Today, almost everyone has at least a small idea of what hypertension is. As for the factors contributing to the occurrence of this pathology, non-specialists know much less about this. Moreover, knowledge of the main causes of the development of hypertension is an important condition for its prevention.
What is hypertension?
Consider the terminology. Arterial hypertension is a cardiovascular disease that is characterized by a steady increase in the level of SBP (systolic blood pressure) and / or DBP (diastolic blood pressure) from 140/90 mm. Hg. Art. respectively.
The prevalence of this pathology among the adult population of the planet is approximately 25%. At the same time, after the age of 60, already 55% of people know by their own example what hypertension is.
This pathology is very dangerous for the reason that it contributes to damage to blood vessels, heart, becoming a provoking factor in the formation of serious diseases.
Development reasons
Depending on the mechanism of its formation, hypertension today is divided into the following 2 types:
In order to determine what kind of arterial hypertension in a patient, you will first have to carry out a whole range of diagnostic studies.
Essential hypertension
Essential arterial hypertension occurs in more than 90% of all cases. To date, it is not possible to establish specific reasons for the development of this pathology. Moreover, a large number of factors are known that contribute to its occurrence. The main ones are the following:
- An increase in body weight (each extra kilogram increases the pressure by at least 1 mmHg).
- A sedentary lifestyle (in the absence of muscle activity, the tone of the blood vessels supplying them decreases over time, which leads to an increase in blood pressure).
- Smoking (nicotine, getting into the bloodstream, damages the vascular endothelium, which provokes their reflex narrowing and an increase in peripheral resistance).
- Alcohol abuse (in a person with constant use of alcoholic beverages, the central mechanisms of pressure regulation are violated).
- Age (in men after 45 years, and in women - 55 years old, the elasticity of the vascular wall begins to decrease, which leads to an increase in pressure level).
- Heredity (persons whose parents suffered from hypertension are much more likely to experience a similar problem).
- Chronic stress
- Diabetes mellitus (this disease is accompanied by a gradual damage to the vascular wall).
- Abuse of salt (according to scientists, no more than 3 g should be consumed per day).
The highest risk of developing hypertension are those patients who have several provoking factors at once. These criteria also play a role in assessing the risk of complications in patients with an established disease.
What is symptomatic hypertension?
This pathological condition develops against the background of other ailments. The most common among them are the following types:
- nephrogenic;
- endocrine;
- neurogenic;
- hemodynamic.
If these reasons are eliminated, the level of blood pressure usually returns to normal. The symptomatic form of hypertension reviews from patients suffering from it leaves the most unpleasant. The fact is that without eliminating the cause of the disease, it is practically impossible to reduce the level of pressure.
Nephrogenic hypertension
Few people know what nephrogenic hypertension is. This pathological condition occurs when a kidney disease develops. In this case, the functioning of the renin-angiotensin-aldosterone system is disrupted. Her work depends on the proper activity of the kidney tissue.
Most often, the diseases that cause their failure are pyelonephritis and glomerulonephritis. At the same time, the acute course of these diseases causes a significantly greater increase in blood pressure than their chronic form.
Endocrine hypertension
This form of hypertension develops in the event of defects in the metabolism of hormones. This is usually observed with the following diseases:
- Thyrotoxicosis.
- Itsenko-Cushing's disease.
- Pheochromocytoma.
- Aldosteroma.
- Climax
With thyrotoxicosis, an increase in the content of thyroid hormones in the blood is observed. Moreover, increased pressure is only one of the many symptoms of this disease. The patient becomes sweaty, he does not tolerate heat. His emotional sphere is also changing. A person begins to get annoyed for almost any reason, he develops tearfulness. On the part of the cardiovascular system, in addition to increasing blood pressure, there is an increase in the pulse rate of contractions, a feeling of palpitations, the development of arrhythmias and signs of circulatory failure. In patients, the volume of muscle tissue decreases, he gets tired very quickly when performing simple manipulations, osteoporosis gradually develops, which can lead to accidental fractures.
Itsenko-Cushing's disease, in addition to increasing pressure, is also characterized by an increase in body weight and a change in the shape of the face. It becomes somewhat puffy and "moon-shaped."
