Diabetes

Hypertension 3 stages, 3 degrees, risk 4: what is it?

Hypertension is a disease. Which in recent decades has received the widest distribution among all segments of the population. The disease, the main symptom is a significant increase in blood pressure due to several reasons.

In a report of the World Health Organization, it is reported that hypertension occurs in every second inhabitant of the Earth.

Therefore, the problem of diagnosis and treatment of this disease brought to the fore. This applies to everyone, and let the absolute symptoms appear more often in older people, but there is a disappointing progression - hypertension is younger, affecting people under 30 and even younger.

Often people do not pay attention to the fleeting manifestations of high pressure until they start the disease until the late stages, 3 and 4, respectively. It is these marginal states that are the most dangerous. What is hypertension 3 degrees and where does it come from?

Hypertension and hypertension

The scientific name of the disease is arterial hypertension, the other analogues are only variations and outdated synonyms. She is of two kinds.

Hypertension (the medical term is primary, or essential arterial hypertension) is a persistent and prolonged increase in blood pressure of unknown origin.

This means that the cause of this disorder is still not known to science, and everything is based only on assumptions.

It is believed that there are about twenty genes in the human genome that somehow influence the work of the blood pressure control system. This disease accounts for more than 90% of all cases. Treatment consists of removing the dangerous symptoms and eliminating the consequences.

Secondary, or symptomatic hypertension, occurs in diseases and disorders of the kidneys, endocrine glands, distorted innervation and malfunctions of the vasomotor center of the medulla oblongata, stressful and due to medication, also called iatrogenic.

The latter category includes hypertension caused by the use of hormonal drugs during therapy during menopause or for contraception.

It is necessary to treat such hypertension etiologically, that is, to remove the main cause, and not just to lower the pressure.

Etiology and pathogenesis of the disease

In the age of genetic engineering it is not difficult to determine that heredity is the dominant factor in the presence of increased pressure. It is highly likely that if your parents complained of a steady increase in blood pressure, the disease will be transmitted to you.

The next in importance, but not in frequency, is the peculiarity of urban residents - a high frequency of stressful situations and a high pace of life. It has been scientifically proven that with significant psycho-emotional overloads, clusters of neurons fall out of common neural circuits, which leads to a violation of their interregulation. The shift in the direction of the activating centers is inextricably linked with an increase in blood pressure.

Risk factors point to those groups of people who have an increased likelihood of developing hypertension.

These include:

  1. Older people. It is believed that everyone over the age of 50 suffers from arterial hypertension, even if they do not feel its primary symptoms. This is due to a decrease in the elasticity of the vessels, as a result, their compensatory ability to withstand the strength of heart contractions. Also with age, the risk of atherosclerosis of large vessels increases, which leads to a narrowing of their lumen and the so-called reactive movement of blood (like an airplane nozzle) through a small hole in the center of the shaft of fatty plaques.
  2. Women. Studies show that girls and women are more likely to suffer from hypertension than men. The reason is a powerful hormonal background, which increases during pregnancy, and disappears sharply at the onset of menopause. Estrogens produced by the ovaries reduce blood pressure, but they dominate only half of the menstrual cycle. When their production stops altogether, women begin to be disturbed by the symptoms of high blood pressure.
  3. Mineral imbalance. This category can be determined addiction to too salty food, which enhances the reabsorption of water in the tubules of the nephron and contributes to an increase in circulating blood volume, as well as reduced calcium intake. It, as the main cardiac ion, is necessary for the proper functioning of the myocardium. Otherwise, arrhythmias and high blood pressure are possible, which leads to an increase in pressure.
  4. Alcohol and smoking. Harmful habits themselves are incredibly harmful, they also damage the inner and elastic membranes of blood vessels, impairing their ability to adequately stretch and contract in tune with the pulse wave. Constant sporadic reduction of blood vessels due to the action of nicotine and cigarette smoke leads to a violation of innervation and vascular pathology.

In addition, one of the factors is the presence of obesity and diabetes. Overweight is inextricably linked with hypodynamia. Such a hypertensive person leads an inactive way of life, because of the lack of regular exercise, his blood vessels lose their muscular element and do not respond to the regulation of the autonomic nervous system.

Additionally, the level of atherogenic lipids, which seep through the endothelium of the blood vessels, degradingly acting on them, increases.

This dystrophy is multiplied by diabetes mellitus, because of the dysfunction of the carbohydrate metabolic boiler, fats are poorly oxidized and split, not digestible and circulate in the blood.

Arterial hypertension rates and possible outcomes

The clinic distinguishes four functional classes of hypertensive disease, each of which has a special approach to diagnosing and treating

In addition, there are several risk groups for the development of complications of the disease.

Risk groups depend on the presence of certain factors complicating the course of the disease.

The following classification of arterial hypertension according to the increased pressure is possible.

  • Grade 1 - systolic 140-159 / diastolic 90-99 mm Hg. Art.
  • Degree 2 - systolic 160-179 / diastolic 100-109 mm Hg. Art.
  • Grade 3 - systolic 180+ / diastolic 110+ mm Hg. Art.
  • Isolated systolic hypertension - systolic 140+ / diastolic 90.

