Hypertension is a disease in which blood pressure increases, which leads to various changes in organs and systems. The cause of hypertension is a violation of the regulation of vascular tone. Distinguish essential (primary) hypertension ( Primary, or essential, hypertension, better known as hypertension, is an independent chronic disease. Hypertension, as its name implies, is characterized primarily by a constant or almost constant increase in blood pressure. In hypertension, increased blood pressure is not a consequence of disease various organs and body systems, but is caused by dysregulation blood pressure. Hypertension accounts for 90-95% of cases arterial hypertension.)and symptomatic hypertension when the immediate cause of high blood pressure is other diseases. Symptomatic hypertension is divided into four groups: with kidney disease, heart disease and large vessels, as a result of damage to the central nervous system, for diseases of the endocrine system.

Algorithm (stages) for diagnosing hypertension.

Diagnostics hypertension is based on anamnesis, patient complaints, systematic measurements of blood pressure levels, data laboratory research. The main symptoms of hypertension are: frequent sharp increase blood pressure; the increase in blood pressure can hardly be brought back to normal with the help of medicines; some time after the decrease under the influence of pharmacological agents, the pressure rises again; headaches localized in the back of the head; nosebleeds; dyspnea; dizziness. The history contains the following parameters: excess weight, lack of physical activity, poor lifestyle, bad habits (smoking, alcohol abuse). If hypertension is suspected, a number of laboratory tests are prescribed that allow a diagnosis to be made. In particular, to mandatory types examinations include: cardiac electrocardiogram; fundus examination; blood chemistry; ultrasound examination of the heart

75.Hypertension. Definition. Priorities of domestic medicine in the development of the doctrine of hypertension. Features of subjective symptoms. Physical changes during examination of the heart and blood vessels. Data from instrumental research methods.

Hypertension - persistent increase in blood pressure from 140/90 mm Hg. and higher.

Priorities of domestic medicine in the development of the doctrine of hypertension.

In the early 20s, Professor G. F. Lang expressed a point of view according to which essential hypertension was defined independently of primary kidney damage and was considered as a consequence of chronic neuropsychic stress. G. F. Lang illustrated this point well in a work published in 1922.

G. F. Lang believed that the reason for the increase in pressure was the increased tone of the muscular elements of the arteries, placing it in direct connection with the above-mentioned neuropsychic factors. This was the beginning of the doctrine of the leading role of neuropsychic traumatization of the central nervous system in the origin of hypertension, which was developed over the course of a quarter of a century by G. F. Lang and his school. This direction has radically influenced the development of ideas about hypertension in our country.” (Yu. V. Postnov. S. N. Orlov, 1987).

In 1986, the publishing house “Medicine” published the third edition of the book by G. A. Glezer and M. G. Glezer “Arterial Hypertension.” The authors state the following:

“The neurogenic theory of the occurrence of hypertension, developed in the Soviet Union by professors G. F. Lang and A. L. Myasnikov and based on the teachings of I. P. Pavlov on higher nervous activity, received the greatest recognition.”

The wide spread in our country of the neurogenic theory of the occurrence of hypertension (this theory has not received support abroad) and the propaganda of the provisions of this theory at the highest scientific medical level forces us to consider this point of view in detail. Several chapters of the book are devoted to this, where evidence is provided that the neurogenic theory is erroneous.

“In recent years, there has been a rapid accumulation of facts that give reason to believe that the origins of primary hypertension go back to widespread dysfunction of cell membranes in relation to the regulation of the concentration of free cytoplasmic calcium and transmembrane transport of monovalent cations” (Yu. V. Postnov, S. N. Orlov , 1987). and this model of the development of hypertension is fundamentally incorrect.

Features of subjective symptoms

During the survey, patients complain of headaches, flies before the eyes, tinnitus, a significant decrease in performance, sleep disturbance, and irritability. Sometimes, despite a significant increase in blood pressure recorded during measurement, there may be no complaints. Episodes of increased pressure may be combined with the appearance of chest pain.

Physical changes during examination of the heart and blood vessels.

The initial stages of the disease (without involvement of target organs) may not manifest themselves during external examination. Measuring blood pressure allows you to determine the level of its increase. Sometimes the apex beat is visually determined.

Percussion. Expansion of the boundaries of relative cardiac dullness to the left due to left ventricular hypertrophy.

Palpation. The apical impulse is rising and strengthened, shifted to the left relative to normal boundaries due to left ventricular hypertrophy. Pulse is hard.

Data from instrumental research methods..

Auscultation. The emphasis of the second tone over the aorta is the most typical change.

ECG. The axis of the heart is shifted to the left. S-T segment depression, T deformation in standard leads I and II, as well as V5 – V6.

An X-ray examination shows a change in the cardiac shadow due to left ventricular hypertrophy and dilation of the aorta.

Atherosclerosis. Risk factors for the development of atherosclerosis. Coronary heart disease (CHD). Clinical manifestations of ischemic heart disease.

Atherosclerosis is a pathological process characterized by the complication of blood lipids in the walls of the arteries, which is accompanied by the formation of fibrous (atherosclerotic) plaque, narrowing the lumen of the vessel. As a result, ischemia develops in tissues supplied by the corresponding affected arteries with the development of necrosis and sclerotic processes. Naib. The coronary and cerebral arteries are often affected, and less commonly the peripheral arteries.

Risk factors for the development of atherosclerosis:

Hyperdyslipidemia (both hereditary and due to excessive consumption of animal fats);

Arterial hypertension;

Insufficient physical activity;

Excess body weight;

Frequent emotional stress;

Smoking;

Hyperhomocysteinemia;

Endocrine disorders (primarily diabetes mellitus).

In addition, the gender and age of the patient also matter.

There are five main clinical forms of IHD:

1) Angina - characterized by attacks of typical chest pain.

2) Myocardial infarction - necrosis of the heart muscle due to an acute discrepancy between the myocardial oxygen demand and its delivery (develops with coronary atherosclerosis). Clinical manifestations myocardial infarction - pain similar to the pain syndrome of angina pectoris, but much more pronounced, lasting more than 15 minutes, not relieved by nitroglycerin.

3) Heart failure - shortness of breath, cyanosis, dry wheezing, hemoptysis, swelling of the extremities, pain in the right hypochondrium.

4) Violation heart rate.

5) Sudden cardiac death.

Coronary heart disease (CHD). Definition of IHD. Myocardial infarction. Priorities of Russian scientists in the diagnosis of myocardial infarction. Diagnosis of myocardial infarction (clinical and laboratory-instrumental). Basic principles of treatment of patients with myocardial infarction.

Coronary heart disease (CHD) is a disease caused by a discrepancy between the myocardial need for oxygen and its delivery; characterized by narrowing of the lumen of the coronary arteries of the heart (most often due to atherosclerosis)

In addition to atherosclerotic narrowing of the coronary arteries, the formation of platelet aggregates in these vessels and the tendency to their spastic contraction are important.

Myocardial infarction - necrosis of the heart muscle due to acute mismatch of myocardial needs develops, as a rule, with coronary atherosclerosis, often accompanied by thrombosis of the coronary arteries.

Heart attack occurs more often in men, mainly over the age of 50, who have risk factors for coronary atherosclerosis.

Myocardial infarction is based on a violation of the integrity of the capsule of the atherosclerotic plaque with the release of its contents (lipid core). In this case, various mediators are released, platelets and the blood coagulation system are activated, which leads to the formation of a blood clot.

