Arterial hypertension 1, 2, 3 degrees

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Arterial hypertension is a syndrome of persistent increase in pressure in the arteries, when the systolic pressure is above 139 mm Hg.st., and the diastolic is higher than 89 mm Hg. Art.

Normal arterial blood pressure of a healthy person is considered to be 120 and 80 mm Hg.(systolic / diastolic, respectively).There are two types of hypertension: primary( essential) hypertension and symptomatic arterial hypertension( it is secondary).

Probably, every person at least once in life faced with increased pressure, experienced it himself or learned about it through complaints of relatives and friends. Not only is hypertension dangerous in itself, it is also a catalyst and the cause of a number of other, much more dangerous diseases that do not so rarely end in a fatal outcome.

Researches of scientists have shown, that changes of parameters of a BP on 10 mm of a mercury column raise the risk of occurrence of serious pathologies. The heart, vessels, brain and kidneys suffer the most. It is these organs that take the blow, so they are also called "target organs".Completely cure this disease is impossible, but blood pressure can be kept under control.

Reasons for the development of

What is it, and what are the risk factors? The causes of hypertension are very diverse. At the heart of the division of hypertension into primary and secondary is the etiology of this disease.

Primary episode occurs independently on the background of certain risk factors. These include:

1. Heredity. Unfortunately, this is the most common cause of the disease. It is especially regrettable that no medications can modify this risk factor and reduce its impact on human health.
2. Gender. Most hypertensive disease affects women, which is explained by the corresponding hormonal background.
3. Age.55 years for women and 60 years for men are already considered risk factors for the development of hypertension.
4. Obesity. Excess body weight affects the work of the heart and leads to a rapid depletion of energy reserves of the myocardium( cardiac muscle).
5. Diabetes mellitus. Excessive exposure to stress;
6. Hypodynamia. The disease of the 21st century is a violation of the work of various organs and systems due to a sedentary lifestyle.

Risk factors increase blood pressure gradually, leading to the development of hypertension.

Arterial hypertension 1, 2, 3 degrees

In medicine, it is customary to classify hypertension in degrees.

• at 1 degree arterial pressure, as a rule, does not leave the limits of 140-150 / 90-99 mm Hg.post.
• 2 degree is characterized by such indicators: 160-179 / 100-109 mm Hg.post.
• 3 the degree of development is manifested in excess of 180 mm Hg. Art.at 110 mm Hg. Art.and is a very disturbing signal.

It should be noted that the severity of arterial hypertension is determined only taking into account all possible risk factors for the development of diseases of the cardiovascular apparatus.

Symptoms of arterial hypertension

The clinical picture depends on the stage and form of the disease.

Increased pressure in the case of hypertension may not be accompanied by any symptoms and detected by accident, when measuring blood pressure. In some cases, there may be a headache, dizziness, flickering flies before the eyes, pain in the heart.

Severe hypertension may occur with severe cardiovascular, neurological, renal symptoms or retinal lesions( eg, clinically manifested atherosclerosis of the coronary vessels, heart failure, hypertensive encephalopathy, renal failure).

The early symptom of high blood pressure is IV heart tone. Changes in the retina may include narrowing of arterioles, hemorrhages, exudation and in the presence of encephalopathy edema of the nipple of the optic nerve. The changes are divided into four groups according to the increase in the probability of a poor prognosis( there are classifications of Kis, Wegener and Barker):

• Stage 1 - restriction of arterioles;
• Stage 2 - restriction and sclerosis of arterioles;
• Stage 3 - hemorrhages and exudation in addition to vessel changes;
• Stage 4 - edema of the nipple of the optic nerve.

The main method for diagnosing arterial hypertension is to detect elevated blood pressure.

When should I see a doctor?

It is very important to make an appointment with a doctor if you are concerned about this symptom:

• frequent headaches;
• dizziness;
• pulsating sensations in the head;
• "flies" in the eyes and tinnitus;
• tachycardia( heart palpitations);
• pain in the region of the heart;
• nausea and weakness;
• puffiness of the extremities and puffiness of the face in the morning;
• numbness of the limbs;
• an unexplained sense of anxiety;
• irritability, stubbornness, throwing from one extreme to the other.

It should be remembered that hypertension, which is not given due attention, can make life much shorter.

Arterial hypertension 3 degrees risk 3 - what is it?

In the formulation of the diagnosis, in addition to the degree of hypertension, the degree of risk is also indicated. Under the risk in this situation, the probability of developing a cardiovascular disease in a given patient for 10 years is implied. In assessing the degree of risk, many factors are taken into account: the age and sex of the patient, heredity, lifestyle, the presence of concomitant diseases, the state of target organs.

Patients with hypertension are divided into four main risk groups:

1. The chances of developing cardiovascular disease are less than 15%.
2. The incidence of diseases for these patients is 15-20%.
3. The development frequency reaches 20-30%.
4. The risk in this group of patients is above 30%.

Patients with a diagnosis of arterial hypertension of the 3rd degree are assigned to 3 or 4 risk groups, since this stage of the disease is characterized by the defeat of internal target organs.4 group is also called a group of very high risk.

