A person is alive as long as his heart beats. The heart "pump" ensures blood circulation in the vessels. In this regard, there is such a thing as blood pressure. Abbreviated as AD. Any deviations from normal blood pressure levels are deadly.
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Risks of developing hypertension
The risk of developing hypertension or arterial hypertension - high blood pressure - consists of a number of factors. Accordingly, the more there are, the greater the likelihood that a person will become hypertensive.
Risk factors for developing hypertension:
- hereditary predisposition. The risk of getting sick is higher for those who have hypertension among first-degree relatives: father, mother, grandmothers, grandfathers, siblings. The more close relatives suffer from high blood pressure, the greater the risk;
- age over 35 years;
- stress (stress hypertension) and mental stress. The stress hormone adrenaline increases your heart rate. It instantly constricts blood vessels;
- taking certain medications, for example, oral contraceptives, and various dietary supplements (iatrogenic hypertension);
- bad habits: smoking or drinking alcohol. Components of tobacco provoke spasms of blood vessels - involuntary contractions of their walls. This narrows the blood flow;
- atherosclerosis – blockage of blood vessels with 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 provokes arterial spasm and retains fluid 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 kilogram 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 interrelated. Thus, heavy smokers in most cases develop atherosclerotic plaques, and physically passive and malnourished people quickly gain excess weight. Such combinations of factors significantly increase the risk of pathological abnormalities in the heart.
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 arterial hypertension:
- low (risk less than 15%);
- average (from 15 to 20%);
- high (more than 20%);
- very high (more than 30%).
Risk factors for the appearance of arterial hypertension are also divided into 2 types based on the possibility of their elimination: correctable (correctable) and not. For example, a person may well quit smoking, but he is not able to change his ancestry. The amount of risk is summed up from a number of indicators. A patient with stage 1 hypertension who begins to abuse alcohol will significantly increase the percentage chance of developing complications.
Hypertension is quite treatable. Much here depends on timely diagnosis of the disease, the patient’s persistence, and his willingness to radically change his lifestyle.
Hypertension 1st degree
Arterial hypertension can be primary, i. e. develop independently, and secondary - to be a complication of another illness. In the latter case, treatment is carried out comprehensively, because it is necessary not only to normalize the pressure, but also to cure the concomitant disease-cause.
A blood pressure reading of 120 per 80 mm Hg is considered normal. This is the "ideal" value, as they say, for astronauts. 120 is the so-called upper blood pressure or systolic pressure (at 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 the blood flow narrows, the heart spends more effort to push blood into 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 enter 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 arterial hypertension is called a mild form of this disease. The upper blood pressure reading ranges from 140 to 159, and the lower one is 90 – 99 mm Hg. Disturbances in the functioning of the heart occur spasmodically. The attacks usually pass without consequences. This is a preclinical form of hypertension. Periods of exacerbations alternate with complete disappearance of symptoms of the disease. During remission, the patient's blood pressure is normal.
Diagnosis of hypertension is simple: measuring blood pressure using a tonometer. For an accurate diagnosis, the procedure is carried out three times a day in a calm environment and in a relaxed state.
Even people at low risk of developing hypertension need to check their blood pressure regularly. One potentially dangerous factor is enough to more closely monitor the work of your heart. For those who are predisposed to heart disease to a significant extent, it is advisable to purchase a cardiovisor - a device for taking an ECG - 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.
We must not forget that in mild forms of hypertension, all these symptoms appear occasionally. If after intense physical activity your pulse quickens or it is difficult to fall asleep due to noisy neighbors, you should not panic and consider yourself hypertensive.
During periods of improvement, the patient feels great. Mild hypertension has all the signs characteristic of heart failure. More severe degrees of the disease differ only in the persistence of symptoms and the occurrence of complications.
Complications of hypertension 1st degree
Complications include:
- kidney sclerosis - nephrosclerosis;
- hypertrophy of the heart muscle (left ventricle).
Most believe that mild arterial hypertension can be cured without consequences. But the risk of complications with grade 1 is average, i. e. about 15%. High pressure in the vessels due to the 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, 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 the respiration and nutrition of cells of any type. Pathological changes are inevitable, for example, sclerosis - replacement by 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 bloodstream.
