The role of risk factors in the development of arterial hypertension. Risk factors for arterial hypertension. The main risk factors for the formation of cardiovascular pathologies

Risk Factors for the Development of Cardiovascular Complications

UNMODABLE RISK FACTORS

1. Age over 55 for men and over 65 for women

With the same blood pressure figures, the risk of complications (stroke, myocardial infarction, and others) in older people is 10 times higher than in middle-aged people, and 100 times higher than in young people. Therefore, in the elderly, it is extremely important to adequately treat arterial hypertension, that is, to achieve normal blood pressure values.

2. Heredity

The more your relatives suffer from hypertension, the higher your risk of developing it. If your male relatives (father, siblings, uncles, etc.) had heart attacks and strokes before the age of 55, and your female relatives (mother, siblings, aunts, etc.) before the age of 65, then the risk of developing complications of arterial hypertension is significantly increased. In addition, a tendency to high blood cholesterol may be inherited, which can also be one of the causes of complications of arterial hypertension.

3. Male sex, as well as physiological or surgical menopause in women.

ACQUIRED (MODABLE) RISK FACTORS

1. Smoking- an independent factor of cardiovascular diseases, increasing the risk of complications by 1.4 times. It has an extremely negative effect not only on the cardiovascular system, increasing the load on the heart, causing vasoconstriction, but also on the entire body. Smoking increases the risk of developing atherosclerosis: patients who smoke 1-4 cigarettes per day, in 2 times more likely to die from cardiovascular complications than non-smokers. In the case of smoking 25 or more cigarettes per day, the risk of death from a complication increases by 25 times. Smoking also increases the risk of lung cancer, bladder cancer, chronic obstructive pulmonary disease, peptic ulcer disease, and peripheral arterial disease. Pregnant women who smoke have a higher risk of miscarriage, premature birth, and low birth weight babies.

2. Dyslipidemia. In the analyzes, pathology is total fasting serum cholesterol more than 6.5 mmol / l, or low-density lipoprotein cholesterol more than 4.0 mmol / l, or high-density lipoprotein cholesterol less than 1.0 mmol / l (for men) and less than 1, 2 mmol/l (for women).

Cholesterol is a fat needed for building cells, certain hormones, and bile acids. Without it, the body cannot fully function. But at the same time, its excess can have the opposite, negative effect. Most of the cholesterol is formed in the liver, and a smaller part comes from food. Fats in general and cholesterol in particular do not dissolve in the blood. Therefore, for their transportation, small globules of cholesterol are surrounded by a layer of protein, as a result of which cholesterol-protein complexes (lipoproteins) are formed. The most important forms of lipoprotein cholesterol are low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, which are in equilibrium with each other. Low-density lipoproteins transport cholesterol to various parts of the human body, and along the way, cholesterol can be deposited in the wall of arterial vessels, which can cause their thickening and narrowing (atherosclerosis). Therefore, low-density lipoprotein cholesterol is called "bad". High-density lipoproteins carry excess cholesterol to the liver, from where it enters the intestines and leaves the body. In this regard, high-density lipoprotein cholesterol is called "good".

Dyslipidemia is an imbalance in the blood of circulating fatty particles in the direction of the so-called "bad" cholesterol, which is responsible for the development of atherosclerosis (low-density lipoprotein cholesterol) with a decrease in "good" that protects us from it and the complications associated with it (stroke, myocardial infarction, damage to the arteries of the legs and others) (high-density lipoprotein cholesterol).

3. Male type of obesity

The male or abdominal type of obesity is characterized by the deposition of fat in the subcutaneous fat of the abdomen and is accompanied by an increase in waist circumference (in men - 102 cm or more, in women - 88 cm or more) (“apple-shaped obesity”).

It helps to identify the type of distribution of adipose tissue by calculating the so-called "waist-hip index" according to the formula:

ITB = OT / OB, where ITB is the waist-hip index, OT is the waist circumference, ABOUT is the hip circumference.

With ITB< 0,8 имеет место бедренно-ягодичный тип распределении жировой ткани (женский). при ИТБ = 0,8-0,9 - промежуточный тип, а при ИТБ >0.9 - abdominal (male).

With an increase in body weight, blood pressure rises, which, along with the need to provide blood for the increased mass, forces the heart to work with increased workload. Also, the level of total cholesterol and low-density lipoprotein cholesterol increases while high-density lipoprotein cholesterol decreases. All this increases the risk of such formidable complications as stroke and heart attack. In addition, excess body weight increases the risk of type 2 diabetes mellitus, gallstones, joint diseases, including gout, menstrual irregularities, infertility, and trouble breathing at night (sleep apnea syndrome). Already in 1913, insurance companies in the United States used tables where body weight served as a predictor of life expectancy, and in 1940 the first tables of "ideal" body weight were published.

4. Diabetes

Patients with diabetes are much more likely to suffer from coronary heart disease and have a worse prognosis in terms of the development of cardiovascular complications. It should be borne in mind that patients with this disease have a whole "bouquet" of risk factors for cardiovascular complications (overweight, dyslipidemia with insufficient compensation for the disease, etc.).

5. Sedentary lifestyle and psychological overload (stress) at home and at work

A constantly acting stressful situation, internal instability lead to the fact that people begin to smoke more, drink alcohol, and sometimes overeat. These actions backfire and further aggravate the state of instability.

Thus, the risk of developing severe complications consists of the level of blood pressure and the presence of other risk factors.

Determining the individual risk (that is, the risk of developing complications in our country) is necessary for the doctor to decide on ways to correct the existing high blood pressure.

Therefore, it is very important to understand that even in the presence of a "small" increase in blood pressure (first degree), the risk of complications can be very high. For example, if you are a person of retirement age, smoke and / or have a “bad” (doctors say “burdened”) heredity.

Remember, arterial hypertension of the first degree can be no less (sometimes even more) dangerous in terms of the development of complications than arterial hypertension of the third degree.

Only the attending physician will be able to assess the real likelihood of complications and decide on ways to correct high blood pressure.

Atrial fibrillation associated with arterial hypertension

Volkov V.E.

Atrial fibrillation (AF) and arterial hypertension (AH) are the two most common, often combined pathologies of the cardiovascular system. The incidence of these diseases increases with age, they lead to numerous complications and high mortality. Despite the fact that the relationship of these pathologies is not fully understood, the treatment of hypertension is far from a new approach in the correction of AF. In patients with this type of atrial tachyarrhythmia, aggressive treatment of hypertension can prevent structural changes in the myocardium, reduce the incidence of thromboembolic complications, and slow down or prevent the onset of AF. Specific pharmacotherapy plays an important role in the primary and secondary prevention of AF and its complications.

Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and a major risk factor for stroke and overall mortality. According to general estimates, the prevalence of AF in the general population is about 0.4% and increases with age. According to the results of the ATRIA study, the prevalence of AF among people younger than 55 years was 0.1%, while among patients older than 80 years it was 9.0%. Among people older than 60 years, AF was diagnosed in approximately 4% of cases. This means that 1 out of 25 people over 60 years of age suffers from this pathology, and the risk of developing it after 60 years of age increases dramatically.

Due to the high prevalence of arterial hypertension (AH) among the population, more cases of AF are associated with it than with any other risk factor. The risk of developing AF in patients with hypertension is 1.9 times higher than in patients with normal blood pressure (BP). In turn, AF serves as an independent risk factor for stroke, which increases by 3-5 times.

Studies of the general population of patients with hypertension have shown that the advanced age of the patient and the increase in the mass of the left ventricle serve as an independent predictor of the onset of AF.

Arterial hypertension as a risk factor for atrial fibrillation

AF was previously considered a common complication of rheumatic heart disease. However, due to the low prevalence of this disease, other risk factors for the development of atrial tachyarrhythmias currently predominate. Currently, hypertension is the most common, independent and modifiable risk factor for AF. The relative risk (RR) of developing AF in hypertension is relatively low (RR 1.4 to 2.1) compared with other diseases such as heart failure (RR 6.1 to 17.5) and valvular disease (RR 2.0 to 2.1). .2 to 8.3). However, due to the fact that hypertension has a high prevalence in the world, it is the main risk factor for AF.

A number of cohort studies have shown that in North America, hypertension was present in 50-53% of patients with AF and was the cause of this tachyarrhythmia in 15% of cases. The incidence of AF in patients with hypertension was 94 cases per 1000 patients per year. In a cohort of patients with hypertension, it was found that those patients who subsequently developed AF had higher ambulatory systolic BP values.

Anatomically, the left atrial appendage often serves as a substrate for the onset of a stroke. It is a remnant of the embryonic atrium - an elongated sac consisting of trabeculae of the pectinate muscles, lined with endothelium. The contractility of the left atrial appendage decreases in AF, but the degree of decrease can vary greatly and this contributes to blood stasis, the underlying process of thrombus formation in the left atrial appendage in AF, which is thought to be mediated by left ventricular diastolic dysfunction. Hypertension as the most common risk factor for stroke leads to a progressive increase in stasis.

Atriomegaly is an independent risk factor for the development of AF. In older patients with this type of tachyarrhythmia, stroke is more common. The development and maintenance of AF are associated with changes in the structure of the myocardium, its functioning, as well as electrical properties - remodeling of the heart. The pathogenesis of AF is very complex and combines many factors, however, it is now known for certain that this type of atrial arrhythmia is associated with abnormal atrial stasis, structural changes in the heart, and impaired blood consistency.

Long-term hypertension, especially if inadequately controlled, leads to left ventricular hypertrophy, which is the most significant manifestation of target organ damage in hypertension. Left ventricular hypertrophy itself is an independent predictor of cardiovascular events. Due to a gradual decrease in the elasticity of the left ventricular myocardium, an increase in its rigidity and a change in the filling pressure of the left ventricle with its hypertrophy, diastolic dysfunction and remodeling of the left atrium, its dilatation and fibrosis develop. Such changes in the left atrium underlie the pathogenesis of AF.

