Essential arterial hypertension

Essential hypertension is statistically the most common form of hypertension. Such a disorder can be very serious for a person's health, so it is important to start treatment on time.

In cardiology, changes in blood pressure are considered a common problem. In most patients with hypertension, this is the primary or essential form of the disease. Its peculiarity is that there is no connection between high blood pressure and pathologies of internal organs.

The disease is dangerous not only caused by discomfort, but also by further consequences for the whole organism.

General characteristics - stages and pathogenesis of the disease

For the normal state of the body, blood pressure must be maintained by optimal vascular tone, the desired concentration of sodium, sufficient blood volume and other processes. Primary hypertension becomes the main cause causing violations. Why this happens has not yet been clarified.

There have been attempts to create a model of pathology in animals, but they have not been successful. It is assumed that essential arterial hypertension can occur if there are nervous, humoral and other factors that disrupt vascular tone, blood volume and lead to an increase in blood pressure.

Primary hypertension affects people over 40 years of age. Most often, the disease affects older women.

There are several stages in the development of the disease.

1. Blood pressure rises not constantly, but when a person exposes the body to emotional or physical stress. This condition is not accompanied by complications or dysfunction of internal organs. This stage can develop over many years.
2. Blood pressure readings are almost always higher than normal. But in this state, drugs to lower blood pressure help well, although hypertensive crises often occur. At the second stage, the condition of the heart, kidneys worsens, eyes suffer. The pathogenesis of the disease is such that problems such as vascular atherosclerosis, retinal pathologies, myocardial hypertrophy develop, and the level of creatinine in the urine increases and protein appears in the urine, which indicates kidney damage.
3. Blood pressure is much higher than normal. In this state, a person is constantly. You can improve your well-being only with the help of combined hypertensive drugs. The chances of developing hypertensive crises are high.

Pathogenesis

With the help of observations, it was possible to find out that some people are more prone to primary hypertension than others.

The most common cases of the disease are:

• those who are constantly exposed to emotional stress. These are people whose professional activities are associated with significant mental and emotional stress. Also, pressure problems often occur in people living in densely populated cities;
• those who are constantly in a state of stress or feel anxiety. Usually these are people who belong to the melancholic type of temperament. This condition occurs with a constant release of adrenaline and noradrenaline into the body, as well as with a constant vascular tone. Because of this, resistance to blood flow increases, which leads to an increase in blood pressure.

In addition to the psycho-emotional state, the pathogenesis of primary hypertension is associated with the following factors.

• genetic predisposition. The role of heredity in the development of the disease is quite large. There are many families where cases of hypertension are passed down from generation to generation. Conducted research on laboratory rats, as a result of which all animals of the same lineage suffered from hypertension. The pathogenesis of this phenomenon is also not fully understood. It is assumed that the causes are in hereditary dysfunctions of the higher nervous regulators of blood pressure.
• Salt abuse. This leads to fluid retention in the body, which increases blood volume and disrupts blood pressure levels.
• Improper nutrition and - as its consequence - problems with weight. Obesity is a common cause of high blood pressure. It has been proven that US residents often suffer from hypertension precisely because of being overweight.
• Floor. It is believed that hypertension affects men more often, although this disease is also common in women after menopause.
• Bad habits. Drinking alcohol and smoking worsen the condition of the whole organism and are the causes of many diseases.
• Low level of physical activity. A sedentary lifestyle contributes to obesity and other health problems.
• Elevated blood cholesterol.
• Diabetes mellitus and vegetovascular dystonia.
• Vascular pathologies. Often, pressure rises when the elasticity of arterioles decreases. Why this happens is not fully understood. The reasons for this phenomenon may be the abuse of salt, a sedentary lifestyle, and age-related changes.

Symptoms

The first unpleasant symptoms are noticed after the hypertension has affected the organs. Thus, the first stage of the disease leads to impaired cerebral circulation.

This phenomenon is accompanied by:

• pain in the head;
• tinnitus.

Headache is considered the main symptom of the disease. Unpleasant sensations arise in the back of the head and gradually spread to the entire head. It can occur at any time of the day, but most often in the morning, after waking up. In some cases, due to increased pressure, the head begins to hurt so much that the person begins to feel sick. People compare their sensations with squeezing or tightness of the skull. Especially these sensations are amplified during emotional or physical stress.