Myocardial infarction due to the development of thrombosis of a large coronary artery was described in 1908 by Kyiv clinicians V.P. Obraztsov and N.D. Strazhesko. They presented the main syndromes of myocardial infarction.

Pain syndrome;

Heart failure with pulmonary edema;

Later, manifestations such as severe disturbances in heart rhythm and conduction were described.

Diagnosis of myocardial infarction:

patients are restless. In the initial period of myocardial infarction, due to the mental agitation of the patient, an increase in the patient’s blood pressure is noted, which is later replaced by a decrease. Auscultation of the heart can reveal a muffled first sound. With the development of pulmonary edema, tachypnea occurs, and moist fine rales are heard in the lower parts of the lung.

In case of myocardial infarction with a Q wave, ECG changes consist of a decrease in the R amplitude, the appearance of a wide and deep Q wave and an elevation of the ST segment, taking on an arched shape with a convexity upward. Subsequently, the ST segment shifts downward and a negative T wave is formed.

Without the Q wave, there is no change in the QRS complex. ECG signs are limited only by the appearance of a negative T wave, which also occurs in many other myocardial diseases.

Stages of myocardial infarction. Myocardial infarction with Q wave occurs in 4 stages:

1) The most acute stage (first hours) - monophasic curve (pronounced elevation of the ST segment, merging with an enlarged T wave)

2) The acute stage (2-3 weeks) is characterized by the appearance of a pathological Q wave and a decrease in the amplitude of the R wave (often it disappears completely - the QS wave is formed) The monophasic curve is preserved.

3) Subacute stage (up to 4-8 weeks from the onset of the disease) - the ST segment returns to the isoline, the pathological Q or (QS) wave is preserved, the T wave is negative.

4) The cicatricial stage is marked by the formation of a scar (post-infarction cardiosclerosis); pathological Q waves, low-amplitude R waves, and negative T waves may remain on the ECG.

Laboratory changes: On the second day of illness, neutrophilic leukocytosis occurs (with a neutrophilic shift to the left), a decrease in the content or complete disappearance of eosinophils from the peripheral blood. Later, on days 3-4, the ESR increases.

Treatment: The initial task is to relieve pain. (Morphine, Promedol.) The patient must be urgently hospitalized in the intensive care unit. Carry out thrombolytic therapy.

Cardiac ischemia. Definition of IHD. Angina pectoris. Angina pectoris (mechanism of formation). Diagnosis of angina pectoris. Angina at rest (mechanisms of formation).

Coronary heart disease (CHD) is a disease caused by a discrepancy between the myocardial need for oxygen and its delivery; characterized by narrowing of the lumen of the coronary arteries of the heart (most often due to atherosclerosis)

In addition to atherosclerotic narrowing of the coronary arteries, the formation of platelet aggregates in these vessels and the tendency to their spastic contraction are important.

Angina pectoris is a form of coronary artery disease characterized by attacks of typical chest pain. The mechanism of development of angina pectoris is based on atherosclerotic narrowing of the coronary artery (one or more) - not enough blood flows through the narrowed lumen of the artery to meet the increased needs, especially during physical activity. Diagnosis of angina pectoris includes an ECG (changes in the ST segment and T wave in the left precordial leads are detected - displacement of the ST segment or a decrease in the amplitude of the T wave). Echocardiography (increase in the size of the left ventricle, zones of hypokinesia, akinesia and dyskinesia). Laboratory research methods (of particular importance is the assessment of lipid levels in the blood, in particular the presence of hypercholesteremia above 5.2 mmol/l. It is also important to increase the level of LDL in the blood to more than 3.1 mmol/l and to reduce HDL to less than 1 mmol/l.)

Rheumatism (rheumatic fever). Definition. Diagnostics (clinical and laboratory-instrumental).

Rheumatic fever is a disease characterized by systemic inflammatory damage to connective tissue of an autoimmune nature involving the heart and joints, initiated by group A beta-hemolytic streptococcus.

Diagnostics:

1) Large criteria:

Arthritis (polyarthritis);

Ring-shaped erythema;

Subcutaneous rheumatic nodules.

2) Small criteria:

Fever;

Arthralgia;

The appearance of acute phase indicators: leukocytosis with a shift to the left, ESR, increased C-reactive protein, dysproteinemia (increased α 2 - and γ-globulins), hyperfibrinogenemia, increased mucoproteins and glycoproteins, specific serological markers (streptococcal antigen in the blood, increased titers antistreptolysin-O (ASL-O), antistreptohyaluronidase (ASH), antistreptokinase (ASK)), increased capillary permeability, changes in immunological parameters (immunoglobulin level, number of B and T lymphocytes, RBTL, inhibition reaction of leukocyte migration and others);

Prolongation of the PR interval on the ECG, blockade.

In addition to the listed signs, it is necessary to establish the presence of a previous group A streptococcal infection. To do this, a swab is taken from the throat and nose to isolate the carriage of streptococcus by inoculating and determining the streptococcal antigen, and a blood test for the presence of anti-streptococcal antibodies. In some cases, confirmation is not required, for example, after recently suffering from scarlet fever.

The diagnosis is considered probable if two major or one major and two minor criteria are met with evidence of a previous streptococcal infection.

Additional signs that should suggest the presence of streptococcal infection are improvement during antirheumatic therapy for 3-5 days. Also pay attention to general symptoms: fatigue, weakness, pale skin, sweating, nosebleeds, abdominal pain.

To diagnose repeated rheumatic attacks and determine the activity of the rheumatic process, they are usually limited to laboratory parameters and additional studies (for example, echocardiography to determine carditis).

X-rays of the affected joints are usually not informative, since in rheumatoid arthritis they do not reveal changes. It is prescribed only in controversial cases (for example, with an erased course of the disease or isolated articular syndrome). But usually this is not required, and the diagnosis is made based on the clinical picture and specific changes in laboratory tests.

To exclude rheumatic carditis, the following are carried out:

ECG: rhythm and conduction disturbances, decreased T wave amplitude and S-T interval.

Echocardiography: thickening and decreased excursion of the valve leaflets (if they are inflamed), identification of acquired heart disease.

X-ray of organs chest: in the presence of carditis, an expansion of the borders of the heart is noted.

80. Mitral valve insufficiency. Changes in intracardiac hemodynamics. Physical and instrumental diagnostics. Isolated mitral valve insufficiency is rare; more often it is combined with mitral stenosis. The etiological factors of organic mitral valve insufficiency can be rheumatism, less often atherosclerosis, infective endocarditis, syphilis, traumatic damage to the leaflets and chords. The formation of rheumatic mitral valve insufficiency occurs due to shortening of the valve leaflets, and often the tendon strands subsequently due to wrinkling of the valve and the deposition of calcium salts.

Hemodynamic changes. Incomplete closure of the valve leaflets causes reverse flow of blood from the left ventricle into the atrium during systole. As a result of such regurgitation, a larger than normal amount of blood accumulates in the left atrium, which stretches its walls, leading to tonogenic dilatation. Operating with a larger volume of blood than usual, the left atrium is emptied by accelerating blood flow through the atrioventricular opening during its own systole, which is ensured by compensatory hypertrophy of the chamber myocardium. During diastole a large number of blood enters the left ventricle. As a result of this, its tonogenic dilation occurs, and then hypertrophy. With this defect, dilatation of the left ventricle noticeably prevails over hypertrophy, since there is no great resistance (during systole, the left ventricle ejects blood in 2 directions - into the aorta and into the left atrium).

