Arterial hypertension is the most common disease in the heart and blood vessels, affecting about 25% of the adult population.No wonder it is sometimes called a non-infectious epidemic.Hypertension and its complications significantly affect the mortality rate in the population.Estimates show that 25% of deaths over the age of 40 are directly or indirectly caused by hypertension.The possibility of complications determines the stage of hypertension.How many stages does hypertension have? How to classify it?See below.
Important!According to the latest estimates from the World Health Organization in 1993, adult hypertension is a steady increase in blood pressure to 140/90 mm Hg.Art.
Classification of arterial hypertension to determine the risk of disease
According to the cause, hypertension in WHO is divided into primary and secondary.
For the main (essential) hypertension (GB), the main organic causes of elevated blood pressure (blood pressure) are not known.Taking into account genetic factors, the combination of external influences and invasion of internal regulatory mechanisms.
External factors:
- environment;
- Overuse of calories, the development of obesity;
- Increase salt consumption;
- Deficiency of potassium, calcium, magnesium;
- alcoholism;
- Repeat stress situation.
Primary hypertension is the most common hypertension, in about 95% of cases.
Separate 3 stages of hypertension:
- Stage 1 - Raise blood pressure without organ changes;
- Stage 2 - Increased blood pressure increases with changes in the organ, but does not impair its function (left ventricular hypertrophy, proteinuria, vascular disease);
- Stage 3 - Organs with impaired function (left heart failure, hypertensive encephalopathy, stroke, hyperosmotic retinopathy, renal failure).
Secondary (symptomatic) Hypertension is an elevated blood pressure, which acts as a symptom of underlying disease and determines the cause.Secondary hypertension is classified as follows:
- Kidney signs hypertension - occurs due to kidney disease; causes: renal parenchymal disease (glomerular nephritis, pyelonephritis), tumor, kidney damage;
- Renal vascular hypertension - stenosis of renal arteries, fibrous fibrillar atherosclerosis, renal venous thrombosis;
- Endocrine hypertension - primary hypnosis (CONN syndrome), hyperthyroidism, pheochromocytoma, Cushing's syndrome;
- Hypertension caused by drugs;
- Pregnancy hypertension - High pressure during pregnancy, after delivery, the condition is usually standardized;
- Aorta reduction.
Pregnant hypertension can lead to congenital diseases in children, especially retinopathy.2 stages of retinopathy (premature birth and complete child) are separated::
- Active - consists of 5 developmental stages that may lead to vision loss;
- Friction - causes the cornea to be covered with shadow.
Important!Both stages of retinopathy in premature birth and intact children lead to anatomical disease!
Hypertensive disorders according to the international system (according to ICD-10):
- Main form-I10;
- Secondary Form-I15.
The degree of hypertension also determines the degree of dehydration.In this case, the classifier is lacking in the body.
Share 3 dehydration degrees:
- Degree 1-Light - Deficiency 3.5%; Symptoms - Dry mouth, severe thirst;
- Degree 2-Average Deficits-3-6%; Symptoms-Sharp fluctuations in stress or decompression, tachycardia, hypouricemia;
- The third degree - the third degree is the most severe, characterized by a lack of 7-14% water; display of hallucinations, despotics; clinic - coma, hypovolemia shock.
Compensation is performed by introducing solutions depending on the degree and stage of dehydration:
- 5% glucose + isotonic NaCl (generally);
- 5% NaCl (average degree);
- 4.2% of Najaco3(severity).
The stage of GB
There are usually no subjective symptoms, especially during the mild and moderate hypertension stages, so an increase in blood pressure is usually found at the risk indicator level.Clinical pictures are divided into 3 stages.Each stage of arterial hypertension has typical symptoms, and the classification of GB comes from this.
Phase 1
In the 1st stage of hypertension, the patient complains of headache, fatigue, rapid heartbeat, disorientation, and sleep disorders.In the 1st stage of GB, objective detection of the heart, ECG, and eye background in the normal range exists.
Phase 2
In the second stage of AH, subjective complaints are similar, with signs of left ventricular hypertrophy, signs of hypertension on the retina, microalbuminuria or proteinuria in the urine.Sometimes red blood cells reproduce in urine precipitation.During the 2 stages of hypertension, the symptoms of renal failure are not present.
Stage 3
With stage III hypertension, dysfunction is diagnosed in organs at a risk of hypertension:
- Damage to the heart - In the beginning, shortness of breath will show - symptoms of heart asthma or pulmonary edema;
- Vascular complications - damage to peripheral and coronary arteries, risk of cerebral atherosclerosis;
- Changes in the fundus - with the nature of hypertensive retinopathy, neurostructural disease;
- A typical thrombosis or transient ischemic outbreak of hemorrhagic vascular stroke shows changes in the cerebrovascular system.
- In the third stage, almost all patients diagnosed with brain disease.
