they tear easily.
- A pathologically narrow lumen increases the risk of developing atherosclerosis - fatty deposits on the walls - and thrombosis - their blockage by a blood clot. Bleeding of brain cells leads to lack of oxygen and their death. This phenomenon is called encephalopathy. Ischemia is a lack of oxygen to the heart. Angina is constant chest pain.
Pathological processes associated with the underlying disease develop in connection with it. As a result, if you do not start treatment on time or violate medical prohibitions, there will be more and more target organs and it will become almost impossible to restore health.
2nd degree hypertensive disability
Hypertensive patients are constantly monitored at the dispensary and are periodically examined. In addition to daily blood pressure measurements, they are regularly prescribed an ECG. In some cases, an ultrasound may be necessary - ultrasound of the heart, urine tests, blood tests and other diagnostic procedures. Hypertensive patients with a moderate form of the disease are less productive than healthy people.
In case of persistent impairment of body functions caused by hypertension, the patient is referred to the office for examination to obtain a medical and social examination report. In rare cases, hypertensive patients are examined at home, in the hospital or even in absentia. Sometimes, a program of additional examinations is established. For disabled people, specialists from the Medical and Social Expertise Bureau develop a mandatory individual rehabilitation program.
To determine the disability group, the expert commission, along with the degree of hypertension, takes into account the following factors:
- information from medical history about hypertensive crises;
- working conditions of the patient.
The procedure for creating a group of disabled people is necessary for good employment. Whether it will be easy to find an employer willing to accept the work of an "inferior" employee is another question. If a job seeker presents documents confirming his disability, then, in accordance with federal legislation, he must be provided with the necessary working conditions.
Employers are hesitant to hire people with disabilities because. . . Their working hours were reduced while maintaining full salary (for groups 1 and 2). In addition, they are forced to take sick leave more often than other employees, and their annual leave has been increased. In this regard, most disabled people of group 3 hide their illnesses in order to get a well-paid place. Violation of medical instructions regarding working conditions leads to worsening of the disease over time.
Disabled people of group 3 receive cash benefits and are allowed to engage in professional activities with certain restrictions:
- strong vibration and noise are contraindicated;
- You cannot work overtime, weekends or night shifts without the employee's consent;
- Constant physical or psycho-emotional stress is not allowed;
- ban on working at high altitude, in hot workshops, near dangerous mechanisms;
- reduce the duration of work involving high concentration of attention;
- seven-hour workday.
A special case is stage 2 malignant arterial hypertension. Its progression is so rapid and the patient's condition is serious that the commission assigns him a group 2 disability. This is no longer a working group. For levels 2 and 3 of disability, a medical-social visit is carried out annually. Persons with disabilities in the following categories are exempt from re-examination:
- men over 60;
- women over 55;
- people with irreversible anatomical defects.
The assignment of a disability group is motivated by the need for social protection of hypertensive patients. His ability to engage in professional activity is limited.
Treatment of stage 2 hypertension
At this stage of the disease, there is no way to do without medication. The tablets are taken regularly, if possible at the same time of day. The patient should not think that to get rid of the disease it will be enough to take medication. If he does this while getting carried away, for example, with fatty foods and alcohol, the positive effect of the therapy will quickly disappear. The disease will progress to the next stage, during which any treatment will no longer be effective.
Hypertension 3 degrees
Why are doctors alarmed by deviations of blood pressure readings from the norm, even by just one? The fact is that when the pressure increases by several units, the risk of developing cardiovascular complications increases by the same percentage. For example, if a person suffers from mild hypertension and his blood pressure deviates from normal by 120 to 80 mm Hg. per 39 units, then there is a very high probability of pathological abnormalities occurring in various organs (39%). What then can we say about the 3rd degree of the disease, in which the deviation is at least 60 units?
Stage 3 hypertension is a serious and chronic form of the disease. Blood pressure exceeds 180/110 mm Hg, it never drops to the normal 120/80. Pathological changes are already irreversible.
Symptoms of stage 3 hypertension
Symptoms of stage 3 hypertension include:
- impaired coordination of movements;
- persistent visual impairment;
- paresis and paralysis due to cerebral circulation disorders;
- prolonged hypertensive crises with speech disturbances, impaired consciousness and sharp pain in the heart;
- significant limitation in the ability to move independently, communicate and care for oneself.