In a number of population-based studies, left ventricular hypertrophy, diastolic dysfunction, and left ventricular dilatation have been used as markers predicting the risk of cardiovascular events and AF. Studies have shown that diastolic dysfunction is highly likely to be associated with an increased risk of AF. In the Framingham study, the level of systolic BP and duration of hypertension were signs suggesting left ventricular remodeling in these patients. In a study involving 1655 elderly patients, it was shown that patients in whom the volume of the left ventricle was increased by 30% had a 48% greater risk of developing AF.

Treatment of atrial fibrillation associated with arterial hypertension

At the moment, there is a lot of evidence that structural and functional changes in the myocardium lead to the onset of AF, as a result of which the arrhythmia can be corrected through the use of specific antihypertensive therapy. However, despite great progress in understanding many electrophysiological mechanisms of formation and maintenance of AF, there is no universal method of treatment today.

Studies in the field of AF pathogenesis have shown that this type of arrhythmia is based on activation of the renin-angiotensin-aldosterone system (RAAS). Thus, the target for the treatment of AF should be the correction of these neurohormonal disorders. In patients with hypertension, a decrease in blood pressure with various drugs is associated with a regression of ventricular hypertrophy. Some drugs, such as calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors, have the most significant effect on myocardial structure, regardless of pressure reduction values.

In a randomized comparative study of verapamil and atenolol therapy in a group of elderly patients, verapamil reduced weight and improved left ventricular filling, in contrast to atenolol, despite the fact that both drugs had the same effectiveness in reducing blood pressure. In the course of two large meta-analyses, it was found that ACE inhibitors and calcium channel blockers have a more significant effect on the regression of left ventricular hypertrophy than β-blockers, diuretics and α-blockers. Even patients with normal left ventricular mass after 8-12 months of aggressive BP lowering with calcium channel blockers showed improvement in ventricular filling, wall thickness, and left ventricular mass.

Left ventricular enlargement is also reversible with antihypertensive therapy. In patients with hypertension, treatment with hydrochlorothiazide reduced the size of the left ventricle to a greater extent than other classes of antihypertensive drugs. In patients with left atrial dilatation, clonidine, atenolol, and diltiazem also reduced the size of this chamber of the heart, while prazosin and clonidine did not have such an effect, despite the equivalent ability of drugs to reduce blood pressure. Other studies have demonstrated varying degrees of left atrial size reduction with verapamil or labetalol, regardless of the effect of these drugs on left ventricular mass and wall thickness.

Thus, lowering blood pressure reduces left ventricular hypertrophy and left atrial dilatation. However, certain classes of antihypertensive drugs used for this purpose are more effective. Recent studies have evaluated the effectiveness of antihypertensive therapy in patients at risk of developing AF. Mean blood pressure in patients after myocardial infarction was 120/78 mm Hg. Art. while treatment with ACE inhibitor trandolapril was associated with a decrease in the incidence of AF from 5.3 to 2.8% (p< 0,01 в период последующих 2-4 лет) .

In the study by Yu.G. Schwartz studied the effect of losartan on patients with hypertension after arresting an attack of paroxysmal atrial fibrillation. During the experiment, it was found that losartan has significant efficacy and good tolerability in the treatment of hypertension in patients with paroxysmal atrial fibrillation. Most importantly, the treatment of patients with a combination of paroxysmal atrial fibrillation and hypertension was accompanied by a significant decrease in the frequency of arrhythmia paroxysms, in contrast to patients treated with nifedipine and atenolol. Thus, the authors suggested that the positive effect of losartan on the clinical course of paroxysmal atrial fibrillation is largely due to its specific effect on the myocardium and, to a lesser extent, to changes in hemodynamics and vegetative status. The data obtained were confirmed by other studies, where the relationship between the regression of left ventricular hypertrophy and the antiarrhythmic effect of antihypertensive therapy was shown.

A meta-analysis has shown that the use of ACE inhibitors and angiotensin II receptor antagonists reduces the risk of AF by 28% in patients with hypertension. Prospective randomized controlled trials have shown that suppression of RAAS with angiotensin II receptor antagonists reduces the incidence of AF by 16-33%, while the number of strokes in these patients also significantly decreases.

The international prospective, randomized, double-blind LIFE study evaluated the efficacy of losartan and atenolol therapy in patients with AF, as well as the preventive effect of these drugs on the occurrence of AF. The study found that, despite the same decrease in blood pressure, losartan therapy was more effective than atenolol treatment. The primary composite endpoint (CV death, stroke, myocardial infarction) was reached by 36 patients in the losartan group and 67 patients in the atenolol group (RR = 0.58; p = 0.009). Death from cardiovascular causes was noted in 20 cases while taking angiotensin II receptor antagonists and in 38 patients taking atenolol (RR = 0.58; p = 0.048). Stroke developed in 18 versus 38 patients of the losartan and atenolol groups, respectively (OR = 0.55; p = 0.039), and myocardial infarction - in 11 and 8 patients (differences are not significant).

Therapy with losartan compared with β-blockade was accompanied by a trend towards a decrease in all-cause mortality (30 vs 49 cases, p = 0.09), a lower rate of implantation of an artificial pacemaker (5 vs 15; p = 0.06) and sudden death (9 vs. 17; p = 0.18). In addition, in the losartan group, there were fewer cases of recurrent AF and the same frequency of hospitalizations for angina pectoris and heart failure.

Among patients in sinus rhythm, new cases of AF were reported in 150 patients in the losartan group and in 221 patients in the atenolol group (RR = 0.67; p< 0,001). Более того, терапия антагонистами рецепторов ангиотензина II сопровождалась тенденцией к более длительному сохранению синусового ритма (1809 ± 225 дней против 1709 ± 254 дней в группе атенолола; р = 0,057). Пациенты с ФП имели двух-, трех- и пятикратный риск развития сердечно-сосудистых событий, инсульта и госпитализации по поводу сердечной недостаточности соответственно. Однако в группе лозартана комбинированная конечная точка и инсульт встречались реже, чем в группе атенолола (31 против 51 случая; ОР = 0,6; р = 0,03 и 19 против 38 случаев; ОР = 0,49; р = 0,01 соответственно). Таким образом, отмечено примерно 25 %-ное снижение частоты инсульта при терапии антагонистами рецепторов ангиотензина II по сравнению с β-блокадой .

Similar results were obtained by S.R. Heckbert et al. . They studied the effect of therapy with ACE inhibitors, angiotensin II receptor antagonists and β-blockers on the incidence of AF paroxysms in patients with hypertension. As a result of the experiment, ACE inhibitors and angiotensin II receptor antagonists were the most effective compared to β-blockers. Similar results were obtained by a team of authors headed by B.A. Schaer.

In their study (J-RHYTHM II), T. Yamashita et al. compared the efficacy of the dihydropyridine calcium channel blocker amlodipine with the efficacy of the angiotensin II receptor antagonist candesartan in patients with paroxysmal atrial fibrillation associated with hypertension. The study found that amlodipine and candesartan were equally effective in reducing the incidence of AF in patients with hypertension.

Calcium overload plays a major role in the development of electrical and mechanical remodeling during AF. Long periods of atrial tachyarrhythmias cause a shortening of the atrial effective refractory period, which reduces the effect of various measures aimed at stopping an arrhythmia attack. Some studies have examined the effect of verapamil and amlodipine in these patients. It has been shown that verapamil can reduce the progression of electrical and mechanical remodeling. The protective effect of low and medium doses of these drugs, having a protective effect on the kidneys and their production of renin, contributes to their beneficial effect on the cardiovascular system.

For many years, β-blockers have been widely used for the treatment of hypertension, but at present these drugs are not a first-line drug for the correction of blood pressure. At the moment, relatively little is known about the effect of β-blockers on atrial and ventricular remodeling.

In his study, E.E. Romanov et al. studied the effect of antihypertensive therapy with calcium channel blockers and ACE inhibitors on the course of paroxysmal AF in hypertensive patients with signs of structural and functional myocardial remodeling. Calcium channel blockers and ACE inhibitors have been shown to be equally effective in lowering blood pressure. Adequate pressure control in such patients can significantly reduce the frequency of AF paroxysms by 80% compared with the use of only “classical” antiarrhythmic drugs. At the same time, drugs of the ACE inhibitor group demonstrated stable anti-relapse activity, while when using drugs of the calcium channel blockers group, the protective effect on AF decreased by 7.9% by the 12th month of the study. Antihypertensive therapy with ACE inhibitors, unlike calcium channel blockers, leads to an improvement in the parameters of structural and functional myocardial remodeling and a decrease in the duration of AF paroxysms by 61.5%, which may be due to a specific blockade of the RAAS.

R. Fogari et al. studied the effect of the combination of drugs valsartan/amlodipine and atenolol/amlodipine on the incidence of AF paroxysms in patients with hypertension in combination with type 2 diabetes mellitus. The combination of drugs was used as an addition to the main antiarrhythmic therapy. At 12 months after the start of the study, it was found that the combination of valsartan/amlodipine was more effective in preventing the occurrence of AF paroxysms than the combination of atenolol/amlodipine. In addition, it was shown that valsartan and amlodipine showed the maximum effect, being an addition to therapy with amiodarone or propafenone, than in the case of other antiarrhythmic drugs or in the absence of them. Thus, despite a similar hypotensive effect, the combination of valsartan/amlodipine was more effective in combination with amiodarone or propafenone than atenolol with amlodipine in preventing episodes of AF in patients with hypertension and type 2 diabetes mellitus.

Conclusion

As already mentioned, the consequences of the presence of hypertension in patients, manifested in the form of left atrial dilatation and left ventricular hypertrophy, lead to the development of cardiovascular events, including AF. In the past, many scientists focused their attention on the electrical aspects of this type of arrhythmia. However, at the moment, more importance is attached to factors (including hypertension) that can provoke fibrillation. A promising therapeutic approach is the correction of structural and electrical changes in the myocardium. In this regard, ACE inhibitors and angiotensin II receptor antagonists seem to be the most effective drugs for the treatment of hypertension and the prevention of AF.

