Examinations for hypertension

Hypertension is one of the most common diseases for both men and women. This pathology is characterized by consistently elevated blood pressure, which occurs against the background of certain diseases or due to factors such as obesity, smoking, alcoholism, physical inactivity.

There are several stages of the disease, which differ in the nature of manifestations, course and methods of treatment. It is believed that hypertension is a disease of the elderly. According to statistics, at a respectable age, this problem occurs 60% more often.

Types and stages of hypertension

Hypertension is not a new disease, but it began to be actively investigated only in the second half of the 20th century. During the study, it was repeatedly proposed to classify the disease depending on the appearance of the patient, the causes of the disease, the nature of the course, the degree of damage to target organs, and the level of pressure. Many separation methods are considered irrelevant today, but some methods are still used.

In medicine, there are three main degrees of pathology:

• Pathology of the 1st stage. In this case, systolic indicators do not exceed 159 mm Hg. Art, and diastolic 100 mm Hg. Art. A distinctive feature of this stage is an abrupt increase in pressure. At the same time, it can return to normal even without taking medication.
• Hypertension 2nd degree. At this stage, systolic pressure does not rise above 179 mm Hg. Art, and diastolic more than 109 mm Hg. Art. High rates in this case are kept for quite a long time. They do not go down on their own, it is possible to normalize blood pressure at this stage only with the help of medicines.

• 3rd degree of the disease. This is a severe form of pathology. The pressure sometimes reaches 210 mm Hg. Art. In this case, the measurement must be carried out systematically, since for quite a long time it is near the critical mark. You can lower the rates with the help of drug treatment.

Depending on the causes of the pathology, primary and secondary forms of the disease are distinguished. Examinations in such cases are aimed at establishing risk factors for the development of heart pathologies, determining the complexity of target organ damage, establishing the presence of concomitant diseases, predicting the development of the disease and possible complications.

Hypertension by origin includes primary and secondary hypertension. Primary (essential) is most often found in people exposed to risk factors such as obesity, smoking, frequent drinking, and a sedentary lifestyle.

It is believed that genetic inheritance also serves as a predisposition to the occurrence of this form. Scientists conducted a study of families with such a disease, and found 15 genes that, in their opinion, can affect the level of blood pressure.

Primary hypertension is divided into the following forms:

1. Hyperdrenergic. It most often develops at a young age. Its peculiarity is that the patient has a significant increase in adrenaline and norepinephrine in the blood. The main symptoms of this form: frequent pulsation in the skull, skin color change from very light to red, anxiety. The heartbeat at rest ranges from 90 to 95 beats.
2. Normo and hyporenin form. These species mainly develop in old age. The causes are the presence of aldosterone in the blood and a significant increase in renin. A person during this period observes swelling of the body, usually on the face. In this case, patients are not recommended to drink a lot of fluids and eat too salty food.
3. Hyperreninous. This type of hypertension is rapidly progressive. In most cases, it occurs in young men. A rather severe form, in which a very rapid and sharp increase in pressure is observed. All this is accompanied by vomiting, headaches, and if timely treatment is not carried out, then atherosclerosis begins to develop in the kidneys.

Secondary (symptomatic) hypertension appears against the background of diseases of organs and systems that are mainly involved in the formation of blood pressure.

Examinations are carried out taking into account the pathology of the damaged organ.

This type of hypertension can be:

• renal;
• endocrine;
• neurogenic;
• cardiovascular;
• blood diseases;
• medicinal.

According to the course of the disease, hypertension is divided into benign and malignant. In the first case, the pathology develops very slowly and may not have pronounced symptoms. But this type has its drawbacks and dangers. Due to the secrecy of manifestations, the disease can be detected at a late stage, when treatment requires more significant approaches.

Examinations for hypertension

Hypertensive disease is chronic and occurs in almost every third. At the first symptoms of the disease, it is necessary to undergo an examination in order to begin the correct treatment.

First, the doctor collects an anamnesis and clarifies the patient's complaints. This allows you to identify risk factors, signs of damage to target organs. In the future, the doctor conducts and prescribes certain studies.

Physical examination of the heart muscles with a stethoscope helps to identify abnormalities in the tissues of the organ. In the case of hypertension, a second tone is sometimes heard over the aorta.

Measurement of blood pressure is carried out on both hands in three approaches, the interval between which should be 3-4 minutes. The pressure is considered elevated if the tonometer readings exceed 139/89 mm Hg. Art. The correctness of the examination also lies in the 14-day observation of the patient. To do this, the pressure should be measured for two weeks in the morning and evening.