In severe cases, hypertensive patients can no longer cope without outside help; they require constant attention and care. The above signs of hypertension show that the patient's well-being gradually deteriorates, the disease spreads to new organ systems, and there are more and more complications.
Complications of grade 3 hypertension
Complications of grade 3 hypertension include the following diseases:
- myocardial infarction – the middle muscular layer of the heart;
- cardiac asthma - attacks of suffocation;
- peripheral arterial damage;
- hypertensive retinopathy affects the retina of the eyes;
- The scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of grade 3 hypertension are otherwise called associated clinical conditions. When cerebral circulation is impaired, a stroke develops, accompanied by loss of sensation in the limbs and fainting. Heart failure is a group of cardiac pathologies. The kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes mellitus, nephropathy is inevitable.
The more advanced the disease, the more terrible and serious its consequences. The circulatory system is so important for the life of the body that the slightest deviation in its functioning has a powerful destructive effect.
3rd degree hypertensive disability
In severe cases of the disease, disability group 1 is established. At this stage, patients are virtually unable to work. Sometimes they are recognized as partially capable of working and continue to work, but only at home or under special conditions.
But even with the most severe degree of disability, the patient must undergo rehabilitation procedures. In this state of affairs, this is necessary to avoid death.
Treatment of stage 3 hypertension
As the course of the disease worsens, more and more powerful drugs are prescribed or their list remains the same, but the dosage increases. At this stage of hypertension, the effect of drug treatment is minimal. Chronic hypertensive patients are condemned to taking pills for life.
When the disease becomes severe, surgery may be necessary. The operation is indicated for certain pathologies of the blood vessels and the heart. The stem cell therapy method for stage 3 high blood pressure is considered innovative.
Hypertension 4 degrees
Some experts also identify stage 4 of the disease, which is very serious. In most cases, death is near. They try to alleviate the patient's suffering as much as possible and, at each hypertensive crisis, they provide first aid. The patient lies down with his head raised. He was urgently given medication that significantly lowered his blood pressure.
Without treatment, new complications appear. Some of them provoke others, and diseases increasingly overwhelm a person. To stop this destructive process in time, you just need to monitor the dynamics of changes in your blood pressure, at least using a regular tonometer.
Example of risk calculation based on the stage of hypertension
Hypertension stages Other risk factors, POM or disease BP (mmHg)
| Normal high | Degree 1 | Degree 2 | Degree 3 | ||
| GARDEN 130-139 DBP 85-89 |
GARDEN 140-159 PAD 90-99 |
GARDEN 160-179 DBP 100-109 |
PAS ≥180 DBP ≥110 |
||
| Stage I | No other FR | Low risk (risk 1) |
Low risk (risk 1) | Moderate risk (risk 2) |
High risk (risk 3) |
| 1-2 EN | Low risk (risk 1) |
Moderate risk (risk 1) |
Moderate / high risk |
High risk (risk 3) |
|
| ≥3 FR | Short / moderate risk (risk 1) |
Moderate / high risk |
High risk (risk 3) |
High risk (risk 3) |
|
| Stage II | POM, CKD stage 3 or DM without organ damage |
Moderate / high risk |
High risk (risk 3) |
High risk (risk 3) |
High / very large risk |
| Stage III | Established CVD, CKD stage ≥4 or diabetes with organic damage |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
Very high risk (risk 4) |
GB - hypertension
SBP - systolic blood pressure
DBP – diastolic blood pressure
RF is a risk factor
CVD – cardiovascular disease
CKD – chronic kidney disease
DM - diabetes mellitus
POM – target organ damage
Once the risk category has been determined, the doctor can identify factors that can be influenced to reduce it. Among these modifiable characteristics:
- Obesity (with a BMI over 30), as well as central or visceral obesity, which is determined by waist circumference.
- Social isolation.
- Chronic stress.
Left ventricular hypertrophy, chronic kidney disease, serious heart rhythm disorders such as atrial fibrillation, and others may also increase the risk.