Risk factors for developing hypertension

• Controlled Risk Factors
• Unmanaged Risk Factors

Risk factors- these are certain circumstances that increase the likelihood of a disease (in our case, hypertension). Eliminating risk factors can reduce the likelihood of disease or improve the effectiveness of treatment. As a rule, risk factors are divided into two groups:

• Controlled Risk Factors(a person can influence them) - obesity; alcohol abuse; smoking; stress; low physical activity, etc.;
• Unmanaged Risk Factors(not dependent on a person) - age, heredity.

Controlled Risk Factors

A person is not able to eliminate the innate predisposition to diseases, but he can control his life:

• undergo an annual medical examination;
• avoid stress;
• eat plenty of fruits and vegetables;
• the amount of salt in the daily diet should not exceed 5 grams;
• do not abuse alcohol;
• maintain normal body weight;
• do not smoke.

Unmanaged Risk Factors

Although a person cannot influence these factors, it is necessary to be aware of them.

Geography of hypertension

Factors such as average life expectancy in the region; ecology; traditions and some others, affect the prevalence of hypertension in specific countries. Thus, in economically developed countries (USA, Japan, European countries, Russia), the incidence rate of hypertension is high (registered in a third of the population). In many third world countries, this figure is much lower, and among representatives of some small nationalities, hypertension does not occur.

• Zero. Some, isolated living, small nationalities;
• Low(up to 15% of the population). In the rural population of Latin and South America, China and Africa;
• high(15-30% of the population). Most developed countries;
• Very high(more than 30% of the population). Russia, Finland, Poland, Ukraine, northern regions of Japan, US African Americans. It is explained by excessive consumption of salt, fatty foods and alcohol.

Heredity

Parents are not chosen. That says it all - if you have two or more relatives who suffered from high blood pressure before the age of 55, you are prone to hypertension. Hereditary predisposition is not only a reliable risk factor for arterial hypertension, but also allows predicting the nature and outcome of the disease.

Geneticists are trying to find the gene responsible for the hereditary transmission of hypertension, but so far they have not been able to pinpoint it. At the time of this writing (2010), none of the genetic theories has been confirmed. Apparently, arterial hypertension is caused by a violation of several genetic mechanisms that are inherited.

Doctors identify the following genes, "guilty" in hypertension:

• angiotensinogen;
• angiotensin-converting enzyme (ACE);
• angiotensin-II receptor;
• aldosterone synthetase;
• haptoglobin;
• calcineutrino;
• G-protein.

An example to illustrate the heredity of hypertension is insulin resistance syndrome and metabolic syndrome(about 20% of hypertensive patients suffer from it). People with this syndrome have elevated levels of insulin and "bad" cholesterol. As a rule, such patients suffer from obesity (with overweight, the likelihood of developing hypertension is 50% more than in people with normal weight).

Men or women?

In youth and middle age, blood pressure rises more often in men. But, after 50 years, when the level of estrogen (sex hormone) decreases in women during menopause, the number of hypertensive women exceeds the number of hypertensive men.

With age, a person's blood pressure rises for quite understandable reasons - liver function worsens, salt is excreted worse, arteries become less elastic, body weight increases. The stage of primary (essential) hypertension occurs, as a rule, by the age of 50. At this time, the risk of circulatory disorders of the heart and brain increases. Without proper treatment, life expectancy is greatly reduced.

In the modern world, diseases of the cardiovascular system are very common. One of these is hypertension. This pathology is getting younger every year. If earlier middle-aged and elderly people were more and more at risk, now arterial hypertension is also diagnosed in young people. This disease is called the "silent killer" because it can be asymptomatic for many years. Next, let's talk about who is at risk. What is the prevention of arterial hypertension. And, of course, consider the symptoms, diagnosis and treatment of this disease.

What is arterial hypertension

This is a chronic pathology with persistent high blood pressure.

A little about how our cardiovascular system works. The heart works like a pump that pumps blood and maintains a constant blood pressure in the vessels. The work of the heart is influenced by many factors, such as:

The vascular bed is a system of branched channels through which blood returns to the heart. Its volume is not constant, because the smallest vessels that are in the walls of arterioles in muscle tissue narrow the lumen of the vessels during contraction and can redirect blood flow depending on the needs of the body. The regulation of vascular tone directly depends on the nervous and hormonal systems. The force that exerts an effect on the walls of blood vessels during the flow of blood is called pressure.

This is an increase in systolic pressure to 140 mm Hg. Art. and more, and diastolic up to 90 mm Hg. and more. The norm is considered to be the pressure in an adult 120/80 mm Hg. Art.

Disease classification

There are two degrees of arterial hypertension:

• Primary.
• Secondary.

Primary is divided into several degrees. Namely:

Arterial hypertension of 2 degrees and 3, as a rule, already gives complications in the form of such disorders:

• vascular atherosclerosis.
• Asthma.
• Heart disease.
• Pulmonary edema.

Secondary arterial hypertension is accompanied by pathology of internal organs. It is violations in the operation of these systems that provoke stable pressure surges:

• Pathology of the heart and aorta.
• Brain tumors and consequences of TBI.
• Kidney diseases.
• Endocrine pathologies.
• Tumor of the adrenal and pituitary glands.
• Removal of two kidneys.

Also, excessive use of certain drugs can cause arterial hypertension. What are these drugs:

Therefore, people who suffer from arterial hypertension should definitely consult a doctor before taking a new drug.

Symptoms of the disease

Different people have different symptoms. often begins with the fact that the patient did not have any serious complaints. However, you should pay attention to frequently recurring conditions:

Other symptoms are also possible. For the first degree of arterial hypertension, damage to the internal organs is not characteristic. However, in order to stop the deterioration of the situation in a timely manner, it is necessary to pay attention to the above listed symptoms.

Arterial hypertension of the 2nd degree can provoke the following conditions:

• Spasm of the vessels of the fundus.
• The walls of the left ventricle may be enlarged.
• There may be protein in the urine.
• There are signs of damage to the walls of large vessels by the atherosclerotic process.

Arterial hypertension of the 3rd degree is characterized by the involvement of the affected organs in the process of pathological processes. The following diseases may appear:

• Heart failure.
• Edema of the optic nerve.
• Angina.
• Myocardial infarction.
• The development of atherosclerotic processes narrowing and obstruction of blood vessels.

Arterial hypertension of the 3rd degree has a significant number of complications.

Manifestations of the secondary form of pathology are more pronounced. The following phenomena are possible:

• Edema.
• Pain in the lumbar region.
• Dysuric phenomena.
• Signs of inflammatory processes in the blood test.
• Changes in urinalysis.

Causes of arterial hypertension

This disease cannot occur without a cause, like any other. Let's name some reasons:

However, it is worth noting that the above causes are only suitable for primary hypertension. The secondary form develops due to an already existing disease that provokes an increase in blood pressure. These are usually the following diseases:

• Kidney diseases.
• Tumors of the adrenal glands.
• Late toxicosis during pregnancy.
• Use of certain medications.

How is hypertension diagnosed?

Before an accurate diagnosis of arterial hypertension, it is necessary to conduct a thorough diagnosis. And at the first visit to the doctor, such a diagnosis is not made. Where to start? Diagnosis of arterial hypertension begins with an examination and questioning of the patient. It is necessary to identify hereditary diseases, past illnesses, what lifestyle is being led, and much more.

1. High blood pressure should be measured and recorded. It is necessary to measure three times, observing all the rules of measurement.

A medical history is started, arterial hypertension, as the diagnosis is at first in doubt. The next record of the doctor's visit will not be earlier than in 2 weeks. Measuring after a short period of time can create a false picture. If the measurements have borderline figures, then in this case, it is recommended to measure the pressure daily. In this case, the values ​​are recorded. Such a system allows you to choose the necessary drugs to normalize the condition.

After determining the blood pressure, it is necessary to determine how seriously the target organs are affected. Diagnosis of arterial hypertension includes the following additional examinations:

This diagnosis will help the doctor to correctly diagnose and prescribe the appropriate treatment. The doctor should also tell you what the prevention of arterial hypertension is.

Risk factors for primary hypertension

There are several risk factors for primary arterial hypertension:

• Large amounts of salt in the diet. This factor is especially reflected in the elderly, those who are obese with kidney disease, as well as those who have a genetic predisposition.
• genetic predisposition.
• Pathology of the arteries. A decrease in their elasticity leads to an increase in pressure. This is typical for people with obesity, low mobility. Also in older people and in people with high salt intake.
• Excessive production of renin by the kidney apparatus.
• Inflammatory processes contribute to jumps in blood pressure.
• Obesity increases the risk of high blood pressure by 5 times. More than 85% of those with arterial hypertension have a body mass index of more than 25.
• Diabetes.
• There are observations that snoring can also be a risk factor for arterial hypertension.
• age factor. With age, the number of collagen fibers in the vessels increases, as a result, the walls of the vessels thicken, and their elasticity is lost.

Prevention of arterial hypertension is necessary to reduce risk factors. We will consider recommendations a little later.

Risk factors for a secondary form of pathology

We know what is associated with the pathology of organs and systems. These are such diseases as:

It should be said that secondary arterial hypertension can contribute to kidney disease in the same way that kidney disease can provoke an increase in pressure. The risk of arterial hypertension can be reduced through preventive actions, which we will discuss a little later. And now let's move on to the methods of treatment.

Ways to treat arterial hypertension

Therapy of arterial hypertension in the first stage does not involve the use of drugs. Your doctor may prescribe a diet, reduced salt intake, increased physical activity, and weight loss.

