Performing a cleansing, hypertonic, siphon, nutritional, medicinal, oil enema. Degrees and stages of hypertension Classification of blood pressure table

Hypertension is one of the most common cardiovascular pathologies. vascular system and is widespread throughout the world, especially in civilized countries. It is most susceptible to active people whose lives are full of actions and emotions. According to the classification, various forms, degrees and stages are distinguished hypertension.

According to statistics, from 10 to 20% of adults in the world are sick. It is believed that half do not know about their disease: hypertension can occur without any symptoms. Half of the patients diagnosed with this condition are not treated, and of those who are treated, only 50% do it correctly. The disease develops equally often in both men and women, and occurs even in children adolescence. Most people get sick after 40 years of age. Half of all older people have been diagnosed with this condition. Hypertension often leads to stroke and heart attack and is a common cause of death, including in people of working age.

The disease manifests itself in high blood pressure, which is scientifically called arterial hypertension. The last term refers to any increase in blood pressure, regardless of the cause. As for hypertension, which is also called primary or essential hypertension, it is an independent disease unknown etiology. It should be distinguished from secondary, or symptomatic, arterial hypertension, which develops as a sign of various diseases: heart, kidney, endocrine and others.

Hypertension is characterized by a chronic course, a persistent and prolonged increase in pressure, not associated with pathologies of any organs or systems. This is a disruption of the heart and the regulation of vascular tone.

Classifications of hypertension

Over the entire period of studying the disease, more than one classification of hypertension has been developed: according to appearance the patient, the reasons for the increase in pressure, etiology, the level of pressure and its stability, the degree of organ damage, the nature of the course. Some of them have lost their relevance, while others continue to be used by doctors today, most often this is a classification by degree and stage.

In recent years, the upper limits of normal blood pressure have changed. If recently the value was 160/90 mm Hg. column was considered normal for an elderly person, today this figure has changed. According to WHO for all ages upper limit The norm is considered to be 139/89 mm Hg. pillar Blood pressure equal to 140/90 mm Hg. column, is the initial stage of hypertension.

The classification of pressure by level is of practical importance:

The optimal is 120/80 mmHg. pillar
Normal ranges from 120/80–129/84.
Border – 130/85–139/89.
Stage 1 hypertension – 140/90–159/99.
Stage 2 hypertension – 160/100–179/109.
Stage 3 hypertension – from 180/110 and above.

Classification of hypertension is very important for correct diagnosis and choice of treatment depending on the form and stage.

According to the very first classification, which was adopted at the beginning of the 20th century, hypertension was divided into pale and red. The form of pathology was determined by the type of patient. With the pale variety, the patient had an appropriate complexion and cold extremities due to spasms of small vessels. Red hypertension was characterized by dilation of blood vessels at the time of increased hypertension, as a result of which the patient’s face turned red and became covered with spots.

In the 1930s, two more types of the disease were identified, which differed in the nature of their course:

The benign form is a slowly progressive disease, in which three stages were distinguished according to the degree of stability of pressure changes and the severity of pathological processes in the organs.
Malignant arterial hypertension progresses rapidly and often begins to develop at a young age. As a rule, it is secondary and has an endocrine origin. The course is usually severe: the pressure is constantly at high levels, and symptoms of encephalopathy are present.

Classification by origin is very important. It is necessary to distinguish primary (idiopathic) hypertension, which is called hypertension, from the secondary (symptomatic) form. If the first one occurs without visible reasons, then the second is a sign of other diseases and accounts for about 10% of all hypertension. Most often, there is an increase in blood pressure due to renal, cardiac, endocrine, neurological pathologies, as well as as a result of constant intake of a number of medicines.

Modern classification of hypertension

There is no uniform systematization, but most often doctors use the classification that was recommended by WHO and the International Society of Hypertension (ISHA) in 1999. According to WHO, hypertension is classified primarily by the degree of increase in blood pressure, of which there are three:

The first degree - mild (borderline hypertension) - is characterized by pressure from 140/90 to 159/99 mm Hg. pillar
In the second degree of hypertension - moderate - hypertension ranges from 160/100 to 179/109 mm Hg. pillar
In the third degree - severe - the pressure is 180/110 mm Hg. pillar and above.

