The classification of arterial hypertension is a system used to assess the seriousness and phase of the development of arterial hypertension.
Attention!In the International Classification of Tenth Audit Disease (ICD-10), arterial hypertension of the inorganic nature is marked with the Code I10.
Hypertonic disease: definition, description and etiology
About 50% of people suffer from hypertension (GB).About half of the hypertension does not know what suffers from the disease.More than 50% of patients with known hypertension or are not treated or inefficient drugs receive.The main cause of patient mortality with adult hypertension is the infarction of the brain or heart.
The prevalence of arterial hypertension increases with age and body weight.Men at young age often suffer from disease from women.Women in Postman's more often suffer from hypertension than men.
Arterial hypertension can be divided into primary (essential) and secondary (organic).
The vast majority (> 90%) hypertension has primary hypertension, defined as idiopathic.Primary hypertension is diagnosed excluding organic pathology.
Some risk factors can increase the risk of developing diseases at an early age.In medicine, unmodified disease formation factors have been amended.They include:
- Obesity;
- Excess salt, alcohol in a diet;
- Cohabitants of smoking (represent a danger because the patient inadvertently becomes a passive smoker);
- Stress;
- Hypodynamia (lack of sports in patient's life);
- Smoking;
- Circulation disorders (in a small or large circle);
- Old-fashioned age;
- Low social status.
Secondary (symptomatic) hypertension was created due to other diseases - sleep apnea syndrome, aorta coarctation or aortic sclerosis.Neurogenic, psychogenic and subordent forms are also known.The last form includes, among other things, ovulation and NSAIDs inhibitors.Medications and toxic substances, as well as very large candy consumption can lead to the secondary form of hypertension.Renal hypertension caused by the stenosis of renal artery, as well as hyperaldosteronism, feochromocytoma, kushing's diseases or hyperthyroidisms belong to secondary forms of hypertension.
Another type of arterial hypertension occurs with a hypertensive pregnancy disorder (GEC).Risk factors include high-breastfed and multiple pregnancies.Different forms are known, including, for example, gestational hypertension with or without proteinuria.
Pathophysiology
Arterial hypertension occurs due to increasing peripheral resistance, increasing the heart exit or combination of both.In this process, there are several adjustment mechanisms, so the blood pressure is constantly maintained at an increased level.To maintain heart ejection, the heart becomes hypertrophy and can withstand a constant pressure load.
Kidneys also play a significant role in the pathogenesis of hypertension.Although the kidney flow of blood and the glomerular filtration rate remain largely constant, sodium excretion and excretion.The influence is discussed, for example, excretion of renins or changed the reabsorption of pressure on pressure.
Symptoms
The symptoms of arterial hypertension often appear too late.In most cases, the disease is asymptomatic.
Hypertension can be characterized by the following symptoms:
- Early morning pain in the head;
- Sleep disorders, dizziness;
- Epistaxis;
- Tinnitus;
- Non-specific heart disorders;
- Autreat shivers.
In case of secondary hypertension, the symptoms of the fundamental disease are added.Special forms of hypertension are hidden hypertension (SG) and white desperate syndrome (SBC).
With SBC, blood pressure increases ≥140 / 90 mm Hg.Art.When measuring in the doctor's office.At home and when monitoring blood pressure, the normal value of blood pressure is recorded.
With hidden hypertension, blood pressure values in doctors are located in a normal range.The measurements of the house or monitoring blood pressure show increased values ≥140 / 90 mm Hg.Art.This form can be associated with such factors as well as male sex and younger age as well as smoking, drinking alcohol and stress.
With a hypertensive crisis, it is necessary to prescribe the correct treatment regime to prevent pathological processes in the organs.Patients with this disease require to cause an ambulance or take him to the clinic themselves.The lack of treatment may jeopardize the patient's life and cause non-refundable consequences.The progress of blood pressure can be malicious, which will lead to unjustified risk.If any vascular symptoms appear, it is recommended that you see the doctor immediately, because the crisis can result in lifelong disability.
Classification of hypertension by degree
The phases of arterial hypertension were distinguished by who.Increasing blood pressure, which occurs, for example, after physical stress, is not considered hypertension.
The disproportionately high blood pressure level at low load is called labyl hypertension.The dangerous form of arterial hypertension is associated with diastolic blood pressure above 120 mm Hg.Art, which decreases in less than 10% during the night.