However, if high blood pressure persists during a second visit to the doctor, or still grows, the doctor may prescribe the following medications:

• Beta blockers are prescribed. They help lower your heart rate, thereby lowering your blood pressure. However, people with heart disease and asthmatics should not use them.
• Diuretics are used in conjunction with other drugs. Promote the removal of salt and water from the body.
• Drugs that limit the access of calcium to muscle cells.
• Angiogenesis receptor blockers allow vasoconstriction as a result of the production of aldosterone.
• In heart failure and kidney disease, ACE inhibitors are prescribed.
• Drugs that constrict arterioles and affect the central nervous system.
• Together with other drugs, drugs of central action are prescribed.

Prevention of arterial hypertension

If high blood pressure is periodically noted, measures must be taken. Contacting a doctor should be immediate. But there are some things you can do to make yourself feel better too. These actions can be qualified as the prevention of arterial hypertension.

• Control your weight. Dropping extra pounds, you can immediately notice a slight decrease in pressure.
• Move more, walk, exercise.
• Reduce the intake of salt in your diet. Refuse semi-finished products and canned foods.
• Refrain from drinking alcoholic beverages.
• Eat more vegetables and fruits that contain potassium.
• Eradicate bad habits like smoking.
• Limit your intake of fatty foods. This will help you lose weight and lower your cholesterol levels.
• Constantly monitor blood pressure. Visit a doctor and take prescribed medications. It is also necessary to inform the doctor about the changes that have occurred while taking the drugs.
• It is worth remembering that even if the pressure has normalized, the medication should not be stopped. They must be taken regularly.
• Also avoid stressful situations.

Features of treatment and prevention in the elderly

The older the person, the more difficult it is to treat arterial hypertension. For several reasons:

• Vessels are no longer as elastic and are easily damaged.
• There are already atherosclerotic lesions.
• Pathological changes in the work of the kidneys and adrenal glands can cause hypertension.
• Drugs are prescribed very carefully in small doses.
• With coronary heart disease, it is impossible to reduce the pressure to normal.
• Pressure must be measured in a sitting and lying position.

Prevention of arterial hypertension in the elderly is also:

• Leading a healthy lifestyle.
• Maintaining normal cholesterol levels.
• Move more, walk more, do exercises.
• Stick to proper nutrition.

We examined what arterial hypertension means. The risk factors and prevention indicated in the article will help you take timely measures to improve your health so that you do not have to deal with this disease.

Arterial hypertension (hypertension) is a disease that requires constant monitoring by the patient himself, and the attention of the treating doctor. To date, a whole range of preventive measures has been developed, which has significantly reduced mortality in recent years. The control of blood pressure indicators with the achievement of the target level is carried out by patients together with family doctors or general practitioners.

It is impossible to completely get rid of hypertension.

But to maintain the level of blood pressure within the normal range is within the power of everyone. It is only necessary to remember that timely diagnosis and control helps to prevent the development of serious complications.

The main methods of dealing with the disease

Methods for the prevention of arterial hypertension begin with the collection of anamnesis. Everyone should know if there are those among the immediate family who suffer from cardiovascular diseases. This information makes it possible to determine whether he is at risk. Hypertension is transmitted primarily through the maternal line. If the mother suffered from high blood pressure, children may face the same problem in adulthood.

Parents of such children should make every effort to ensure that this kind of heredity does not develop into a disease over time.

There are only three types of preventive measures for people with high blood pressure. Their goal is to prevent the development of complications in the form of problems of the cardiovascular system and reduce the number of deaths associated with an increase in blood pressure.

Primary prevention of hypertension

Identifying risk factors and minimizing their influence on the development of hypertension is the most important goal. Preventive measures should be aimed at preventing the occurrence of dangerous symptoms.

Preventive measures consist of:

• Moderate exercise. With mild and moderate hypertension, a properly selected set of exercises contributes to the overall strengthening of the body, increasing efficiency, and normalizing pressure. It is recommended to start training with a low load with a gradual increase. It is enough to do 3-5 times a week for half an hour walking, running, swimming, exercising on simulators or cycling.
• Healthy food. Salty, fried, spicy - banned. Daily salt intake should not exceed 5 grams. This is worth remembering if the diet contains smoked meats, mayonnaise, sausages, canned food, pickles, cheeses, which contain a lot of sodium.
• Enough time to rest. To cope with stress, which is most often the cause of high blood pressure, doctors recommend mastering some relaxation techniques. It can be auto-training, meditation, self-hypnosis. We must strive to find something good and pleasant in everything. Look at life with optimism.
• Refusal of bad habits. In most cases, smoking and alcohol lead to tragic consequences. A complete rejection of cigarettes is recommended, and alcohol consumption should be reduced to 50 g per day.

Secondary prevention of hypertension

The goal of secondary prevention of hypertension is to diagnose the disease at an early stage. Most often, the pathology does not show any symptoms for a long time. To identify the problem, you need to regularly measure blood pressure.

If the diagnosis is established, then the pressure is normalized with the help of. Drug therapy is selected by the doctor in accordance with international standards.

For the treatment of arterial hypertension, ß-blockers and thiazide diuretics are primarily used.

If the patient has contraindications for them, then the attending physician selects other drugs.

During the period of drug therapy, it is important to record blood pressure indicators in. Once a month, you need to show the records to the attending physician to adjust the treatment and prevention.

Tertiary prevention of severe pathology

Tertiary prevention of hypertension is aimed at avoiding complications in the form of cardiovascular disease, disability, and mortality. The main way to prevent cardiovascular problems and death in patients with high blood pressure is to constantly monitor blood pressure levels.

Permanent control allows:

• assess the degree of progression of the disease;
• determine the risk of target organ damage;
• determine the presence of other diseases;
• assess the risk of developing complications of the cardiovascular system.

At a high degree of risk, non-drug treatment in combination with drug therapy is indicated. A high risk entitles the treating doctor to prescribe treatment to the patient in a hospital setting.

At home, the patient must strictly follow the doctor's advice:

1. take antihypertensive drugs strictly in the prescribed doses and regimen;
2. to prevent complications, take antiplatelet agents (Cardiomagnyl, Thrombo ACC, Aspirin).

Risk factors

You can fight high blood pressure and achieve a positive effect if you exclude the factors contributing to its development.

Factors that increase the risk of developing arterial hypertension:

• Age. Most people experience an increase in blood pressure as they age. Most often, the disease develops in people after 35 years. Over time, the pressure only increases.
• Heredity. The likelihood of developing the disease is very high if one of the close relatives suffers from high blood pressure.
• Gender identity. In women, the risk of developing hypertension increases only after menopause, while in men it is much higher, especially between 35 and 50 years of age.
• Smoking. Tobacco contains harmful substances that damage the walls of the arteries, which leads to the formation of atherosclerotic plaques.
• Alcoholism. Daily intake of drinks with a high content of alcohol contributes to an increase in blood pressure by 5 - 6 mm Hg. in a year.
• Exposure to stress. Pressure indicators increase under the influence of the hormone adrenaline, which makes the heart beat faster. With constant stress, the load on the heart increases, the vessels wear out, blood pressure rises. The disease passes into the chronic stage.
• Atherosclerosis. The work of the heart is difficult due to the narrowing of the lumen of the vessels and the loss of their elasticity, which is facilitated by an excess of cholesterol in the blood. The pressure is growing.
• Excessive salt intake. Excess salt provokes arterial spasm, fluid retention and increased blood pressure.
• Obesity. Thin people are much less likely to suffer from hypertension. Each extra kilogram adds 2 mmHg. on the tonometer.
• Lack of physical activity. With a sedentary lifestyle, metabolic disorders occur, the heart does not cope well with stress, which invariably leads to an increase in pressure.

It should be remembered that the risk of complications is reduced with constant monitoring of the level of pressure and following the doctor's recommendations. Careful diagnosis and prevention of arterial hypertension can save a person's life.

In this article, your attention will be provided with information on the main mechanisms for the formation of this pathology, as well as the most important factors that are involved in the development of hypertension.

There are actually a lot of reasons for the development of this pathology, and all of them are very diverse. Depending on the causes that lead to the development of this disease, the following forms of hypertension are distinguished:

• Hemodynamic arterial hypertension is the result of circulatory disorders inside the heart, as well as through the arteries. This type of arterial hypertension is observed, as a rule, in the presence of atherosclerosis or in pathologies accompanied by damage to the valvular apparatus of the heart.
• Neurogenic arterial hypertension - develops against the background of a violation of the nervous mechanisms of pressure regulation. Most often, it is observed with encephalopathy due to atherosclerosis and brain tumors.
• Endocrine arterial hypertension - occurs as a result of diseases of the endocrine system, which are accompanied by excessive secretion of hormones that tend to increase blood pressure. In this case, we are talking about such ailments as: toxic goiter, Itsenko-Cushing's disease, reninoma, pheochromocytoma .
• Drug-induced arterial hypertension - occurs as a result of taking medications that increase blood pressure.
• Nephrogenic arterial hypertension is a consequence of various pathologies of the kidneys, in which there is a destruction of the kidney tissue or circulatory disorders within this organ. This form of hypertension can be observed with pyelonephritis, atherosclerosis of the renal arteries, after removal of the kidneys, with glomerulonephritis.

All of the above forms of this disease are accompanied by violations of the regulation of pressure. There is an opinion that essential hypertension occurs due to genetic disorders in which the balance of electrolytes in the extracellular environment or inside the cell is lost. Symptomatic types of this disease make themselves felt against the background of violations of the neurohumoral mechanisms of pressure regulation, which in turn arise due to various pathologies in the body.

Predisposing factors play an important role in the formation of this pathology. All these kinds of factors represent certain conditions of both the internal and external environment. It is these conditions that provoke the accelerated development of this disease, since they tend to disrupt the functioning of internal organs, as well as metabolism. The main risk factors for this disease include:

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/ Risk factors for hypertension

Hypertension - risk factors.