You can find classifiers that distinguish 4 degrees of hypertension. In this case, the third form is characterized by pressure from 180/110 to 209/119 mm Hg. column, and the fourth is very heavy - from 210/110 mm Hg. pillar and above. The degree (mild, moderate, severe) indicates solely the level of pressure, but not the severity of the course and condition of the patient.

In addition, doctors distinguish three stages of hypertension, which characterize the degree of organ damage. Classification by stages:

Stage I. The increase in pressure is slight and inconsistent, work cardiovascular system not broken. Patients usually have no complaints.
Stage II. Blood pressure is high. There is an enlargement of the left ventricle. Usually there are no other changes, but local or generalized narrowing of the retinal vessels may be noted.
Stage III. There are signs of organ damage:
- heart failure, myocardial infarction, angina pectoris;
- chronic renal failure;
- stroke, hypertensive encephalopathy, transient cerebral circulatory disorders;
- from the fundus of the eye: hemorrhages, exudates, swelling of the optic nerve;
- lesions of peripheral arteries, aortic aneurysm.

When classifying hypertension, variants of increased blood pressure are also taken into account. The following forms are distinguished:

systolic – only the upper pressure is increased, the lower – less than 90 mm Hg. pillar;
diastolic – lower pressure is increased, upper – from 140 mm Hg. pillar and below;
systolic-diastolic;
labile - pressure rises for a short time and normalizes on its own, without medications.

Certain types of hypertension

Some varieties and stages of the disease are not reflected in the classification and stand apart.

Hypertensive crises

This is the most severe manifestation of arterial hypertension, in which the pressure rises to critical levels. As a result, it is violated cerebral circulation, intracranial pressure rises, brain hyperemia occurs. The patient experiences severe headaches and dizziness, accompanied by nausea or vomiting.
in turn, they are divided according to the mechanism of pressure increase. In the hyperkinetic form, the systolic pressure rises, in the hypokinetic form, the diastolic pressure rises; in the eukinetic crisis, both the upper and lower levels increase.

Refractory hypertension

IN in this case we're talking about arterial hypertension, which cannot be treated with medications, that is, the pressure does not decrease even when using three or more drugs. This form of hypertension is easily confused with those cases where treatment is ineffective due to an incorrect diagnosis and incorrect choice of medications, as well as due to the patient’s non-compliance with doctor’s prescriptions.

White coat hypertension

This term in medicine means a condition in which an increase in pressure occurs only in a medical facility during blood pressure measurement. This seemingly harmless phenomenon should not be ignored. According to doctors, a more dangerous stage of the disease may occur.

Called a disease that involves any persistent excess of indicators blood pressure relative to standard normal figures (120/80 mmHg). Based on diagnostic data, the doctor determines the type of hypertension and determines treatment tactics. The article describes in detail the classification of the disease.

Stages of arterial hypertension

The disease develops gradually, going through several stages. Usually the patient consults a doctor for later when symptoms already affect quality of life. Therefore, it is necessary to pay attention to the first signs of the disease, when the prognosis for treatment is most favorable.

Stage 1

The blood pressure of a patient who has been diagnosed with stage 1 hypertension is noted to be within 159/99 mmHg. Art. If you do not take the necessary measures to reduce it, your blood pressure may remain elevated for a couple of days or even several weeks.

Stage one hypertension can be asymptomatic, which is where its danger lies, since, without feeling any special changes in their usual state, the patient is in no hurry to see a doctor. Reduce pressure on initial stage rest can help the illness, it is better to avoid during this period stressful situations.

If a higher stage of hypertension is diagnosed, medication is no longer necessary to reduce blood pressure.

The first stage of hypertension, as a rule, does not affect internal organs. General symptoms of the disease are:

insomnia,
pain in the heart.

At the first stage of hypertension, a change in tone can be detected blood vessels in the fundus. Possible rare ones. Women aged during menopause are at risk. The risk of a hypertensive crisis in this group of patients is possible due to the body’s reaction to weather changes.

Stage 2

At this stage, the pressure can rise to 179/109 mmHg. Art. It is no longer possible to stabilize blood pressure in patients with the second stage without drug intervention. Arterial hypertension stage 2 is characterized by the following symptoms:

sleep disturbances,
dyspnea,

After conducting a series of tests, the doctor may detect protein in the urine, an increase in the amount of creatine in the blood plasma, and a significant narrowing of the blood vessels in the retina. A characteristic symptom of the development of stage 2 hypertension is hypertrophy of the left ventricle of the heart.