Pheochromocytoma is a tumor of the adrenal gland. With its development, blood pressure may not be increased constantly, but with an increase it reaches very impressive numbers and practically does not decrease when using antihypertensive drugs.
Aldosteroma or Conn's disease is a tumor pathology. As a result of its development, the level of the hormone aldosterone production increases. This active substance delays the excretion of sodium ions from the body, which leads to a violation of the regulation of blood pressure.
Menopause in women usually develops at the age of 50-55 years. It is accompanied by periodic “tides,” during which the patient's level of pressure increases, the frequency of cardiovascular contractions, a feeling of heat, sweating develops, disturbances in the emotional sphere and anxiety occur.
Degrees of hypertension
The diagnosis of arterial hypertension is made in cases where a patient with a 2-fold measurement of pressure level, this indicator exceeds 139/89 mm. Hg. Art. In this case, the interval between measurements should be at least 2 weeks. In cases where the pressure is in the range from 130/85 mm. Hg. Art. up to 139/89 mm. Hg. Art., speak of a highly normal level of this indicator.
Currently, 3 main degrees of arterial hypertension are distinguished:
- 1st - the pressure level is set from 140/90 mm. Hg. Art. up to 159/99 mm. Hg. Art.
- 2nd - the pressure level is determined in the range from 160/100 and up to a maximum of 179/109 mm. Hg. Art.
- 3rd - the pressure level is in the range from 180/110 mm. Hg. Art. and higher.
The degree of hypertension is determined by the highest rate. If the patient has a pressure at the level of 135/100, then he is exposed to the 2nd degree of this pathology. In such situations, they speak of isolated arterial hypertension. More often it is observed in persons belonging to the older generation.
The main symptoms of the disease
Hypertension has quite characteristic manifestations. The main signs of this disease are:
- Persistent increase in blood pressure.
- Headaches, mainly in the occipital region.
- Decreased visual acuity (with a long-term illness).
- "Sparks" in front of the eyes (manifests itself at a fairly high blood pressure).
- Nausea, which can lead to vomiting.
- General weakness.
- Unpleasant sensations, soreness in the heart.
It is important to consult a doctor immediately after the onset of the first symptoms of hypertension, since arterial hypertension can lead to such serious complications (myocardial infarction and stroke).
Diagnosis of the disease
In order to establish the diagnosis of "arterial hypertension", as well as to clarify the degree of its severity, doctors use the following methods:
- Collection of anamnestic data (allows you to clarify the possible causes of the development of the disease, as well as determine the level of risk).
- General blood and urine tests (to exclude concomitant pathology or to establish the fact of its presence).
- A biochemical blood test (in this case, used to determine the level of electrolytes, including sodium and potassium, which affect the level of blood pressure).
- Thyroid imaging with ultrasound.
- Ultrasound of the heart.
- Ultrasound of the brachycephalic arteries.
- Ultrasound of the kidneys.
- Daily monitoring of blood pressure.
- A blood test for hormones.
Thanks to these diagnostic measures, the doctor receives information that allows one to judge the feasibility of establishing a diagnosis, the severity of the disease, as well as the causes of its occurrence, which helps determine the tactics of further patient management.
Disease treatment
Hypertension is a rather dangerous disease, the negative impact of which, with proper therapeutic effect, can be, if not eliminated, then significantly reduced. The treatment of hypertension suggests that antihypertensive drugs are prescribed to the patient. Most commonly used drugs from the following groups:
- Angiotensin converting enzyme inhibitors (Captopril, Lisinopril, Enalopril, Ramipril).
- Beta-blockers (Metoprolol, Bisoprolol, Carvedilol).
- Angiotensin II receptor blockers (Lazartan, Valsartan).
- Diuretics ("Hypothiazide", "Furasemide", "Indapamide", "Spironalactone").
- Calcium channel antagonists (Amlodipine, Diltiazem, Verapamil).
Each medicine for hypertension, depending on its severity, the cause of the occurrence and the presence of concomitant pathology, can be prescribed as monotherapy or in combination with other drugs. In addition, the patient is recommended to eliminate risk factors such as overweight, eating excessive amounts of salt, coffee, alcohol and stop smoking.