Next in pathological process the pulmonary circulation and right ventricle are involved. However, with mitral insufficiency for the left atrium, the hemodynamic situation is more favorable: without experiencing much resistance during diastole, it hypertrophies to a lesser extent. The increase in pressure in the atrium, and, consequently, in the pulmonary circle, does not reach the same level as with stenosis, and damage to the right parts of the heart occurs later. There are no complaints specific to this defect.

Inspection. Sometimes the apical impulse may be visualized to be displaced outward. Less commonly, the presence of a cardiac impulse and epigastric pulsation can be noted.

Palpation. The detection of a displaced and extended apical beat is typical; a cardiac beat and epigastric (right ventricular) pulsation may appear.

Percussion. An enlargement of the left atrium is manifested by an upward displacement of the upper limit of relative cardiac dullness, and an enlargement of the left ventricle leads to an outward displacement of the left border of the heart. Sometimes it is possible to shift outward and the right border of the relative dullness of the heart (enlargement of the right ventricle).

Auscultation. At the apex of the heart, a weakening of the first sound is heard (up to its complete disappearance), which is associated with the absence of a closed valve period and large diastolic filling of the left ventricle. Sometimes a third sound is heard at the apex of the heart, which occurs due to weakening of the myocardial tone of the left ventricle. Its timbre is duller than the tone of the mitral valve opening. The most characteristic auscultatory sign of mitral insufficiency is a systolic murmur, starting with the first sound or immediately after it and extending to the axillary region. This noise occurs due to the reverse flow of blood into systole through an incompletely closed mitral orifice. At the base of the heart, a moderately pronounced accent of the second tone is usually heard on pulmonary artery, which is associated with an increase in pressure in the pulmonary circulation.

Diagnosis of the defect. The diagnosis of mitral regurgitation is made on the basis of displacement of the upper and left borders of cardiac dullness, weakening of the first sound and systolic murmur at the apex, carried into the axillary region.

Additional research methods. X-ray examination reveals left ventricular hypertrophy; “mitral configuration” of the heart - smoothness of the left contour of the heart in the anterior projection; enlargement of the left atrium along an arc of large radius (more than 6 cm), detected in the left lateral projection. With significant blood regurgitation during fluoroscopy, bulging of the left atrium during ventricular systole can be seen. The electrocardiogram shows signs of left atrial hypertrophy (P-mitralae). Signs of left ventricular hypertrophy are detected. With severe pulmonary hypertension, signs of right ventricular hypertrophy may appear. An echocardiographic study reveals the absence of complete closure of the mitral valve leaflets, an increase in the amplitude of their diastolic movement, an increase in the size of the cavities of the left ventricle and left atrium, and hyperkinesia of the walls of the left ventricle. A Doppler study records reverse systolic blood flow into the cavity of the left atrium (mitral regurgitation).

Essential hypertension: causes, symptoms, diagnosis, treatment, prognosis

Essential hypertension is one of the most common diseases of cardio-vascular system, which does not have geographical boundaries and increasingly affects people young. The reasons for it still remain not fully understood, although the risk factors and probable preconditions are well known.

Primary, or essential, hypertension is chronic enlargement blood pressure, starting from 140 mm Hg. Art. for systolic (“upper”) and 90 mm Hg. Art. for diastolic (“lower”). Both an isolated increase in the first digit and a simultaneous increase in both are possible.

Only the lazy have not heard about chronically high blood pressure and its danger in the form of a stroke. However, not every person who knows that their blood pressure is “jumping” immediately goes to the doctor. Among those who have survived, there are many who do not follow the instructions of specialists, do not take medications, or grab them when they are overtaken by a hypertensive crisis.

Lack of proper attention to blood pressure, inconsistent use of medications or refusal of treatment lead to a manifold increase in the risk of acute vascular accidents in the brain, while maintaining blood pressure at a normal level, even with the help of medications, not only improves well-being, but also prolongs the life of blood vessels, heart and brain.

In an age of increased psycho-emotional stress and chronic stress, with constantly deteriorating environmental conditions, lifestyle, and nutrition, it is very important to monitor not only individual symptoms that can talk about advanced stage diseases, but also regularly visit a doctor for the purpose of prevention and early diagnosis insidious hypertension. This applies, first of all, to people of the older generation, but it will also not hurt young people aged 30-35.

Causes of primary hypertension

Essential arterial hypertension is called primary. This means that a specific cause in the form of a disease of the organs that regulate blood pressure could not be found. It can be considered that the diagnosis of essential hypertension is a diagnosis of exclusion, when examinations have confirmed that the pressure rises as if by itself, with healthy kidneys, heart, endocrine system(in contrast to the increase in blood pressure at ).

However, you should not think that there is no reason as such, and the pressure really fluctuates on its own. The exact factor that provokes hypertension has not been formulated, but scientists have named the conditions under which the disease develops. To date, Primary hypertension is recognized as a multifactorial pathology, in the appearance of which a combination of various reasons is actively involved.

Most significant reasons Chronic prolonged primary increase in pressure is considered:

• Hereditary predisposition, which is confirmed in almost half of patients with essential hypertension;
• Being overweight increases your risk of hypertension by up to five times;
• Smoking is also a risk factor ischemic changes in heart;
• Low physical activity, often combined with overweight, which is quite natural;
• Dietary features - excess salt and liquid, lack of microelements (magnesium, especially), vitamins, abuse of coffee, tea, alcohol;
• Stress and psycho-emotional overload.

Traditionally, essential hypertension was recently classified as a disease of older people, but today the situation is changing, All larger number Patients with this diagnosis are under 50 years of age. This speaks, first of all, about the role of stress and lifestyle rather than about risk factors associated with age-related changes.

Among the unfavorable conditions that significantly increase the risk of high blood pressure, which are reflected in the lipid profile, is an unhealthy lifestyle. Persons over 55 years of age are also very susceptible to pathology.

Degrees and stages of primary hypertension

In order to more accurately judge the possible risks of complications of hypertension, as well as reflect the characteristics of its course, the degree of pressure increase was calculated. A combination of degrees in accordance with pressure figures and certain risk factors, as well as concomitant diseases, talking about risk of dangerous complications– strokes, heart attacks, acute renal or heart failure.

There are three degrees of essential hypertension:

• Stage 1 hypertension, when systolic pressure is 140-159 mm Hg. Art., diastolic 90-99 mm Hg. Art.
• At grade 2, the pressure readings are 160-179 and 100-109 mmHg, respectively. Art.
• Stage 3 is the most severe, when the pressure reaches 180/110 mmHg. Art. and higher.

The diagnosis usually includes the extent, stage of the disease and the risk of complications. So, the degree is determined according to the above parameters, and what is important is not a one-time increase in pressure, but a constant one, in at least three or four dimensions throughout the month.

Stage of primary hypertension determined by characteristic symptoms and signs of internal organ involvement. At the first stage There may be no symptoms or signs of changes in target organs, and the presence of hypertension is indicated only by the numbers on the tonometer. At the second stage Changes in the walls of blood vessels progress, some myocardial hypertrophy becomes noticeable, but these phenomena do not yet affect the activity of the heart and other organs. Third stage- it is also called the stage of organ changes - carries signs of obvious vascular pathology and disorders of target organs in connection with it.

By summing up the degree of essential hypertension, existing risk factors and features of target organ damage, the doctor can easily determine the risk - insignificant, low, high, very high, which determines the likelihood of fatal complications.

