home Folk remedies Treatment regimens for arterial hypertension. Itsenko-Cushing syndrome and disease. Symptomatic arterial hypertension and its types

Treatment regimens for arterial hypertension. Itsenko-Cushing syndrome and disease. Symptomatic arterial hypertension and its types

Arterial hypertension (AH, hypertension) is one of the most important socio-economic and medical problems modernity. This is not only due to widespread of this disease among different age categories of the population, but also with high rates of severe complications, disability and mortality from arterial hypertension in the absence of timely treatment.

People who are prone to increased values pressure, it is recommended to take measurements on both hands. Latest Research showed that arterial hypertension can be confirmed if the difference in readings on different arms is 10 - 15 mm Hg. This sign (difference in indications) has a probability of identifying hypertension of up to 96%.

Despite the fact that at the moment there is a huge number of antihypertensive drugs that make it possible to maintain blood pressure at an adequate level, the incidence of hypertensive crises and complications such as heart ( ) and renal failure (RF) in the aortic and mitral valves, and aorta, MI (heart attacks), strokes, etc. in patients with hypertension remains extremely high.

This is primarily due to the fact that many patients do not want to systematically take antihypertensive therapy, believing that the hypertensive crisis that they developed was a one-off and it will not happen again.

According to statistics, of the patients who are aware that they have arterial hypertension, only about 40% of women and 35% of men receive drug treatment. At the same time, only 15% of women and about five percent of men achieve the required blood pressure levels through the systematic use of antihypertensive therapy, monitoring blood pressure levels and regular visits to the doctor and compliance with his recommendations.

Attention. Despite the fact that arterial hypertension is a controllable risk factor for the formation of CVS pathologies, such deplorable indicators are due to the patient’s banal lack of understanding of the seriousness of his diagnosis, and, consequently, the lack of a serious and responsible approach to treatment.

They remember many work colleagues who were taken away by ambulance with a hypertensive crisis, their relatives who constantly complain of high blood pressure, etc. Therefore, many people believe that with the modern busy rhythm of life, after forty years, hypertension is something that goes without saying, and only a hypertensive crisis needs to be treated.

This attitude towards one’s health has led to the fact that about 40% of deaths from CVS pathologies in Russia are associated with arterial hypertension and its acute (crises, strokes, heart attacks, etc.) or chronic (HF and PN, etc.) complications.

The most common severe complications that develop due to crises of hypertensive origin are:

stroke (about thirty percent of patients);
pulmonary edema (twenty-three percent);
hypertensive encephalopathy (16%);
acute heart failure (fourteen percent);
cerebral hemorrhage (five percent of cases);
dissecting aortic aneurysm (2.5%), etc.

Attention. It should be noted that in the absence of adequate and systematic treatment of hypertension, 30 to 40% of patients die from heart and kidney failure within three years after suffering a severe (complicated) hypertensive crisis.

Comprehensive treatment, responsible approach to your health, systematic reception taking medications against arterial hypertension and controlling your blood pressure can help reduce these frightening numbers to a minimum.

Arterial hypertension - what is it?

For reference. The diagnosis of hypertension is made after a minimum of three separate blood pressure measurements.

Typically, for people not receiving treatment with antihypertensive drugs, the diagnosis of hypertension implies an increase in blood pressure above 140 mmHg. for indicators and more than ninety mmHg, for indicators DBP (diastolic).

Arterial hypertension - classification

For convenience, there are several divisions of degrees of arterial hypertension. To divide blood pressure into normal, normal high blood pressure and hypertension, classification by percentiles is used (normal values by age, height and gender, which are calculated using standardized tables).

According to percentile classification, pressure can be:

normal, in which systolic and diastolic values are above the tenth, but below the ninetieth percentile of the distribution of normal blood pressure values, taking into account the patient’s age, height and weight;
high normal, in which blood pressure readings are above the ninetieth, but below the ninety-fifth percentile. Or, the patient experiences an increase in blood pressure above 120/80 mmHg, even if these values in the table are below the ninetieth percentile;
classified as arterial hypertension. This diagnosis is made when the average systolic and/or diastolic (calculated after three independent blood pressure measurements) values increase above the ninety-fifth percentile.

Also, arterial hypertension is divided according to the causes of high blood pressure into:

primary or essential. Such hypertension is an independent pathology, so this diagnosis is made only after excluding all other causes of arterial hypertension. Essential hypertension is classified as essential hypertension (hypertension);
secondary and symptomatic. Secondary arterial hypertension is called increased blood pressure caused by the presence of a background disease (adrenal tumor, glomerulonephritis, coarctation of the aorta, etc.), accompanied by SAH (arterial hypertension syndrome).

A distinction must be made between SAH and hypertension.

Attention. Hypertension is a chronic disease manifested by increased blood pressure. Elevated blood pressure with hypertension is not a consequence of other diseases.

However, hypertension can lead to the development of pathologies (HF, regurgitation of the mitral and aortic valves, renal failure, etc.), which in the future will significantly aggravate the course of hypertension (that is, a vicious circle is formed).

Arterial hypertension syndrome is characterized by an increase in blood pressure against the background of an existing pathology. Therefore, hypertensive syndrome can be renal (renal), cerebral, endocrine, hemodynamic, etc. character.

Symptomatic hypertension can develop in patients with renal pathologies (glomerulonephritis, pyelonephritis), anomalies in the development of renal arteries, endocrine pathologies (symptomatic hypertension can develop against the background of acromegaly, diffuse toxic goiters, pheochromocytoma, etc.).

Degrees of arterial hypertension

It should be taken into account that this classification implies a gradual progression of hypertension. That is, arterial hypertension of the 1st degree, according to the classification (SBP from 140 to 159) for a patient with a first increase in blood pressure, can be classified as a hypertensive crisis.

Stages of hypertension, depending on the presence of OM lesions (target organs)

Important. With first-degree hypertension, complications of this kind rarely occur. However, when hypertension debuts with a severe complicated hypertensive crisis, OM damage can be observed after the first attack.

According to the degree of damage to the OM during hypertension, the following are distinguished:

Stage 1, in which there is no evidence of damage to the OM;
Stage 2, accompanied by the appearance of objective, laboratory-confirmed signs of moderate damage to the OM. The second stage of arterial hypertension may be accompanied by the development of:
- LV hypertrophy (left ventricle),
- generalized stenosis of retinal vessels, thickening of the walls carotid arteries, the development of atherosclerotic plaques in their lumen,
- kidney damage and the appearance of microalbuminuria, as well as an increase (moderate) in blood creatinine levels.
Stage 3. On at this stage note significant damage to the OM, leading to dysfunction of the organ. The third stage of hypertension may be accompanied by damage to:
- heart, with the development of heart failure or acute coronary syndrome and myocardial infarction;
- brain, with the occurrence of strokes, transient ischemic attacks (TIA), cerebral hemorrhages, acute hypertensive encephalopathies, severe vascular dementia;
- fundus, leading to retinal hemorrhages and damage to the optic nerve;
- kidneys, accompanied by the formation of renal failure;
- vessels, leading to the development of occlusions in the peripheral vascular bed and/or aortic dissection.