If you observe at least a few symptoms that characterize stage 2 hypertension, you should contact a specialist as soon as possible: simple rest and avoidance of stress will not get rid of this stage of the disease.

Ignoring the problem for a long time can lead to complications in the functioning of the kidneys, vision and brain. Besides, high blood pressure over a long period of time may cause symptoms coronary disease hearts and even

Stage 3

The third stage of the disease can be described as extremely severe. Hypertension at this stage provokes dysfunction of organs, disturbances in the functioning of which were noticed already at the second stage - these are the heart, brain and organs of vision. Blood pressure readings at stage 3 hypertension rarely fall below 180/110 mmHg. Art.

The consequences of the disease can be stroke, kidney failure,... A patient who has suffered a heart attack may experience sudden changes in pressure: from high to below normal. This phenomenon is called “decapitated hypertension.” Patients with the third stage of hypertension often complain of frequent migraine attacks, discoloration skin(blue discoloration or cyanosis).

Degrees of hypertension

The extent of the disease is determined by the severity of symptoms, and is often related to the stage of the disease.

1st degree

3rd degree

Considered severe. The pressure in this group can rise to 180/110 mm. rt. Art. The disease can be aggravated by the patient’s addiction to cigarettes and alcohol, heavy physical activity, obesity, diabetes mellitus, unhealthy diet. Signs of stage 3 disease include: cough with bloody discharge, unsteady gait, arrhythmia, significant deterioration visual function, paralysis In addition, complications with grade 3 hypertension can cause a number of problems with functioning internal organs.

Risks

Risks are assessed by the threat the disease poses to the normal functioning of other organs of the body and to human life in general.

Low, insignificant

The low risk group for patients with hypertension includes patients under 55 years of age who have been diagnosed with stage 1 disease. As a rule, in this group of patients there are no serious complications of the disease at all. However, you still need to visit a therapist regularly. It is not necessary to see a cardiologist for a low-risk group.

Average

The average risk group includes patients with first and second degrees of hypertension. The pressure in patients in this group remains at 179/110 mm. rt. Art. Patients from the low-risk group may also fall into this category if they abuse smoking, fatty and spicy foods, do not get enough physical activity, or have overweight. Not the least role in the development of arterial hypertension with average degree The risk factor is heredity.

High

The high-risk group includes patients with stage 2 and 3 hypertension in the presence of aggravating factors in the development of the disease, such as bad habits, heredity, etc.

As a rule, patients who are classified in this risk group have a 30% chance of developing complications of hypertension. In addition, patients at high risk may experience pathological changes internal organs (kidneys, brain, endocrine system).

Very tall

The highest risk group includes patients with stage 3 arterial hypertension. Typically, treatment of these types of patients is carried out in a hospital setting. Complications are diagnosed in more than 30% of patients. Blood pressure in very high-risk patients exceeds 180 mmHg. Art.

Risk level 4 is characterized by symptoms:

sweating;
hyperemia of the skin;
decreased skin sensitivity;
visual impairment;
renal failure;
cardiac hypertrophy, heart failure;
decreased intelligence (vascular dementia).

To prevent hypertension or control its dynamics, representatives of all age groups need to pay more attention to their health, not neglect sports, give up or significantly limit bad habits, and immediately seek help from a specialist at the first symptoms of the disease.

Almost everyone has experienced increased blood pressure at least once in their life and knows how much trouble it causes. However, hypertension is not as harmless as it might seem at first glance.

Serious fluctuations in pressure negatively affect the body, and a chronic disease, if left untreated, even leads to the most disastrous consequences. Today we will talk about how each stage differs and what risks it carries.

Stages of headache

Stage I

The pressure at stage 1 of hypertension does not exceed 159/99 mm. rt. Art. In this elevated state Blood pressure may persist for several days. Even ordinary rest and the exclusion of stressful situations significantly help to reduce its indicators. In more severe stages, it is no longer possible to normalize blood pressure so easily.

