Hypertension: what it is, main symptoms, signs

Hypertension is one of the most common cardiovascular diseases. According to the World Health Organization, more than 1. 1 billion people live with the disease. worldwide. High blood pressure increases the risk of other heart diseases. High blood pressure is one of the leading causes of death, and the disease is rapidly affecting younger people. It happens not only to older people but also to young people. Below you'll learn why it occurs, how to identify it, and control it.

What is high blood pressure?

This is a chronic disease in which blood pressure increases. It is expressed as two numbers, with the optimal value being 120/80 mmHg. Art. The first number is systolic blood pressure, which occurs when blood is ejected from the heart's left ventricle into the aorta as it contracts (ventricular contraction). The second number represents the diastolic blood pressure when the heart muscle relaxes. Blood pressure increases during physical activity and emotional arousal, but it should be close to normal at rest. If multiple measurements are taken at different times, systolic blood pressure exceeds 139 mmHg. Art. and/or diastolic blood pressure exceeds 90 mmHg. Art, diagnosed with hypertension.Persistently elevated blood pressure is linked to a variety of factors, including excess weight, lack of physical activity, poor diet, bad habits and excessive stress.

Causes and risk factors

Hypertension can be primary or secondary:

• main (required)High blood pressure is more common – According to various estimates, high blood pressure is more common in 85-95% of cases. Its appearance is independent of concomitant diseases; stress increases under the influence of various factors;
• Secondary (symptomatic)The incidence of hypertension is 5-15%. In this case, hypertension is one of the symptoms that may be associated with endocrine disorders, kidney disease, and macrovascular abnormalities.

Essential hypertension occurs when the regulation and maintenance of optimal blood pressure is impaired. It usually occurs because of persistent nervous stress. When diagnosing, it is important to determine as accurately as possible what causes high blood pressure and whether there are secondary causes (whether there is a disease that causes high blood pressure).There are many risk factors that increase the chance of developing essential hypertension:

• Being overweight (obesity);
• Inactivity, lack of physical activity, lack of physical activity;
• drinking and smoking;
• Stress, ongoing emotional tension;
• Lack of sleep, its poor quality, insomnia;
• excessive salt intake;
• Improper sleeping and resting patterns (including due to irregular or long working hours);
• changes in hormonal levels (in women, may be related to the use of oral contraceptive pills and the onset of menopause);
• genetic factors (in total, more than 20 genes have been identified as determining susceptibility to hypertension);
• Over 65 years old (young people can also develop the disease, and blood pressure should be monitored regularly after the age of 35);
• Malnutrition (a diet lacking in vegetables and fruits and excessive intake of foods high in trans fats and saturated fats);
• Kidney disease, diabetes and several other related conditions and diseases.

Many of these factors are interrelated and mutually reinforcing. Some of these can be controlled (e. g. diet and eating, sleep, physical activity, weight, alcohol consumption, smoking). This is a simple way to reduce your risk of high blood pressure or improve your health if your blood pressure is already high.

Classification

To classify diseases, two methods are used: by degree and by stage. The degree of hypertension differs in the value of the increase in blood pressure, and the differences between stages lie in the course of the disease, the number and severity of accompanying organic lesions.

first level

Systolic blood pressure - More than 139 mmHg and less than 159 mmHg. Art, diastolic blood pressure was in the range of 90-99 mmHg. Art. If the values are elevated, lifestyle adjustments can be made to normalize blood pressure. To do this, you need to increase your physical activity, modify your diet, give up bad habits, and reduce your stress levels.

second degree

In the second degree, the blood pressure value becomes higher, reaching 160-179 mmHg. Art. Systolic blood pressure and 100-109 mmHg. Art. for diastolic blood pressure. With such a value, the burden on the heart will be greatly increased. The blood supply to the brain deteriorates, which can lead to headaches, dizziness, and decreased performance. There are changes in the fundus of the eyes. Kidney tissue and blood vessels begin to harden, excretory function is impaired, and kidney failure may occur. The condition of blood vessels worsens. For treatment, you need to make lifestyle changes and start taking medications.