The constant feeling of discomfort makes a person irritable. The patient constantly accompanies fatigue, even after rest.

Hypertension often leads to increased heart rate. In the region of the heart, discomfort may be felt, which can occur even in the absence of physical exertion, when the patient is in a calm state.

With the development of the disease, when the internal organs begin to suffer, the following symptoms may occur.

1. Eye damage is evidenced by visual impairment in the form of double vision or flies before the eyes. This is due to the fact that blood circulation is disturbed in the retina. Due to the lack of necessary treatment, fiber can exfoliate, which will lead to deterioration of vision or its complete loss.
2. If the brain is damaged, then the person becomes emotionally unbalanced, suffers from insomnia, constantly feels anxiety, and hearing deteriorates.
3. The pathologies of the kidneys are evidenced by swelling of the face, especially bags under the eyes, frequent urination at night and rare during the day.
4. Damage to the heart leads to a condition where even minor physical exertion causes shortness of breath. With the progression of the disease, this symptom occurs even if the person is resting.

The pathogenesis of essential hypertension continues to be studied. To avoid serious consequences, it is necessary to undergo an examination if you feel unwell for several days.

How is the diagnosis made?

The diagnosis of "essential hypertension" is made when, as a result of examinations, it was not possible to identify abnormalities in the functioning of internal organs that could cause an increase in blood pressure.

If there is no reason to assume secondary hypertension, begin to treat primary.

If during the examination it was possible to detect a pathology of any organ, the doctor must find out whether this was due to high blood pressure or the disease caused this increase.

In order to completely exclude all pathologies of the kidneys, heart, blood vessels, eyes and brain, it is necessary to conduct a lot of research, which in a polyclinic will take a lot of time. Therefore, the patient can be admitted to the hospital in order to make an accurate diagnosis in a hospital setting. This is especially necessary if a person under the age of 30 has a constant high level of blood pressure.

The exact definition of the disease begins with an examination and questioning of the patient for complaints. After that, pressure is measured and laboratory and instrumental procedures are prescribed.

Laboratory diagnostic measures include:

• general analysis of blood and urine;
• a blood test to determine the level of cholesterol, glucose, liver enzymes, urea and creatinine;
• study of hormonal status. The level of hormones in the blood is determined if hyperthyroidism or a pituitary tumor is suspected;
• a glucose tolerance test is done to rule out or confirm diabetes mellitus.

Instrumental diagnostics consists of the following studies.

1. Electrocardiogram. It is necessary to detect violations in the work of the heart. At the first stage, essential hypertension may not cause any disturbances, but the second and third stages are manifested by hypertrophy and myocardial ischemia, signs of a heart attack.
2. Ultrasound examination of the kidneys, thyroid gland, internal organs. This method makes it possible to determine the presence of kidney pathologies that led to hypertension or to assess the degree of damage to the kidney tissue in essential hypertension.
3. Echocardiography. Allows to exclude or confirm the pathology of the cardiovascular system.
4. Chest X-ray. Additional study to detect heart defects, myocardial hypertrophy and heart failure.
5. Coronary angiography. It is prescribed for people suffering from angina pectoris, who have had a heart attack, or who have atherosclerosis of the coronary vessels.
6. Magnetic resonance imaging of the brain and kidneys. This procedure is necessary if the doctor suspects neurogenic disorders, as well as tumors of the kidneys or adrenal glands.

To obtain more accurate information about the level of blood pressure throughout the day, the patient is prescribed daily monitoring of blood pressure and ECG. This procedure is carried out using an automatic tonometer. It is put on the patient and not removed during the day. You need to get at least ten results. The rate of increase and decrease in pressure can indirectly indicate hypertension. It is also measured at the time of diagnosis.

How is hypertension treated?

First of all, the treatment of the disease is aimed at lowering the level of blood pressure. This avoids serious organ damage and increases the survival rate of patients.

Complications arise due to pathological changes in blood vessels that occur regardless of what the pathogenesis is, with any type of hypertension.

Research is constantly being done to determine the most appropriate treatment method. Thanks to the efforts of scientists, the number of deaths from hypertension was reduced by 40%.

Before starting treatment, it is necessary to make sure that the patient really has essential arterial hypertension. With such a diagnosis, a person needs to use hypertensive drugs throughout his life and adhere to a healthy lifestyle.

The method of treatment is prescribed individually, depending on the course of the disease.