It is important to note that even the first degree of hypertension can be accompanied by a very high risk of complications in the presence of diabetes, target organ damage, a combination of more than three risk factors, previous transient ischemic attacks or strokes. Patients with such aggravating factors should be extremely vigilant, even if the pressure “has not exceeded” 140-149 mm Hg. Art.

A few words about target organs

Blood pressure is a general body indicator; it affects not only blood vessels and well-being, but also causes damage to various organs. WITH the heart, kidneys, central nervous system, and retina of the eyes are affected. These organs are traditionally considered targets for essential hypertension.

Heart works with high voltage, the result is . On initial stages hypertrophy ensures adequate blood flow in the organs and is considered a mechanism of adaptation to new conditions, and subsequently the heart becomes depleted and lacks nutrition. This circumstance explains the greater tendency of patients with hypertension to heart attack, rhythm disturbances, and sudden coronary death.

Kidneys – important organ regulating pressure. They suffer to a large extent from its increase: sclerosis and degeneration of arterioles and vascular loops of the glomeruli develop, and the tubules are involved. With a long history of hypertension, there is a high probability of chronic renal failure, which is secondary to essential hypertension, but significantly aggravates it.

Brain experiences the “burden” of hypertension from the initial stages of the disease. Vascular changes lead to disruption of its nutrition, microinfarctions, dystrophy nerve tissue, and in the end – heavy. Most of the symptoms of the pathology are associated with brain damage - headache, noise in the ears or head, memory loss and mental activity etc. Of particular danger are hemorrhages and heart attacks, which often occur against the background of hypertensive crises.

Retina is also considered a target organ. Its vessels acquire character traits, and a routine examination of the fundus at the first stage of hypertension can help in diagnosing correct diagnosis. Over time, the patient notices a decrease in vision, and retinal detachment is possible with significant pressure levels.

Manifestations of essential hypertension

The main and very first manifestation of essential arterial hypertension is excess pressure readings on the tonometer, recorded multiple times. For some time the patient lives with initial hypertension and does not even notice it. This is understandable, because the vascular walls have not yet changed and are able to control their tone and lumen width, “adjusting” to the pressure numbers, so there may be no symptoms. Some patients at this stage, even if they note some symptoms, do not give them due attention due to their apparent insignificance.

Excessive blood pressure can only be asymptomatic for the time being. The structure of blood vessels - arteries and arterioles - gradually and inevitably changes, and first of all, the heart suffers. Without treatment, the pathology becomes clinically pronounced, and at this stage the patient almost always sees a doctor.

At the initial stage, among the signs of trouble, patients note headaches, dizziness, weakness, possibly tinnitus, darkening of the eyes. These symptoms do not bother you continuously; they occur periodically, often during severe physical or psycho-emotional stress, or after errors in diet.

Such phenomena are not considered specific signs namely hypertension, because they often occur in people with normal blood pressure, but you still need to be wary. An increase in headaches, their duration and intensity, and the lack of effect from usual analgesics should be the first reason to measure your blood pressure at home or consult a doctor.

At the second stage, the symptoms of the pathology become more and more distinct, often with vivid symptoms high blood pressure:

• Anxiety, facial flushing, sweating;
• Severe headache, feeling of pulsation in the head;
• Nausea and even vomiting are possible;
• Feeling of pressure, chest pain, shortness of breath;
• Flickering of flies before the eyes, darkening in the eyes.

These signs are the most characteristic, but it happens that with relatively low blood pressure numbers the patient experiences a severe headache, is apathetic, and pale. Often such crises are accompanied by a tendency to edema.

If the hypertensive crisis was stopped with medication, then the patient continues his usual life, and not always paying due attention to the tonometer readings and timely intake of medications. If the diagnosis of essential hypertension is no longer in doubt, the crisis has occurred more than once, then one cannot hope for spontaneous improvement or recovery - the disease is chronic, progressive, and dangerous with complications.

Gradually, excess blood pressure leads to changes in the internal organs, which is associated primarily with the vascular factor. The vascular walls are the first to take the blow of hypertension. For some time they adapt to pressure fluctuations, either expanding their lumen or reducing it to the required diameter, but this cannot happen indefinitely.

Constant load contributes to irreversible changes up to sclerosis, when the walls of arteries and arterioles become dense, brittle and incapable of fast response to change pressure. As a result, essential hypertension becomes permanent, its degree increases, and the risk becomes maximum.

In parallel with the vessels, adaptation to new conditions occurs on the part of the myocardium. The heart pumps blood with greater force than normal, its fibers hypertrophy, and its walls thicken. Myocardial hypertrophy can be associated with pain in the chest and heart area, which appear as symptoms in a number of patients. For more late stages disease, ischemia of the heart muscle is clearly expressed, characteristic coronary atherosclerosis, symptoms of angina pectoris, cardiac arrhythmia, acute left ventricular failure (pulmonary edema) occur.

Persons with the third stage of essential hypertension have a number of signs from other organs, which makes their complaints quite varied. The symptoms listed above are accompanied by signs of vascular encephalopathy - decreased intellectual abilities, attention, memory, behavioral changes, tendency towards apathy or depression. Many patients lose vision, and its decline can be rapidly progressive. Signs increase, and kidney damage leads to metabolic disorders (an increase in creatinine in the blood, the appearance of protein in the urine, etc.).

Treatment of essential hypertension

Treatment of essential arterial hypertension is aimed at normalizing blood pressure, lifestyle and improving the function of target organs. It includes both drug therapy, as well as general measures.

When a diagnosis is made, the first step is to change your lifestyle. Giving up bad habits, changing your diet, fighting obesity and low motor activity- the first thing to do. In addition, these measures are the simplest and do not require trips to the pharmacy and spending large sums of money.

Clinic doctors tirelessly tell all patients with essential hypertension about the need for constant, systematic reception medications according to the recommended regimen. Despite this, many patients, if they take pills, do so periodically, when the disease makes itself felt with a hypertensive crisis.

In the case of essential hypertension, delaying treatment or skimping on medications is very dangerous. It can happen at any moment critical increase pressure with the most different consequences, including deadly ones.

Drug treatment of essential hypertension is prescribed by a doctor. Self-administration of medications is considered unacceptable, even if the blood pressure monitor shows hypertension, and a pill offered by a relative or neighbor helps them. In the case of this disease, the success of treatment depends on the correctness of the prescribed therapy, and this can only be achieved with the help of a specialist.

Currently, approaches have been adopted in the complex treatment of primary hypertension, when it is possible to prescribe several from different groups at once. Are used:

• Diuretics;
• ACE inhibitors;
• Calcium antagonists;
• Beta blockers;
• Angiotensin II receptor antagonists;
• Imidazoline receptor agonists.

Drugs from each group have their own contraindications, so they should be prescribed only by a doctor based on the stage of the disease, response to treatment, and concomitant background. First, one drug may be prescribed as monotherapy (an ACE inhibitor, as a rule); if the effect is insufficient, drugs from other groups are added to it. This combination allows the use of drugs not in maximum dose, thereby reducing the likelihood of side effects.

- the most commonly used means. Capropril (also effective during a crisis), enalapril, lisinopril are prescribed. These drugs reduce the likelihood of complications, are well tolerated by patients and can be taken long time. They are especially indicated for cardiac and renal pathology, are safe for use in old age, pregnancy, and carbohydrate and fat metabolism disorders.

Angiotensin receptor blockersII(losartan, valsartan) is one of the most modern groups of drugs for primary hypertension. They act selectively, so they are practically free of side effects. They are prescribed quite often, but the disadvantage can be the high cost.

