Classification of hypertension

For several years now, doctors have been sounding the alarm: in developed countries that have overcome epidemics, arterial hypertension continues to consistently occupy a leading 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 is rapidly getting younger.A couple of decades ago, a 35-year-old stroke patient was considered nonsense.Lately, such a case will not surprise anyone.

According to the World Health Organization, about a quarter of the world's inhabitants suffer from arterial hypertension.Half of people over 65 years of age are hypertensive.

What kind of illness is this?

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

In itself, pressing on the walls of blood vessels is a necessary, normal process and is necessary for the movement 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 talk about hypertension.

Blood pressure is divided into two types:

1. Systolic.The first, top number indicates the strength of the blood pressure at the moment when the heart contracts and pushes blood out of the arteries.
2. Diastolic.The second, lower number shows blood pressure when the heart muscle (myocardium) relaxes.

Arterial hypertension (hypertension) is not without reason called the “silent killer”: it can cause the appearance of various pathologies.The heart and brain are especially 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 of time, 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 came to full agreement - the debate is still going on.
2. Identification of disease variants.The approach delves 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 one German doctor classified the disease.Looking at the patient, F. Volgard divided the disease into red and pale.In the first case, when pressure increases, redness of the face and body is noticeable due to dilation of the capillaries.Often red spots appear.In the second case, a person suffering from the disease experiences a vascular spasm with a surge in pressure, becomes cold and turns pale.

By origin

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

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

Arterial hypertension of the 1st degree is called “mild”.Pressure - 140–159 and 90–99 mm Hg.Art.Blood pressure “jumps”, sometimes rising, then returning to normal.First degree hypertension has a borderline subgroup with indicators of 140–149 and 90–94 mm Hg.Art.The likelihood of crises (sharp sudden jumps) is small, if they happen, it is rare.

But for grade 2 hypertension (moderate) the risk is greater.The tonometer shows 160–179 and 100–109 mmHg.Art.Hypertension of the second degree is characterized by the fact that the pressure is constantly increased.

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

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

1. systolic.Pressure is more than 140 and less than 90 mmHg.Art.;
2. subgroup: borderline – 140–149 and less than 90 mmHg.Art.In this case, the “upper” pressure creeps to 140 mmHg.Art.and higher, while the “lower” remains normal.Then we are talking about an isolated systolic form of hypertension.

Secondary hypertension is less common and is diagnosed in approximately 20% of cases (in young people under 35 years old - in 25%).This type of illness 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, arterial hypertension was divided by experts into three stages.The stage of hypertension (first, second and third) shows the progression of the disease over time.Thus, the division reflects 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 digital blood pressure values (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 means digital pressure indicators, and not 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 begin to happen to the organs.Those that are affected earlier than others are called target organs by doctors.Along with 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 first, 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 they feel tolerable and do not particularly interfere with their lives.Hypertensive crises are the exception rather than the rule.Beginning hypertensive patients ignore health problems in vain, because at this stage the disease is easiest to tame.Sometimes treatment for stage 1 hypertension comes down more to changing your lifestyle than to taking medications.But it is necessary.Therefore, when the tonometer periodically shows high levels, it is better to go to a specialist.Timely 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 defects in the blood vessels of the retina.A person with hypertension is stage 2.crises happen much more often.But the disease is still treatable.If the doctor diagnoses “Hypertension stage 2”, his recommendations should be followed especially carefully.Because the disease, with further development, begins to threaten life.

When stage 3 hypertension occurs, all target organs make themselves known with a heap of complications.Pressure surges in hypertension, stage 3.may be accompanied by attacks of heart failure and cardiac asthma.Atherosclerosis, angina pectoris, renal failure and other “gifts” often develop.Often, the third stage of hypertension is noted when the patient already has hemorrhages in the fundus, heart attack, aneurysms, stroke and other ailments.

Signs of blood pressure problems

Identifying hypertension in a timely manner and understanding how long a person has had it is problem number one.Many hypertensive patients learn about the diagnosis 3 or more years after the onset of the disease.

Factors that increase the risk of developing hypertension are heredity, excess weight, smoking, frequent stress, elevated cholesterol levels, a sedentary lifestyle, and old age.

The alarm bell rings if you see:

• occasional headache;
• pain “threats” on the back of the head or knocks in the temples;
• often feel nauseous and dizzy;
• glare flickers in the eyes or “black flies” fly;
• everything is annoying or covered by apathy;
• fingers tingling or numb;
• swelling of the arms, legs and/or face;
• out of the blue a rapid heartbeat appears.

If you recognize yourself, you should at least systematically measure your blood pressure.But it’s better, of course, to go to the hospital.

Diagnosis of arterial hypertension

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

The first, simplest one is to measure your blood pressure.

The second is a complete physical examination.It can only be carried out by a specialist.He 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 sound), and a standard examination.

In the third case, an electrocardiograph helps to draw conclusions.

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 who have an easily excitable nervous system, blood pressure numbers can jump up even with minor emotional upheavals.When visiting a doctor, such patients experience “white coat” syndrome: as soon as the doctor starts measuring blood pressure, it increases.But the reason for these fluctuations is stress, and not illness at all.Although such a reaction to a shock in the long term can provoke disruptions in the normal functioning of the heart and kidneys.In such impressionable patients, the health care 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 evidence of symptomatic hypertension.
• Medical history.Without interviewing the patient - nowhere.It is needed to find out what diseases a person has encountered before and whether there are any ailments at the moment.Risk factors and lifestyle are analyzed (presence/absence of bad habits, diet, cholesterol level; it is determined whether there is diabetes), whether 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 tones 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 needed to find out the level of sugar, cholesterol and lipoproteins, and to understand how prone a person is to atherosclerosis.
• ECG.An electrocardiogram is an integral element of the diagnostic process.It helps to see irregularities in heart rhythm.Having the results in hand, we can judge the presence of hypertrophy of the wall of the left side of the heart, typical of arterial hypertension.
• Ultrasound of the heart.With its help, the doctor can see a picture of changes and heart defects, assess the function and condition of the valves.
• X-ray examination.Doctors do 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 arterial hypertension, 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 through 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 any 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 helps assess their condition.

Treatment methods

Today there are many methods for treating hypertension.Some came to us from antiquity; pharmacists and scientists worked on the creation of others for years and years.

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

1. Calcium antagonists are aimed at reducing heart rate.
2. Diuretics, most often thiazide diuretics, work to improve urine production and waste.
3. Adrenergic drugs.
4. Vasodilators dilate the blood vessels and thereby level 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 prevent scars from appearing after the intervention, the entire length of the vein is affected.Performed under local anesthesia.

A variety of methods that came from the past are classified as alternative medicine.This includes leg parkas, vinegar lotions, and much more.

Non-traditional remedies based on valerian, motherwort, beets, lemon, honey, and horseradish are also effective in the treatment of arterial hypertension.

There are many herbal decoctions for the treatment of arterial hypertension.Here's one 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 drug three times a day, 1/3 cup.The course is designed for a month.

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

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