This stage of hypertension development is characterized by the absence of any signs that target organs are affected by high blood pressure, therefore, in many cases there is a practically asymptomatic course of the disease. Only occasionally do sleep disturbances, pain in the head or heart appear. At clinical examinations may reveal a slight increase in tone in the fundus of the arteries.

The group is distinguished by the appearance of the first signs from the internal organs. Often this form of damage has virtually no effect on their functions. There are also no obvious subjective symptoms that bother the patient. Most often, at stage 2 of the development of hypertension, the following are detected:

signs characteristic of left ventricular hypertrophy;
the amount of creatine in the blood increases;
narrowing of the arteries occurs in the retina;
Protein is found in the urine.

Hypertensive crises are not uncommon in stage 2 hypertension, which entails the threat of developing very serious complications, up to. In this case, we can do without constant drug therapy it won't be possible anymore.

Stages of hypertension

Stage III

The last stage of hypertension has the most severe course and has the most extensive group of disorders in the functioning of a whole group of target organs. The kidneys, eyes, brain, blood vessels and heart suffer the most. Blood pressure is persistent, and it is quite difficult to normalize its level even if you take pills. Increases in blood pressure to 180/110 mm are not uncommon. rt. Art. and higher.

The symptoms of stage 3 of the disease are in many ways similar to those listed above, but they also include quite danger signs from affected organs (for example, renal failure). Memory often deteriorates, severe heart rhythm disturbances occur, and vision decreases.

The most dangerous thing is that hypertension invariably affects the heart. The contractility and conductivity of the muscle is almost always impaired. At clinical studies Many violations are also revealed on the part of other organs.

Hypertension has not only stages 1, 2, 3, but also degrees 1, 2, 3, which we will talk about later.

Degrees

I degree

The first degree of severity refers to the mildest, in which periodic surges in blood pressure are observed. Another characteristic of it is that the pressure level is able to stabilize on its own. The most common reason the appearance of stage 1 hypertension means constant stress.

The video below will talk about the degrees of hypertension:

II degree

A moderate degree of hypertension is distinguished not only by the impossibility of independent stabilization of blood pressure, but also by the fact that periods of normal pressure are very short. The main manifestation is severe headaches.

If the disease develops very quickly, we can talk about a malignant course of hypertension. This form is very dangerous, since the disease can develop rapidly.

Degrees of hypertension

III degree

With grade 3 hypertension, the pressure always remains in a stable elevated state. If blood pressure decreases, the person is plagued by weakness, as well as a number of other symptoms from the internal organs. The changes that occur at this stage of the disease are already irreversible.

Also, the classification of hypertension includes, in addition to 1, 2, 3 degrees and stages, 1, 2, 3, 4 risks, which we will talk about later.

Risks

Low, insignificant

The lowest risk of complications is found in women under 65 years of age and men under 55 years of age who have developed stage 1 “mild” arterial hypertension. Over the next 10 years, only about 15% will develop vascular or cardiac pathologies that develop as a result of the disease. Such patients are often managed by general practitioners, since there is no point in serious treatment by a cardiologist.

If a minor risk is still present, patients need to try to significantly change their lifestyle in the near future (no more than 6 months). He can be observed by a doctor for some more time if the dynamics are positive. If similar treatment did not bring results, and a decrease in pressure could not be achieved, doctors may recommend a change in treatment tactics, which will entail the prescription of medications. However, doctors often insist on leading a healthy lifestyle, because such therapy will not have any negative consequences.

Average

This group includes patients with hypertension of both the second and first types. Their blood pressure usually does not exceed 179/110 mm. rt. Art. A patient in this category may have 1-2 risk factors:

heredity,
obesity,
little physical activity,
high cholesterol,
impaired glucose tolerance.

Over 10 years of observation, 20% of cases may develop cardiovascular pathologies. Modification of normal lifestyle is necessarily included in the list of treatment measures. For 3-6 months medicines may not be prescribed to give the patient a chance to normalize their condition through life changes.

High

Patients with forms 1 and 2 of hypertension should also be included in the risk group with a high probability of detecting complications, but if they already have several predisposing factors described above. It is also customary to include any damage to target organs, diabetes mellitus, changes in retinal vessels, high creatinine levels, etc.