Classification according to degrees of cardiovascular risk

In addition to the main classifications of arterial hypertension and hypertension (hypertension), when making a diagnosis, risk factors that influence the rate of disease progression and the development of OM lesions are taken into account.

All risk factors are divided into 4 categories (low, medium, high, and very high). Each category determines the risk of severe complications from the cardiovascular system in a patient with arterial hypertension within ten years from the date of diagnosis.

Attention. For low risks, the probability of developing complications is less than 15%, for medium risks – from 15 to 20%, for high risks – from twenty to thirty percent, and for very high risks – more than thirty percent.

Risk factors for arterial hypertension or worsening its course include:

long-term smoking;
presence of a burdened family history (meaning the presence of cases of early cardiovascular diseases close relatives);
the patient has lipid imbalance and/or atherosclerosis;
age factor (for men, the risk factor for hypertension is age over 55 years, and for women – over 65 years):
the patient has impaired glucose tolerance, normal obesity or abdominal obesity (an increase in the waist over one hundred and two centimeters for men and over eighty-eight for women).

Risk factors for poor prognosis (severe course and development of complications) include:

The presence of OM lesions (this includes left ventricular hypertrophy, atherosclerotic lesions of the walls of the carotid arteries, microalbuminuria and a decrease in glomerular filtration rate (GFR), an increase in the speed of PV (pulse wave) in large arteries over 10 meters per second).
The presence of concomitant background pathologies in a patient with hypertension that can affect the prognosis (note the patient’s history of strokes and heart attacks, coronary heart disease, chronic renal failure or heart failure, diabetes mellitus (DM), as well as diabetic retinopathy and nephropathies.

Development of isolated systolic hypertension

For reference. The development of isolated systolic hypertension (ISAH) is typical, as a rule, for elderly patients, due to an age-related decrease in the elastic properties of the vascular intima.

ISAH is characterized exclusively by an increase in systolic blood pressure, with normal or even slightly reduced diastolic pressure values (the lower the DBP, the worse the prognosis and the higher the risk of complications). Among the causes of hypertension in older people, ISAH accounts for almost ninety percent of all cases.

“White coat or office” hypertension is characterized by an increase in pressure only in a stressful situation for the patient (going to the doctor, calling the boss at work (office variant of hypertension), etc.).

Causes of symptomatic hypertension

Symptomatic hypertension can develop due to:

kidney diseases (pyelo- and glomerulonephritis);
anomalies of the development of the renal arteries and organs of the genitourinary system;
lesions of the prenal vessels due to atherosclerosis, thrombosis, autoimmune pathologies, vasculitis, compression of blood vessels by a tumor, etc.;
acquired and congenital heart defects;
rhythm disturbances and damage to the cardiac conduction system;
pathologies of the central nervous system (CNS);
TBI (traumatic brain injury);
brain tumors;
neoplasms in the adrenal glands (pheochromocytomas);
infections affecting the membranes of the brain (meningitis);
reception medications having a hypertensive effect;
pathology thyroid gland etc.

Arterial hypertension - symptoms

The main danger of hypertension is that the first manifestations of the disease are, as a rule, nonspecific and asymptomatic. Patients may be concerned about:

increased fatigue,
headaches,
transient visual dysfunctions (flickering of colored spots, diplopia, impaired clarity of perception, etc.),
tachycardia,
not expressed painful sensations behind the sternum,
feeling of interruptions in the work of the heart.

The specific symptoms of hypertension will depend on the involvement of the OM. That is, with the development of HF, patients will complain of severe weakness and shortness of breath during physical activity, chest pain. Violation cerebral circulation will manifest itself as headache, dizziness, impaired coordination of movement, speech and visual disturbances, fainting, etc.

For reference. Symptoms of atherosclerotic vascular disease will depend on the level of vascular occlusion (ischemia lower limbs, atherosclerosis of the coronary arteries of the heart, cerebrovascular atherosclerosis, etc.).

The appearance of hypertensive crises will be accompanied by:

severe intense headaches,
visual dysfunctions,
vomiting like a fountain (does not bring relief),
tachycardia,
pain syndrome similar to angina attack,
increased sweating,
shortness of breath, etc.

Diagnostics

Diagnostic measures must include:

study of complaints and medical history;
complete examination of the patient;
auscultation of the heart and large vessels;
measuring blood pressure on both arms and legs;
assessment of laboratory parameters (BAC, TAM, determination of daily protein in urine, lipilogram, coagulogram, biochemistry, blood glucose, etc.);
conducting instrumental studies ( ultrasound diagnostics kidneys, adrenal glands, thyroid gland, etc., Dopplerography of blood vessels, X-ray examination of the chest organs, electrocardiograms, ECHO-CG, ophthalmoscopic diagnostics of the fundus, etc.).

Arterial hypertension - treatment

Basic principles of hypertension treatment:

All therapy is carried out depending on the severity of the disease, the reasons for its development and the presence of OM lesions.

Attention. Treatment of hypertension should always be comprehensive. Prescribing antihypertensive drugs alone is not enough. Lifestyle correction and reduction of controllable risk factors (smoking, obesity, dilipidemia, etc.) are mandatory.

Basic treatment tactics:

Treatment tactics depending on risk factors:

All drug therapy is prescribed exclusively by the attending physician. The choice of basic drugs, their dosages and duration of treatment will depend on the severity of the disease and the age of the patient.

The main drugs used to treat hypertension are:

diuretics (furosemide, amiloride, spirolactone);
beta-blockers (atenolol, meoprolol, propranolol) and calcium channel blockers (amlodipine, nifedipine);
ACE inhibitors (the use of captopril, enalapril, ramipril is indicated);
agents that can block angiotensin receptors (losartan, valsartan).

Additionally, the following may be prescribed:

drugs for correcting lipid balance indicators (hypolipidemic drugs),
B vitamins,
antioxidants,
anticoagulants and antiplatelet agents,
medications that improve metabolic processes in tissues.

Symptomatic therapy is also carried out, aimed at correcting developed complications (treatment of cardiac and renal pathologies, correction of circulatory disorders in the GM (brain), etc.).

For symptomatic hypertension, the basis of treatment will be the elimination of the underlying disease that caused the increase in blood pressure.

