Arterial hypertension 1, 2, 3 degrees: symptoms and treatment

What is it - arterial hypertension is a condition in which systolic blood pressure is 140 mm Hg.and above and / or diastolic, equal to 90 mm Hg.and higher.

A prerequisite is to measure elevated blood pressure two to three times in the absence of any causal factor( eg, white coat hypertension).

The prevalence of arterial hypertension is 40 to 50%, and at the age of 40 years it is more common in men, and over 40 years in women. However, with age, there is a distinct increase in blood pressure, especially systolic blood pressure.

Causes of

The nature of arterial hypertension is multifactorial and it is often impossible to single out any one cause.

The main predisposing factors are:

1. 1) Weighed heredity, which is associated with mutations in the genes of the renin-angiotensin system, nitric oxide, etc.
   
2. 2) Obesity
   
3. 3) Metabolic syndrome, which is a combination of overweight, impaired glucose tolerance, increased levels of atherogenic cholesterol and instability of blood pressure
   
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4. 4) Systematic daily use of alcohol that leads to an increase in blood pressure
   
5. 5) Increasedsalt intake that leads to fluid retention in the body
   
6. 6) Hypodinamia
   
7. 7) Psychoemotional stress
   
8. 8) Mental personality characteristics, catThey are in increased responsibility, aggressiveness for any situation, etc.

From primary( essential) arterial hypertension, referred to in this article, it is necessary to distinguish secondary hypertension. In the latter case, there is a clearly defined disease, which leads to an increase in blood pressure. It can be pheochromocytoma, stenosis of the renal arteries and other pathologies.

How to correctly measure blood pressure

The most accurate method that allows you to measure blood pressure is bloody. It involves inserting a needle into the wall of the artery. The needle must be connected to the manometer. However, in practical medicine, the bloodless method with the use of the Riva-Rocchi apparatus and the listening to the stethoscope of Korotkov's tones was most widespread.

There are certain rules for measuring blood pressure that allow you to get the most reliable values:

1. 1) A cuff that should not be less than 12 cm is used.
   
2. 2) It is applied to the shoulder from which the clothes should be removed
   
3. 3) Air must be pumped up toAs long as its pressure does not exceed systolic blood pressure( as a result, pulsation in the brachial artery should stop)
   
4. 4) Gradually begin to lower the level of pressure in the cuff, which leads to the appearancepulsations on the radial artery
   
5. 5) In parallel, listening to Korotkov's tones with a stethoscope on the brachial artery. For systolic blood pressure, the first tone is taken, and for the diastolic one - the tones of the fourth phase( these are muffled tones that replace the sonorous tones)
   
6. 6) Measure blood pressure on two hands, with the highest value being taken as the true value of the intra-arterial pressure.

Blood pressure measurement should be started if the following conditions are met:

• Patient's finding in a quiet and comfortable environment
  
• between food intake and blood pressure measurement should take at least 1-2 hours
  
• one hour before measurement the patient should not drink coffee and smoke
  
• patientshould be in a sitting position
  
• feet should be relaxed and uninvested
  
• minimal rest before measuring blood pressure should be 5 minutes
  
• to repeated measurementsexamines resort after 1-2 minutes after deflating the air from the cuff.

Symptoms of hypertension 1, 2 and 3 degrees

For a long time, symptoms of increased blood pressure are absent. They can only be in some patients.

The following clinical signs are suspicious in this respect:

• headache
  
• dizziness
  
• flashing of the flies before the eyes
  
• weakness
  
• redness of the face
  
• excessive sweating, etc.

However, the presence of clinical symptoms is mandatory for the diagnosis of the hypertensive crisis. This is a condition in which there is an increase in blood pressure above normal values ​​and neurovegetative manifestations appear.

Classification of arterial hypertension in degrees determines the involvement of organs that affect this disease.

For the first degree, there is no defeat.

On the second degree, it is not accompanied by deficiency of the affected organs. At this stage, the following conditions can be identified:

• enlargement of the wall of the left ventricle
  
• spasm of the fundus of the fundus
  
• insignificant amount of protein in the urine as a result of renal damage
  
• ultrasound signs of the lesion of the walls of large vessels by the atherosclerotic process.

With the third degree of arterial hypertension, there are symptoms from the secondarily involved in the pathological process of the organs. This means that there are such diseases as:

• angina
  
• heart failure
  
• myocardial infarction
  
• edema of the nerve of the optic
  
• obstruction of the vessels against the background of an atherosclerotic process, etc.

See also, symptoms of hypertension.

Diagnosis of arterial hypertension

The World Health Organization has identified specific criteria on the basis of which this diagnosis can be made.

These include:

1. 1) Registration of elevated blood pressure level( see above) with a three-dimensional measurement of
   
2. . 2)
   
3. should be performed between visits to the doctor 3) 2 visits to the therapist or cardiologist are sufficient.

If these conditions are not observed, it is possible to receive false positive results and hyperdiagnosis of arterial hypertension. In addition, blood pressure should be measured by all the recommended rules.

In those cases where systolic and diastolic arterial pressure determine a different degree of disease, the doctor takes into account the greatest increase, since it is associated with a higher risk of complications.

In the presence of boundary values ​​of blood pressure, daily monitoring is recommended. This is a method of investigation in which a special apparatus performs a BP measurement within 24 hours with simultaneous registration of the values ​​obtained.

This diagnostic test also allows you to determine the type of increase and decrease in blood pressure, which is necessary to select the most appropriate pharmacological correction and the optimal time for taking medications.

Three types of diurnal blood pressure curves:

1. 1) With a submerged type, there is a decrease in arterial pressure at night
   
2. 2) Non-submerged type-there is not enough pressure reduction at night
   
3. 3) Excessive night time increase in blood pressure.

In addition to these examinations, standard tests are performed, which allow to determine the degree of damage to target organs. These studies include:

• ultrasound of the heart, kidneys using Dopplerometry
  
• Biochemical blood test, including lipidogram
  
• General clinical urine analysis
  
• Daily proteinuria
  
• Eye examination( ophthalmoscopic examination)
  
• X-ray examination of the lungs to detect congestive changes on their part
  
• Doppler examination of vessels on the lowerextremities
  
• electrocardiography.

Treatment of arterial hypertension

The main goals of treatment of hypertension are:

• blood pressure lowering
  
• correction of identified risk factors.

As a result, it reduces the risk of complications from the heart and blood vessels, which lead to serious diseases( heart attack, stroke, atherosclerosis of the main arteries, etc.).

The main groups of drugs that are used to treat hypertension are:

1. 1) Angiotensin converting enzyme inhibitors( drugs of choice)
   
2. 2) Angiotensinogen receptor blockers( used with intolerance to ACE inhibitors)
   
3. 3) Calcium channel blockers
   
4. 4) Diuretic drugs
   
5. 5) Betta-adrenoblockers
   
6. 6) Central action drugs, which are currently used only during pregnancy and for relief hypertensionabout the crisis.

Prevention

There are no effective preventive measures against hypertension. Recommended activities are:

• salt restriction
  
• smoking cessation
  
• moderate alcohol use
  
• regular measurement of blood pressure.

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