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Hypertension

symptoms of hypertension

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

Causes of hypertension

In clinical cardiology, hypertension is classified into 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 (sudden 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, renal artery obstruction, etc.These diseases lead to inhibition of the intensity of blood circulation in the kidneys, as a result of which the organs secrete a substance to compensate 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.

Additionally, provoking factors such as:

  • a diet with excessive consumption of fats, salt, sugar and insufficient amounts of products of plant origin in the menu;
  • age over 55;
  • hereditary predisposition;
  • physical inactivity;
  • smoking, alcohol abuse;
  • chronic stress.

Hypertension can also develop when taking certain medications (glucocorticoids, anabolic steroids, antidepressants).

Types of diseases

Depending on the cause and nature of the lesion, we distinguish:

  • primary hypertension;
  • hypertensive disease with primary lesions of the heart;
  • hypertension with predominant renal damage;
  • high blood pressure with predominant damage to the heart and kidneys;
  • secondary hypertension.

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

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

Depending on severity, hypertension is classified into:

  • mild - increase in blood pressure in the range from 140/90 to 159/99 mm Hg. Art.;
  • moderate - indicators between 160/100 and 179/109 mm Hg. Art.;
  • severe - blood pressure above 180/110 mm Hg. Art.

We also distinguish isolated hypertension, the peculiarity 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 early stages, the disease may be asymptomatic, then patients complain of:

  • headache, dizziness;
  • noise, ringing in the ears;
  • the appearance of “flies” and spots before the eyes;
  • sensation of active heartbeat, pulsation in temples, back of head;
  • facial redness;
  • squeezing pain in the heart area;
  • shortness of breath;
  • swelling of the face, hands;
  • excessive sweating;
  • loss of appetite, nausea.

Further manifestations depend on the form and presence of complications of hypertension.This may include blurred vision, tremors, numbness of limbs, problems with coordination, fine motor skills, etc.

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

Possible complications of hypertension

In advanced forms of the disease, complications such as:

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

The risk of complications depends on the combination of various 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 doctor or cardiologist.During the consultation, the doctor asks about complaints, their characteristics, and also studies the medical history in detail in order to identify factors in 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. 

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

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.

To clarify the provoking factors and detect pre-existing pathological processes, the patient can undergo the following diagnostic methods:

  • electrocardiography;
  • echocardiography;
  • Doppler ultrasound examination of the brachiocephalic, renal and iliofemoral arteries;
  • Ultrasound of the heart, urinary 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 treatment of hypertension is to normalize heart function, eliminate the symptoms of the disease and prevent the development of complications.The treatment regimen is chosen on an individual basis.

Non-drug therapy

Involves a change in lifestyle.To do this you need:

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

Drug therapy

Several groups of drugs are used to treat hypertension:

  • diuretics;
  • beta-blocking medications;
  • angiotensin-converting enzyme inhibitors;
  • antagonists of calcium channels, as well as angiotensin II receptors;
  • centrally acting substances. 

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

Prevention of hypertension

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

  • maintain optimal body weight;
  • exercise regularly;
  • adhere to dietary nutrition;
  • give up bad habits;
  • promptly treat endocrine, nephrological and cardiac diseases;
  • minimize stressful situations;
  • control blood pressure levels.

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

In a multidisciplinary medical center, you will be able to benefit from the advice of highly qualified specialists.Experienced therapists and cardiologists will prescribe the necessary examination and select effective treatment for each patient.