Arterial hypertension

Arterial hypertension is the causes of the appearance of what diseases arise, diagnosis and methods of treatment.

According to world statistics, diseases of the cardiovascular system are in the first place among all causes of mortality.

Arterial hypertension is one of the most common diseases of the circulatory system, which also acts as a factor in the development of other heart disease and blood vessels, such as coronary heart disease, chronic heart failure, hemorrhagic and ischemic stroke.

Arterial hypertension is a persistent increase in systolic (upper) blood pressure above 140 mm Hg.Art.and/or diastolic (lower) above 90 mm Hg.Art.According to the recommendations of the European Society for Arterial Hypertension and the European Society of Cardiologists, the criterion of arterial hypertension from 135/85 mm Hg is adopted for home measurement of pressure.Art.And above.

The main symptoms accompanying an increase in blood pressure include headache, nausea, ears in the ears, palpitations, decreased visual acuity, irritability, sweating.

Sometimes an increase in blood pressure can be asymptomatic.In this case, blood pressure control is required.

Varieties of arterial hypertension

Before talking about increased blood pressure (blood pressure), it should be understood how the pressure should be normal.For each person, the values of blood pressure are individual.However, there is a generally accepted classification of blood pressure.

• Optimal, where systolic blood pressure is less than 120 mm Hg.Art., and diastolic blood pressure is less than 80 mm Hg.Art. 
• Normal, where the upper blood pressure values are from 120 to 129 and lower values from 80 to 84 mm Hg.Art.
• High normal, where the upper blood pressure values are from 130 to 139 mm Hg in the interval.Art.and lower ones in the interval from 85 to 89 mm Hg.Art.

Arterial hypertension is divided according to degrees, depending on the maximum values obtained when measuring pressure.

1st degree-systolic blood pressure 140-159 mm Hg.Art.and/or diastolic blood pressure 90-99 mm Hg.Art.

2nd degree-systolic blood pressure 160-179 mm Hg.Art.and/or diastolic blood pressure 100-109 mm Hg.Art.

3rd degree-systolic blood pressure 180 and more mm Hg.Art.and/or diastolic blood pressure 110 and more mm Hg.Art.

Separately isolated isolated arterial hypertension, when only systolic blood pressure increases more than 140 mm Hg.ST, and the diastolic remains within normal values.

Causes of increased blood pressure

It is believed that most patients with high pressure suffer Primary arterial hypertension, the development of which cannot be associated with specific causes.This is the so -called essential arterial hypertension, which more often occurs in age -related patients.

In other cases, when a certain cause of pressure is revealed, they mean secondary Arterial hypertension.

Among the main causes leading to secondary arterial hypertension, they distinguish:

1. Kidneys and blood vessels.These pathologies lead to a decrease in the intensity of blood flow in the kidneys and, as a result, to the release of the buds of substances that contribute to increasing blood pressure and compensation for impaired renal blood flow.Chronic kidney disease, chronic glomerulonephritis, urolithiasis - these diseases can lead to the development of arterial hypertension.Among the diseases of the blood vessels, the narrowing (stenosis) of the renal arteries is most often noted, which can be congenital pathology or occur with atherosclerosis in adulthood. 

2. Different Endocrine diseases lead to the development of arterial hypertension and other related symptoms.For example, with thyrotoxicosis, the production of thyroid hormones is enhanced, which is accompanied by the appearance of a goiter (an increase in the gland itself), a rise in systolic blood pressure, a heartbeat, increased excitability and a decrease in body weight.With hypothyroidism, the products of thyroid hormones are reduced.Pathologies are accompanied by endothelial dysfunction and impaired relaxation of smooth muscle cells of blood vessels, which leads to an increase in the peripheral resistance of blood vessels.This helps to increase blood pressure.Such patients are characterized by an increase in diastolic blood pressure, a slowdown in the pulse, weakness and rapid fatigue.With pheochromocytoma (adrenal glands), the release of catecholamines (adrenaline, norepinephrine) increases into the blood, which leads to sharp jumps in blood pressure to very high values.Arterial hypertension is a frequent satellite of obesity.Fat tissue cells (adipocytes) produce biologically active substances that affect the entire organism as a whole and, in particular, on the vessels.Also, do not forget that the “extra” fabric also needs to be blood supply, and this leads to an additional load on the cardiovascular system. 
3. Different heart disease and blood vessels They can lead to high arterial pressure.For example, aorta coarctation is a local narrowing of the aortic lumen, more often congenital pathology;Atherosclerotic narrowing of the vessels. 
4. Pregnancy (preeclampsia). 
5. Arterial hypertension when taking some medicines: oral contraceptives, anabolic steroids, glucocorticosteroids, antidepressants.