They have been used to treat essential hypertension for decades, but they do not lose their relevance. Hydrochlorothiazide, veroshpiron, furosemide, torsemide, etc. are prescribed. Diuretics are indicated for both long-term use, and to relieve a hypertensive crisis. They can be part of combined antihypertensive drugs together with drugs from other groups.

(amlodipine, diltiazem, verapamil) help relax the vascular walls, and spasm, as is known, is the main link in the pathogenesis of hypertension. They have advantages for patients with coronary heart disease, rhythm disturbances, and severe myocardial hypertrophy.

(atenolol, metoprolol) not only reduce blood pressure, but also reduce the load on the myocardium, have an analgesic effect in angina pectoris, normalize the heart rhythm, therefore they are usually prescribed for cardiac pathology - coronary artery disease, tachyarrhythmias, cardiosclerosis. They should be used with caution in diabetes, obesity and other metabolic disorders.

Imidazoline receptor agonists(moxonidine) have a number of advantages compared to other drugs, among which the main one is considered not only the absence negative influence on metabolic processes, but also improving them. Moxonidine is good for essential hypertension in patients with obesity and diabetes mellitus.

In addition to the listed groups, it is possible to prescribe nootropic drugs for symptoms of discirculatory hypertensive encephalopathy, vitamins and microelements for changes in the myocardium, sedatives with high levels of stress and emotional lability. Acceptance allowed plant extracts, tea with antihypertensive properties, but get carried away traditional medicine It’s not worth it - herbal treatment will not replace drug therapy prescribed by a doctor.

The diagnosis of essential hypertension is not a death sentence, and it does not necessarily end in a stroke or myocardial infarction. To prevent such developments, it is important to monitor your blood pressure at home, periodically visit a doctor, and be sure to take all prescribed medications, even if you have to do this for life. Taking a pill is much easier than fighting heavy and very dangerous complications hypertension.

Video: series of lectures on arterial hypertension and its types

And among all pathologies, blood vessels occupy one of the first places that become the cause of death of patients. Arterial hypertension is most often diagnosed, but there is also essential hypertension. What is the difference between these two pathologies, what symptoms and treatment methods exist? Let's look into this issue.

What is essential hypertension?

This pathology is a form arterial hypertension. Patients consult a doctor about high blood pressure. If the readings only occasionally rise to 140 mm. rt. Art., it is too early to talk about the disease, but with a steady increase, doctors diagnose “essential arterial hypertension.” To prescribe therapy, it is necessary to establish the reasons that provoked this condition. The choice of treatment tactics is also influenced by the form and degree of development of the disease.

Many people have a question: “What is the difference between essential hypertension and arterial hypertension?” A specialist can answer it this way: the first form is primary, but the second most often develops against the background of many chronic pathologies. The essential form poses a great danger due to constant progression, which leads to damage internal systems organs. With hypertension, it is enough to get rid of the underlying pathology to eliminate the symptoms of the disease.

In the international classification of diseases, essential hypertension (ICD-10) also has its own code. For appointment effective treatment the doctor must determine the cause of the pathology.

Etiology of the disease

The exact reasons causing the development have not yet been established of this disease. Most doctors are of the opinion that the onset of hypertension is provoked by certain factors, and the transition of the disease to stable form is influenced by others. Essential primary hypertension can be caused by the following reasons:

• Age-related changes in the body. With age, blood vessels become less elastic.
• Stressful situations.
• Menopause in women.
• Alcohol abuse.
• Smoking.
• Errors in nutrition.

• Excess body weight.
• Consuming a lot of salt.
• Gender (it has been established that the male population suffers from this pathology much more often).

Risk factors also include:

• Impact unfavorable factors external environment.
• Low physical activity.
• Hereditary predisposition. If one of your relatives has this disease, the risk of developing the disease increases significantly.

If we add the above reasons to the risk factors, then we can say with almost 100% confidence that a person will definitely develop essential hypertension.

Symptoms of the disease

Often this pathology develops asymptomatically, it can only be noted that slight increase blood pressure. Indicators can reach 140-150 mm. rt. Art. - upper pressure and 90-95 - lower.

We have discussed what essential hypertension is. Symptoms of the disease may be as follows:

• A headache appears, most often it is localized in the back of the head and forehead.
• Cardiopalmus.
• There is dizziness.

• There is noise in the ears.
• Double vision.
• Increased fatigue.
• Irritability.
• Chronic fatigue develops.

If you do not pay attention to these symptoms, then gradually the disease will begin to progress and you will suffer. internal organs.

Target organs for essential hypertension

The disease has several stages of development, and we will definitely look at them a little later, but for now we will name the organs that suffer most often if a person is diagnosed with hypertension (essential hypertension).

1. Heart. During the development of pathology, the heart muscle experiences severe stress, as a result, the walls of the left ventricle become thicker. The heart requires increased blood supply, and the reserve is reduced due to high blood pressure. This can lead to myocardial infarction, heart rhythm disturbances and other complications.
2. Already in the early stages of the disease, the brain begins to suffer from a lack of oxygen. Therefore, patients begin to feel noise and dizziness.
3. Pathology and kidneys are not spared. Sclerosis of the renal vessels develops, which leads to disruption of their function. As a result, kidney failure may develop.
4. Blood vessels.

If you do not take appropriate measures, serious consequences cannot be avoided.

Stages of development of hypertension

Essential hypertension goes through several stages in its development:

1. At the first stage, pressure sometimes rises, most often this occurs after heavy physical exertion or emotional stress. Internal organs are not affected, and there are practically no complications. This period can last several years.
2. The second stage is characterized by a persistent increase in pressure. Indicators return to normal after taking medications. Periodically observed hypertensive crises. Target organs begin to suffer from high pressure.
3. The third stage is the most serious; high blood pressure can only be eliminated by combining various medications. Hypertensive crises, strokes, heart attacks, and angina pectoris are often diagnosed. There may be hemorrhage in the retina.

In addition to stages, the disease also has degrees of development. There are only three of them:

• Essential hypertension 1st degree. Indicators vary from 140 to 160 mm. rt. Art. (SBP) and from 90 to 99 (DBP).
• 2nd degree - from 160-180 (SBP) to 100-110 (DBP) mm. rt. Art.
• The third degree is diagnosed if the upper pressure is more than 180 mm. rt. Art., and the lower one - more than 110.

Therapy is selected taking into account both the stage and extent of the disease.

Diagnosis of the disease

For therapy to be as successful as possible, it is necessary to contact a specialist as early as possible. The diagnosis of “essential hypertension” is made not only on the basis of a conversation with the patient - it is necessary to undergo a series of studies that will confirm the doctor’s suspicions.

During the conversation, the doctor listens to complaints and finds out under what circumstances pressure increases. It is very important for a specialist to find out the presence of provoking factors, such as bad habits, hereditary predisposition, and eating habits.

Examination of the patient is mandatory. The doctor measures blood pressure, listens to the heartbeat to detect murmurs and rhythm disturbances, and then sends the patient for tests:

• General blood analysis. With developing hypertension, an increase in leukocyte levels and ESR is observed. Biochemical analysis will show the level of metabolic processes.
• Analysis of urine. In case of malfunction renal tubules proteinuria was detected.