New (2017) Classification of hypertension at the phase and degrees: The table is given below.
| Phase AG | Systolic pressure in mm Hg.Art. | Diastolic pressure in mm Hg.Art. |
|---|---|---|
| Optimal | <120 | <75 |
| Normal | 120-125 | 75-79 |
| Highly normal | 126-129 | 80-85 |
| 1. Phase: Home Hypertension | 130-150 | 85-99 |
| 2. Phase: Moderate hypertension | 160-179 | 100-109 |
| Phase 3: Heavy hypertension | ≥180 | ≥110 |
| Isolated systolic hypertension | ≥130 | <90 |
Classification of arterial hypertension by degree
Hypertension can be classified depending on the damage to blood vessels, eyes, hearts, kidneys.In accordance with the recommendations, there are 3 degrees of hypertension.There are no clinical signs of organs in the first instance.In the second instance, the target bodies were affected, and the atherosclerosis of the vessel was discovered.With a third degree, obvious cardiovascular complications arise frog, cardiac and cerebral heart attack, transient ischemic attacks.
Risk stratification of the pronounced arterial hypertension determines the likelihood of complications.Depending on the phase of arterial hypertension, the risk can vary significantly.
Important!Only a doctor can determine the correct diagnosis, the category of risk, giving certain types of recommendations for prevention and treatment.It is not recommended to calculate the risk on unverified scales and try to treat the disease.The treatment of a child and teenagers may vary.The doctor is elected various treatment based on medical history.
Complications
The problem of arterial hypertension is that often remains undiagnosed for a long time or treats poorly.The absence of symptoms forces patients not to seek medical attention.This leads to complications that often appear in the heart, kidneys, central nervous systems and eyes or in pots of lower extremities.Atherosclerosis has often developed.
Hearts and insufficiency, as well as coronary heart disease, the consequences of heart hypertension are important.The heart increases to withstand the increased load.The result is left -ontricular failure.
As a result of atherosclerotic changes in coronary arteries, the coronary reserve is so limited that even a slight increase in the heart exit during stress can cause angina pectoris, myocardial infarction or sudden coronary death.
Hypertonic nephropathy - kidney damage due to hypertension.May occur as a result of endothelial damage.The high blood pressure exposure can cause a pronounced nephrosclerosis with renal failure of the last phase.
AG can lead to transient ischemic attacks (TIA), cerebral heart attack, hypertonic mass bleeding or acute encephalopathy.The risk of stroke can significantly reduce antihypertensive therapy.
Hypertonic retinopathy, as a rule, occurs as a result of the spread of atherosclerosis in the blood vessels of the retina.Vascular diseases caused by hypertension are OZPA, abdominal aorte aneurism and aortic dissection.
Method of treatment
Hypertension treatment begins with an attack intervention.Main methods of unsuccessful disease therapy:
- Reduction of body weight of up to 25 units according to BMI;
- Prelazak na dijetu sa niskim soli od <5-6 g nacl dnevno (preporučuje se odabir prehrane crtice);
- Refusing smoking, alcohol;
- Limiting caffeine consumption.
It is also necessary to restrict the use of hypertensive drugs if there is hypertension.Patients are recommended to engage in the type of training at the end of residence 3-4 times a week swimming, running cowardices or cycling.
In addition to these general measures, it is necessary to treat diseases that cause secondary hypertension.According to the European Association of Hypertension, the target value of blood pressure should be> 140/90 mm Hg.For patients under 80 years, a> 150/90 mm Hg.- For older patients.
Medicine therapy begins with monotherapy with a choice of choice.At the values that strongly deviated from the normal blood pressure values (> 20/10 mm HG) or primary combined therapies are performed with simultaneous diseases.
Choice preparations:
- Beta blockers;
- ACE inhibitors;
- Thiazide diuretics;
- AT1 receptor antagonists;
- Calcium blocks from long - Donnon.
As a double combination, you can use a diuretic combined with beta-blocker, long-term calcium antagonists, ACE inhibitors or AT1 receptor blockers.
Calcium antagonists Types of non-hefidropyridine must not be prescribed together with beta blockers, because they contribute to the development of bradycardia or atrioventricular blockade.
Depending on the simultaneous disease, certain medications cannot be prescribed.Diuretics are recommended for hypertension in combination with heart failure.ACE inhibitors can be used for heart failure, as well as in diabetic nephropathy.In the presence of myocardial insufficiency, beta blockers can also be used.
Regarding the use of individual drugs, factors such as side effects, individual tolerance and interaction with other drugs added to the use of the patient.Triple combinations are also possible if the double combination does not give the desired effect.