For emotional patients with increased excitability nervous system Sedatives or tranquilizers may be recommended.

Disease prognosis

With adequate and systematic treatment the prognosis of the disease is favorable. The most important role in the treatment of hypertension is played by the patient’s attitude and his clear understanding of the need for lifestyle correction, compliance with the doctor’s recommendations and taking prescribed medications.

Attention. In the absence of medical care, about forty percent of patients die from the consequences of complicated hypertensive crises within three years.

What is arterial hypertension? We will discuss the causes, diagnosis and treatment methods in the article by Dr. Zafiraki V.K., a cardiologist with 18 years of experience.

Definition of disease. Causes of the disease

Main criterion arterial hypertension(or arterial hypertension) as a whole group of diseases - stable, that is, identified through repeated measurements in different days, increased blood pressure (BP). The question of what kind of blood pressure is considered elevated is not as simple as it might seem. The fact is that among practically healthy people the range of blood pressure values is quite wide. The results of long-term observation of people with different blood pressure levels showed that already starting from the level of 115/75 mm Hg. Art., each additional increase in blood pressure by 10 mm Hg. Art. is accompanied by an increased risk of developing diseases of the cardiovascular system (primarily coronary heart disease and stroke). However, the benefits modern methods treatment of arterial hypertension has been proven mainly only for those patients whose blood pressure exceeded 140/90 mmHg. Art. It is for this reason that it was agreed to consider this threshold value as a criterion for identifying arterial hypertension.

An increase in blood pressure can be accompanied by dozens of different chronic diseases, and hypertension is only one of them, but the most common: approximately 9 cases out of 10. The diagnosis of hypertension is established in cases where there is a stable increase in blood pressure, but no other diseases that lead to an increase in blood pressure, is not detected.

Hypertension is a disease for which a stable increase in blood pressure is its main manifestation. Risk factors that increase the likelihood of its development have been established through observations of large groups of people. In addition to the genetic predisposition that some people have, these risk factors include:

obesity;
inactivity;
excess consumption table salt, alcohol;
chronic stress;
smoking.

In general, all those features that accompany the modern urban lifestyle in industrialized countries. This is why hypertension is considered a lifestyle disease, and targeted changes for the better should always be considered as part of a hypertension treatment program on a case-by-case basis.

What other diseases are accompanied by increased blood pressure? These are many kidney diseases (pyelonephritis, glomerulonephritis, polycystic disease, diabetic nephropathy, stenosis (narrowing) of the renal arteries, etc.), a number of endocrine diseases (adrenal tumors, hyperthyroidism, Cushing's disease and syndrome), obstructive sleep apnea syndrome, and some other, rarer diseases. Regular use of medications such as glucocorticosteroids, non-steroidal anti-inflammatory drugs, and oral contraceptives can also lead to a persistent increase in blood pressure. The diseases and conditions listed above lead to the development of so-called secondary, or symptomatic, arterial hypertension. The doctor establishes the diagnosis of hypertension if, during a conversation with the patient, finding out the history of the disease, examination, as well as based on the results of some, mostly simple laboratory and instrumental methods studies, the diagnosis of any of the secondary arterial hypertension seems unlikely.

Symptoms of arterial hypertension

High blood pressure itself does not manifest itself in any subjective sensations for many people. If high blood pressure is accompanied by symptoms, this may include a feeling of heaviness in the head, headache, flashing before the eyes, nausea, dizziness, unsteadiness when walking, as well as a number of other symptoms that are rather nonspecific for high blood pressure. The symptoms listed above manifest themselves much more clearly during a hypertensive crisis - a sudden significant increase in blood pressure, leading to a clear deterioration in condition and well-being.

It would be possible to continue listing separated by commas possible symptoms GB, but there is no particular benefit in this. Why? Firstly, all these symptoms are non-specific for hypertension (i.e. they can occur either individually or in various combinations in other diseases), and secondly, to establish the presence of arterial hypertension, the very fact of a stable increase in blood pressure is important . And this is revealed not by assessing subjective symptoms, but only by measuring blood pressure, moreover, repeatedly. This means, firstly, that “in one sitting” one should measure blood pressure twice or three times (with a short break between measurements) and take the arithmetic mean of two or three measured values as true blood pressure. Secondly, the stability of the increase in blood pressure (a criterion for diagnosing hypertension as a chronic disease) should be confirmed by measurements on different days, preferably with an interval of at least a week.

If a hypertensive crisis develops, there will definitely be symptoms, otherwise it is not a hypertensive crisis, but simply an asymptomatic increase in blood pressure. And these symptoms can be either those listed above or others, more serious - they are discussed in the “Complications” section.

Symptomatic (secondary) arterial hypertension develops as part of other diseases, and therefore their manifestations, in addition to the actual symptoms of high blood pressure (if any), depend on the underlying disease. For example, with hyperaldosteronism, this can be muscle weakness, cramps, and even transient (lasting hours - days) paralysis in the muscles of the legs, arms, and neck. With obstructive syndrome sleep apnea- snoring, sleep apnea, daytime sleepiness.

If hypertension over time - usually many years - leads to damage to various organs (in this context they are called “target organs”), then this can manifest itself as a decrease in memory and intelligence, a stroke or a transient cerebrovascular accident, an increase in the thickness of the walls of the heart, accelerated development of atherosclerotic plaques in the vessels of the heart and other organs, myocardial infarction or angina pectoris, decreased rate of blood filtration in the kidneys, etc. Accordingly, clinical manifestations will be caused by these complications, and not by increased blood pressure as such.

Pathogenesis of arterial hypertension

In hypertension, dysregulation of vascular tone and increased blood pressure are the main content of this disease, so to speak, its “quintessence”. Factors such as genetic predisposition, obesity, inactivity, excessive consumption of table salt, alcohol, chronic stress, smoking and a number of others, mainly related to lifestyle characteristics, lead over time to disruption of the functioning of the endothelium - the inner layer of arterial vessels, which is thick one cell layer that is actively involved in the regulation of tone, and therefore the lumen of blood vessels. The tone of microvasculature vessels, and hence the volume of local blood flow in organs and tissues, is autonomously regulated by the endothelium, and not directly by the central nervous system. This is a system of local blood pressure regulation. However, there are other levels of blood pressure regulation - the central nervous system, endocrine system and kidneys (which also realize their regulatory role largely due to their ability to participate in hormonal regulation at the level of the whole organism). Violations in these complex regulatory mechanisms lead, in general, to a decrease in the ability of the entire system to finely adapt to the constantly changing needs of organs and tissues for blood supply.

