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Hypertension

symptoms of hypertension

Hypertension is a systemic disease characterized by a constant increase in blood pressure above 140/90 mm Hg.Art.

Causes of hypertension

In clinical cardiology, hypertension is classified as primary, which occurs as an independent disease, and secondary, which develops as a complication of other pathologies.

The causes of primary hypertension can be the following factors:

  • dysregulation of vascular pressure;
  • excessive cardiogenic reactivity (a sharp change in blood pressure against the background of external stimuli);
  • increased arteriolar tone;
  • disruption of the process of excretion of sodium from the urinary system.

Secondary hypertension develops as a complication of certain pathologies, including:

  • Diseases of the kidneys and adrenal glands - chronic glomerulonephritis, pyelonephritis, tumors of the kidneys and adrenal glands, blockage of the renal artery, etc.These diseases lead to inhibition of the intensity of blood circulation in the kidneys, as a result of which the organs release a substance that compensates for the pathological condition.
  • Endocrinological diseases - diabetes mellitus, hyperthyroidism, myxedema, tumors, metabolic disorders, hormonal imbalance, etc.
  • Cardiovascular pathologies - atherosclerotic narrowing of blood vessels, aortic lumen, valve defects, etc.

In addition, provoking factors such as:

  • a diet with excessive consumption of fat, salt, sugar and an insufficient amount of vegetable products in the menu;
  • age over 55 years;
  • hereditary predisposition;
  • lack of physical activity;
  • smoking, alcohol abuse;
  • chronic stress.

Hypertension can also develop when taking certain drugs (glucocorticosteroids, anabolic steroids, antidepressants).

Types of diseases

Depending on the cause and nature of the lesion, the following are distinguished:

  • primary hypertension;
  • hypertensive disease with primary heart damage;
  • hypertension with predominant kidney damage;
  • arterial hypertension with predominant damage to the heart and kidneys;
  • secondary hypertension.

Taking into account the degree of influence of the pathology on the internal organs, the following is diagnosed:

  • I stage (uncomplicated) - there is no damage to the target organs, but there is a constant increase in blood pressure;
  • Stage II (asymptomatic) - characterized by damage to the target organs, but there are no signs of the pathological process;
  • III - organ damage occurs, which is accompanied by severe clinical symptoms.

According to severity, hypertension is divided into:

  • mild - increased blood pressure in the range of 140/90-159/99 mm Hg.Art.;
  • moderate - indicators within 160/100-179/109 mm Hg.Art.;
  • severe - blood pressure above 180/110 mm Hg.Art.

There is also isolated hypertension, the feature of which is an increase only in systolic pressure.

Symptoms

The clinical manifestations of hypertension depend on the cause of the pathology and the degree of increase in blood pressure.In the initial stages, the disease can be asymptomatic, after which patients complain of:

  • headache, dizziness;
  • noise, ringing in the ears;
  • the appearance of "flies" and spots before the eyes;
  • a feeling of an active heartbeat, pulsation in the temples, the back of the head;
  • facial flushing;
  • pressing pain in region of heart;
  • shortness of breath;
  • swelling of the face, hands;
  • excessive sweating;
  • loss of appetite, nausea.

Other manifestations depend on the form and presence of complications of hypertension.This can include blurred vision, tremors, numbness in the limbs, impaired coordination, fine motor skills, and more.

Quite often, with a long course of the disease, the patient is initially worried about the above symptoms, but then they disappear.This is due to the fact that the receptors lose sensitivity and the body adapts to the increased blood pressure parameters.However, it is necessary to regularly measure blood pressure, record indicators and follow medical recommendations.

Possible complications of hypertension

In advanced forms of the disease, complications such as:

  • hypertensive crisis;
  • stroke;
  • myocardial infarction;
  • encephalopathy (reduced cognitive abilities with subsequent development of vascular dementia);
  • renal, chronic heart failure;
  • atherosclerosis;
  • dissecting aortic aneurysm;
  • hypertensive retinopathy (damage to the retina);
  • nephrosclerosis (predominantly shriveled kidney).

The risk of complications depends on the combination of different provoking factors, but even a slight increase in blood pressure can have negative consequences.

Diagnosis of the disease

If symptoms of hypertension appear, you should consult a therapist or cardiologist.During the consultation, the doctor asks about the complaints, their characteristics, and also studies the medical history in detail to identify the factors for the development of the disease.After that, the specialist conducts an examination, including a general examination, auscultation, percussion, palpation, measurement of heart rate and blood pressure. 

A minimum of 3 isolated blood pressure measurements (on different days in a medical facility) or ABPM (24-hour blood pressure monitoring) data are required to confirm the diagnosis. 

As part of the initial diagnosis, the patient is prescribed:

  • clinical analysis of blood, urine;
  • blood test for the content of hormones and glycated hemoglobin.

In order to clarify the provoking factors and detect existing pathological processes, the patient can undergo the following diagnostic methods:

  • electrocardiography;
  • echocardiography;
  • duplex ultrasound examination of brachiocephalic, renal and iliofemoral arteries;
  • Ultrasound of the heart, excretory system;
  • ophthalmological examination.

Depending on the causes of the disease, the general practitioner may refer the patient for further treatment and diagnostic measures to a cardiologist, endocrinologist, nephrologist, neurologist or ophthalmologist.

Treatment of hypertension

The goal of treating hypertension is to normalize heart activity, eliminate the symptoms of the disease and prevent the development of complications.The treatment regimen is selected individually.

Non-drug therapy

It suggests a change in lifestyle.To do this you need:

  • regularly engage in therapeutic exercises;
  • weight control;
  • give up bad habits and coffee;
  • exclude fatty, spicy, canned foods, fast food and confectionery from the diet;
  • minimizing salt and sugar consumption;
  • eat more seasonal vegetables, fruits, fish, low-fat dairy products;
  • normalizing the drinking regime (the daily volume of liquid should be 1-1.5 liters).

Drug therapy

Several groups of drugs are used to treat hypertension:

  • diuretics;
  • beta-blocker drugs;
  • angiotensin-converting enzyme inhibitors;
  • calcium channel antagonists, as well as angiotensin II receptors;
  • centrally acting substances. 

According to indications, renin inhibitors, vasodilators, lipid-lowering drugs, sedatives, etc. can be prescribed.The specific drugs, dosage and frequency of administration are determined by the doctor.

Prevention of hypertension

There is no specific prevention of the disease.In order to minimize the risk of developing hypertension and dangerous complications, it is necessary to observe a set of general preventive measures:

  • maintains optimal body weight;
  • exercise regularly;
  • adhere to dietary nutrition;
  • give up bad habits;
  • timely treatment of endocrine, nephrological and heart diseases;
  • minimizing stressful situations;
  • control blood pressure levels.

It is also important to undergo regular preventive examinations and follow all medical recommendations.If your blood pressure rises, you should make an appointment with your doctor.

In a multidisciplinary medical center, you can get advice from highly qualified specialists.Experienced therapists and cardiologists will prescribe the necessary examination and choose an effective treatment for each patient.