This dictates the need to establish a diagnosis of hypertension grade 3 risk 4 to urgently carry out intensive treatment. This means that patients with 1 and 2 risk groups are allowed to follow the patient and use non-drug treatment methods, then patients with 3 and 4 risk groups require immediate appointment of antihypertensive therapy immediately after diagnosis.

Arterial hypertension 2 degrees risk 2 - what is it?

At grade 2, risk factors may be absent or only one or two similar signs will be available. At risk 2, the probability of the onset of irreversible changes in organs after 10 years, fraught with heart attacks and strokes, is 20%.

Therefore, the diagnosis of "grade 2 arterial hypertension, risk 2" is set when this pressure lasts for a long time, there are no endocrine disorders, but one or two internal target organs have already begun to undergo changes, atherosclerotic plaques have appeared.

Prevention of

Preventive measures should be taken to reduce the risk of hypertension. Basically it is:

1. Preventing bad habits: drinking alcohol, drugs, smoking, overeating.
2. Active way of life. Hardening. Dosed physical exercise( skating, skiing, swimming, running, biking, walking, rhythmic, dancing).For boys 5-18 years of age the norm of motor activity is 7-12 hours a week, for girls 4-9 hours.
3. Rational nutrition that prevents obesity. Restriction of salt intake.
4. Increased resistance to stress, a favorable psychological climate in the family.
5. Mandatory measurement of blood pressure at different periods of life.

Diagnosis of arterial hypertension

When collecting anamnesis, the duration of arterial hypertension and the highest BP figures that were previously registered are specified;any indication of the presence or manifestation of PVS, HF or other concomitant diseases( for example, stroke, kidney failure, peripheral arterial disease, dyslipidemia, diabetes, gout), and family history of these diseases.

Anamnesis of life includes the level of physical activity, smoking, drinking alcohol and stimulants( prescribed by a doctor and taken independently).Features of nutrition are specified in terms of the amount of salt and stimulants consumed( for example, tea, coffee).

The main tasks of diagnosing this pathological process are to determine a stable and elevated degree of blood pressure, the elimination or detection of symptomatic arterial hypertension, and the assessment of the overall risk of S.S.S.

Necessary: ​​

• to perform biochemical analysis to determine the concentration of glucose, creatinine, potassium ions and cholesterol.
• must pass the ECG, Echo KG.
• pass ultrasound of the kidneys.
• check the renal arteries, peripheral vessels.
• to investigate the fundus.

Also important monitoring method of monitoring is the monitoring of pressure throughout the day, providing the necessary information about the mechanisms of cardiovascular regulation with daily variability of blood pressure, nighttime hypertension or hypotension, uniformity of antihypertensive action of drugs.

Treatment of arterial hypertension

In the case of hypertension, treatment should begin with a change in their lifestyle and non-drug therapy.(An exception is the syndrome of secondary hypertension, in which case the treatment of a disease whose symptom is AG is also prescribed).

The treatment regimen includes therapeutic nutrition( with limited intake of liquid and table salt, with obesity - with a restriction of daily calories);restriction of alcohol intake, smoking cessation, observance of the work and rest regime, exercise therapy, physiotherapy( electrosleep, medicinal electrophoresis, warm - coniferous or fresh, radon, carbon dioxide, hydrogen sulphide baths, circular and fan shower, etc.).

Recommendations include regular physical activity in the fresh air, at least 30 minutes a day 3-5 times a week;weight loss before reaching a BMI of 18.5 to 24.9;a diet under increased pressure, rich in fruits, vegetables, low-fat foods with a reduced amount of saturated and total fat;the use of sodium.

Medical treatment

According to the recommendations of the Moscow Association of Cardiologists, it is necessary to treat hypertension with medication in the following cases:

1. With an increase in blood pressure to 160/100 mm Hg, Art.and higher;
2. With blood pressure less than 160/100 mm Hg. Art.in case of ineffectiveness of non-drug treatment;
3. When target organs are involved( hypertrophy of the left ventricle of the heart, changes in the fundus, changes in urinary sediment and / or an increase in the level of the creatinine of the blood);
4. In the presence of two or more factors of development of the risk of coronary heart disease( dyslipidemia, smoking, etc.).

For treatment can be used such groups of drugs:

1. Diuretics( diuretics);
2. Alpha-blockers;
3. Beta-blockers;
4. Angiotensin-converting enzyme( ACE) inhibitors;
5. Angiotensin II antagonists;
6. Calcium antagonists;

The choice of a specific agent for the treatment of hypertension depends on the degree of increase in blood pressure and the risk of developing coronary heart disease, as well as age, sex, concomitant diseases and individual characteristics of the patient's body.

Forecast

Despite the fact that high blood pressure is the main risk factor for serious complications, the prognosis for a particular patient can be quite favorable.

AG, like any other disease, requires considerable attention and respect. Timely detection of this disease, adequate treatment, as well as accurate and consistent performance of the patient's appointments by the attending physician, significantly improve the prognosis.