Over time, a persistent spasm of small arteries develops, and subsequently their walls change so much that they are no longer able to return to their original state. In larger vessels, due to constantly elevated blood pressure, atherosclerosis develops at an accelerated pace. The walls of the heart become thicker, myocardial hypertrophy develops, and then dilation of the cavities of the left atrium and left ventricle. Increased pressure damages the glomeruli, their number decreases and, as a result, the ability of the kidneys to filter blood decreases. In the brain, due to changes in the blood vessels supplying it, negative changes also occur - small foci of hemorrhages appear, as well as small areas of necrosis (death) of brain cells. When an atherosclerotic plaque ruptures in a sufficiently large vessel, thrombosis occurs, the lumen of the vessel is blocked, and this leads to a stroke.

Classification and stages of development of arterial hypertension

Hypertension, depending on the magnitude of elevated blood pressure, is divided into three degrees. In addition, taking into account the increase in the risk of cardiovascular diseases on a “year-decade” scale, already starting from a blood pressure level above 115/75 mm Hg. Art., there are several more gradations of blood pressure levels.

If the values of systolic and diastolic blood pressure fall into different categories, then the degree of arterial hypertension is assessed by the highest of the two values, and it does not matter - systolic or diastolic. The degree of increase in blood pressure when diagnosing hypertension is determined by repeated measurements on different days.

In our country, stages of hypertension continue to be distinguished, while the European recommendations for the diagnosis and treatment of arterial hypertension do not mention any stages. The identification of stages is intended to reflect the phasing of the course of hypertension from its onset to the appearance of complications.

There are three stages:

Stage I implies that there is still no obvious damage to those organs that are most often affected by this disease: there is no enlargement (hypertrophy) of the left ventricle of the heart, there is no significant decrease in the filtration rate in the kidneys, which is determined taking into account the level of creatinine in the blood, protein is not detected in the urine albumin, thickening of the walls of the carotid arteries or atherosclerotic plaques in them, etc. is not detected. Such a lesion internal organs usually asymptomatic.
If there is at least one of the listed signs, diagnose Stage II hypertension.
Finally, about Stage III hypertension is said to exist when there is at least one cardiovascular disease with clinical manifestations associated with atherosclerosis (myocardial infarction, stroke, angina pectoris, atherosclerotic lesions of the arteries of the lower extremities), or, for example, serious kidney damage, manifested by a pronounced decrease in filtration and/or significant loss of protein in the urine.

These stages do not always naturally replace one another: for example, a person suffered a myocardial infarction, and after a few years an increase in blood pressure occurred - it turns out that such a patient immediately has stage III hypertension. The purpose of staging is mainly to rank patients according to their risk of cardiovascular complications. Treatment measures also depend on this: the higher the risk, the more intensive the treatment. When formulating a diagnosis, risk is assessed in four gradations. At the same time, the 4th gradation corresponds to the greatest risk.

Complications of arterial hypertension

The goal of treatment for hypertension is not to “bring down” high blood pressure, but to maximally reduce the risk of cardiovascular and other complications in the long term, since this risk - again, when assessed on a “year-decade” scale - increases for every additional 10 mmHg Art. already from a blood pressure level of 115/75 mm Hg. Art. This refers to complications such as stroke, coronary heart disease, vascular dementia(dementia), chronic renal and chronic heart failure, atherosclerotic vascular lesions of the lower extremities.

Most patients with hypertension do not worry about anything for the time being, so they do not have much motivation to be treated, regularly taking a certain minimum medicines and changing your lifestyle to a healthier one. However, in the treatment of hypertension there are no one-time measures that would allow you to forget about this disease forever without doing anything more to treat it.

Diagnosis of arterial hypertension

With the diagnosis of arterial hypertension as such, everything is usually quite simple: this requires only repeatedly recorded blood pressure at the level of 140/90 mm Hg. Art. and higher. But hypertension and arterial hypertension are not the same thing: as already mentioned, an increase in blood pressure can manifest itself in a number of diseases, and hypertension is only one of them, although the most common. When conducting a diagnosis, the doctor, on the one hand, must verify the stability of the increase in blood pressure, and on the other hand, assess the likelihood of whether the increase in blood pressure is a manifestation of symptomatic (secondary) arterial hypertension.

To do this, at the first stage of the diagnostic search, the doctor finds out at what age blood pressure first began to rise, whether there are symptoms such as, for example, snoring with breathing stops during sleep, attacks of muscle weakness, unusual impurities in the urine, attacks of sudden heartbeat with sweating and headache. pain, etc. It makes sense to clarify what medications and dietary supplements the patient is taking, because in some cases, they can lead to an increase in blood pressure or aggravation of an already elevated one. Several routine (performed in almost all patients with high blood pressure) diagnostic tests, along with information obtained during a conversation with a doctor, help assess the likelihood of some forms of secondary hypertension: a general urine test, determination of blood concentrations of creatinine and glucose, and sometimes potassium and other electrolytes. In general, taking into account the low prevalence of secondary forms of arterial hypertension (about 10% of all its cases), further search for these diseases as a possible cause of high blood pressure must have good reasons. Therefore, if at the first stage of the diagnostic search no significant data are found in favor of the secondary nature of arterial hypertension, then in the future it is considered that blood pressure is increased due to hypertension. This judgment may sometimes be subsequently revised as new data about the patient becomes available.

In addition to searching for data on the possible secondary nature of the increase in blood pressure, the doctor determines the presence of risk factors for cardiovascular diseases (this is necessary to assess the prognosis and a more targeted search for damage to internal organs), as well as, possibly, pre-existing diseases of the cardiovascular system or their asymptomatic damage - this affects the assessment of the prognosis and stage of hypertension, the choice therapeutic measures. For this purpose, in addition to talking with the patient and examining him, a number of diagnostic studies are performed (for example, electrocardiography, echocardiography, ultrasonography vessels of the neck, and, if necessary, some other studies, the nature of which is determined by the medical data already obtained about the patient).

Daily blood pressure monitoring using special compact devices allows you to assess changes in blood pressure during the patient’s usual lifestyle. This study is not necessary in all cases - mainly, if the blood pressure measured at a doctor’s appointment differs significantly from that measured at home, if it is necessary to evaluate nighttime blood pressure, if episodes of hypotension are suspected, sometimes to assess the effectiveness of the treatment.

So alone diagnostic methods when examining a patient with high blood pressure, they are used in all cases; the use of other methods is more selective, depending on the data already obtained about the patient, to check the assumptions that the doctor made during the preliminary examination.