If the blood vessels are narrowed, the heart strains to push blood through them. This leads to pathological enlargement of the heart muscle. This hypertrophy is called true or working. The volume and mass of the left ventricle increase due to 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 growths can close the exit from the left ventricle. Cardiac hypertrophy sometimes leads to sudden death.
Complications from grade 1 hypertension occur extremely rarely. To avoid them, it is enough to minimize the risk of developing arterial hypertension, i. e. eliminate its prerequisites and causes.
Treatment of stage 1 hypertension
First, the doctor will advise the patient to change his lifestyle. The patient will be advised to have restful sleep, avoid stress, targeted relaxation exercises, a special diet, exercise, etc. If these measures are not enough, drug therapy is used.
The cardiologist prescribes the following medications: sedatives and other antihypertensive medications.
Medicines are selected strictly individually, becauseMany hypertensive patients have concomitant diseases. The choice of drugs is influenced by the patient’s age and the medications he uses.
If it is possible to stop the disease at the initial stage and completely get rid of it, prevention cannot be neglected in the future. Its principle is simple - it is to avoid all risk factors for hypertension. Thanks to a healthy lifestyle, you can prevent the occurrence of even hereditary pathologies.
Hypertension 2 degrees
This is hypertension in moderate form. The upper blood pressure is 160 - 179 mm Hg, and the lower blood pressure is 100 - 109 mm Hg. At this stage of the disease, 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, the disease progresses so rapidly that it is often fatal. Hypertension is dangerous because an increase in the speed of blood movement through the vessels leads to thickening of their walls and an even greater narrowing of the lumen.
Symptoms of stage 2 hypertension
Typical signs of arterial hypertension appear even in mild forms of the disease.
At the second stage, they are joined by the following symptoms:
- sensation of pulsation in the head;
- hyperemia - overflow of blood vessels, for example, redness of the skin;
- microalbuminuria – the presence of albumin proteins in the urine;
- numbness and chills of the fingers;
- fundus pathologies;
- hypertensive crises - sudden surges in pressure (sometimes by 59 units at once);
- the appearance or worsening of signs of target organ damage.
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 bowel movements, shortness of breath, and tears. Sometimes it lasts for several hours. Complications of a hypertensive crisis are myocardial infarction and pulmonary or cerebral edema.
Forms of hypertensive crisis:
- neurovegetative (increased heart rate, overexcitation, hand tremors, unmotivated panic, dry mouth);
- edematous (lethargy, swelling of the eyelids, inhibited consciousness);
Symptoms of stage 2 hypertension are more difficult for patients to tolerate. He constantly suffers from pathological manifestations of high blood pressure. The disease at this stage recedes reluctantly 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.
To target organs, i. e. internal organs affected due to hypertension include:
- Hemorrhages in various organs occur because the walls of blood vessels thicken more and more, lose their elasticity and become brittle. Increased blood flow easily destroys such vessels. The reverse process occurs with the development of aneurysms. Here the walls become stretched and thinned due to increased blood circulation. They are so weakened that they tear easily.
- A pathologically narrow lumen increases the likelihood of developing atherosclerosis - fat deposits on the walls - and thrombosis - blockage of them with a blood clot. Bleeding of brain cells leads to oxygen starvation and their death. This phenomenon is called encephalopathy. Ischemia is oxygen starvation of the heart. Angina pectoris is constant chest pain.
Pathological processes associated with the underlying disease develop in connection with it. Accordingly, if you do not start treatment in a timely manner or violate medical prohibitions, there will be more and more target organs, and it will become almost impossible to restore health.
Hypertension disability 2nd degree
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, ultrasound may be required - ultrasound examination 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.
If there is a persistent impairment of body functions caused by hypertension, the patient is sent to the bureau for examination to obtain a medical and social examination report. In rare cases, hypertensive patients are examined at home, in a hospital, or even in absentia. Sometimes an additional examination program is drawn up. For disabled people, specialists from the Bureau of Medical and Social Expertise 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 the medical history about hypertensive crises;
- working conditions of the patient.