There may be no risk factors, but a patient with stage 3 arterial hypertension also belongs to this group of patients. All of them are already being observed by a cardiologist, since hypertension is mostly long-term. The probability of complications reaches 30%. Lifestyle changes can be used as an adjuvant strategy, but the main part of therapy is medication. The selection of medications must be carried out in a short time.

Risks hypertension

Very tall

Patients with the highest risk of complications in the functioning of the heart and blood vessels are a group of patients with stage 3 hypertension or stages 1 and 2 if the latter have any disorders of the target organs. This group is one of the smallest. The main treatment is carried out in a hospital. Drug therapy is carried out actively and often includes several groups of drugs.

The probability of developing complications is more than 30%.

The following video contains useful information about the stages and degrees of hypertension:

Hypertension is a pathology of the cardiovascular system, in which persistent high blood pressure is noted, which leads to dysfunction of the corresponding target organs: heart, lungs, brain, nervous system, kidney.

Hypertension (HD) or arterial hypertension develops as a result of a malfunction of higher centers that regulate the functions of the vascular system, neurohumoral and renal mechanisms.

Basic clinical signs GB:

Dizziness, ringing and noise in the ears;
Headaches;
Shortness of breath, suffocation;
Darkening and “stars” before the eyes;
Painful sensations in the chest, in the area of the heart.

There are different stages of hypertension. Determination of the degree of hypertension is carried out using the following methods and studies:

Biochemical blood test and urine test.
Doppler ultrasound of the arteries of the kidneys and neck.
Electrocardiogram of the heart.
EchoCG.
Blood pressure monitoring.

Taking into account risk factors and the degree of target organ damage, a diagnosis is made and treatment is prescribed using medications and other techniques.

Hypertension - definition and description

The main clinical signs of hypertension are sudden and persistent jumps in blood pressure, while blood pressure is consistently high, even if there is no physical activity and the patient’s emotional state is normal. Blood pressure decreases only after the patient takes antihypertensive drugs.

Systolic (upper) pressure – no higher than 140 mm. rt. Art.;
Diastolic (lower) pressure is not higher than 90 mm. rt. Art.

If during two medical examinations in different days the blood pressure was higher than the established norm, a diagnosis of arterial hypertension is made and adequate treatment is selected. Hypertension develops in both men and women with approximately the same frequency, mainly after the age of 40 years. But clinical signs of HD are also observed in young people.

Arterial hypertension is often accompanied by atherosclerosis. One pathology complicates the course of another. Diseases that occur against the background of hypertension are called associated or concomitant. It is the combination of atherosclerosis and hypertension that becomes the cause of mortality among the young, working-age population.

According to the mechanism of development, according to WHO, we distinguish primary or essential hypertension, and secondary or symptomatic. The secondary form occurs in only 10% of cases. Essential arterial hypertension is diagnosed much more often. As a rule, secondary hypertension is a consequence of such diseases:

Various kidney pathologies, stenosis renal artery, pyelonephritis, tuberculosis hydronephrosis.
Dysfunctions thyroid gland– thyrotoxicosis.
Adrenal gland disorders – Itsenko-Cushing syndrome, pheochromocytoma.
Atherosclerosis of the aorta and coarctation.

Primary hypertension develops as an independent disease associated with impaired regulation of blood circulation in the body.

In addition, hypertension can be benign - that is, it occurs slowly, with minor deterioration in the patient’s condition over a long period of time; the pressure can remain normal and increase only occasionally. It will be important to maintain pressure and lead proper nutrition for hypertension.

Or malignant, when the pathology develops rapidly, the pressure rises sharply and remains at the same level, the patient’s condition can only be improved with the help of medications.

Pathogenesis of hypertension

An increase in pressure, which is the main cause and sign of hypertension, occurs due to an increase in cardiac output of blood into the vascular bed and an increase in peripheral vascular resistance. Why is this happening?

There are certain stress factors, which influence higher centers brain - hypothalamus and medulla oblongata. As a result, disturbances in the tone of peripheral vessels appear, and spasm of arterioles occurs in the periphery - including the kidneys.

Dyskinetic and dyscirculatory syndrome develop, the production of Aldosterone increases - this is a neurohormone that participates in water-mineral metabolism and retains water and sodium in the vascular bed. Thus, the volume of blood circulating in the vessels increases even more, which contributes to an additional increase in pressure and swelling of the internal organs.

