Arterial hypertension is a disease accompanied by a significant and prolonged increase in pressure. About 30% of the country's adult population suffers from it. Hypertension is one of the most serious pathologies of the cardiovascular system.
With age, the risk of disease is increasing. The genetic factor is of great importance, which is why if there is a predisposition, you need to undergo a periodic examination with a doctor so that treatment can be started in a timely manner.
Disease feature
A normal indicator is a pressure of 120/80 mm RT. Art. This value can change to a lesser or greater extent under the influence of certain factors. If the change occurs within a short period of time, it means that the person is completely healthy. Otherwise, you can suspect the development of the disease. In the primary lesion, the ICD-10 code of arterial hypertension is I10.
With a persistent increase in pressure, negative changes in the internal organs are observed. Based on these indicators, a classification of this disease is made. According to ICD-10, symptomatic arterial hypertension , that is, a secondary form of the disease, has code I15.0.
In addition, there is an uncontrolled form, characterized by the absence of a positive result during therapy. It can be pseudo or true hypertension. Often, a positive prognosis is absent due to an improperly selected dosage of the drug or its regimen.
Classification
An increase in blood pressure occurs due to a narrowing of the lumen of the main arteries, provoked by complex hormonal and nervous processes. With narrowing of their walls, the work of the heart is significantly enhanced, and the patient begins to develop primary arterial hypertension, which occurs in almost 90% of patients. It leads to damage to various organs and systems.
In the remaining patients, a secondary type of the disease is observed, which is caused by the course of other pathologies. They can be divided into:
- renal;
- hemodynamic;
- endocrine;
- neurogenic.
If the disease was triggered by impaired renal function, then according to the ICD, arterial hypertension has the code I12.0. The disease develops due to hydronephrosis, pyelonephritis, polycystic kidney disease, radiation sickness.
Endocrine disorders occur with a hormone-active tumor of the adrenal gland, as well as with damage to the thyroid gland. The neurogenic type of the disease is formed during brain damage, as well as changes in acid-base balance. If the violation was provoked by heart disease, then the code in the ICD of arterial hypertension is I13.0. Pathology develops due to aortic valve insufficiency, atherosclerosis, as well as many other diseases.
In addition, there may be other types of the disease that develop with late toxicosis during pregnancy, poisoning with toxic substances, carcinoma, overdose with medications. By the nature of the course, arterial hypertension can be:
- transient;
- stable;
- labile;
- crisis;
- malignant.
The most dangerous type is malignant, as the pressure rises to very high rates, and the disease progresses very quickly. Such a form can lead to very dangerous complications and even death of the patient.
Stages of the disease
Specialists distinguish several degrees of arterial hypertension, differing in the speed of development and the features of the course. The easiest is considered to be stage 1, characterized by insignificant pressure rises. Its level throughout the day can be quite unstable, however, after resting, this indicator begins to gradually stabilize.
It is worth noting that at the same time the patient does not experience absolutely any health problems. In some cases, the following symptoms may occur:
- headache;
- sleep disturbance;
- noise in the head;
- decreased mental activity.
Dizziness and nosebleeds can sometimes occur. Renal function is not impaired, and the fundus is practically unchanged.
With a 2 degree of hypertension, a steady increase in pressure occurs, which can vary within 180-200 mm RT. Art. Patients very often complain of headache, dizziness, heart pain. Hypertensive crises are characteristic of this stage. In this case, damage to the internal organs is detected.
From the side of the nervous system, manifestations of vascular insufficiency, cerebral ischemia, and strokes are possible. On the fundus there are signs of compression of the veins. Renal blood flow is greatly reduced, although there are no abnormalities in the analyzes.
With grade 3 hypertension, frequent occurrence of vascular crises, depending on the increase in pressure, which can remain stable for a long time. The clinical picture is determined by the defeat:
- brain
- heart
- fundus;
- the kidneys.
In some patients with grade 3 hypertension, despite increased pressure, for many years there have been no severe vascular complications.
Causes of occurrence
When assessing the degree of risk of arterial hypertension, it is necessary to take into account the reasons why such a violation occurs. The main factor in increasing pressure is considered narrowing of blood vessels. Blood flow exerts significant pressure on their walls. Among the main causes of increased pressure, it is necessary to highlight the presence of atherosclerosis. This disease over time leads to the development of symptomatic hypertension.