The procedure for establishing a disability group is necessary for proper employment. Whether it will be easy to find an employer willing to put up with the work of an "inferior" employee is another question. If an applicant for employment submits documents confirming his disability, then, in accordance with federal legislation, he must be provided with the necessary working conditions.
Employers are reluctant to hire people with disabilities because. . . working hours for them have been reduced while maintaining full wages (for groups 1 and 2). In addition, they are forced to go on 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 a worsening of the disease over time.
Group 3 disabled people receive cash benefits and are allowed to engage in professional activities with some restrictions:
- strong vibration and noise are contraindicated;
- You cannot work overtime, on weekends or on night shifts without the consent of the employee;
- Constant physical or psycho-emotional stress is not allowed;
- prohibition of work at high altitudes, in hot shops, near dangerous mechanisms;
- reducing the duration of work involving high concentration of attention;
- seven hour working day.
A special case is stage 2 malignant arterial hypertension. Its development 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 2 and 3 degrees of disability, a medical and social examination is carried out annually. Disabled persons of the following categories are exempt from re-examination:
- men over 60 years of age;
- women over 55 years of age;
- people with irreversible anatomical defects.
The assignment of a disability group is caused by the need for social protection of hypertensive patients. His ability to engage in work 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 just take medications. If he does this while simultaneously getting carried away, for example, by fatty foods and alcohol, then the positive effect of therapy will quickly disappear. The disease will move to the next stage, at which any treatment is no longer effective.
Hypertension 3 degrees
Why are doctors alarmed by deviations in blood pressure readings from the norm, even by 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 has mild hypertension and blood pressure deviates from normal 120 to 80 mm Hg. by 39 units, then there is a very high probability of pathological abnormalities occurring in various organs (39%). What then can be said about the 3rd degree of the disease, in which the deviation is at least 60 units?
Stage 3 hypertension is a severe, chronic form of the disease. Blood pressure rises above 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, clouded consciousness and sharp pain in the heart;
- significant limitation of 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 is gradually deteriorating, the disease is spreading 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 artery damage;
- hypertensive retinopathy affects the retina of the eyes;
- scotoma ("darkness") is a defect, a blind spot in the field of vision.
Complications of grade 3 arterial 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 whole complex of heart pathologies. The kidneys gradually fail. If hypertension is a secondary disease and occurs against the background of diabetes mellitus, then nephropathy is inevitable.
The more advanced the disease, the more terrible and severe 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.
Hypertension disability 3rd degree
In severe cases of the disease, disability group 1 is established. At this stage, patients are practically unable to work. Sometimes they are recognized as partially able to work and continue to work, but only at home or in 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 prevent death.
Treatment of stage 3 hypertension
As the course of the disease worsens, more and more potent medications are prescribed or their list remains the same, but the dosage increases. At this stage of hypertension, the effect of drug therapy is minimal. Chronic hypertensive patients are doomed to take pills for life.
When the disease becomes severe, surgery may be required. The operation is indicated for certain pathologies of blood vessels and the heart. The method of stem cell therapy for stage 3 arterial hypertension is considered innovative.
Hypertension 4 degrees
Some experts also identify stage 4 of the disease, which is very severe. In most cases, death is close. They try to alleviate the patient’s suffering as much as possible, and with each hypertensive crisis they provide first aid. The patient is laid down, raising his head. He is urgently given medications that sharply lower his blood pressure.
Without treatment, new complications appear. Some of them provoke others, and diseases increasingly overcome 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 depending on the stage of hypertension
Stages of hypertension Other risk factors, POM or disease BP (mmHg)
| High normal | Degree 1 | Degree 2 | Degree 3 | ||
| GARDEN 130-139 DBP 85-89 |
GARDEN 140-159 DBP 90-99 |
GARDEN 160-179 DBP 100-109 |
SBP ≥180 DBP ≥110 |
||
| Stage I | No other FRs | Low risk (risk 1) |
Low risk (risk 1) | Moderate risk (risk 2) |
High risk (risk 3) |
| 1-2 FR | 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 tall risk |
| Stage III | Established CVD, CKD stage ≥4 or diabetes with organ 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 is 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, severe heart rhythm disturbances such as atrial fibrillation, and others may also increase the risk.