All these factors also affect blood viscosity. It becomes thicker, the nutrition of tissues and organs is disrupted. At the same time, the walls of the vessels become denser, the lumen becomes narrower - the risk of developing irreversible hypertension increases significantly, despite treatment. Over time, this leads to elastofibrosis and arteriolosclerosis, which in turn provokes secondary changes in target organs.

The patient develops myocardial sclerosis, hypertensive encephalopathy, and primary nephroangiosclerosis.

Classification of hypertension by stage

There are three stages of hypertension. This classification, according to WHO, is considered traditional and was used until 1999. It is based on the degree of damage to the target organs, which, as a rule, if treatment is not carried out and the doctor’s recommendations are not followed, becomes greater and greater.

In stage I hypertension, signs and manifestations are practically absent, therefore such a diagnosis is made very rarely. No target organ damage is noted.

At this stage of hypertension, the patient very rarely consults a doctor, since there is no sharp deterioration in the condition, only occasionally the blood pressure “goes through the roof.” However, if you do not see a doctor and start treatment at this stage of hypertension, there is a risk of rapid progression of the disease.

Stage II of hypertension is characterized by a steady increase in blood pressure. Disturbances in the heart and other target organs appear: the left ventricle becomes larger and thicker, and sometimes damage to the retina is observed. Treatment at this stage is almost always successful with the cooperation of the patient and the doctor.

In stage III hypertension, damage to all target organs occurs. The blood pressure is consistently high, and the risk of myocardial infarction, stroke, and coronary heart disease is very high. If such a diagnosis is made, then, as a rule, a history of angina pectoris, renal failure, aneurysm, and hemorrhages in the fundus is already noted.

The risk of sudden deterioration of the patient's condition increases if treatment is not carried out properly, the patient has stopped taking medications, abuses alcohol and cigarettes, or experiences psycho-emotional stress. In this case, a hypertensive crisis may develop.

Classification of arterial hypertension by degree

This classification is for at the moment is considered more relevant and appropriate than by stage. The main indicator is the patient’s blood pressure, its level and stability.

Optimal – 120/80 mm. rt. Art. or lower.
Normal - it is permissible to add no more than 10 units to the upper indicator, and no more than 5 to the lower indicator.
Close to normal - indicators range from 130 to 140 mm. rt. Art. and from 85 to 90 mm. rt. Art.
Stage I hypertension – 140-159/90-99 mm. rt. Art.
Hypertension II degree – 160-179/100-109 mm. rt. Art.
Hypertension III degree – 180/110 mm. rt. Art. and higher.

Hypertension of the third degree, as a rule, is accompanied by lesions of other organs; such indicators are characteristic of a hypertensive crisis and require hospitalization of the patient for emergency treatment.

Risk stratification for arterial hypertension

There are risk factors that can lead to increased blood pressure and the development of pathology. The main ones:

Age indicators: for men it is over 55 years, for women – 65 years.
Dyslipidemia is a condition in which the lipid spectrum of the blood is disrupted.
Diabetes mellitus.
Obesity.
Bad habits.
Hereditary predisposition.

Risk factors are always taken into account by the doctor when examining a patient in order to make a correct diagnosis. It has been noted that most often the cause of surges in blood pressure is nervous overstrain, increased intellectual work, especially at night, and chronic fatigue. This is the main negative factor according to WHO.

The second place goes to salt abuse. WHO notes that if you consume more than 5 grams daily. table salt, the risk of developing arterial hypertension increases several times. The risk increases if there are relatives in the family who suffer from high blood pressure.

If more than two close relatives are being treated for hypertension, the risk becomes even higher, which means that the potential patient must strictly follow all the doctor’s recommendations, avoid worries, refuse bad habits and watch your diet.

Other risk factors, according to WHO, are:

Chronic diseases of the thyroid gland;
Atherosclerosis;
Chronic infectious diseases - for example, tonsillitis;
Menopause in women;
Pathologies of the kidneys and adrenal glands.

By comparing the factors listed above, the patient’s blood pressure indicators and their stability, the risk of developing a pathology such as arterial hypertension is stratified. If 1-2 unfavorable factors are identified in first-degree hypertension, then risk 1 is assigned, according to WHO recommendations.

