Arterial hypertension

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

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

Arterial hypertension is one of the most common diseases of the circulatory system, which also acts as a factor for 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 resistant increase in systolic (upper) blood pressure above 140 mm Hg.Art.and/or diastolic (lower) over 90 mm Hg.Art.According to the recommendations of the European Society for Arterial Hypertension and the European Society of Cardiologists, the criterion for arterial hypertension of 135/85 mm Hg has been accepted to measure home pressure.Art.And above.

The main symptoms accompanying increased 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 high blood pressure (blood pressure), one must understand how the pressure should be normal.For each person, blood pressure values are individual.However, there is a generally accepted classification of blood pressure.

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

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

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 or 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 diastole remains within normal values.

Causes of high blood pressure

Most high pressure patients are thought to suffer Primal Arterial hypertension, the development of which cannot be associated with specific causes.This is the so -called main arterial hypertension, which is more common in age -related patients.

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

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

1. Kidneys and blood vesselsSThese pathologies lead to a decrease in the intensity of blood flow to the kidneys and, as a result, the release of buds of substances that contribute to increased 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 is the narrowing (stenosis) of the renal arteries, which can be congenital pathology or occur with atherosclerosis in adulthood. 

2. Different Endocrine diseases They lead to the development of arterial hypertension and other related symptoms.For example, in thyrotoxicosis, the production of thyroid hormones increases, which is accompanied by the appearance of goiter (enlargement of the gland itself), increased systolic blood pressure, heart rate, increased excitability and weight loss.In hypothyroidism, thyroid hormones are reduced.Pathologies are accompanied by endothelial dysfunction and impaired relaxation of the smooth muscle cells of the blood vessels, leading to an increase in the peripheral resistance of the blood vessels.This helps to increase blood pressure.Such patients are characterized by an increase in diastolic blood pressure, pulse slowing, weakness and rapid fatigue.With pheochromocytoma (adrenal glands), the release of catecholamines (adrenaline, norepinephrine) increases in the blood, leading to sharp blood pressure jumps to very high values.Arterial hypertension is an honor satellite of obesity.Cells of adipose tissue (adipocytes) produce biologically active substances that affect the whole body as a whole and more special on vessels.Also, remember that "additional" tissue should also be the circulation supply and this leads to an additional load of the cardiovascular system. 
3. Different heart disease and blood vessels They can lead to high blood pressure.For example, coarctation of the aorta is a local narrowing of the aortic lumen, more often congenital pathology;Atherosclerotic narrowing of the vessels. 
4. Pregnancy (preeclampsia)S 
5. Arterial hypertension when adopted medication: Oral contraceptives, anabolic steroids, glucocorticosteroids, antidepressants.

It should be remembered for the factors that contribute to the development of arterial hypertension: hereditary predisposition, prolonged nervous overvoltage, frequent stressful situations, excessive physical activity, smoking, alcohol abuse and consumption of large amounts of salt and fatty foods.

What diseases cause arterial hypertension?

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

We will point out some of them.

• Atherosclerosis, including renal arteries. 
• The lesion of the kidney vessels (thrombosis, embolism, stenosis, compression of the kidney vessels with a tumor or organ). 
• Chronic pyelonephritis. 
• Chronic glomerulonephritis. 
• Chronic kidney disease. 
• Thyroid disease (hypo- and hyperthyroidism). 
• The disease and syndrome of the coaching. 
• Pheochromocytoma. 
• Primary hyperaldosteronism.
• Metabolic syndrome. 
• Aortic coarctation. 
• Preeclampsia.

What doctors to contact when raising blood pressure?

To identify the causes of the pressure, you should initially contact the therapist.The doctor will examine and prescribe the required amount of examinations and consultations to specialists.Among them can be:

• Cardiologist; 
• endocrinologist; 
• neurologist; 
• surgeon; 
• Ophthalmologist.

Diagnosis and examination with an increase in blood pressure

First, the self -control of blood pressure at home is necessary to maintain a diary, where all pressure measurements over time should be fixed drugs and episodes of stress, which can cause an increase in blood pressure.

The following laboratory tests have been prescribed to all patients in the first stage of the study:

• Clinical blood test;
• General urine analysis;
• Biochemical blood test (cholesterol control; lipoproteins are very low; and high density to assess the risk of atherosclerosis, blood electrolytes - potassium, sodium, chlorine, calcium; creatinine levels; blood glucose levels);
• blood test for glycated hemoglobin; 
• Blood test for the hormone content (Th4 - T4; triiodothyronine - T3; thyrotropic hormone - TSH; antibodies to the thyroid gland - Peridase; antibodies to thyroidoglobulin).

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

• Daily monitoring of blood pressure; 
• electrocardiographic examination; 
• echocardiography; 
• Daily Daily Monitoring; 
• Duplex scanning of brachiocephalus, 
• renal/iliac and lamping arteries; 
• Ultrasound examination of the kidneys and adrenal glands; 
• Exploring the bottom of the eyes.

Treatment of arterial hypertension

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

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

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

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

We should not expect a quick effect of 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 the degree of the disease, drug therapy is prescribed.In clinical practice, several groups of medicines are used to treat arterial hypertension:

• diuretics (diuretics); 
• beta-blockers; 
• Calcium channel antagonists; 
• Angiotensin -producing enzyme (IAC) inhibitors; 
• Angiotensin II receptors; 
• Central medicines.

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

What to do with high pressure?

Pressure should not be reduced quickly: during the first two hours, blood pressure should be reduced by no more than 20% of the original high level.

When blood pressure increases moderately, but the overall stable for good behavior (no other symptoms), you should try to fall asleep or lie down with your eyes closed.If after rest the pressure remains high, it is necessary to take medicines recommended by the attending physician.

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