Laboratory diagnostics is considered mandatory. This procedure helps to obtain additional information about the state of the organs affected by hypertension.

For this, the following analyzes are given:

• urine test (to find out the amount of protein);

• blood test (to evaluate the formed components);
• kidney tests (creatinine, urea);
• the presence of potassium and sodium in the blood;
• the state of glucose in the blood;
• the presence and level of cholesterol and triglycerides.

Electrocardiography is prescribed for almost all patients with suspected hypertension. It allows you to identify the patient with myocardial ischemia and the presence of hypertrophy of this muscle. Changes in the heart occur in the vast majority of cases after a long course of the disease.

Also, during the examination, the doctor may prescribe an ultrasound. This allows you to determine the condition of the blood arteries and the heart directly. Thus, ultrasound examination of brachiocephalic vessels is necessary to determine the thickness of the arterial walls and the presence of atherosclerotic deposits.

Examination of the fundus. A prolonged increase in pressure entails a spasm of small arteries. The presence of such changes is fraught with the fact that the patient begins to develop retinopathy. Viewing the fundus in the early stages of the disease is very important. You can see narrowing of the arteries. Retinopathy at stages 3 and 4 of development can lead to blindness of the patient.

If secondary hypertension is suspected, an ultrasound examination of the kidneys may be ordered. This procedure allows you to identify changes, damage to organs, the appearance of neoplasms.

With any type of hypertension, the patient has frequent and severe headaches. But if nausea, vomiting, dizziness are added to them, then this may indicate the appearance of hypertensive encephalopathy. Such a diagnosis is made by a doctor only after the complete exclusion of other diseases of the nervous system. In this case, the patient is necessarily sent for a consultation with a neurologist.

It can be:

• aortography:
• scanning of cervical vessels;
• MRI of the brain;
• ECG recording during the day.

These studies are optional, but in some cases without them it is impossible to establish an accurate diagnosis and start the right treatment.

Causes of the disease

Every year, hypertension is becoming more common among young people.

There are many reasons for its appearance.

• Primary hypertension occurs as an independent disease due to factors such as obesity, heavy drinking, smoking. If such reasons are revealed after the examination, the doctor, first of all, recommends changing the way of life.
• The secondary type of hypertension most often occurs due to pathological changes in the kidneys. Ultrasound is prescribed to detect organ damage.
• Also, consistently high levels of blood pressure are observed in Itsenko-Cushing's disease. With such a pathology, in addition to high blood pressure, studies reveal obesity, a "moon-like" face, the appearance of secondary male sexual characteristics is ascertained in women.
• Congenital narrowing of the aorta can lead to hypertension. In the process of diagnostics, the indicators of the tonometer are compared after measuring procedures on the upper and lower extremities. In this case, when measuring on the arm, the pressure will be increased, on the leg - reduced.
• As a secondary manifestation, hypertension may occur due to the intake of certain groups of drugs. For example, steroids, sympathomimetics, cyclosporines, drugs that contain cocaine, licorice.
• Hypertension at a young age. The main cause of the disease is heredity. The quality of vessels can be inherited. Therefore, it is more likely that if the parents suffered from this disease, then it will also manifest itself in children. In addition, hypertension can occur in those young people who are a lot of nervous, lead a nocturnal lifestyle.
• disease in women. There are several reasons for the increase in pressure in the fairer sex. The first is birth control pills. They contain estrogens in their composition, which have the ability to significantly increase the level of blood pressure on the walls of blood vessels. The emotionality of women also affects this indicator.

• Nocturnal hypertension. At night, the disease may appear due to VVD - during the activity of the nervous system at night. If there is a jump in pressure during sleep, then this may also indicate problems with the left ventricle of the heart.

If, after the examination, the doctor stated the presence of hypertension, the first thing to do for treatment is to get rid of bad habits that only aggravate this disease.

It is worth quitting smoking, taking alcohol, getting rid of excess weight, learning to adequately perceive unpleasant situations.

The simplest evening run in the fresh air will normalize the state of the nervous system, strengthen the muscles of the heart.

To reduce pressure in the initial stages of hypertension, diuretics are prescribed, which remove excess fluid from the body, thereby lowering blood pressure on the walls of blood vessels. In more complex forms of pathology, drugs are prescribed, the action of which is aimed at dilating the arteries. In order for the treatment to be correct and effective, it is necessary to undergo an examination. Only a doctor can tell which medicines to use.