Not only tests help diagnose the disease, but also some research methods:

1. Cardiogram of the heart. She allows for early stages detect left ventricular hypertrophy.
2. Echo CG makes it possible to assess the size of the heart, its structure, and analyze the functioning of the valves.
3. X-ray reveals atherosclerotic changes and disorders in the lung tissue.
4. Daily blood pressure monitoring is carried out using special device, which is attached to the patient's belt and connected to the cuff on the shoulder.
5. An ophthalmologist performs a fundus examination.
6. Coronary angiography is prescribed if the patient has angina, as well as after suffered a heart attack myocardium.
7. MRI is necessary if there is a suspicion of a neurogenic origin of the disease. For example, with brain tumors and brain injuries, blood pressure may increase.
8. Computed tomography of the kidneys is necessary if there is a suspicion of a tumor in this organ, as well as malignant pathologies adrenal glands

Only by assessing the results of all these studies and tests can a specialist make (or refute) the diagnosis of “essential hypertension.” Treatment is prescribed taking into account the characteristics of the patient’s body, concomitant diseases, stage and degree of development of the pathology.

Therapy for essential hypertension

If the disease is diagnosed, then treatment should be comprehensive. Most often it is long-term, sometimes the count goes not for months, but for years. Therapy is carried out in several directions:

1. Lifestyle changes.
2. Drug therapy.
3. Non-drug treatment methods.
4. Ethnoscience.

Any treatment must be carried out under the supervision of a physician.

Changing our lifestyle

If essential arterial hypertension is at the initial stage of development and manifests itself in mild degree, then most likely the doctor will not rush to prescribe medications. Any therapy is impossible unless you adjust your lifestyle. You should follow simple recommendations:

1. Eliminate alcohol and nicotine from your life. Substances contained in alcoholic drinks and cigarettes, provide negative impact on the vessels, disrupting their structure.
2. Limit consumption table salt: Excess sodium chloride retains fluid in the body, which leads to increased blood volume.
3. Pay attention to your diet: exclude smoked foods, pickles, fried and fatty foods. Introduce more into the diet fresh vegetables and fruits, it is advisable to eat more often, but in small portions. To reduce bad cholesterol increase the amount of plant foods.
4. Doing your best is required physical exercise, even regular exercise can benefit the body. Any professional sports activities are permitted only with the approval of a doctor.
5. Bring your body weight back to normal.

If the disease is just developing, then often a change in lifestyle normalizes all processes in the body and the pathology does not progress.

Treating hypertension with medications

If the disease progresses and target organ damage is observed, then without effective drug therapy not enough. Doctors, if the diagnosis of “essential hypertension” is confirmed, the following drugs are prescribed:

1. ACE inhibitors and ARA II. Simply irreplaceable if you need to protect internal organs from high pressure. This group of drugs includes: “Prestans”, “Zocardis”, “Lorista”.
2. Calcium antagonists and beta-blockers. These medications, which include Nebilet and Betalok, reduce vascular tone and reduce their resistance.
3. If there is swelling, then you cannot do without diuretics, for example “Diuvera”, “Arifon”. These drugs help remove excess liquid from the body.
4. Drugs that help fight the consequences of angina, heart attack and other complications.

Any medications are prescribed taking into account the contraindications and characteristics of each patient, so there is no single treatment regimen for hypertension. Very often, several drugs are prescribed simultaneously, which complement each other’s action.

Every patient should understand that if he has essential hypertension, treatment will be ongoing throughout his life. It is a mistake to cancel therapy when noticeable improvements appear: as a rule, after stopping the medication, the condition very quickly worsens again.

Non-drug treatments

Methods that do not involve the use of drugs provide significant assistance in treatment:

• Acupuncture.
• Autotraining.
• Psychotherapy sessions.
• Electrosleep.

Traditional medicine against hypertension

If you supplement drug therapy folk ways treatment of hypertension, the effectiveness will increase significantly. Let's name the most popular recipes:

1. Combine 800 ml of beet juice and honey in equal quantities, add 1 liter of vodka. Leave for two weeks in a dark place. Take 2 tablespoons three times a day.
2. Before meals, take a mixture consisting of onion juice, honey and lemon zest in equal proportions.
3. Take 100 grams of cranberries, honey and lemon, mix and take for two weeks.

Despite the safety of traditional recipes, it is better to consult your doctor before using them, especially if you have chronic pathologies.

Complications of the disease

If you do not take the treatment of the disease seriously, you will not have to wait long for complications of essential hypertension, and there are quite a few of them:

1. Hypertensive crisis, in which there is a sharp increase in blood pressure. Moreover, it should be noted that for some, this condition may occur at readings of 180 mm. rt. st, and for some 160 is enough. In addition to the pressure surge, patients report severe headaches and tinnitus.
2. A “hypertensive heart” develops, with the walls of the muscle thickening and contractility decreasing. The risk of developing a heart attack and heart failure increases.
3. With hypertension, kidney damage cannot be avoided.
4. The nervous system is affected, and strokes are not uncommon.
5. As a result of the development of hypertension, the fundus of the eye suffers.
6. Pulmonary edema.

If the patient is diagnosed with any of the complications, then urgent hospitalization is required. Most often this happens if the patient does not follow the doctor’s recommendations or takes medications irregularly.

How to prevent the development of hypertension

Any disease can be prevented, this also applies to essential hypertension. The most important thing is to constantly monitor your blood pressure, this is especially true for the following categories of people:

• patients who experience frequent headaches, dizziness, and nosebleeds.
• The female half of the population during menopause.
• Patients after surgical interventions.
• Suffering from kidney diseases.
• People who are stressed and overworked.

The disease can be prevented by following these recommendations:

• Balance your diet. Eliminate fatty and smoked foods, animal fats, reduce salt intake.
• Avoid strenuous physical activity.
• News active image life.
• To refuse from bad habits.
• Monitor your body weight.
• Avoid psycho-emotional stress.
• Monitor blood pressure readings.

Having studied medical literature, you can find information about one or another treatment tactics for high blood pressure, but a real specialist will never rely on templates. Therapy should be selected individually each time, taking into account not only the severity of the pathology and its degree, but also the personal characteristics of the patient’s body.

Hypertension – high pressure– one of the common diseases affecting the modern population. According to statistics, essential hypertension affects about 20% of adults. Approximately 2% of patients have a disease resulting from occlusion renal branches. Although this number is already quite high, it does not include people who suffer from essential hypertension without seeing a doctor with high rates. This means that the percentage of patients is higher.

Essential arterial hypertension is often called a non-infectious epidemic, and is included in the group of civilizational diseases. It is estimated that 25% of deaths over the age of 40 years are caused by hypertension. One of the reasons for the sad statistics is that hypertension (high blood pressure) in the early stages has almost no symptoms, therefore, people are not aware of the presence of high levels, or simply ignore their minor symptoms, and treatment is not carried out.

What is essential hypertension?

Essential arterial hypertension (EAH) is a disease characterized by an increase in blood pressure above 140/90. This is one of the most common modern diseases. Arterial hypertension affects almost every person over 40 years of age. About essential hypertension we're talking about, if high indicators are measured repeatedly.

Etiology of the disease

The etiology and pathogenesis of essential arterial hypertension of the secondary form are well known, susceptible and generally removable along with the cause of high blood pressure. The formation of primary essential hypertension - an increase in blood pressure - is influenced by the complexity of various factors: inheritance, lifestyle, and external environment. The most important pathophysiological mechanisms and etiological factors are:

• increased activity of the sympathetic nervous system, manifested by increased pulse rate, minimum heart rate and peripheral vascular resistance;
• – chronic stress in genetically predisposed people causes a steady increase in TZ;
• renin-angiotensin-aldosterone system;
• obesity;
• physical activity;
• inheritance;
• salt consumption;
• alcohol.