Three degrees

Systolic blood pressure is higher than 180 mm Hg. Art, diastolic blood pressure - above 110 mm Hg. Art. With high blood pressure, the heart is overloaded and causes irreversible changes. Blood pressure must be continuously lowered with medication. Without this, there is a threat of acute heart failure, cardiac arrhythmias, angina, myocardial infarction and other serious conditions. People with stage 3 hypertension require constant monitoring by a doctor. Continued use of blood pressure-lowering medications is necessary.

arterial pressure	Systolic blood pressure (mmHg)	Diastolic blood pressure (mmHg)
beautiful	< 130	< 85
Often, what is called prehypertension	130–139	85–89
1 - Mild hypertension	140–159	90–99
2 - Moderate hypertension	160–179	100–109
3 - Severe hypertension	≥180	≥110

stages of hypertension

The disease progresses gradually. There are three stages in total.

1. The first stage:Moderate hypertension. Blood pressure is unstable and may fluctuate throughout the day. During this stage, the condition of the internal organs and central nervous system remains normal, with no signs of organic damage. Hypertensive crises occur rarely and are relatively mild.
2. second stage:Severe hypertension. In the second stage, blood pressure rises significantly, health conditions often worsen, and hypertensive crises become severe. During this stage, changes in internal organs begin to occur due to ongoing high blood pressure. Vascular disease occurs and the blood supply to the brain deteriorates. Narrowing of retinal arteries. Enlargement of the left ventricle of the heart, which increases the risk of serious heart disease. Signs of renal dysfunction (increased albumin levels in urine, elevated creatinine levels in serum)
3. The third phase:Very severe high blood pressure. Blood pressure becomes very high - over 200 mmHg. Art. Systolic blood pressure and 125 mmHg. Art. for diastolic blood pressure. Organic diseases worsen, and serious diseases such as heart failure, cerebrovascular thrombosis, aneurysm, and renal failure occur. Severe hypertensive crises often occur.

symptom

High blood pressure can go without symptoms for a long time, even if blood pressure is significantly elevated. Therefore, you should check your blood pressure regularly (monitoring is especially important for people over 35). You can measure your blood pressure with an automatic electronic tonometer - this device is available in pharmacies.The main symptoms of high blood pressure include headache, dizziness, and heavy head. These manifestations are associated with vasospasm and deterioration of blood supply to the brain. Possible nosebleeds, tinnitus, vision loss, and cardiac arrhythmia. In severe cases of hypertension, weakness, chest pain, nausea, vomiting, and tremors ("muscle tremors") may occur. Other symptoms include blurring or dark spots in front of the eyes, trouble sleeping, heart palpitations and ringing in the ears. As the condition progresses, vision gradually decreases, sensitivity in the arms or legs may decrease, and in severe cases, paralysis may occur. Symptoms may increase during times of stress, against the background of nervousness or physical activity. It mostly occurs in middle-aged and elderly people. The disease is more severe if you are overweight, have bad habits, tend to overeat, or are stressed.If you frequently experience headaches, dizziness, or vision problems, or if your blood pressure frequently rises when you measure it yourself, you should consult a therapist or cardiologist.

diagnosis

Typically, diagnosis proceeds from three directions:

• Blood pressure measurement.This is done every few hours or 2-3 days to determine the degree and stage of high blood pressure;
• Determine the cause of the disease.It is important to determine whether hypertension is primary or secondary (caused by another condition). In the second case, special treatment may be needed;
• Monitor general health.During the examination, the condition of the heart, cerebral blood vessels, fundus of the eyes, and kidneys are monitored. Due to high blood pressure, the function of these organs is impaired. When diagnosing, it is important to assess their condition.

At the first appointment, the doctor will conduct surveys and collect medical history details relevant to the disease. Information required includes how long the patient has had high blood pressure, what the blood pressure level is, whether there are symptoms of heart disease, apnea, severe snoring, and whether the patient or a close relative has had stroke, peripheral artery disease, gout, diabetes, kidney disease. The doctor will definitely ask questions about lifestyle: physical activity, bad habits, diet, taking medications.In patients with arterial hypertension, the following tests are performed:

• Blood pressure measurement.Take multiple measurements at rest (excluding physical activity, caffeine consumption, smoking half an hour before measurement) and at different times of the day;
• ordinary inspection:Measure height, weight, waist circumference, palpate abdomen, assess peripheral arterial pulse;
• Urinalysis.Albumin and creatinine levels are important - deviations from normal values indicate renal dysfunction and require ultrasound;
• blood analysisTo monitor potassium, creatinine, and blood lipid levels, an ultrasound of the kidneys is performed. Assessment of serum lipid levels is needed to control lipid metabolism to eliminate the risk of cardiovascular system complications;
• electrocardiogramIt is performed when left ventricular hypertrophy is detected to monitor the condition of the heart.