Treatment of arterial hypertension

With regard to non-drug measures aimed at treating hypertension, the most convincing evidence has accumulated on the positive role of reducing salt intake, reducing and maintaining body weight at this level, regular physical training (exertion), no more than moderate alcohol consumption, as well as increasing the content of vegetables and fruits in the diet. Only all these measures are effective as part of long-term changes in the unhealthy lifestyle that led to the development of hypertension. For example, a decrease in body weight by 5 kg led to a decrease in blood pressure by an average of 4.4/3.6 mm Hg. Art. - it seems like a little, but in combination with the other measures listed above to improve your lifestyle, the effect can be quite significant.

Improving lifestyle is justified for almost all patients with hypertension, but drug treatment is indicated, although not always, in most cases. If patients with increased blood pressure of 2 and 3 degrees, as well as with hypertension of any degree with a high calculated cardiovascular risk, drug treatment is mandatory (its long-term benefit has been demonstrated in many clinical studies), then in case of stage 1 hypertension with low and average calculated cardiovascular risk, the benefit of such treatment has not been convincingly proven in serious clinical trials. In such situations possible benefit from destination drug therapy assessed individually, taking into account the patient's preferences. If, despite improving lifestyle, the increase in blood pressure in such patients persists for a number of months during repeated visits to the doctor, it is necessary to re-evaluate the need for medication use. Moreover, the magnitude of the calculated risk often depends on the completeness of the patient’s examination and may turn out to be significantly higher than initially thought. In almost all cases of treatment of hypertension, they strive to achieve stabilization of blood pressure below 140/90 mm Hg. Art. This does not mean that in 100% of measurements it will be below these values, but the less often the blood pressure when measured in standard conditions(described in the "Diagnostics" section) will exceed this threshold, the better. Thanks to this treatment, the risk of cardiovascular complications is significantly reduced, and hypertensive crises if they do happen, it is much less common than without treatment. Thanks to modern medications, those negative processes that, in hypertension, inevitably and latently destroy internal organs over time (primarily the heart, brain and kidneys), these processes are slowed down or suspended, and in some cases they can even be reversed.

Of the medications for the treatment of hypertension, the main ones are 5 classes of drugs:

diuretics (diuretics);
calcium antagonists;
angiotensin-converting enzyme inhibitors (names ending in -adj);
angiotensin II receptor antagonists (names ending in -sartan);
beta blockers.

Recently, the role of the first four classes of drugs in the treatment of hypertension has been especially emphasized. Beta blockers are also used, but mainly when their use is required by concomitant diseases - in these cases, beta blockers serve a dual purpose.

Nowadays, preference is given to combinations of drugs, since treatment with any one of them rarely leads to achieving the desired level of blood pressure. There are also fixed combinations of drugs that make treatment more convenient, since the patient takes only one tablet instead of two or even three. The selection of the necessary classes of medications for a particular patient, as well as their doses and frequency of administration, is carried out by the doctor, taking into account such data about the patient as blood pressure level, concomitant diseases, etc.

Thanks to the multifaceted positive action With modern medications, the treatment of hypertension involves not only lowering blood pressure as such, but also protecting internal organs from the negative effects of those processes that accompany high blood pressure. In addition, since the main goal of treatment is to minimize the risk of its complications and increase life expectancy, it may be necessary to correct blood cholesterol levels, take medications that reduce the risk of blood clots (which leads to myocardial infarction or stroke), etc. Refusal Smoking, no matter how trivial it may sound, allows you to significantly reduce the risks of stroke and myocardial infarction associated with hypertension, and slow down the growth of atherosclerotic plaques in blood vessels. Thus, treating hypertension involves addressing the disease in many ways, and achieving normal blood pressure is only one of them.

Forecast. Prevention

The overall prognosis is determined not only and not so much by the fact of high blood pressure, but by the number of risk factors for cardiovascular diseases, the degree of their severity and the duration of the negative impact.

These risk factors are:

smoking;
increased blood cholesterol levels;
high blood pressure;
obesity;
sedentary lifestyle life;
age (with each decade lived after 40 years, the risk increases);
male gender and others.

In this case, not only the intensity of exposure to risk factors is important (for example, smoking 20 cigarettes a day is undoubtedly worse than 5 cigarettes, although both are associated with a worse prognosis), but also the duration of their exposure. For people who do not yet have obvious cardiovascular diseases other than hypertension, the prognosis can be assessed using special electronic calculators, one of which takes into account gender, age, blood cholesterol level, blood pressure and smoking. The SCORE electronic calculator is suitable for estimating the risk of death from cardiovascular diseases in the next 10 years from the date of risk assessment. At the same time, the risk obtained in most cases, which is low in absolute numbers, can produce a misleading impression, because the calculator allows you to calculate exactly the risk cardiovascular death. The risk of non-fatal complications (myocardial infarction, stroke, angina pectoris, etc.) is many times higher. The presence of diabetes mellitus increases the risk compared to that calculated using a calculator: for men by 3 times, and for women - even by 5 times.

With regard to the prevention of hypertension, we can say that since the risk factors for its development are known (inactivity, excess weight, chronic stress, regular lack of sleep, alcohol abuse, increased consumption of table salt and others), then all lifestyle changes that reduce the impact of these factors also reduce the risk of developing hypertension. However, it is hardly possible to reduce this risk completely to zero - there are factors that do not depend on us at all or depend little on us: genetic characteristics, gender, age, social environment, and some others. The problem is that people begin to think about the prevention of hypertension mainly when they are already unhealthy, and blood pressure is already increased to one degree or another. And this is not so much a question of prevention as of treatment.

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7. Barsukov A.V. et al. Left ventricular hypertrophy and the renin-angiotensin-aldosterone system: AT1-angiotensin receptor blockers are in focus. Systemic hypertension. 2013. 1: 88-96
8. Yakhno N.N. et al. Dementia. M.: MEDpress-inform., 2010. 272 p.
9. Recommendations for the treatment of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology. Russian Journal of Cardiology. 2014. 1:7-94
10. Diagnosis and treatment of arterial hypertension: clinical guidelines Russian Medical Society about arterial hypertension. Cardiological Bulletin. 2015. 1: 5-30

Hypertension (arterial hypertension) is the most common disease of the cardiovascular system.

Hypertension is rapidly becoming “younger”; today it is no longer a disease only of older people, but is often found in pregnant women, and is becoming increasingly common in adolescents.

What is arterial hypertension? The answer to this question can be found in the definition of the condition for this disease.

It is characterized by chronically high blood pressure, when the highest value (systolic pressure) exceeds 140 mm Hg. and the lowest (diastolic pressure) is above 90 mm Hg. subject to at least three measurements made in different times in a person who is in a calm state.

Optimal blood pressure readings are 120-130 at 80-89 mmHg. if they are higher, then it is necessary to begin actively treating hypertension. However, few people diagnose this disease on early stage: about 35% of men and 55% of women know about their high blood pressure, only half of them are treated for arterial hypertension, and only 6% of the male population and 20% of women control their blood pressure.