- The benign renal blood vessels of the kidneys are severe - leading to increased glomerular filtration, proteinuria, red blood cells, hyperuricemia, and later lead to chronic renal failure.
Which stage or degree is the most dangerous?Despite various symptoms, all stages and stages and degrees of arterial hypertension are dangerous and require appropriate systemic or symptomatic treatment.
degree
According to the blood pressure indicators (blood) determined at the time of diagnosis, three hypertension were distinguished:
- Light;
- Average;
- Heavy.
There is also a fourth concept - the determination of drug resistance (persistent) hypertension, even if the combination of antihypertensive drugs is selected, the blood pressure indicator will not be reduced below 140/90 mm.Art.
A clearer overview of the extent of arterial hypertension is listed in the table.
Classification of Ag and normal blood pressure stratification according to ESH/ESC guidelines in 2007.
| category | Systolic pressure, mm Hg.Art. | diastolic blood pressure, mmHg.Art. |
|---|---|---|
| The best | <120 | <80 |
| Ordinary | 120–129 | 80–84 |
| Normal situation increases | 130–139 | 85–89 |
| 1 degree | 140–159 | 90–99 |
| 2 degrees | 160–179 | 100–109 |
| 3 degrees | More than 180 | More than 110 |
| Isolated systolic hypertension | More than 140 | Less than 90 |
Patients' difficulties vary by dividing hypertension into degrees.The choice of disease treatment options depends on the degree of determination.
My degree
The disease can only be detected by regular measurement of blood pressure.Measurements should be performed at least 3 times in a relaxed environment.
This is the only way to assess the presence or absence of hypertension.The clinical situation of the disease varies depending on the degree of increase in blood pressure.
Degree II
Second degree hypertension is characterized by a decrease in the cycle of increased stress and an index or an increase in diastolic value only.In this case, hypertension, in some cases, increases in stress are typical, especially in patients with nervous system instability.
III Degree
III AG level is characterized by a sharp increase in blood pressure.
III GB is characterized by serious complications caused by the harmful effects of hypertension on all organs and systems.First, the heart, kidneys, eyes, and brain are affected.With III levels of hypertension, symptoms and treatment are closely related to insufficient or improper treatment, the disease can lead to serious consequences: stroke, encephalopathy, renal failure, irreversible eye lesions, blood vessels.The lack of treatment for III hypertension increases the risk of isolated systolic hypertension.
At this stage of arterial hypertension, the degree of risk increases greatly!Memory, psychological activities, and frequent loss of consciousness are manifested.
The hypertonic crisis is a complexity of the third century and is considered to be the art of IV.GB.
risk
Patients are classified into risk groups based on the severity of AG, according to the classification of hypertension based on stage and degree.Four categories were distinguished (i.e., they were as much as hypertension) and these categories were determined by the principle of the possibility of future damage to internal organs.
Risk of disease degree:
- The risk is less than 15%;
- Up to 20% risk;
- Risk 20-30%;
- Risk is above 30%.
Low, insignificant
A low-risk group includes men up to 55 years of age and women over I Art to 65 years of age.Arterial hypertension.In this group, the risk of cardiovascular pathology for up to 10 years is less than 15%.It is recommended that people who belong to low-risk groups change their lifestyles.If non-drug treatment does not show efficiency within 6-12 months, it is recommended to prescribe medicine.
Average
The average risk group included people from the I-II art.Hypertension, as long as there are 1-2 risk factors.The risk increases with high weight, smoking, cholesterol, invasion of glucose tolerance, and lack of exercise.Genetic factors are also important.These people have a higher risk of cardiovascular complications, 15-20% in a decade.It is recommended that those associated with the group adhere to a healthy lifestyle.If the pressure is not reduced within 6 months, medication should be prescribed.
High
High-risk groups include people from the I-II century.Hypertension is affected by at least 3 risk factors, including:
- diabetes;
- Failed target organ;
- atherosclerotic vascular disease;
- left ventricular hypertrophy;
- Increased creatinine;
- Changes in eye container.
The group also included 3rd century hypertension without risk factors (the risk of cardiovascular disease is 10 years, 20-30%).The representatives of the group are under the supervision of cardiologists.
Very high
A group of hypertension (over 10 years) with very high risk of cardiovascular disease included people with III ART.Hypertension, provided that there is at least 1 risk factor.In addition, this group included patients with AH I-II ART.In cases of invasion of cerebral circulation, ischemia, and kidney disease.The group is controlled by cardiologists and requires active treatment.
in conclusion
The problem with arterial hypertension is that the disease has no typical symptoms, which are characterized by various clinical conditions.Therefore, usually one person does not know the existence of this disease.Therefore, during examination or in the manifestation of complications, hypertension is detected by chance.When diagnosing hypertension, it is important to correctly inform the patient that after a healthy lifestyle, he may greatly affect his course of illness.