It should be noted that there are a number of conditions that affect the occurrence and development of high blood pressure. Therefore, before considering those risk factors that affect the occurrence of arterial hypertension, we recall that there are two types of this disease:

Primary arterial hypertension (essential) is the most common type of hypertension. It makes up to 95% of all types of arterial hypertension. The causes of essential hypertension are very diverse, that is, its occurrence is influenced by many factors.

Secondary arterial hypertension (symptomatic) - accounts for only 5% of all cases of hypertension. The cause is usually a specific pathology of a particular organ (heart, kidneys, thyroid gland, and others).

Risk factors for essential hypertension

As already mentioned, essential hypertension is the most common type of hypertension, although its cause is not always identified. However, some characteristic relationships have been identified in people with this type of hypertension.

Excess salt in food.

At present, scientists have reliably established that there is a close relationship between the level of blood pressure and the amount of daily salt consumed by a person. Essential hypertension develops only in groups with high salt intake, more than 5.8 g per day.

In fact, in some cases, excessive salt intake can be an important risk factor. For example, excessive salt intake may increase the risk of hypertension in the elderly, Africans, people who are obese, genetically predisposed, and have kidney failure.

Sodium plays an important role in causing hypertension. Approximately one third of cases of essential hypertension is associated with increased intake of sodium in the body. This is due to the fact that sodium is able to retain water in the body. Excess fluid in the bloodstream leads to an increase in blood pressure.

The genetic factor is considered the main one in the development of essential hypertension, although the genes responsible for the occurrence of this disease have not yet been discovered by scientists. Currently, scientists are investigating genetic factors that affect the renin-angiotensin system - the one that is involved in the synthesis of renin, a biologically active substance that increases blood pressure. It is in the kidneys.

Approximately 30% of cases of essential hypertension are due to genetic factors. If relatives of the first degree (parents, grandparents, siblings), then the development of arterial hypertension is highly likely. The risk increases even more if two or more relatives had high blood pressure. Very rarely, a genetic disease of the adrenal glands can lead to arterial hypertension.

Men are more predisposed to the development of arterial hypertension, especially as they age. However, after menopause, the risk increases significantly in women. The risk of developing hypertension in women increases during menopause. This is due to a violation of the hormonal balance in the body during this period and an exacerbation of nervous and emotional reactions. According to studies, hypertension develops in 60% of cases in women during the menopause. In the remaining 40%, during menopause, blood pressure is also persistently elevated, but these changes pass when the difficult time for women is left behind.

It is also a fairly common risk factor. With age, there is an increase in the number of collagen fibers in the walls of blood vessels. As a result, the wall of the arteries thickens, they lose their elasticity, and the diameter of their lumen also decreases.

High blood pressure most often develops in people over 35 years of age, and the older the person, the higher the number of his blood pressure, as a rule. Hypertension in men aged 20-29 years old occurs in 9.4% of cases, and in 40-49 years old - already in 35% of cases. When they reach the age of 60-69, this figure rises to 50%.

It should be taken into account that under the age of 40, men suffer from hypertension much more often than women. After 40 years, the ratio changes in the other direction. Although hypertension is called the "disease of the autumn of a person's life", today hypertension has become much younger: more and more often people who are not yet very old suffer from it.

In a large number of patients with essential hypertension: there is an increase in resistance (that is, loss of elasticity) of the smallest arteries - arterioles. The arterioles then pass into the capillaries. Loss of elasticity of arterioles and leads to an increase in blood pressure. However, the reason for this change in arterioles is unknown. It is noted that such changes are typical for persons with essential hypertension associated with genetic factors, physical inactivity, excessive salt intake and aging. In addition, inflammation plays a certain role in the occurrence of arterial hypertension, so the detection of C-reactive protein in the blood can serve as a prognostic indicator.

Renin is a biologically active substance produced by the juxtaglomerular apparatus of the kidneys. Its effect is associated with an increase in the tone of the arteries, which causes an increase in blood pressure. Essential hypertension can be either high or low renin. For example, African Americans have low renin levels in essential hypertension, so diuretics are more effective in treating hypertension.

Stress and mental strain.

Under stress understand the presence of changes that occur in the body in response to extremely strong irritation. Stress is the body's response to a strong influence of environmental factors. Under stress, those parts of the central nervous system that ensure its interaction with the environment are included in the process. But most often, a disorder in the functions of the central nervous system develops as a result of prolonged mental overstrain, which also occurs under adverse conditions.

With frequent mental trauma, negative stimuli, the stress hormone adrenaline makes the heart beat faster, pumping a larger volume of blood per unit time, as a result of which the pressure rises. If stress continues for a long time, then the constant load wears out the vessels, and the increase in blood pressure becomes chronic.

The fact that smoking can cause the development of many diseases is so obvious that it does not require detailed consideration. Nicotine primarily affects the heart and blood vessels.

A very common risk factor. Overweight people have higher blood pressure than thin people. Obese people are 5 times more likely to develop hypertension than those of normal weight. More than 85% of patients with arterial hypertension have a body mass index > 25.

It has been established that diabetes mellitus is a reliable and significant risk factor for the development of atherosclerosis, hypertension and coronary heart disease. Insulin is a hormone produced by the cells of the islets of Langerhans in the pancreas. It regulates the level of glucose in the blood and promotes its transition into cells. In addition, this hormone has some vasodilating properties. Normally, insulin can stimulate sympathetic activity without causing an increase in blood pressure. However, in more severe cases, such as diabetes mellitus, the stimulatory sympathetic activity may exceed the vasodilating effect of insulin.

It has been noted that snoring can also be a risk of essential hypertension.

Risk factors for secondary hypertension.

As already noted, in 5% of cases of arterial hypertension it is secondary, that is, associated with any specific pathology of organs or systems, for example, kidneys, heart, aorta and blood vessels. Vasorenal hypertension and other kidney diseases.

One of the causes of this pathology is the narrowing of the renal artery that feeds the kidney. At a young age, especially in women, this narrowing of the renal artery can be caused by thickening of the muscular wall of the artery (fibromuscular hyperplasia). At an older age, this narrowing may be caused by atherosclerotic plaques, which occur in atherosclerosis.

Renovascular hypertension is usually suspected when arterial hypertension is detected at a young age or when arterial hypertension reappears in old age. Diagnosis of this pathology includes radioisotope scanning, ultrasound (namely, dopplerography) and MRI of the renal artery. The purpose of these research methods is to determine the presence of narrowing of the renal artery and the possibility of the effectiveness of angioplasty. However, if according to the ultrasound of the kidney vessels there is an increase in their resistance, angioplasty may be ineffective, since the patient already has renal failure. If any of these research methods show signs of pathology, renal angiography is performed. This is the most accurate and reliable method for diagnosing vasorenal hypertension.

The most common treatment for vasorenal hypertension is balloon angioplasty. In this case, a special catheter with an inflating balloon at the end is inserted into the lumen of the renal artery. When the constriction level is reached, the balloon is inflated and the lumen of the vessel expands. In addition, a stent is installed at the site of the narrowing of the artery, which, as it were, serves as a frame and does not prevent narrowing of the vessel.

In addition, any other chronic kidney disease (pyelonephritis, glomerulonephritis, urolithiasis) can cause an increase in blood pressure due to hormonal changes.

It is also important to know that not only does kidney disease lead to high blood pressure, but hypertension itself can cause kidney disease. Therefore, all patients with high blood pressure should have their kidneys checked.

One of the rare causes of secondary arterial hypertension may be two rare types of adrenal tumors - aldosteroma and pheochromocytoma. The adrenal glands are paired endocrine glands. Each adrenal gland is located above the upper pole of the kidney. Both types of these tumors are characterized by the production of adrenal hormones that affect blood pressure. Diagnosis of these tumors is based on blood, urine, ultrasound, CT and MRI data. The treatment of these tumors is to remove the adrenal glands - adrenalectomy.

Aldosteroma is a tumor that is the cause of primary aldosteronism, a condition in which the level of aldosterone in the blood rises. In addition to an increase in blood pressure, this disease has a significant loss of potassium in the urine.

Hyperaldosteronism is suspected primarily in patients with high blood pressure and signs of low potassium levels in the blood.

Another type of adrenal tumor is pheochromocytoma. This type of tumor produces excess amounts of the hormone adrenaline, resulting in high blood pressure. This disease is characterized by sudden attacks of high blood pressure, accompanied by hot flashes, reddening of the skin, increased heart rate and sweating. Diagnosis of pheochromocytoma is based on blood and urine tests and the determination of the level of adrenaline and its metabolite, vanillylmandelic acid, in them.

Coarctation of the aorta is a rare congenital disease that is the most common cause of arterial hypertension in children. With coarctation of the aorta, there is a narrowing of a certain part of the aorta, the main artery of our body. Usually, such narrowing is determined above the level of the renal arteries from the aorta, which leads to a deterioration in blood flow in the kidneys. This, in turn, leads to the activation of the renin-angiotensin system in the kidneys, thereby increasing the production of renin. In the treatment of this disease, balloon angioplasty, the same as in the treatment of vasorenal hypertension, or surgery can sometimes be used.

Metabolic syndrome and obesity.

Metabolic syndrome refers to a combination of genetic disorders in the form of diabetes, obesity. These conditions contribute to the occurrence of atherosclerosis, which affects the condition of the blood vessels, compaction of their walls and narrowing of the lumen, which also leads to an increase in blood pressure.

Diseases of the thyroid gland.

The thyroid gland is a small endocrine gland whose hormones regulate the entire metabolism. In diseases such as diffuse goiter, or nodular goiter, the level of thyroid hormones in the blood may increase. The effect of these hormones leads to an increase in heart rate, which is manifested in an increase in blood pressure.

Drugs that cause arterial hypertension.

In most cases, arterial hypertension is the so-called. essential or primary character. This means that the cause of arterial hypertension in this case cannot be identified.