If the unfavorable factors are the same, but hypertension is already of the second degree, then the risk from low becomes moderate and is designated as risk 2. Further, according to WHO recommendations, if hypertension of the third degree is diagnosed and 2-3 unfavorable factors are noted, the risk is set to 3. Risk 4 implies a diagnosis of third-degree hypertension and the presence of more than three unfavorable factors.

Complications and risks of hypertension

The main danger of the disease is the serious heart complications it causes. For hypertension combined with severe damage to the heart muscle and left ventricle, there is a WHO definition - decapitated hypertension. Treatment is complex and lengthy; decapitated hypertension is always difficult, with frequent attacks; in this form of the disease, irreversible changes in the blood vessels have already occurred.

By ignoring pressure surges, patients put themselves at risk of developing the following pathologies:

Angina;
Myocardial infarction;
Ischemic stroke;
Hemorrhagic stroke;
Pulmonary edema;
Dissecting aortic aneurysm;
Retinal detachment;
Uremia.

If a hypertensive crisis occurs, the patient needs urgent help, otherwise he may die - according to WHO, it is this condition in hypertension that in most cases leads to fatal outcome. The risk is especially high for those people who live alone, and in the event of an attack there is no one near them.

It should be noted that it is impossible to completely cure arterial hypertension. If, in case of hypertension of the first degree, at the very initial stage, you begin to strictly control your blood pressure and adjust your lifestyle, you can prevent the development of the disease and stop it.

But in other cases, especially if associated pathologies are added to hypertension, complete recovery is no longer possible. This does not mean that the patient should give up on himself and abandon treatment. The main measures are aimed at preventing sudden jumps in blood pressure and the development of a hypertensive crisis.

Arterial hypertension is a chronic disease of the heart and blood vessels. Characterized by an increase in pressure in the arteries above 140/90 mmHg. The pathogenesis is based on a disorder of the neurohumoral and renal mechanisms, which lead to functional changes in the vascular wall. Play a role in the development of hypertension the following factors risk:

age;
obesity;
lack of physical activity;
nutritional disorders: consumption of large amounts of fast carbohydrates, reduction in the diet of vegetables and fruits, increased content salt in dishes;
lack of vitamins and microelements;
drinking alcohol and smoking;
mental overload;
low standard of living.

These factors are controllable; influencing them can prevent or slow down the progression of the disease. However, there are also uncontrollable risks that cannot be corrected. These include old age and hereditary predisposition. Old age– this is an uncontrollable risk factor, since over time a number of processes occur that predispose to the appearance of atherosclerosis plaques on the vessel wall, its narrowing and the appearance high level pressure.

All over the world a single modern classification hypertension according to blood pressure level. Its widespread introduction and use is based on data from studies conducted by the World Health Organization. Classification of arterial hypertension is necessary to determine further treatment And possible consequences for the patient. If we talk about statistics, first degree hypertension is the most common. However, over time, the level of pressure increases, which occurs at ages of 60 or more years. Therefore, this category should be used increased attention.

The division into degrees basically contains different approaches to treatment. For example, during therapy mild degree hypertension can be limited to diet, physical activity and eliminating bad habits. While third degree treatment requires the use of antihypertensive drugs daily in significant doses.

Classification of blood pressure levels

Optimal level: pressure in systole less than 120 mmHg, in diastole - less than 80 mm. Hg
Normal: DM in the range of 120 - 129, diastolic - from 80 to 84.
Elevated level: systolic pressure in the range of 130 - 139, diastolic - from 85 to 89.
Blood pressure level related to arterial hypertension: DM above 140, BP above 90.
Isolated systolic variant – DM above 140 mmHg, DD below 90.

Classification according to the degree of disease:

Arterial hypertension of the first degree - systolic pressure in the range of 140-159 mmHg, diastolic - 90 - 99.
Arterial hypertension of the second degree: DM from 160 to 169, diastole pressure 100-109.
Arterial hypertension of the third degree - systolic above 180 mmHg, diastolic - above 110 mmHg.

Classification by origin

According to the WHO classification of hypertension, the disease is divided into primary and secondary. Primary hypertension is characterized by a persistent increase in blood pressure, the etiology of which remains unknown. Secondary or symptomatic hypertension occurs when diseases affect the arterial system, thereby causing hypertension.