Under the influence of atherosclerosis, the walls of the arteries begin to condense, and the vessels lose their former elasticity. In addition, they are covered from the inside with atherosclerotic plaques. This poses a threat to life, as it significantly increases the risk of a heart attack or stroke.
Among the main factors provoking the development of hypertension, it is necessary to highlight:
- overweight;
- bad habits;
- excessive consumption of salt.
Knowing exactly what causes the disease, you can prevent the risk of its development. In addition, people who have a predisposition to increase pressure need to undergo periodic examinations by a doctor and strictly follow his recommendations.
The main symptoms
With the occurrence of arterial hypertension, clinical signs may not be observed for a long time, so if you do not use a tonometer, you may not even be aware of the presence of problems, which greatly interferes with timely therapy. The most important symptom may be persistent high blood pressure. However, not all of us control its level. That is why you need to pay attention to such symptoms as:
- headache;
- heartache;
- noise in ears;
- palpitations
- visual impairment;
- damage to arteries;
- dyspnea;
- swelling of the legs.
Headache is often localized in the temples, nape or parietal region. Discomfort may occur at night or immediately after waking up. As a rule, pain intensifies with physical and mental stress.
If the first signs of the disease occur, you should immediately consult a doctor for a comprehensive diagnosis, as this will make it possible to timely diagnose and prescribe treatment in order to avoid the development of a hypertensive crisis.
Diagnostics
If the pressure level rises, you should immediately consult a doctor. At the initial stage, the diagnosis is a study of the history of the disease, as well as existing symptoms.
In addition, such laboratory and instrumental studies as:
- blood and urine tests;
- electrocardiogram;
- biochemical research;
- ultrasonography.
It is also important to control blood pressure by using a special apparatus - a tonometer. The patient must purchase it in order to be able to respond in a timely manner to the occurrence of negative changes in the body. A physical examination is required, which includes examining the patient with a phonendoscope. It helps to determine the presence of heart murmurs and many other characteristic changes in the body.
To get complete information about the state of the walls of the vessels, you need to undergo arteriography, which is an X-ray examination method. In addition, an ultrasound examination of blood flow is carried out.
Treatment feature
The treatment of arterial hypertension should be carried out comprehensively, as well as strictly follow all the recommendations of the attending doctor so as not to provoke a deterioration in well-being. When conducting therapy, it is necessary to eliminate risk factors such as:
- smoking and alcohol consumption;
- overweight;
- sedentary lifestyle.
In addition, it is necessary to normalize the level of lipids in the blood. This can be achieved through drug therapy or through proper nutrition. A diet for arterial hypertension involves a reduction in the amount of salt consumed, as well as the introduction of seaweed, potatoes, and legumes into the usual diet.
Drug therapy is required if for a long time the pressure remains at the level of 140 or more, despite a change in lifestyle. With the occurrence of arterial hypertension, clinical recommendations must be observed very strictly. The patient is treated by a cardiologist. If a secondary form has been identified, then the patient is referred to a nephrologist or endocrinologist.
In addition, it is recommended to undergo an additional examination by a neurologist and ophthalmologist to determine the condition of the internal organs. Compliance with simple recommendations leads to a fairly good result.
Drug therapy
Drug treatment of hypertension consists in the use of such drugs as:
- antihypertensive drugs;
- diuretics;
- adrenergic blockers;
- ACE inhibitors;
- calcium antagonists.
Treatment should begin with the introduction of a minimum dosage of antihypertensive drugs and increase it only in the absence of the required result. To prevent the risk of complications, medications must be taken throughout life, as they will constantly maintain optimal pressure. When choosing drugs, preference should be given to long-acting drugs, as this will allow you to organize only a single dose in the morning.
Treatment of symptomatic arterial hypertension should be started with monotherapy and gradually move on to a combination of drugs of different groups. For older people, calcium channel blockers should initially be used. It is undesirable that they include components that alter the metabolism of insulin and glucose. The main goal of therapy is to prevent death in patients.
Diuretics have a positive effect on the heart muscle and are well tolerated by most patients. They are used for hypertension therapy only in the absence of gout and diabetes. Often, diuretics are prescribed along with other medications to lower blood pressure.