The sooner you identify arterial hypertension and begin to keep it under control, the lower the risk of developing complications of hypertension in the future (coronary artery disease, atherosclerosis, kidney disease, decreased testosterone levels in the blood, erectile dysfunction).

Hypertension can be one of the causes of impotence in men.

It is worth noting

The main goal of treating hypertension is to constantly monitor blood pressure in order to avoid even more serious problems with health, since it is impossible to completely cure this disease.

Why is hypertension dangerous?

With prolonged high blood pressure, the walls of blood vessels thicken and lose their ability to relax, this prevents normal blood supply and, as a result, the saturation of tissues and organs with oxygen and other nutrients, reducing their functional activity. Let's take a closer look at why hypertension is dangerous:

To avoid any complications that are so dangerous with hypertension, it is necessary to consult a doctor in a timely manner and undergo an examination, which will help determine the stage of development of the disease and prescribe the required treatment.

Degrees of hypertension: classification, forms

Based on the nature of the assessment of one or more criteria, a number of classifications of hypertension are used.

There are stages of development such as origin, form of course, blood pressure level, degree of damage to target organs.

The primary task when diagnosing arterial hypertension is to differentiate the nature of the disease. There are two large groups here:

primary or essential hypertension - increased blood pressure is the root cause;
secondary or symptomatic arterial hypertension - high blood pressure is caused by diseases of other organs or systems: kidneys, heart, endocrine glands, lungs, thyroid gland.

According to experts

Treatment of symptomatic hypertension cannot occur without treating the disease that caused it, and begins with it. In some cases, along with the elimination of the underlying disease, hypertension also disappears.

Also, blood pressure, up to a hypertensive crisis, can increase due to improper use of certain medications, neuroses, excessive consumption of caffeine, and other stimulants.

When diagnosing and choosing the right treatment tactics for essential hypertension, doctors usually classify the disease according to blood pressure level. In international practice, there are three degrees of hypertension:

Hypertension 1st degree- systolic pressure 140−159 mm Hg. diastolic pressure 90−99 mm Hg. A mild form of the disease, which is characterized by sudden changes in blood pressure, can either return to normal on its own or rise again.
Hypertension 2 degrees- systolic 160−179 mmHg. diastolic 100−109 mm Hg. Moderate form, the increase in pressure is more prolonged, up to normal values rarely falls.
Hypertension 3 degrees- systolic above 180 mm Hg. diastolic above 110 mm Hg. Severe form, pressure is consistently at the level of pathological indicators, occurs with severe complications, and is difficult to correct with medications.

Separately, isolated systolic hypertension is distinguished; it occurs in about a third of elderly people with arterial hypertension. This form is caused by age-related loss of elasticity of large vessels, often accompanied by myocardial infarction, coronary heart disease, congestive heart failure and left ventricular hypertrophy. Blood pressure indicators: systolic up to 160 mm Hg. and above, diastolic - below 90 mm Hg.

Helpful information

It is worth noting another minor group - the so-called “white coat hypertension”, when, under the influence of psycho-emotional factors, a person’s blood pressure increases only at the time it is measured by a medical professional. In such cases, the diagnosis is clarified by repeated pressure measurements in a quiet home environment.

In addition to the degree of hypertension, when making a diagnosis, risk factors that can lead to complications of the cardiovascular system and the stage of the clinical course of the disease are also assessed:

Transistor (initial stage) hypertension. The increase in pressure is periodic, returning to normal values; Blood pressure lowering drugs are not used.
Labile hypertension. An increase in blood pressure is directly related to the provoking factor: stress, severe psychological or physical stress. To stabilize the pressure, drug treatment is necessary.
Stable arterial hypertension. Persistent increase in blood pressure, which requires serious supportive therapy.
Malignant form. Increasing blood pressure to very high levels, the disease quickly progresses and leads to the development of serious complications.
Crisis form. Characterized by periodic hypertensive crises against a background of normal or slightly elevated blood pressure.

Assessment of hypertension severity and risk possible complications is possible only on the basis of a thorough examination: general and biochemical tests, Ultrasound of the heart and other organs, ECG, fundus examination. Full examination A patient with arterial hypertension is usually treated as an inpatient.

High blood pressure is the main warning sign of hypertension in both men and women

Symptoms of hypertension may be absent for quite a long time, and if a person does not constantly use a blood pressure monitor, he can find out about his disease, having already begun to treat its complications.

Often hypertension has no manifestations at all, except for its main symptom - persistent high blood pressure.

Moreover, the concept of “persistent” or “chronic” is key here, since in a number of situations (stress, fear or anger) pressure can increase and then return to normal on its own. However, few people control their blood pressure levels, so you should pay attention to the following symptoms indicating the development of arterial hypertension:

Headache. Most often it appears in the occipital, parietal region or temples. It can occur both at night and immediately after waking up. As a rule, it intensifies with mental or physical stress. Sometimes accompanied by swelling of the eyelids and face.
Dizziness. Sometimes even with little physical effort: coughing, turning or tilting the head, or sudden rise.
Pain in the heart area. They occur not only during emotional stress, but also at rest. Both long-term aching, squeezing pain and short-term, stabbing pain are possible. They do not disappear after taking nitroglycerin.
Palpitations.
Noise in ears.
Visual impairment: blurred vision, fog, spots before the eyes.
Arterial damage: cold extremities, intermittent claudication.
Swelling of the legs. Indicate a violation of the excretory function of the kidneys or heart failure.
Dyspnea. Occurs as if physical activity, and at rest.

It is important to know

Hypertensive crisis - an emergency condition caused by excessively high blood pressure levels, can also be considered symptoms of stage 2 and 3 hypertension. At the same time, patients with arterial hypertension of the 1st degree, strictly following the doctor’s recommendations and following a diet for hypertensive patients, can achieve complete disappearance unpleasant symptoms diseases.

It cannot be said that the symptoms of hypertension in men and women are significantly different, but in fact, men are indeed more susceptible to this disease, especially age group from 40 to 55 years. This is partly explained by the difference in physiological structure: men, unlike women, have greater body weight, and accordingly, the volume of blood circulating in their vessels is significantly higher, which creates favorable conditions for high blood pressure.

On the other hand, women are more responsible for their health, the right image life. Quantity stressful situations at work, alcohol consumption and cigarette smoking are higher among men, but this no longer refers to the symptoms of hypertension, but to the reasons for its development.

Treatment of hypertension with medications and folk remedies

Treatment of hypertension, as well as other diseases that are difficult to diagnose and require constant therapy ( diabetes, allergies, prostatitis and impotence), should be compiled and prescribed only by a specialist. If restrictions on food, the use of table salt, giving up alcohol and smoking, avoiding stress and other correctable causes of hypertension do not help normalize blood pressure levels, pills will be prescribed for high pressure.