Secondary arterial hypertension occurs for certain reasons. And among one of the causes of high blood pressure are medications that are prescribed for one reason or another.

Drugs that can cause high blood pressure include:

Some medicines used for colds

Some oral contraceptives

Nasal sprays for colds

non-steroidal anti-inflammatory drugs,

Appetite enhancing drugs

Cyclosporine is a drug that is prescribed to patients who have undergone a donor organ transplant.

Erythropoietin is a biologically active substance that is prescribed to stimulate hematopoiesis.

Some aerosol preparations for the treatment of asthma.

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🔻🔻The most important risk factors for developing hypertension

Arterial hypertension is a chronic form of the disease that cannot be completely cured. The stages of remission are replaced by exacerbations, and if drug treatment is refused, serious complications can be provoked. There are certain prerequisites leading to the formation of a pathological process.

The main risk factors for the formation of cardiovascular pathologies

All prerequisites for the onset of the development of arterial hypertension are divided into two main subspecies:

• modified or acquired - may appear throughout life, through the fault of the patient himself;
• unmodified or congenital - does not depend on a person's lifestyle and is considered a natural and inevitable factor for the formation of hypertension.

Acquired Risk Factors

They belong to a subgroup of causes that can be dealt with. The number of exogenous factors is significant, but each of them can be easily adjusted. Without effort on the part of the patient and unwillingness to change habits, the root causes of the development of the pathological process will come into force, and the gradual formation of the disease will begin.

Risk factors for arterial hypertension are:

Insufficient physical activity

Civilized society is universally affected by hypertension. The amount of physical activity insufficient for the normal functioning of the body returned to normal. Constant work in the office, relaxing at the computer and TV, refusing to walk - all these indicators gradually reduce muscle tone, relax the cardiovascular department.

The habit of moving exclusively on vehicles - personal or public, the lack of time for sports training and attending fitness clubs played a role in reducing physical activity. The constant absence of the required loads gradually leads to:

• disorders in the muscular system;
• weakening of the respiratory department;
• deterioration of general and local blood circulation.

These factors lead to the development of a rapid heartbeat or an increase in blood pressure with the slightest physical exertion. Stressful situations cause blood pressure levels to rise to maximum levels, and their constant presence provokes the gradual development of hypertension.

Excess body weight

Increased weight appears against the background of hypodynamia and a violation of the correct diet. If the overall body mass index exceeds 30 units, then its owner should seriously think about the possible consequences. These figures indicate the presence of obesity and a high risk of developing arterial hypertension - twice. Of particular concern should be male-type obesity - with an increase in fatty tissue in the abdomen.

If the male waist exceeds 94 cm, and the female - 80 cm, then the indicated type of obesity is implied. The second option for determining the abdominal type of obesity is by the ratio of the circumference of the waist and hips. For men, the upper indicator is a mark of 1 unit, for women - 0.8 units.

Persons prone to rapid weight gain often suffer from high cholesterol in the blood stream. An excess amount leads to the formation of atherosclerotic changes in the vessels and narrowing of their lumen. An increase in the stiffness of the walls of the arteries, a slow reaction to external stimuli provokes a periodic rise in blood pressure.

Uncontrolled salt intake

A high risk of hypertension is provoked by excessive love for sodium chloride. The permitted daily amount of salt should not exceed 5 grams. In fact, individuals can use up to 18 grams of "white death" per day. Increased salting of food products occurs spontaneously, without any need.

Salty food causes a constant feeling of thirst, and sodium ions tend to provoke a delay in the removal of fluid from the body. Large volumes of fluid cause congestion and an increase in circulating blood volumes. The result of the pathological condition is the acceleration of contraction of the heart muscle and an increase in blood pressure.

Sodium ions located outside the cellular structures lead to an increase in the amount of calcium inside them. Next, an increase in vascular muscle tone and a gradual increase in blood pressure indicators are recorded.

Deficiency of magnesium and potassium

These trace elements are necessary for the body for the normal functionality of the heart muscle and blood vessels. With their help, it is reduced, preventing the formation of atherosclerotic changes. The main task of magnesium is to relax the smooth muscles of the walls of arterial vessels, in order to expand them and lower elevated blood pressure.

Potassium is a sodium ion antagonist. With the intake of excess amounts of salt, potassium reduces the negative reactions of the body to their presence. With a potassium deficiency, the opposite result occurs - the effectiveness of sodium will be several times higher. Insufficient intake of foodstuffs enriched with potassium and magnesium, their rapid loss (against the background of the use of diuretic drugs), may become a precursor to the development of arterial hypertension.

nicotine addiction

The negative impact of the strongest cardiotoxin is experienced by all smoking patients. When you inhale the elements contained in tobacco smoke, they quickly spread throughout the body and have a negative effect on a certain type of receptor. Increased release of adrenaline into the blood stream, increases the frequency of contractions of the heart muscle and increases the level of blood pressure.

The active substance provokes vasospasm, having a negative effect on the state of the vascular walls. At this point, the formation of atherosclerotic plaques and the formation of blood clots begins. In chronic patients, an accelerated process of atherosclerosis formation and an increased risk of death due to acute myocardial infarctions and strokes are recorded.

The most important problem of nicotine addiction is the difficulty of weaning from its main active substance, which is a drug. Passive smoking of family members also negatively affects their health status - they are at high risk for the development of pathological conditions of the cardiovascular department.

alcohol addiction

People who drink alcoholic and low-alcohol drinks are more likely to be affected by pressure surges than anyone else. Clinical studies show that daily use of the desired product raises working pressure by 6 units.

Increased dosages of alcoholic beverages disrupt the functionality of the nervous system, which is responsible for stabilizing vascular tone. The initial expansion of the lumens of the arteries is replaced by their sharp spasm. The abuse of alcoholic products often ends in the development of a spontaneous hypertensive crisis.

Ethanol and its derivatives cause increased performance of the adrenal glands, under the influence of which adrenaline is released into the bloodstream. Alcoholic drinks are often used with foods containing high amounts of sodium chloride. An excess content of sodium ions leads to the development of stagnation (fluid accumulation) and a subsequent increase in blood pressure levels.

Ethanol itself disrupts the metabolic metabolic processes in the heart, which are factors in the occurrence of arrhythmias, insufficient functionality of the heart muscle. The formation of blood clots occurs in both large and small vessels, and the total amount of cholesterol in the blood stream increases. The gradual influence of negative factors contributes to the occurrence of atherosclerotic changes.

The constant use of alcoholic and low-alcohol drinks leads to the formation of acute myocardial infarction and circulatory disorders in the brain.

Dyslipidemia

Excess intake of cholesterol into the body is caused by an incorrectly selected daily composition and diet. An excess of lipids leads to the development of atherosclerosis on the walls of large and small vessels. The level of cholesterol does not depend on the total body weight - the main role in the pathology is played by heredity and metabolic disorders.

stress

Psycho-emotional outbursts caused by an unstable state against the background of stressful situations lead to an increase in the activity of the sympathetic department of the nervous system. The release of adrenaline into the bloodstream is accompanied by a spasm of peripheral vessels, with increased blood supply to the brain and heart muscle. Under the influence of the hormone, there is an increase in heart rate and increased blood ejection.

As a result, there is a delay of sodium ions in the area of ​​the renal tubules and fluid retention in the body. An increase in the total blood volume leads to effects characteristic of an excess of sodium ions. Stressful situations have a widespread effect on internal organs and systems, together leading to a gradual increase in blood pressure levels.

The chronic variant of the pathology is one of the root causes of the formation of persistent hypertension.

Medications

The development of hypertension can provoke uncontrolled intake of medications. Subgroups of agents and exogenous substances are presented in the table:

Congenital Risk Factors

Unchangeable causes of increased risk include:

Age period

In males, the development of the disease is recorded after 55 years; in females, transformation is noted upon reaching the 65th anniversary. With age, there are irreversible changes in the functionality of the body. The possible development of complications (with identical blood pressure figures) in the elderly is 10 times higher than in middle-aged people and 100 times higher than in young people. In the elderly age period, constant monitoring of pressure marks, timely access to a cardiologist and accurate implementation of the prescribed treatment are necessary.

hereditary predisposition

With a history of data on similar pathological conditions of the cardiovascular department and other diseases of the vessels and heart muscle, the risk of arterial hypertension is doubled. If close people had acute myocardial infarctions, coronary artery disease and other ailments, then younger relatives have a significantly increased risk of developing complications.

In addition to the theoretical possibility of the formation of hypertension and its complications, a tendency to constantly increased amounts of cholesterol in the blood stream can be inherited by a genetic factor. The development of the disease under the influence of the desired factor will take place at an accelerated pace.

gender

The male sex is more prone to the formation of hypertension against the background of constant stressful situations. The clinical picture changes dramatically when women reach the age limit of 65 years. From this point on, the risk of developing the disease is equalized in both sexes.

In women, pathological abnormalities are more likely to occur as a result of age-related or surgical menopause.

Prevention methods

1. Periodic physical activity - needed to train muscles, improve the general condition of the body. Experts advise more often to take walks in the fresh air, go swimming, jogging.
2. Reducing the amount of table salt entering the body - sodium chloride is already present in many prepared foods. Given these receipts, the daily salt intake should not exceed 5 grams.
3. Avoiding constant stressful situations.
4. Refusal of alcoholic, low-alcohol drinks and tobacco products - if necessary, the patient can seek qualified help from a narcologist.
5. Limiting the intake of animal fats - for full prevention, you should review your usual diet. In the daily menu, you need to add fresh fruits and vegetables enriched with vitamins and minerals.
6. Normalization of body weight - with the existing excess weight, a transition to dietary nutrition and an increase in physical activity is required, especially in the presence of concomitant diabetes mellitus.

To avoid the diagnosis of "arterial hypertension", patients should adhere to the rules of prevention and monitor their health status more.