Adrenergic blockers very well affect the lipid composition of the blood. They do not change glucose levels at all, lower blood pressure without increasing heart rate. It is worth noting that during the first use of such drugs, there may be some deterioration in well-being, and a person may even lose consciousness. To avoid this, certain rules must be followed. Before taking this remedy, you need to cancel diuretics, and the first dose should be in the evening.
ACE inhibitors block the formation of hormones that provoke vasoconstriction. Due to their effect on the patient's body, a significant decrease in pressure is observed. In addition, their use reduces the risk of developing nephropathy in diabetes. It is worth noting that their use is shown primarily in chronic heart failure.
Hormone antagonists are prescribed if the use of inhibitors is contraindicated for some reason. In the treatment of hypertension, clinical recommendations must be followed very strictly, since the success of recovery depends on this in many respects. The doctor may prescribe one or more drugs for medical treatment.
Even after the normalization of pressure, you can not stop treatment without consulting a doctor, as this can provoke the development of a hypertensive crisis.
Non-medication
With the occurrence of hypertension, the doctor's recommendations must be observed very strictly, since self-medication can provoke various complications. Non-drug treatment methods are widely used, which combine well with various medications.
Be sure to give up smoking, as it has a very bad effect on the state of the cardiovascular system. In addition, you must always monitor your weight, as a decrease in body weight has a beneficial effect on reducing pressure and helps to eliminate the main risk factors for developing disorders.
It is necessary to increase the consumption of fruits and vegetables rich in potassium and magnesium, as well as limit animal fats in your diet. Be sure to try to avoid stress, mental and physical stress. Doctors recommend increasing physical activity. For example, brisk walking and swimming will be beneficial. It is worth noting that some types of loads, on the contrary, contribute to an increase in pressure level.
The consequences of the disease
It is absolutely necessary to understand exactly what the risks of arterial hypertension may be. With a prolonged increase in pressure, the walls of the vessels significantly thicken and lose their ability to relax. As a result, the saturation of tissues and organs with oxygen is disrupted, which leads to a decrease in their activity. Among the main risks of hypertension can be distinguished such as:
- hypertensive crisis;
- stroke;
- heart attack;
- angina pectoris;
- heart failure;
- coronary artery disease;
- renal failure;
- visual impairment.
Among the most common risks of the course of the disease, the occurrence of a hypertensive crisis can be distinguished. It can be observed with a relatively satisfactory condition of the patient. This is one of the most common risks of grade 2 hypertension. It can be triggered by the psychophysical stress of the patient. It develops very quickly, and at the same time it is observed:
- a sharp increase in pressure;
- Strong headache;
- nausea;
- arrhythmia or tachycardia.
The risk of grade 3 hypertension is the occurrence of myocardial infarction. This complication lasts for several minutes and can lead to the death of the patient. The main symptom is a prolonged pain attack.
Hypertensive crisis
Hypertensive crisis - a condition requiring emergency care. It implies a sharp increase in pressure to very high rates. In this case, there is a violation of the blood supply to internal organs, including vital ones. It occurs when exposure to the body of adverse factors.
Hypertensive crisis is very dangerous in that it is absolutely impossible to predict. In the absence of timely assistance, a fatal outcome is possible. To provide emergency assistance, the patient needs to be urgently taken to the hospital, where he will be lowered blood pressure by using special medications.
Influence on the internal organs
Arterial hypertension is quite acute, since a constant increase in pressure leads to the defeat of many internal organs and systems. In particular, they include:
- brain;
- a heart;
- blood vessels;
- the kidneys.
The symptomatology of the course of the disease largely depends on which of the organs are affected in the first place. Pathological changes in the vessels relate primarily to their walls, as they thicken, narrow the lumen and are affected by plasma proteins. This leads to disruption of the functioning of blood vessels and hypoxia of organs.
Changes in the heart muscle begin with myocardial hypertrophy. Subsequently, heart failure occurs and the risk of sudden death increases. Important mechanisms are suppressed in the kidneys at the very beginning. Then degenerative and structural changes occur in the renal arteries, and atrophy of the kidneys occurs.
The same degenerative changes occur in the brain as in the vessels of the kidneys. This leads to encephalopathy, hemorrhagic stroke, as well as ischemia.
Arterial hypertension leads to increased pressure and increased load on the heart. This provokes a thickening of the myocardium and the development of heart failure.