In addition, doctors may refer patients for cardiology or neurological testing or respiratory testing.

Treatment of high blood pressure

Hypertension is a disease that cannot be completely cured but can be controlled. Treatment and lifestyle changes can stop the development of high blood pressure, reduce the frequency and severity of crises, and eliminate symptoms. But the most important thing is to reduce the risk to the cardiovascular system, brain and kidneys.Treatment begins with lifestyle adjustments:

• quit smoking;
• Refusing to drink alcohol or strictly limiting alcohol consumption;
• Diet: Adjust your diet, reduce salt intake (less than 3. 75 grams per day), increase the amount of vegetables and fruits (preferably 5 servings per day), and limit the calorie intake of whole wheat, dairy products, low-fat products, etc. limited. If there are no contraindications or kidney disease, increase the intake of potassium-containing foods (spinach, beans, pumpkin, fish, milk, kefir, yogurt, etc. );
• Increase physical activity. Moderate exercise is recommended to promote weight loss and strengthen the cardiovascular system.

During treatment, blood pressure is lowered to target values (below 130/80 mmHg) to reduce the risk of complications. With this reduction comes continued monitoring by a physician. Tonometers used for home measurements must be calibrated regularly. People with diabetes, pregnant women, the elderly and the frail should use antihypertensive drugs with special caution. The following medicines can be used to treat high blood pressure:

• Adrenergic modulators.They reduce sympathetic nervous system activity and lower blood pressure, but can cause drowsiness and drowsiness and are therefore rarely used;
• ACE inhibitors.Reduce peripheral vascular resistance, often used in patients with diabetes;
• Angiotensin II receptor blockers.They work similarly to ACE inhibitors and are not prescribed with them. Not prescribed during pregnancy;
• Beta blockers.Lower blood pressure by slowing heart rate;
• Calcium channel blockers.They reduce total peripheral vascular resistance and may cause reflex tachycardia;
• Direct vasodilator.They have a direct effect on blood vessels and are used to treat severe hypertension;
• Diuretics.They reduce plasma volume, thereby lowering blood pressure, but can also cause hyperkalemia.

important!The therapist or cardiologist should prescribe the medication and its dosage after examination. Taking medications without a doctor's prescription can be dangerous.

If your doctor prescribes medications, you will need regular follow-up exams to evaluate the effectiveness of your treatment and make adjustments. It is important to make lifestyle adjustments and return to normal health so that the course of high blood pressure can be controlled with minimal medication.

possible complications

As blood pressure rises, artery walls lose elasticity and the heart muscle becomes overworked. This increases the risk of angina, acute heart failure, and heart attack. Transient ischemic attacks and strokes may occur due to compromised blood supply to the brain. Without treatment and lifestyle correction, the severity of high blood pressure will increase: pressure will continue to rise, which will lead to damage to internal organs and worsen overall health and well-being. Smoking, drinking, overeating, lack of physical activity and excessive stress can accelerate the development of hypertension and complicate its course.

result

If left untreated, arterial hypertension can have serious consequences. Sustained spasm of cerebral blood vessels can lead to ischemia and stroke. They are dangerous and can cause severe disability or even death. When the heart muscle is overloaded, tachycardia, arrhythmias, and heart failure can occur. Without treatment, myocardial infarction may occur.Hypertensive crises can increase in severity, become complex, life-threatening, and may be accompanied by stroke, acute coronary syndrome, and other serious conditions. Without adequate treatment and restoration of normal health, the quality of life in the setting of hypertension can decrease dramatically and even lead to severe disability.

forecast

If patients seek medical attention promptly and take measures to control blood pressure and factors that affect hypertension, the prognosis is good. In this case, it is possible to avoid the long-term consequences of hypertension and its serious course. Even severe hypertension requires treatment and lifestyle modifications.

prevention

To prevent high blood pressure, it is recommended to self-monitor your blood pressure if you are over 35 years old or if you have symptoms of high blood pressure. It is important to eliminate the influence of factors that increase blood pressure: control your diet, stop smoking and drinking, reduce stress levels, spend more time in physical activity: in short, maintain a healthy lifestyle.

in conclusion

High blood pressure is a dangerous disease, but it can be controlled by maintaining normal health and reducing the risk of complications. For this reason, it is important to monitor blood pressure levels, control weight, maintain a healthy lifestyle, and undergo preventive check-ups with a therapist or cardiologist.