Therapy Methods

Treatment of arterial hypertension depends entirely on the degree, stage of its development. At the initial stages of the pathological process, patients are recommended:

• physiotherapy procedures;
• exercise therapy classes;
• visiting a consultant psychologist;
• spa therapy.

In the absence of positive results in non-drug treatment, the cardiologist prescribes a drug therapy regimen. The specialist takes into account the degree of risk of complications, the general condition of the body, the presence of concomitant diseases. More often, combined treatment with several drugs from different subgroups is used:

• ACE inhibitors;
• diuretics;
• alpha and beta blockers;
• calcium antagonists, etc.

Lack of timely access to a medical institution, ignoring prescribed medications and continuing the usual lifestyle leads to the development of arterial hypertension. Further conniving attitude towards one's own health can cause the formation of complications and disability. Disability in hypertension is a fairly common phenomenon.

The accelerated development of the disease is caused by congenital pathological disorders associated with endocrine, renal ailments, increased blood viscosity and other syndromes. Patients at risk for predisposition to arterial hypertension should constantly monitor their blood pressure and seek help at the slightest deviation from the norm.

Arterial hypertension. Risk factors, prevention. Technique for measuring blood pressure

Performed

4 courses 3 groups

Alexandrovna

Arterial hypertension ( AG) - syndrome of high blood pressure. 90-95% of cases of hypertension is essential arterial hypertension, in other cases, secondary, symptomatic arterial hypertension is diagnosed: renal (nephrogenic) 3-4%, endocrine 0.1-0.3%, hemodynamic, neurological, stress, caused by the intake of certain substances and hypertension in pregnant women, in which increased blood pressure is one of the many symptoms of the underlying disease.

Hypertension (essential hypertension) is a disease, the leading symptom of which is arterial hypertension, not associated with any other disease, and resulting from dysfunction of the centers that regulate blood pressure, followed by the inclusion of neurohumoral and renal mechanisms in the absence of diseases of organs and systems, when arterial hypertension is one of the symptoms.

Optimal blood pressure< 120/80 мм рт. ст.

normal blood pressure< 130/85 мм рт. ст.

Elevated normal blood pressure 130-139 / 85-90 mm Hg. Art.

Grade 1 (mild hypertension) - SBP / DBP 90-99.

Grade 2 (borderline hypertension) - SAD / diastolic blood pressure.

Grade 3 (severe hypertension) - SBP 180 and above / DBP 110 and above.

· Isolated systolic hypertension - SBP above 140/dBP below 90.

The risk factors that affect the prognosis in patients with hypertension, according to WHO recommendations, include:

Risk factors for cardiovascular disease:

Increased blood pressure III degree;

Men - age over 55;

Women - age over 65;

Serum total cholesterol greater than 6.5 mmol/L (250 mg/dL);

Family history of cardiovascular disease. Other factors affecting the prognosis:

Reduced high-density lipoprotein cholesterol;

Increasing the level of low-density lipoprotein cholesterol;

Unhealthy Lifestyle;

Increased fibrinogen level;

Group of high socioeconomic risk;

Left ventricular hypertrophy;

Proteinuria and / or a slight increase in plasma creatinine (1.2-2 mg / dl);

Ultrasound or radiological (angiographic) signs of the presence of atherosclerotic plaques (carotid, iliac, femoral arteries, aorta);

Generalized or focal narrowing of the retinal arteries. Cerebrovascular:

Transient ischemic attack. Heart disease:

History of coronary revascularization surgery;

Heart failure. Kidney diseases:

Renal failure (increased plasma creatinine more than 200 µmol/l).

Occlusive lesions of peripheral arteries. Complicated retinopathy:

Hemorrhages or exudates;

Edema of the optic disc.

Clinic

The clinic of hypertension is determined by the stage of the disease and the nature of the course. Before the development of complications, the disease may be asymptomatic. More often, patients are worried about headache in the forehead and neck, dizziness, tinnitus, flickering "flies" before the eyes. There may be pain in the region of the heart, palpitations, shortness of breath on exertion, and heart rhythm disturbances.

The onset of the disease is typically between the ages of 30 and 45 and a burdened family history of hypertension.

On clinical examination, the most important symptom is a persistent increase in blood pressure detected by repeated measurements.

Examination - allows you to identify signs of left ventricular hypertrophy (resistant cardiac impulse, displacement of the left border of the heart to the left), expansion of the vascular bundle due to the aorta, accentuation of the tone over the aorta. A more informative method for diagnosing left ventricular hypertrophy is an electrocardiographic study. On the electrocardiogram, it is possible to detect a deviation of the electrical axis of the heart to the left, an increase in the voltage of the R wave in I, aVL, left chest leads. As hypertrophy increases in these leads, signs of “overload” of the left ventricle appear in the form of T wave smoothing, then ST segment depression with a transition to an asymmetric T wave.

On a chest x-ray, changes are detected with the development of dilatation of the left ventricle. An indirect sign of concentric hypertrophy of the left ventricle may be rounding of the apex of the heart.

Echocardiographic examination reveals thickening of the walls of the left ventricle, an increase in its mass, in advanced cases, dilatation of the left ventricle is determined.

Prevention of arterial hypertension

1 If you are overweight, you should at least partially lose it, as excess weight increases the risk of developing hypertension. Having lost weight by 3-5 kg, you will be able to reduce pressure and subsequently control it well. By achieving a lower weight, you can also lower your cholesterol, triglycerides, and blood sugar levels. Normalization of weight remains the most effective method of pressure control.

2 Start each morning with a cold shower. The body hardens, the vessels train, the immune system strengthens, blood circulation improves, the production of biologically active substances and blood pressure normalize.

3 For the prevention of arterial hypertension, it is extremely useful to live above the 4th floor in a building without an elevator. Constantly going up and down, you train the vessels, strengthen the heart.

4 Walking at a good pace, jogging, swimming, cycling and skiing, practicing oriental health-improving gymnastics is an excellent prevention of arterial hypertension and related troubles. Physical exercises performed from a prone position; with breath holding and straining; quick bends and lifts of the body; such emotional game sports as tennis, football, volleyball, in those who are prone to arterial hypertension, can cause a sharp increase in blood pressure and cerebrovascular accident.

5 The air, saturated with the smells of chamomile, mint, garden violets, roses and especially fragrant geraniums, is an effective remedy for those who have "playful" pressure. Inhalation of these aromas significantly reduces blood pressure, soothes, raises vitality.

6 Good and "healthy" characters in an optimistic and balanced sanguine, slow and calm phlegmatic. Arterial hypertension practically does not threaten them. Neuroses and arterial hypertension most often occur in two extreme types: an easily excitable choleric and a melancholic who quickly becomes discouraged.

8 Are you at risk? Get a tonometer and regularly (once a week, and if it’s not the first day that your head hurts, you suffer from insomnia, the feeling of fatigue doesn’t go away, stress “presses”, then more often: 1-2 times a day) measure blood pressure. You can do it in the morning without getting out of bed. Constantly elevated blood pressure is a sure sign indicating the development of arterial hypertension.

9 In autumn and spring, not only arterial hypertension exacerbates more often, but also many other diseases occur during this period. To support your body during this dangerous time, take: - motherwort infusion, 2-3 tablespoons before meals (2 tablespoons of chopped herbs, pour 0.5 liters of boiling water and leave for 2 hours); - infusion of lemon balm (2 tablespoons of chopped herbs, pour 2 cups of boiling water, after cooling, strain and drink throughout the day).

10 Stuffiness, tightness psychologically cannot be endured by all predisposed to arterial hypertension. It is hard for them to be in the crowd, among a large number of people.

11 Turtlenecks and sweaters are not clothing for people prone to hypertension. A high collar tightly wrapped around the neck, as well as a tight-fitting shirt collar, a tightly tightened tie can cause an increase in blood pressure.

12 Red, orange, yellow colors cause irritation, an influx of excess energy, excite, increase blood pressure.

13 Excessive salt intake retains sodium in the body and causes exacerbation of arterial hypertension. When preparing food, do not salt it, but add a little salt, already served.

14 Food should not be very fatty. Observations show that a low-fat diet helps lower blood cholesterol levels and thereby reduce the risk of coronary artery disease. In addition, a low-fat diet promotes weight loss.

15 Dutch cheese, bananas, pineapples can increase blood pressure. It turns out that these products, absorbed in large quantities, due to the special substances they contain, often lead to an increased production of hormones that provoke “jumps” in blood pressure.

16 Limit your alcohol intake. It has been noticed that people who drink alcohol excessively are more likely to experience hypertension, weight gain, which makes it difficult to control blood pressure. Your best bet is not to drink alcoholic beverages at all, or limit your intake to two drinks a day for men and one for women. The word "drink" in this case means, for example, 350 ml of beer, 120 ml of wine or 30 ml of 100% liqueur.

17 Eat more potassium, as this can also lower blood pressure. Sources of potassium are various fruits and vegetables. It is advisable to eat at least five servings of vegetable or fruit salads, desserts per day.

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Probably, there is no other such widespread human disease on the globe as arterial hypertension. There is a kind of “trap”: the more a person strives to live, the older he is, and the older he is, the more his blood pressure can rise.

Thus, every 5th adult suffers from arterial hypertension; in Russia alone, it is common in almost 25 million people. This is a colossal number.

• When a person reaches the age of 75 years and older, the prevalence of arterial hypertension (AH) reaches 50% or more.

It is known that for the first time blood pressure and its value were measured by the English doctor Steve Hells, in the year of birth of M.V. Lomonosov, that is, in 1711. It was a dangerous procedure that required the cutting of an artery, and could only be used in extreme cases, for example, with a combat injury that had already taken place. In addition, any such intervention was fraught with potential infection, which at that time was only beginning to be guessed at.