There are 5 variants of primary arterial hypertension:

Kidney pathology: damage to blood vessels or renal parenchyma.
Pathology of the endocrine system: develops with diseases of the adrenal glands.
Damage to the nervous system, which results in an increase in intracranial pressure. Intracranial pressure It could possibly be the result of an injury or a brain tumor. As a result, parts of the brain involved in maintaining pressure in the blood vessels are injured.
Hemodynamic: for pathology of the cardiovascular system.
Medicinal: characterized by poisoning the body with a large number of drugs that trigger a mechanism of toxic effects on all systems, primarily the vascular bed.

Classification by stages of development of hypertension

Initial stage. Refers to transient. Its important characteristic is the unstable indicator of pressure increase throughout the day. At the same time, there are periods of increased normal pressure figures and periods of a sharp jump. At this stage, the disease can be missed, since the patient may not always clinically suspect an increase in pressure, citing the weather, poor sleep and overexertion. There will be no target organ damage. The patient feels fine.

Stable stage. At the same time, the indicator increased steadily and for a fairly long period of time. In this case, the patient will complain about feeling unwell, blurred eyes, headaches. During this stage, the disease begins to affect target organs, progressing over time. In this case, the heart suffers first.

Sclerotic stage. It is characterized by sclerotic processes in the arterial wall, as well as damage to other organs. These processes burden each other, which further complicates the situation.

Classification by risk factors

The classification by risk factors is based on symptoms of vascular and cardiac damage, as well as involvement of target organs in the process; they are divided into 4 risks.

Risk 1: Characterized by the absence of involvement of other organs in the process, the probability of death in the next 10 years is about 10%.

Risk 2: The probability of death in the next decade is 15-20%, there is damage to one organ related to the target organ.

Risk 3: Risk of death of 25–30%, the presence of complications aggravating the disease.

Risk 4: Life-threatening due to involvement of all organs, risk of death greater than 35%.

Classification according to the nature of the disease

According to its course, hypertension is divided into slow-flowing (benign) and malignant hypertension. These two options differ from each other not only in their course, but also in their positive response to treatment.

Benign hypertension occurs over a long period of time with a gradual increase in symptoms. At the same time, the person feels normal. Periods of exacerbations and remissions may occur, but the period of exacerbation does not last long. This type of hypertension can be successfully treated.

Malignant hypertension is the worst prognosis for life. It proceeds rapidly, acutely, with rapid development. The malignant form is difficult to control and difficult to treat.

According to WHO, arterial hypertension annually claims the lives of more than 70% of patients. The most common causes of death are dissecting aortic aneurysm, heart attack, renal and heart failure, and hemorrhagic stroke.

Just 20 years ago, arterial hypertension was a serious and difficult to treat disease that claimed lives a large number people. Thanks to the latest methods diagnostics and modern drugs, you can diagnose early development disease and control its course, as well as prevent a number of complications.

With timely complex treatment You can reduce the risk of complications and prolong your life.

Complications of hypertension

Complications include involvement in the pathological process of the heart muscle, vascular bed, kidneys, eyeball and cerebral vessels. If the heart is damaged, a heart attack may occur, pulmonary edema, cardiac aneurysm, angina pectoris, cardiac asthma. When the eyes are damaged, the retina becomes detached, which can result in blindness.

Hypertensive crises, which are classified as acute conditions, may also occur without medical care which even the death of a person is possible. Provokes their stress, overexertion, prolonged physical exercise, changes in weather and atmospheric pressure. In this condition, headaches, vomiting, visual disturbances, dizziness, and tachycardia are observed. The crisis develops acutely, loss of consciousness is possible. Others may develop during a crisis acute conditions, such as myocardial infarction, hemorrhagic stroke, pulmonary edema.

Arterial hypertension is one of the most common and severe illness. Every year the number of patients is growing steadily. More often these are older people, mostly men. The classification of hypertension is based on many principles that help to diagnose and treat the disease in a timely manner. However, it should be remembered that the disease is easier to prevent than to treat. It follows from this that disease prevention is one of the most simple way preventing hypertension. Regular exercise, giving up bad habits, a balanced diet and healthy sleep can protect you from arterial hypertension.

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