Methods for treating hypertension

In the treatment of hypertension folk remedies side effects, as a rule, are absent. You don’t have to run to the pharmacy for expensive medications and stand in line for the doctor to write out another prescription. All you need to do is take some time for yourself, change your diet and learn how to manage stress.

Causes of high blood pressure and the development of hypertension

The causes of arterial hypertension are still not completely clear; the development of the disease important role Both internal systems of the body and external factors play a role. If with symptomatic hypertension the causes of increased blood pressure are caused by other diseases, then with essential hypertension, and this form is registered in 85% of cases, the exact causes of high blood pressure cannot be established; it arises independently.

There are many risk factors that contribute to a persistent increase in blood pressure; they are usually considered to be the causes of hypertension. These include:

Age, for men over 55 years, for women over 65 years. With age, the walls of blood vessels lose their elasticity, which increases their resistance to blood flow, and as a result, the pressure increases.
Hereditary predisposition.
Floor. As already mentioned, men are more likely to suffer from arterial hypertension.
Impaired fat metabolism, obesity (men with a waist size of more than 102 cm, women with a waist size of more than 88 cm).
Diabetes.
Smoking. Causes an immediate rise in blood pressure, and smokers with many years of experience are susceptible to vascular diseases.
Alcohol abuse. The blood pressure of a person who stops drinking drops by at least fifteen points.
Excessive salt intake. Excessive intake of sodium, the main component of table salt, into the body is one of the most significant causes of increased blood pressure in hypertensive patients: sodium chloride prevents the removal of fluid from the body, which increases the already high vascular tone of the patient. Remember, the average person consumes three times the amount of salt that he needs, learn not to add salt to your food.
Insufficient physical activity, sedentary lifestyle.
Exposure to stress.
Cholesterol metabolism disorder.
Insufficient intake of potassium from food.
Increased level of adrenaline in the blood.
Congenital heart defects.

Various kidney diseases, late toxicosis of pregnant women, regular use of certain medications, in some cases this also applies to oral contraceptives, should be attributed to the causes of secondary hypertension.

The above risk factors can be divided into two large groups :

Which can be eliminated independently or with the help of doctors: treat obesity, reduce blood cholesterol levels, the number of cigarettes smoked, alcohol or salt consumed, lose excess weight, and so on.
Which cannot be avoided: age and hereditary predisposition.

Therefore, those who are in the so-called second risk group need to especially carefully monitor their health and monitor and prevent arterial hypertension. And for everyone who has at least one of the above factors, constantly monitor blood pressure levels and, of course, maintain normal and active image life.

Arterial hypertension is a pathological condition that occurs when blood pressure in the systemic circulation rises above normal levels. Normal blood pressure readings are conventionally called normal. Normal indicators are determined by analyzing a huge number of people. The average pressure value of healthy people is taken as the norm. Accordingly, all deviations are considered an increase or decrease in blood pressure. The connection between blood pressure indicators and complications (kidney disease, brain and heart damage), including deaths, is also taken into account.

Based on research, blood pressure in adults is considered high if it is more than 140/90 mmHg. Art. During the hypertensive process, both pressure indicators (“upper” systolic and “lower” diastolic) do not always increase. For example, the “upper” pressure may increase to more than 160 mmHg. Art., and the “lower” will remain 90 mm Hg. Art. and less. This form of hypertension is called isolated and is formed, as a rule, with atherosclerotic vascular damage, thyrotoxicosis, advanced anemia, and aortic valve insufficiency.

Arterial hypertension for reasons of development is divided into two main forms:

Primary (in other words, essential, systolic).
Secondary (symptomatic).

There are three types physiological reasons, causing a rise in blood pressure:

An increase in pressure due to an increase in the amount of circulating blood in the vascular bed.
Due to increased resistance due to high tone small vessels.
By increasing the number of blood cells in the bloodstream (polycythemia).

Factors in the formation of the primary disease

Nine out of ten patients (especially the elderly) have a primary form of hypertension. The reasons causing its development are not clear. The disease can be mild, moderate, severe or extremely severe. The mild type of flow accounts for about 80% of cases. The course of hypertension can be benign or malignant. If the course is malignant, then, as a rule, it manifests itself immediately, at initial stages formation. The pressure with this form of flow rises sharply and by long time, diastolic pressure (“lower” indicator) can rise to 140 mm Hg. Art. and higher. Rarely, such signs may be present when benign hypertension, but only in case long absence treatment.

There is hypertension, in which only systolic pressure rises. This form of the disease is called “isolated systolic hypertension” and is more common in older people. This is explained by the fact that in older people the elasticity of arterioles is significantly reduced, the volume of the atria is increased and, as a rule, there are pathologies of the kidneys and heart.

Elderly people with isolated systolic hypertension need to be under dynamic observation doctor This will help identify the cause of the disease and prescribe adequate treatment.

Risk factors for the formation of pathologically high blood pressure are:

Age. In older people, the disease occurs in 70% of cases (usually over 55 years of age).
Heredity.
Bad habits. Smoking has a particularly adverse effect.
Chronic stress.
Low physical activity.
High body weight.
Concomitant diseases. Diabetes mellitus is common and extremely unfavorable.
Excess table salt in food.
Lack of calcium in the diet.

Most cases of arterial hypertension are caused by the essential form. The reasons leading to the formation of this form of the disease are unknown. There are several theories:

Neurogenic. As a rule, it is hereditary. The central nervous system plays the leading role. Severe emotional shocks, chronic stress, and mental trauma lead to a malfunction of neural regulation. At the same time, sympathetic vasoconstrictor signaling from certain brain structures is enhanced. Signals along nerve fibers go to all peripheral organs and increase the tone of the vascular wall.
Volume-salt. Associated with impaired renal function of removing excess fluid from the body and some trace elements. There is an accumulation of sodium and water in the body and, as a result, the volume of blood in the vascular bed increases and the cardiac output increases. The body, trying to maintain homeostasis, causes spasm of small vessels. This response helps bring cardiac output back to normal, but blood pressure rises even further. In addition, excess salt in food is one of the most common factors in the development of hypertension.

It is believed that high activity is a factor in the development of hypertension sympathetic system. This activity leads to an increase in cardiac size, the volume of blood flow through the heart per minute and vasospasm. Other reasons that can push the occurrence of arterial hypertension are: hereditary malfunction central mechanisms regulating blood pressure, age-related neuroendocrine changes, hard work adrenal glands

Primary hypertension is usually a disease of older people. Many people develop high blood pressure after 50 years of age, so such “age-related” changes may seem natural, but this is not so. Hypertension in older people can cause many complications and early death. Although recently the age of the disease is rapidly getting younger.