Blood pressure values, by nature, change constantly throughout the day. In the morning they are higher, in the evening they decrease, the lowest levels are during sleep. If a person changes the rhythm of the day, for example, switches to night shifts, pressure variability will “adjust” to these changes. Critical values ​​for people with a classical biorhythm are the period in the morning and early morning, when the most high level cardiovascular complications. A meta-analysis of the population showed a clear dependence of cerebrovascular and cardiovascular morbidity and mortality on high blood pressure - hypertension.

Symptoms of the disease

Symptoms of mild to moderate essential hypertension are less pronounced and nonspecific. Due to increased blood pressure in the arteries, most people experience the following signs of hypertension:

• headache;
• cardiopalmus;
• chest pressure;
• visual impairment;
• irritability;
• dizziness;
• fatigue;
• insomnia;
• nosebleeds;
• swelling of the ankles;
• excessive sweating.

These are insignificant signs that a person often does not pay attention to for a long time. Therefore, hypertension - high blood pressure - is usually diagnosed by chance. Symptoms in more advanced stages occur due to organ damage.

Target organs for essential hypertension

It must be said that systolic pressure increases with age, while diastolic pressure decreases slightly after 60 years of age in men and after 10 years in women. Various factors (environment, endogenous regulatory systems, etc.) are involved in the onset of the disease. But essential hypertension in adults can develop secondarily, representing a consequence or manifestation endocrine diseases, diseases of the kidneys, blood vessels, heart and other organs.

Target organs are mainly the following organs:

• kidneys;
• vessels;
• heart.

Hypertension (high blood pressure) manifests itself depending on the degree of damage to these organs.

Is it possible to distinguish essential hypertension from other types based on symptoms?

It is possible to determine the differences between EAH and the manifestations of high rates in other types of hypertension, but they are few. First of all, the following factors are taken into account:

• age of the patient - the age of 35-45 years is typical for the development of essential hypertension, for others age groups other types of disease are typical;
• stability of indicators - with essential hypertension, pressure indicators are steadily increased, they are easy to treat;
• research results - with essential hypertension there are no characteristic test findings typical for other types of disease.

Diagnosis of hypertension

The diagnosis of hypertension is closely related to repeated blood pressure measurements. But here it is necessary to distinguish whether there is a disease or a so-called . A 24-hour blood pressure measurement should also be taken. However, since there are so many hypertensive patients, it is impossible to provide everyone with an extensive examination. Typical research methods:

• disease history;
• gynecological examination;
• impulse test on large blood vessels;
• measurement of blood pressure in different positions (sitting, standing), pressure is also measured on the lower extremities;
• Analysis of urine;
• blood biochemistry;
• fundus examinations.

Important! If necessary, a chest x-ray is also performed.

Classification of hypertension by stages and ICD-10

Essential hypertension can be divided into 3 groups depending on the stage of development and involvement of the target organ.

• 1st degree of severity - an increase in pressure that does not affect the organs.
• – a change in organs is recorded that does not cause their failure or dysfunction. For example, detection in the fundus, changes in the arteries, detection on ECG and echocardiography, calcification of the aorta and other arteries, microalbuminuria (detection of protein in the urine as a result of the study).
• – serious changes in organs with functional disorders. There is left heart failure, atherosclerosis, aneurysm, stroke, ischemic disease, renal failure, neuroretinopathy and myocardial infarction.

Phase 3 is also referred to as, occurring mainly in essential hypertension, which is not treated or pressure control is insufficient. The pressure at this stage often exceeds 230/130. With rapid organ damage, which was accompanied by early failure.

High blood pressure is also classified according to international classification– he was assigned a code according to ICD-10. Essential primary hypertension according to ICD-10 has the number I10:

ICD-10 – I10-I15 – hypertensive diseases, I10 – essential primary hypertension – Hypertensio arterialis essentialis (primaria).

Treatment of essential hypertension

Treatment of essential hypertension includes a non-pharmacological approach (i.e. without taking drugs), regimens (always), pharmacological therapy and the establishment of a specific diet.

Treatment of hypertension with medications

Blood pressure should be urgently reduced in case of essential hypertension if the systolic or diastolic value is above 110 (lower value).

Diuretics

Most often they are prescribed in combination with other antihypertensive drugs. These are first-line medications for older people with heart weakness, high blood pressure, and accompanying accumulation of water and sodium. Diuretics help remove water from the body. With a decrease in fluid volume in vascular system, there is a decrease in blood pressure.

β-blockers

These drugs may be taken alone or in combination with other medications. The most suitable combination is a combination with calcium channel blockers. β-blockers are prescribed for hypertension (high blood pressure), accompanied by ischemia, angina pectoris, congestive heart failure, and tachycardia. After consulting with your doctor, these medications can be taken by pregnant women. They are not recommended for asthmatics, people with a slow heart rate, or severe heart failure. This group is not suitable for people with metabolic syndrome, impaired glucose tolerance, and diabetics.

ACE inhibitors

These drugs have a positive effect on kidney and heart function. Unlike β-blockers, they do not have a negative metabolic effect. Medicines are also used in the form of so-called. single boluses at . However, they can be taken long-term as a standalone medicine for high blood pressure. In combination, they are usually taken for more severe forms hypertension (high blood pressure). The most common combination of ACE inhibitors is with diuretics and calcium channel blockers. Indications for the use of these drugs are high blood pressure (hypertension), heart failure, left ventricular systolic dysfunction, myocardial infarction, diabetes, kidney disease, proteinuria, renal failure.

Sartans

These hypertension drugs are very similar to ACE inhibitors, therefore they can replace drugs in this group. Sartans are very well tolerated.

Calcium channel blockers

The reduction in blood pressure when taking these drugs occurs through systemic vasodilation (widening blood vessels). Medicines are not provided negative influence on fat metabolism, does not lead to narrowing respiratory tract. The drugs have a positive effect on systolic hypertension. In the long term, they are prescribed to older people with high blood pressure accompanied by diabetes, left ventricular enlargement, kidney disease, and peripheral arterial disease. They are not suitable for the treatment of high blood pressure accompanied by heart failure, A-V conduction disturbances, and slowing of the sinoatrial and atrioventricular lines.

Non-drug treatments

Before starting, but also during treatment for hypertension, lifestyle changes that can reduce blood pressure, the dose of antihypertensive drugs and cardiovascular risk should not be ignored. The most important changes to the mode are made as follows:

• to give up smoking;
• weight loss for overweight and obesity, maintaining optimal body weight;
• limiting alcohol consumption (for men – up to 20–30 g/day, for women – up to 10–20 g/day);
• sufficient physical activity (regular moderate exercise, preferably 30–45 minutes per day);
• limiting salt intake (up to 5 g/day);
• increasing the consumption of fruits and vegetables, limiting the consumption of fats (especially saturated fats).

Lifestyle changes are an integral part complex treatment arterial hypertension (high blood pressure).

Traditional medicine against hypertension

You can reduce high blood pressure using folk methods. Herbs and spices have a positive effect on high blood pressure levels.

Garlic

Contains many different substances. The most important is allicin, which has an antibacterial, antioxidant effect, reduces fat deposits, and has a positive effect on reducing high blood pressure in hypertension.

Cinnamon

Cinnamon contains a large amount of antioxidants and substances that prevent the formation of heart disease, helping to reduce high levels of hypertension.

Onion

Onions contain quercetin, an antioxidant flavonol, and other substances that studies have shown to prevent heart disease and stroke. Studies have also confirmed that onions reduce high diastolic and systolic blood pressure.