A real "boom" in the determination of blood pressure began after the ingenious discovery by the Russian doctor Korotkov of the principle of indirect determination of the level of pressure on the radial artery. His principles and demonstration were so simple and perfect that the authoritative commission for the acceptance of the invention, consisting of venerable physicians and engineers, did not ask Korotkov a single question.

The first data that appeared by the beginning of the 1920s began to indicate that arterial hypertension with its long course leads to the development of cardiovascular diseases. The development of basic knowledge about hypertension was interrupted by the Second World War. And only in the 1950s, thiazide diuretics began to be introduced into the practice of therapists and cardiologists, many of which (especially the first ones) are now considered "rough" drugs.

What kind of pathology is this, which leads to the most frequent complications, heart attack and stroke, and is the cause of a significant decrease in the quality of life?

Arterial hypertension - what is it?

Arterial hypertension is... The "trick" lurks from the very beginning. It is impossible to accurately determine this disease, since pressure indicators vary greatly in the population. The risk of an increase in cardiovascular pathology is so “dense” on the corresponding curve close to the increase in blood pressure that it is quite difficult to “isolate” and show the border.

But, doctors still found a way out and the answer "what is it?" Arterial hypertension is a level of blood pressure that leads to a significant increase in cardiovascular disease, and with treatment this risk decreases.

After numerous studies using the methods of mathematical statistics, it turned out that arterial hypertension "begins" with the numbers 140/90 mm or more. rt. st, at a constantly elevated pressure.

Hypertension and hypertension. Is there a difference?

In foreign literature, there is no difference between these concepts. And in domestic publications such a difference exists, but unprincipled and more historical. Let's explain this with simple examples:

• When an increase in blood pressure of any nature is detected in a patient for the first time, he is given the primary diagnosis of “arterial hypertension syndrome”. This in no way means that you need to start treating the patient immediately, and doctors can “rest on their laurels”. This means that you need to look for the cause;
• In the event that a specific cause is found (for example, a hormonally active tumor of the adrenal glands, or stenosis of the renal vessels), then the patient is diagnosed with secondary arterial hypertension. This indirectly indicates that the disease has a cause that can be eliminated;
• In the event that, despite all the searches and analyzes, the cause of the increase in pressure could not be found, then a beautiful diagnosis of "essential" or "elementary" arterial hypertension is made. From this diagnosis is already "at hand" and to "hypertension". That is how the diagnosis sounded in the late USSR.

Therefore, you can put an "equal sign" between "essential arterial hypertension", "hypertension" and "arterial hypertension".

In Western literature, everything is simpler: if it is “arterial hypertension” and there is no indication that it is secondary, for example, it developed against the background of diabetes or injury, then this means hypertension, the cause of which is unclear.

Causes of hypertension, risk factors

First, we list those conditions that lead to the development of secondary hypertension syndrome, which doctors try to identify and exclude in the first place. This succeeds in no more than 10% of cases.

The main causes of secondary pressure increase are disorders in the functioning of the kidneys (50%), endocrinopathy (20%), and other causes (30%):

• diseases of the parenchyma of the kidneys, for example, polycystic, glomerulonephritis (autoimmune, toxic);
• diseases of the renal vessels (stenosis, atherosclerosis, dysplasia);
• in general vascular diseases, for example, aortic dissection or its aneurysm;
• adrenal hyperplasia, Kohn's syndrome, hyperaldosteronism;
• Cushing's disease and syndrome;
• acromegaly, chromocytoma, adrenal hyperplasia;
• disorders in the thyroid gland;
• coarctation of the aorta;
• abnormal, severe pregnancy;
• use of drugs, oral contraceptives, certain drugs, rare blood diseases.

In general, it must be said that secondary hypertension often occurs in young patients, as well as in those patients who are resistant to any therapy.

It is especially necessary to emphasize the connection of a persistent increase in pressure with a long course of type 2 diabetes mellitus.

High blood pressure is detected in 43% of cases in men and in 55% of cases in women over 55 years of age. In such patients, the vessels "age" prematurely. They lose elasticity, become more rigid, and this leads to a form such as isolated systolic hypertension. Insulin increases the "elasticity" of the vascular wall, and tissue resistance to it worsens the course of diabetes.

Degrees of arterial hypertension, risks

First of all, you need to know the indicators of normal pressure:<130 мм рт. ст. в систолу и < 85 в диастолу.

There is also a "high normal" pressure range, from 130-139 and from 85-89 mmHg. Art. respectively. It is here that "white coat" hypertension "fits" and various functional disorders. Anything above refers to arterial hypertension.

There are 3 stages of arterial hypertension (syst. and dist.):

1. 140-159 and 90-99;
2. 160-179 and 100-109;
3. 180 and >110, respectively.

It should be clarified that at present, approaches to the meaning of various types of hypertension have changed. For example, in the past, a very significant risk factor was constantly elevated diastolic, “lower” pressure.

Then, at the beginning of the 21st century, after the accumulation of data, systolic and pulse pressure began to be considered much more important in determining prognosis than isolated diastolic hypertension.

The classic symptoms of hypertension are:

• the fact of the presence of an increase in pressure when it is measured three times during the day;
• heartache;
• shortness of breath, redness of the face;
• feeling of heat;
• trembling in the hands;
• flashing "flies" before the eyes;
• headache;
• noise and ringing in the ears.

In fact, these are symptoms of a sympathoadrenal crisis, which manifests itself, including a rise in pressure. Asymptomatic arterial hypertension often occurs.

So, in our time there is a lot of "isolated" systolic arterial hypertension, for example, associated with diabetes, in which large arteries are very stiff. But, in addition to determining the height of pressure, it is necessary to determine the risk. You can often hear: from a doctor: “arterial hypertension grade 3 risk 3”, or “arterial hypertension grade 1 risk”. What does it mean?

How to determine the risk and its degree in hypertension?

Which patients are at risk, and what is it? We are talking about the risk of developing cardiovascular disease. The degree of risk is assessed using the Framingham scale, which is a multivariate statistical model that is in good agreement with actual results over a large number of observations.

So, to remove the risk, take into account:

• gender is male.
• age (men over 55 and women over 65);
• blood pressure level,
• smoking habit,
• overweight, abdominal obesity;
• high blood sugar levels, the presence of diabetes in the family;
• dyslipidemia, or elevated plasma cholesterol levels;
• the presence of heart attacks in history, or in the family;

In addition, a normal, thoughtful doctor will determine the level of physical activity of a person, as well as various possible damage to target organs that can occur with a prolonged increase in pressure (myocardium, kidney tissue, blood vessels, retina).

What diagnostic methods can be used to confirm arterial hypertension?

Diagnosis of hypertension - confirmation of the diagnosis

In most cases, hypertension is discovered during routine blood pressure measurements. Therefore, all other methods, although they are very important, are of secondary importance. These include:

• Urinalysis to determine red blood cells, proteinuria and cylindruria. Protein in the urine is an important sign of kidney damage in hypertension;
• Biochemical blood test for the determination of urea, electrolytes, blood glucose and lipoproteins;
• ECG. Since left ventricular hypertrophy is an independent factor in arterial hypertension, it must be determined;

Other studies, such as dopplerography and studies, for example, of the thyroid gland, are carried out according to indications. Many people think that making a diagnosis is difficult. This is not so, it is much more difficult to find the cause of secondary hypertension.

Treatment of arterial hypertension, drugs and recommendations

"Our people don't take taxis to the bakery." A Russian person considers non-drug treatment (by the way, the least expensive one) as an insult.

In the event that a doctor starts talking about a “healthy lifestyle” and other “strange things”, then gradually the patient’s face is drawn out, he begins to get bored, and then leaves this doctor to find a specialist who will immediately “prescribe medicines”, and even better - "injections".

Nevertheless, it is necessary to start the treatment of "mild" arterial hypertension by following the recommendations, namely:

• reduce the amount of sodium chloride, or table salt, entering the body, up to 5 g per day;
• reduce abdominal obesity. (In general, a weight loss of only 10 kg in a 100 kg patient reduces the risk of overall mortality by 25%);
• reduce alcohol consumption, especially beer and spirits;
• increase the level of physical activity to the average, especially for people with an initially low level of it;
• quit smoking if such a bad habit exists;
• start regularly eating fiber, vegetables, fruits, drinking fresh water.

Medications

The prescription of drugs and the treatment of arterial hypertension with drugs lies entirely within the competence of the attending physician. The main groups of drugs include diuretics, beta-blockers, calcium blockers, ACE inhibitors, angiotensin receptor antagonists.

Sometimes alpha-blockers, vasodilators are used.

Which scheme to prescribe - a single drug, or a combination of them - is decided by the doctor. But, in any case, when mild hypertension syndrome is detected, the doctor should prescribe a complete examination to identify a secondary type of pressure increase, along with non-drug recommendations.

Prognosis and complications of hypertension

Timely diagnosis and treatment of arterial hypertension aims not only to normalize pressure figures, but also to significantly reduce the risk of complications. These direct complications include diseases and conditions such as:

• angina pectoris, myocardial infarction and left ventricular hypertrophy;
• cerebrovascular diseases: strokes, transient ischemic attacks, dementia and the development of hypertensive encephalopathy;
• the appearance of vascular diseases, such as aortic aneurysm and peripheral vascular occlusion;
• the occurrence of hypertensive encephalopathy and the appearance of progressive renal failure.

All these diseases, and especially heart attacks and strokes, are the "leaders" in mortality in our time. Although in a significant percentage of patients, hypertension can occur for many years without any manifestation at all, a malignant course of the disease may also appear, which is characterized by symptoms such as progressive loss of vision, headache, and confusion.

May be disturbed by epileptic seizures, nausea, vomiting. Such signs are characteristic of the addition of cerebral symptoms associated with an increase in intracranial pressure, and require urgent hospitalization.

In conclusion, it must be said that we tried to make the article useful for a person who wants to be examined and find the best way to maintain health without drugs, given that arterial hypertension is the best fit for the fact that it is easier to prevent than to treat.