Factors in the formation of symptomatic increased blood pressure

The causes of secondary arterial hypertension are varied:

Neurogenic. Trauma, brain tumors, inflammatory diseases of the lining of the brain, strokes.
Renal. Diseases of the kidney parenchyma, renal arteries, congenital pathologies, tumors, as well as conditions after kidney removal.
Endocrine. Increased or decreased activity of the thyroid gland, adrenal disease (hyperaldosteronism, pheochromacytoma), Itsenko-Cushing syndrome and disease, as well as pathologies that occur during menopause.
Hemodynamic. Atherosclerotic lesion aorta, pathology of the carotid arteries, congenital narrowing of the aorta (coarctation), aortic valve insufficiency.
Medicinal. Uncontrolled treatment with certain drugs (antidepressants, hormonal drugs, contraceptives in tablets, cocaine).

Of all these causes, renal hypertension is the most common. Endocrine pathologies are the second most common cause of high blood pressure.

Symptoms of secondary hypertension consist of signs of the underlying pathology and symptoms of increased blood pressure. Due to increased pressure in the blood vessels, the patient may present with the following symptoms:

headache;
dizziness, weakness;
obsessive ringing in the ears and flickering spots before the eyes;
pain syndrome in the projection of the heart.

Symptoms of the underlying pathology can be either vague or pronounced. With a detailed picture of the underlying pathology, it is easy to establish the cause of the increase in blood pressure:

High blood pressure in pregnant women

It is worth highlighting hypertension in pregnant women. This type of high blood pressure is divided into several groups:

Hypertension developed as a result of pregnancy, without edema and protein excretion in the urine. This form of pathology is considered an adaptive mechanism for insufficiency of blood flow in various organs. Develops after the fifth month of pregnancy and disappears after childbirth. Treatment, as a rule, does not require.
Hypertension that develops as a result of pregnancy and is characterized by severe edema and the release of protein in the urine (from 0.3 g/l or more). Another name for this pathology is preeclampsia. Develops after the fifth month. Counts pathological condition requiring observation and treatment by a doctor.
Chronic arterial hypertension that developed even before conception. It was present before pregnancy and persists after childbirth for at least 1.5 months. Treatment is prescribed if necessary.
Chronic arterial hypertension combined with preeclampsia or eclampsia. Severe combined form requiring hospital treatment.

Knowing what caused hypertension in pregnant women influences the management of pregnancy, as well as the prescription of adequate treatment, the choice of method and timing of delivery.

There are two reasons for the occurrence of high blood pressure in pregnant women in different groups.

In women at low risk of developing hypertension, risk factors include:

Deficiency of blood volume in the vascular bed (hemoglobin more than 130 g/l, high hematocrit (above 0.4), endogenous creatinine clearance below 100 ml/min).
There is no adaptive decrease in diastolic “lower” pressure after the 12th week of pregnancy. Normally, this figure is below 75 mmHg. Art.
Increase in “upper” pressure by 30, and “lower” by 15 mmHg. Art. from normal for a particular woman, but not more than 140 and 90 mm Hg. Art. respectively.
Excessive weight gain without concomitant hypertension.
Fetal growth retardation.

In women at high risk of developing preeclampsia:

With all of the above, it should be taken into account that most pregnant women with chronically high blood pressure without preeclampsia have a normal pregnancy and childbirth. Mild and moderate edema appears in every second woman and is an example of the body’s adaptation during pregnancy. Treatment of pregnant women is carried out under the strict supervision of a doctor.

What is arterial hypertension (people often call it hypertension, hypertension)? - this is a persistent excess of the pressure level of 140/90 mm Hg. Art.

The most common disease in cardiology is arterial hypertension.

According to the American Heart Association (AHA), cardiovascular disease is the leading cause of death in the world (more than 60%). Every year in Russia more than 1 million people die from cardiovascular diseases. Myocardial infarction and cerebral stroke cause death in 90% of these cases.

How to find out your real pressure? How to understand what exactly is happening in your heart and blood vessels during high blood pressure? What exactly should you do if you see that your blood pressure is elevated?

We'll talk today about arterial hypertension- the most common disease in cardiology. It's hard to believe that hypertension actually affects about 1/4 of the entire adult population on Earth. In people over 65 years of age, hypertension occurs in 50-65% of cases.

Highlight:

primary (essential) hypertension (also known as hypertension): 90-95% of cases of increased pressure;
as well as secondary (symptomatic) hypertension: renal origin - 3-4%, endocrine - 0.1-0.3%, very rarely - neurological; caused by taking certain substances (hormonal contraceptives). Hypertension in pregnant women is also identified.

Causes

It is clear why secondary hypertension occurs: renal - due to problems in the kidneys, etc.

Why primary hypertension (HP) occurs is still not fully understood. The occurrence of headache may be caused by genetic mechanisms: These are at least 20 combinations in the human genetic code. Hypertension may occur in a patient as a result of nervous strain, which causes dishormonal disorders. Many other factors can contribute to the development of hypertension: heredity in the first place, as well as a sedentary lifestyle, smoking, diabetes mellitus, increased levels of atherogenic lipids in the blood, obesity, poor nutrition (excessive consumption of table salt, alcohol abuse, diet with low calcium intake) , age, gender.

The immediate cause of hypertension is the activation of biological mechanisms that cause an increase in minute blood volume and total peripheral vascular resistance.

As you can see, there are many reasons for headaches. This is not tuberculosis: scientists once identified mycobacterium, and then found an antibiotic to suppress it.

A common person You don't have to go into all the details. But what everyone should know for sure is how to understand that something is wrong with blood pressure.

What could be symptoms of high blood pressure?
and when you should measure your blood pressure:

headaches, heaviness in the head, often in the back of the head;
“flies” before the eyes;
ringing, tinnitus, some kind of stupor;
dizziness;
unexplained anxiety;
insomnia;
prolonged stress;
heartbeat;
redness of the skin of the face, chest;
some kind of strange nausea.

What to do with all this?

Go to a qualified doctor!

Otherwise, treatment of those patients who did not start treatment for hypertension on time and suffered a stroke is very expensive and time-consuming. People later become disabled, their familiar image life, many lose their jobs, many families break up. Often we are talking about quite capable young people.

In most domestic clinics, unfortunately, there are still big problems with early diagnosis cardiovascular diseases. A person often has to spend a lot of time moving from one office to another. Many studies turn out to be inaccessible. The doctor does not always have time to properly orient the patient taking into account the results of the studies, explain possible risks, and warn about possible complications.