Olives

Olives are considered one of the healthiest natural crops around the world. Determined that daily use 40 g olive oil reduces the dosage of medications in patients with high blood pressure by up to 50%. Polyphenol is responsible for this substance.

Hawthorn

It has long been used in the treatment of hypertension - high blood pressure. The plant has a positive effect not only on hypertension, but also on diabetes.

Cardamom

Just 3g of powder for 3 months works wonders. The spice destroys blood clots, has an antioxidant effect, reduces lipid and fibrinogen levels, and reduces high blood pressure.

mistletoe

Extracts of this poisonous and at the same time medicinal plant to reduce high blood pressure in traditional Chinese medicine has been using it for a very long time. It must be used in strictly defined doses, otherwise mistletoe is toxic.

Melissa

Melissa is known as a calming and sleep-inducing herb. In addition, it relieves pain and helps reduce high blood pressure in hypertension.

Creeping tenacious

This popular herb also relieves problems associated with high blood pressure - hypertension.

Potato

In case of problems with high blood pressure (hypertension), consume potatoes. It contains substances that reduce increased performance, improve blood circulation, remove toxins from the body, which prevents constipation, promotes mental freshness, stimulates hormone function.

Green tea

– a wonderful remedy that has an antioxidant effect, promotes weight loss, reduces fat and sugar levels, and helps reduce high blood pressure in hypertension.

Complications of the disease

Damage to organs and their functions at the 3rd stage of hypertension can be considered as complications of hypertension (high blood pressure). This is coronary heart disease, especially left heart failure, acute heart attack myocardium.

In addition, hypertension can lead to stroke, kidney failure, blindness, and lower limb ischemia.

How to prevent the development of hypertension

Primary prevention of high blood pressure and arterial hypertension includes measures and actions aimed at preventing the occurrence of the disease. Prevention and non-pharmacological treatment include:

• lifestyle changes;
• achieving and maintaining optimal body weight;
• reducing fat consumption (for example, replacing whole milk products with low-fat ones, consuming cheeses with a fat content of less than 30%);
• reducing alcohol and salt intake (avoid foods such as sausages, canned and instant foods, mineral water high in salt);
• often eating raw food instead of processed food.

Regime measures also include increased physical aerobic activity and smoking restrictions. Hypertension (high blood pressure) is highly dependent on mental stress, especially feelings of anger, apathy, and disappointment. That's why primary prevention includes the regulation of social relations, self-regulation, and increased self-esteem.

All arterial hypertension is divided by origin into two large groups: essential (primary) arterial hypertension and symptomatic (secondary) arterial hypertension.

Essential (primary) arterial hypertension - a chronic disease of unknown etiology with a hereditary predisposition, arising as a result of the interaction of genetic factors and environmental factors, characterized by a stable increase in blood pressure in the absence of organic damage to the organs and systems that regulate it.

Etiology

Essential arterial hypertension, as follows from the above definition, is a disease in the development of which the interaction of genetic factors and adverse exogenous influences - environmental factors - is of leading importance. The exact etiology of essential hypertension remains unknown.

The role of genetic factors

Essential arterial hypertension is a disease that is highly characterized by hereditary predisposition. A high positive correlation has been established between the blood pressure values ​​of parents and children.

Currently, intensive research is being conducted to study the role of various genes in the development of arterial hypertension.

However, there are reliably established genetic abnormalities that cause the development of arterial hypertension:

angiotensinogen gene mutations;

mutations causing ectopic expression of the enzyme aldosterone synthetase;

amiloride-sensitive β-subunit mutations sodium channels renal epithelium.

In addition, changes in the angiotensin-converting enzyme and renin genes also play a major role in the development of essential arterial hypertension.

The role of environmental factors

Environmental factors also play a large role in the development of essential arterial hypertension. It should be emphasized that the importance of these factors is most significant in individuals with a genetic predisposition to the development of arterial hypertension.

Excessive consumption of table salt

Currently, there is no doubt that excessive consumption of table salt is an important risk factor for the development of arterial hypertension.

The adequate amount of table salt for an adult is 3.5 g per day.

The development of arterial hypertension under the influence of excess salt consumption is due to the following mechanisms:

excess sodium increases the volume of circulating blood, which in itself leads to increased blood pressure; in addition, the following mechanism is activated: an increase in circulating blood volume → overflow of the venous bed → an increase in venous return of blood to the heart → compensatory vasoconstriction → an increase in peripheral resistance → arterial hypertension;

increased sodium intake into the walls of arteries and arterioles causes their swelling, swelling, decreased lumen, and increased peripheral resistance;

accumulation of sodium in vascular wall sharply increases its sensitivity to the vasoconstrictor influence of the sympathetic nervous system and angiotensin 2.

Insufficient intake of calcium from food and water

Calcium deficiency in drinking water may cause the development of arterial hypertension in some patients.

Insufficient dietary intake of magnesium

In recent years, a relationship has been established between the amount of magnesium consumed in food and blood pressure levels.

Smoking

The role of smoking in the development of arterial hypertension has not yet been fully determined. Many cardiologists believe that the connection between smoking and blood pressure levels is not very clear. However, literature data recent years indicate a pronounced negative effect of smoking on vascular tone and endothelial function.

Alcohol

The effect of alcohol on blood pressure has been discussed in the medical literature for a long time. A definite relationship has been established between alcohol consumption and systolic and diastolic blood pressure.

Obesity

Excess body weight and arterial hypertension are interrelated. Excess body weight is a factor that predisposes to the development of arterial hypertension from childhood, and then continues to have this effect in adults.

The pathogenesis of arterial hypertension in obesity is complex; activation of the sympathetic-adrenal system and the renin-angiotensin-aldosterone system should be considered the main pathogenetic factors. In addition, most obese patients have increased sensitivity to salt and develop sodium-volume-dependent hypertension. It is also necessary to take into account that excess body weight is the most important component of the metabolic syndrome, which is characterized by arterial hypertension.

Low physical activity, physical inactivity

A sedentary, inactive lifestyle is a risk factor for the development of hypertension, and physical exercise lowers blood pressure.

It is assumed that physical inactivity contributes to the development of arterial hypertension because conditions of prolonged physical rest and lack of physical activity cause a disruption in the ability of the cardiovascular system to subtly adapt to a stressful situation.

Psycho-emotional stressful situations

Currently, the assumption is considered confirmed that, along with genetic factors and other environmental factors, chronic psycho-emotional stress is involved in the development of arterial hypertension.

There is a number of clinical and experimental evidence of the role of psycho-emotional stress, especially long-term stress, in the development of arterial hypertension. It should be emphasized that the ability to overcome stressful situations is largely determined by genetic factors.

"Ambulatory hypertension" or "white coat hypertension" is arterial hypertension, recorded only when measuring blood pressure at a doctor’s appointment.

“Arterial hypertension in the workplace” (stress-ind option)induced arterial hypertension)- this is a relatively stable increase in blood pressure due to the highly stressful nature of work, while the values ​​of blood pressure at the workplace are higher than the values ​​​​obtained when measured in the clinic.

Currently, it is customary to distinguish risk factors for development tia of essential arterial hypertension . In fact, they correspond to the above genetic and environmental factors, and also include age (the prevalence of hypertension increases with age, in addition, there are age differences between increases in systolic and diastolic pressure - among older people, the most common form of hypertension is isolated systolic hypertension); gender (under the age of 40, arterial hypertension is more common in men than in women; in older age groups this predominance of men is not so pronounced); postmenopausal period.