Medical treatment

In moderate and severe cases of the disease, medications are prescribed. Experts believe that it is advisable to prescribe drugs if the patient has a long-term, persistent increase in pressure. After the appointment of drugs, the patient must take them continuously, for a long time. According to observations, after stopping the use of drugs to reduce blood pressure, hypertension is restored in 85% of cases. Therefore, patients who have decided to stop drug treatment should be monitored.

Therapy for hypertension consists of the use of one or combinations of drugs.

1. Angiotensin-converting enzyme inhibitors. They solve the problem of fluid and sodium retention in the body, and also protect the internal organs from the negative effects of high blood pressure.
2. Beta-blockers and calcium antagonists. They improve the condition of blood vessels and reduce their tone.
3. Diuretic. They help to remove excess fluid from the body.

Non-drug therapy

Non-drug treatment should include such items.

1. Adhering to a special diet that includes limiting salt intake. Patients are advised to consume no more than a teaspoon of salt per day, it is also necessary to adhere to a balanced diet. You need to eat enough calories. If you are overweight, you need a low-calorie diet.
2. Restriction of the use of alcoholic beverages. It is believed that a moderate amount of alcohol will not do harm, as it has a relaxing effect, but its abuse will lead to a deterioration in well-being and the development of arrhythmias.
3. Regular exercise. They allow you to strengthen the body and get rid of excess weight, which helps to improve well-being.
4. Rejection of nicotine. Cigarette use increases the risk of dying from hypertension. This habit causes various disorders in the cardiovascular system. If the patient has left ventricular hypertrophy, sudden death may occur. Therefore, those who have blood pressure far from normal should definitely stop smoking.
5. Avoiding stress, strengthening the nervous system. Psychotherapy, auto-training, yoga can help with this. These methods improve well-being, but do not replace medications. If a person has essential arterial hypertension, then he should not be engaged in work activities that are associated with constant stress, as well as noise.

Possible complications and consequences of the disease

This condition is characterized by a significant increase in pressure to a high level, which can last several hours or days. This phenomenon is accompanied by a significant deterioration in well-being and unpleasant symptoms.

Hypertensive crises are usually manifested by a headache of such strength that there are:

• nausea;
• vomit;
• noise in ears.

Unpleasant symptoms are aggravated during movement. In addition, in the light or during movement, the eyes may hurt.

Hypertensive crises are dangerous because they occur abruptly, without warning. The duration of this state depends on the degree of the crisis. The average duration is several days. Symptoms can be noticed already from the first minutes or within one or two hours from the onset of the crisis.

For each person, blood pressure has its own norm. If low blood pressure prevails throughout life, then even a slight increase can cause a hypertensive crisis.

This condition requires urgent hospitalization. To avoid such a complication, it is impossible to stop treatment on your own. If the drug needs to be canceled, then this should not be done abruptly. It is necessary to gradually reduce the dosage - until the complete cessation of use.

Hypertension is constantly progressing and complicated by more serious pathologies. How severe the consequences for internal organs will be depends on how blood pressure has increased, on the degree of damage to target organs, risk factors or their absence.

With a prolonged increase in blood pressure and the absence of adequate treatment, problems may arise:

• various manifestations of ischemia;
• heart attacks and strokes;
• congestive or acute heart failure;
• hemorrhage in the brain, retina and other organs;
• dissection of a cardiac aneurysm and the like.

Most of the complications of hypertension cause disability or death of a person.

Prevention of pathology

Experts recommend monitoring the level of blood pressure in order to diagnose and start treatment in time if there are deviations.

Preventive measures will also be useful.

1. Special physical exercises to improve well-being and strengthen the body. Running, swimming, walking, breathing exercises, cardio training can increase working capacity and improve health.
2. Salt intake in moderation. It is also necessary to abandon animal fats, fried and spicy foods. The diet should be dominated by fruits, vegetables and dairy products. The right diet normalizes cholesterol levels, relieves excess weight and enriches the body with vitamins.
3. It is necessary to get rid of bad habits, as they significantly increase the chances of developing serious diseases.
4. Strengthening the nervous system. For this, auto-training, meditation, self-hypnosis are used.

Essential and other types of hypertension pose a serious danger to human life. Therefore, it is very important to take the necessary measures in time. Timely diagnosis will significantly reduce the level of damage to internal organs.