Stages of hypertension

The WHO classification distinguishes three stages of arterial hypertension, which differ in potential risks, symptoms and the degree of damage to all organs and systems.

Hypertension is a disease in which the pressure is periodically or constantly elevated. The second name of the pathology is arterial hypertension. This diagnosis is established in more than 20% of the adult population.

Classification of risks and stages of development of arterial hypertension helps doctors to assess the risk of the disease in each case.

Arterial hypertension: classification of stages and risks

High blood pressure is normal for many people. Such patients do not experience tangible discomfort. For others, this disease becomes an occasion for lifestyle changes: high blood pressure in them provokes many unpleasant symptoms.

Arterial hypertension can develop in three stages:

1. At the first stage, the pressure is in the normal state, the patient does not feel discomfort and deviations from the norm in the indicators.
2. The second stage is characterized by short-term rises in tonometer readings and a small number of additional symptoms.
3. The third stage is characterized by serious pathological changes in the work of internal organs and the cardiovascular system.

During the examination, in addition to determining the stage of the disease, a risk group is also established. It depends on the lifestyle of the patient, whether he is overweight, bad habits and genetic predisposition. At the first and second stages, 4 degrees of risk are diagnosed, at the third - three. The criteria for determining at each stage of arterial hypertension are different.

Each stage of hypertension is characterized by a specific clinical picture and diagnostic methods.

First stage of the disease: transient hypertension

In hypertension at this stage, there are 4 degrees of risk:

• 1 degree is established if the patient has a 15% chance that over the next 10-12 years he will have complications in the work of the cardiovascular system;
• 2 degree is established if the risk of developing pathologies in the next 10-12 years is 20%;
• 3 degree is established if there is a possibility of developing diseases of the cardiovascular system with a forecast of up to 30%;
• if the risk of complications exceeds 30%, the 4th degree of risk is established.

Forecasts of the possibilities for the development of various types of complications are formed on the basis of the results of studies of the heart, blood vessels, the presence of additional or past diseases, and genetic predisposition.

In most cases, arterial hypertension of the 1st degree has no symptomatic severity. Many patients detect high blood pressure by chance during a routine examination. Sometimes they may be disturbed by headaches and ailments, but rarely anyone knows about their root cause.

Additionally, the following symptoms may disturb:

• periodic dizziness, nausea;
• frequent heartbeat;
• feeling of fatigue, weakness;
• nose bleed;
• noise in ears.

Diagnosis of the disease is to establish the stability of the increase in pressure. To do this, you need to measure its indicators for some time and compare. The table, where days and tonometer data are noted, helps to evaluate the dynamics of pressure indicators. The presence of additional diseases should be excluded: high blood pressure can be a symptom of other pathologies in the body.

The second stage of the disease: potential risks

Stage 2 hypertension is characterized by the following symptoms:

• chronic fatigue;
• increased sweating;
• problems with remembering small amounts of information;
• dilated vessels in the eye proteins;
• frequent headaches localized in the occipital lobe, accompanied by a sensation of throbbing in the back of the head or temples;
• reddening of the surface of the skin as a result of overcrowding of blood vessels;
• swelling of the face;
• fatigue, lethargy.

When making a diagnosis, each patient is assigned one of four risk groups. When assessing it, factors aggravating the disease (genetic predisposition, age, blood cholesterol levels, overweight, bad habits) and the possibility of causing irreparable damage to target organs (heart, kidneys, brain, eyes) are taken into account.

Risk groups for stage 2 hypertension:

• the risk of group 1 is established for patients with a minimum number of negative factors: additional diseases and bad habits. The risk of complications in the next 10 years is less than 10%;
• the risk of group 2 is determined in those who have several or one aggravating factor. Patients in this group did not suffer a stroke and do not have disorders in the endocrine system. The probability of further development of cardiovascular pathologies is 15-20%;
• if the risk of developing pathologies is from 20 to 30%, the patient is assigned the third group. Most patients at this risk have diabetes mellitus, elevated cholesterol levels;
• in the presence of four or more factors aggravating the disease, the patient develops hypertensive pathology. The diagnosis is established by those who have suffered a myocardial infarction, and also suffer from coronary heart disease, diabetes mellitus and atherosclerosis. An important factor here is the presence of several serious diseases. The possibility of complications is more than 30%.

Diagnosis of stage 2 arterial hypertension is carried out using a set of methods: collecting a complete history, systematic measurement of pressure in dynamics, studying the state of peripheral vessels, listening to the heart and lungs, ultrasound examination of the kidneys, liver, pancreas, heart and echocardiogram.

The third stage of the disease: the nature of pathological changes

If the pressure during the measurement reaches 180/110 mm Hg. Art. and above, patients are diagnosed with stage 3 arterial hypertension. It is characterized by more pronounced symptoms that disturb patients for a long time.

Patients complain of such sensations:

• severe headaches combined with vomiting or nausea;
• dizziness, which is accompanied by flashing "flies" in the eyes, blurred vision;
• tinnitus acquires a permanent character and is provoked by sclerosis of cerebral vessels;
• recurrent pain in the region of the heart, which is accompanied by attacks of panic fear. Most patients cannot lie on their left side;
• as a result of severe atherosclerosis of the vessels of the extremities, numbness of the fingers and toes occurs;
• thought processes slow down, the work of memory and intellect is disrupted.

The results of diagnostic studies also allow us to draw conclusions about the third stage of the disease.

The final diagnosis is made on the basis of the following results:

• a blood test detects elevated cholesterol levels;
• the ophthalmologist notes a reddish hue of the whites of the eyes;
• the borders of the heart are significantly expanded, noises are found in the listening area;
• ECG notes a violation of the heart rhythm and ischemia of some myocardial zones;
• ultrasound confirms heart failure.

In the second stage of hypertension, the first risk group is not established. The second, third and fourth are determined depending on the presence of additional diseases and factors complicating the course of the disease.

Information about risks and criteria for their selection is presented in the table:

The third stage of arterial hypertension is the most difficult, it often leads to death.

Classification of stages and risks helps doctors assess the complexity of the disease and form some predictions. The effectiveness of treatment depends on the correct establishment of the stage of hypertension and the degree of risk. High-quality comprehensive diagnostics provides the most accurate definition of these data. People whose pressure periodically rises to the mark characteristic of the first stage should pay more attention to the state of their cardiovascular system and undergo a comprehensive examination of the body to identify the cause of the deviation. Depending on the stage of hypertension, medication may be prescribed.