It should be remembered about the factors contributing to the development of arterial hypertension: hereditary predisposition, prolonged nervous overstrain, frequent stressful situations, excessive physical activity, smoking, alcohol abuse and coffee, the consumption of a large amount of salt and fatty foods.

What diseases does arterial hypertension occur?

Arterial hypertension is divided according to degrees, depending on the maximum values obtained when measuring pressure.

We will indicate some of them.

• Atherosclerosis, including the renal arteries. 
• The lesion of the renal vessels (thrombosis, embolism, stenosis, compression of the renal vessels with a tumor or organ). 
• Chronic pyelonephritis. 
• Chronic glomerulonephritis. 
• Chronic kidney disease. 
• Thyroid diseases (hypo- and hyperthyroidism). 
• Izenko-Cushing's disease and syndrome. 
• Feochromocytoma. 
• Primary hyperaldosteronism.
• Metabolic syndrome. 
• Coarctation of the aorta. 
• Preeclampsia.

What doctors to contact when increasing blood pressure?

To identify the causes of increasing pressure, you should initially contact the therapist.The doctor will conduct an examination and prescribe the necessary amount of examinations and consultations of specialists.Among them can be:

• Cardiologist; 
• endocrinologist; 
• neurologist; 
• surgeon; 
• ophthalmologist.

Diagnosis and examination with increasing blood pressure

First of all, self -control of blood pressure at home is necessary with maintaining a diary, where all the measurements of the pressure on time, taking drugs and episodes of stress should be fixed, which could provoke a rise in blood pressure.

The following laboratory studies are prescribed to all patients at the first stage of the examination:

• Clinical blood test;
• general urine analysis;
• biochemical blood test (control of cholesterol; lipoproteins are very low; and high density for assessing the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium; creatinine levels; blood glucose levels);
• blood test for the level of glycated hemoglobin; 
• A blood test for the content of hormones (th4 - T4; triiodotyronine - T3; thyreotropic hormone - TSH; antibodies to thyroid -peroxidase; antibodies to thyroidoglobulin).

If necessary, the doctor may prescribe a complex of laboratory and instrumental examination methods:

• daily monitoring of blood pressure; 
• electrocardiographic study; 
• echocardiography; 
• Holter Daily monitoring; 
• duplex scanning of brachiocephalous, 
• renal/iliac and lamp arteries; 
• ultrasound study of the kidneys and adrenal glands; 
• Study of the eye bottom.

Treatment of arterial hypertension

Arterial hypertension is a disease, the development of which depends on many factors, and therefore the first recommendation in the correction of high pressure is a change in lifestyle.

Firstly, they make changes to the diet: they limit the consumption of canned and finished products, sauces and mayonnaise, and gradually reduce the amount of salt added to food.

The menu should include more fresh vegetables, fruits and dairy products.Alcohol and smoking should also be limited.

In the presence of excess body weight and the absence of contraindications, a diet is used.Regular moderate physical exertion of at least half an hour per day contributes to the normalization of vascular tone.

We should not expect a quick effect from diet and physical education.However, at the beginning of the disease, it is these actions that can play a positive role.

Depending on the stage and degree of the disease, drug therapy is prescribed.In clinical practice, several groups of drugs are used to treat arterial hypertension:

• diuretics (diuretics); 
• beta-blockers; 
• Calcium canal antagonists; 
• angiotenzinzinoproding enzyme (IAC) inhibitors; 
• Angiotensin II receptor anatagonists; 
• Central drugs.

Depending on the cause of the development and course of the disease, as well as on related diseases, the doctor prescribes an individual treatment regimen.The therapy selected by the attending physician, the constant use of drugs and a change in lifestyle will help normalize blood pressure.

What to do with high pressure?

The pressure should not be reduced quickly: in the first two hours when assisting, blood pressure should decrease by no more than 20% of the initial high level.

When the blood pressure increased moderately, but the general well -being stable (there are no other symptoms), you should try to fall asleep or lie down with closed eyes.If after rest the pressure remains high, it is necessary to take medications recommended by the attending physician.

If an increase in blood pressure is accompanied by severe headache, dizziness, shortness of breath, visual impairment, pain, nausea or vomiting, it is necessary to cause an ambulance.