From this classification it is obvious that the most dangerous is the 3 degree, which has the highest pressure, pre-hypertensive crisis. The degree is determined by ordinary pressure measurement according to the Korotkov method, but does not carry clinical indications. To reflect the changes in the organs most sensitive to an increase in blood pressure (the so-called target organs) and possible consequences, a classification by stages was developed. These organs include the brain, liver, kidneys, lungs. The main signs are hemorrhages in the parenchyma of the organ, with subsequent violation of its function and the development of deficiency.

Stage 1 - no changes in target organs are detected. The outcome of such hypertension is recovery of the patient with the right approach to treatment.

Stage 2 - if at least one organ is affected, the patient is in this stage of the disease. At this stage, it is necessary to conduct an examination of the affected area and consult a specialist. ECG, echocardiography, examination by an oculist for the presence of retinopathy when examining the fundus (the most informative and easily diagnosed symptom at the moment), general and biochemical blood test, urinalysis.

Stage 3 - a state bordering on the occurrence of a hypertensive crisis. Characterized by the presence of multiple and extensive lesions of more than one target organ. These may include: hemorrhagic stroke and ischemic due angiopatiymogzovyh vascular encephalopathy different genesis of CHD (coronary heart disease) with symptoms of angina (chest pain that radiates to the left arm, neck, jaw), myocardial infarction, followed by necrotic and toxic changes - Dressler syndrome, reperfusion syndrome and cardiogenic shock. This will be followed by damage to the renal barrier, in consequence of which proteinuria will arise, the filtration processes and reabsorption of blood plasma in the nephron will worsen, and acute renal failure. Large vessels will be affected by the following, which will manifest as an aortic aneurysm, massive atherosclerosis and damage to the coronary arteries. The retina is very sensitive to high levels of blood pressure, which is manifested by damage to the optic nerve and intraocular hemorrhages. This stage requires decisive measures to compensate for the destructive processes of drugs.

Stage 4 is a terminal condition that, if persisted for more than a week, leads to irreversible disability.

In addition, there are several risk groups for the development of complications:

  1. the first is that at the time of the examination there are no complications, and the probability of their development over 10 years is up to 15%;
  2. the second - there are three factors, and the risk of complications is no more than 20%;
  3. the third - the presence of more than three factors was revealed, the risk of complication is about 30%;
  4. Fourth, severe damage to organs and systems is detected, the risk of developing a heart attack and stroke is more than 30%.

Based on the above, it becomes clear that hypertension is stage 3 risk 4. In simple words, the disease is deadly.

Treatment of hypertension

Grade 3 arterial hypertension, risk 4 requires emergency care and does not tolerate delays. Complications of the most unpleasant - heart attack, stroke, renal failure.

In order not to wait for a hypertensive crisis, it is necessary to call an ambulance as soon as possible if there are main alarming symptoms - systolic pressure above 170, dull spilled headaches, nausea of ​​central origin due to high intracranial pressure (after vomiting with such nausea, the state is not relieved) tinnitus due to increased blood flow, burning pain behind the sternum, weakness in the limbs and their numbness.

Perhaps the feeling of "goose bumps" under the skin, progressive deterioration of memory and loss of intellectual abilities, visual impairment.

In such a state, physical loads, sudden movements are contraindicated, patients are strictly forbidden to undergo surgery, give birth, drive a car.

The recommendations of specialists consist in the use of a wide range of drugs, each of which will affect its own segment of the pathogenesis chain.

Preparations of the main group, which are primarily used for hypertension:

  • Loop diuretics are substances that block the Na + K + Cl –cotransporter in the ascending part of the loop of Henle nephron, which reduces fluid reabsorption, water does not return to the bloodstream, and is strongly excreted from the body. The volume of circulating blood decreases, and with it the blood pressure. Such remedies include Furosemide (aka Lasix), Indapamide (also known as Indap or Arifon), Hydrochlorothiazide. Used most often, because inexpensive compared to peers.
  • Beta-blockers. Reduce the contractility of the heart, which has increased in grade 3 hypertension, by blocking the adrenergic synapses of the myocardium. The drugs of this group include Anaprilin (Propranolol), Atenolol (Atebene), Kordanum, Metoprolol (there are forms Spicicor, Corvitol and Betalok), Nebivalol. It is necessary to use these medications clearly according to the instructions, because an extra blocker pill can lead to conduction and automatism disorders and arrhythmias.
  • Angiotensin-converting enzyme inhibitors. Angiotensin greatly increases blood pressure, and if its production is interrupted at the level of tissue angiotensinogen, you can quickly and effectively relieve symptoms of grade 3 hypertension, even with risk 4. The most famous representatives of the group are Captopril (Capoten), Captopress, Enap (Renitec), Lisinopril. Possible blockade directly to the angiotensin receptor means Losartan.
  • Calcium antagonists - Nifedipine and Amlodipine - reduce the strength of the heartbeat and the volume of the surge of blood, thereby lowering blood pressure.

Prevent GB and hypertensive crisis can be at home. The basis of the method is a strict diet as the main way of therapeutic influence, in particular the use of lightly salted table No. 10 by Pevzner.

It includes wheat bread, lean meats, fiber-rich salads, boiled eggs, fermented milk drinks, soups. Be sure to limit salt intake to 6 grams per day. Popular methods are sedatives - valerian, motherwort, peppermint, hawthorn.

Stage 3 hypertension is described in the video in this article.

Watch the video: High Blood Pressure. Hypertension. Nucleus Health (September 2019).