Hypertension

Hypertension.

There is hardly a person who has never heard of anyone complaints about high blood pressure, or he did not have such problems. And no wonder, because periodic or permanent increase in blood pressure is detected, according to various estimates, 10-30% of the adult population. About 9 out of 10 times it is a separate disease — eseentsialnoy, or primary hypertension. In other cases, increased pressure develops on the basis of diseases of other organs, most commonly the kidneys, endocrine glands and lungs — the so-called secondary hypertension.

Untreated hypertension leads to disruption of many organs and body systems. In particular, at times increases the risk of terrible diseases such as myocardial infarction and stroke, impaired kidney function, vision suffers. As a consequence, the deteriorating quality of life, reduced performance until the disability. No wonder many countries have national programs to combat hypertension and many pharmaceutical laboratories are developing ever more efficient, safe and convenient for the use of drugs to control blood pressure.

But despite all efforts, the statistics do not inspire much optimism, and blame themselves often hypertensive, disorderly related to his condition — Scientists from the U.S. It is estimated that of all Americans suffering from hypertension, only the third is aware of this, only one third of this third receives treatment, and of these, in turn, is only 1/3 adequately treated, t is maintains its pressure in the normal range. In our country the situation is, unfortunately, no better.

What is hypertension?

The term "hypertension" in the sense similar to the term "hypertension", but its use is considered less correct, as the word literally translates as hypertension increased pressure and hypertension — as rising tone (which is not always strictly correspond to the situation — blood pressure may rise during unchanged or even reduced vascular tone).

Generally it is a question of diseases or conditions in which blood pressure is higher than normal.

At any age is considered a normal pressure of 130/85 mmHg (Millimeters of mercury). Since the pressure of 140/90 mmHg we can speak of hypertension. Pressure 130-140/85-90 mmHgconsidered high normal. The amount of pressure is reflected by two numbers. The larger of these isSystolic pressure (also sometimes referred to as the "upper"), which is fixed at the time of systole — contraction of the heart muscle, and less — diastolic (Or "lower"), it is determined at the time of diastole — relaxation of the heart muscle. Furthermore, an important characteristic of vascular tone is a so-called "Average" blood pressure, calculated as the product of twice the systolic and diastolic blood pressure, divided by three.

Why did this happen?

The pressure rises because of increase in cardiac output or increasing the tone of blood vessels, is a significant role in the regulation of which belongs to the kidneys.

There are two major groups of arterial hypertension:

  • Essential arterial hypertension (Obsolete term "hypertension") — disease, based on the increase in blood pressure is not caused by diseases of other organs (kidney, endocrine glands, heart);
  • secondary (symptomatic) arterial hypertension, in which high blood pressure is associated with certain diseases or injuries of organs or systems involved in the regulation of blood pressure. Thus, hypertension may be renal (eg, glomerulonephritis or pyelonephritis), center (with lesions of the brain), hemodynamic (in lesions of the aortic heart valve or aortic lesions) pulmonogennoy (chronic lung disease), endocrine (in diseases of the adrenal glands or of the thyroid gland). It is important that the treatment of symptomatic hypertension — a treatment of the disease, which caused her. In some cases, hypertension persists after removing the underlying disease.

Periodic rises in blood pressure may be caused by impaired breathing during sleep, such as obstructive sleep apnea. Neurosis is often accompanied by a rise or low blood pressure, and they can alternate. Also, blood pressure may rise (up to the crisis) because of improper use of certain drugs, excessive consumption of caffeine (and drinks containing it), and other stimulants.

Diagnosis

To determine the presence and extent of hypertension with the regular measurement of blood pressure for a few days at different times — the so-called pressure profile. More precisely it is defined only by daily monitoring of pressure, usually with concurrent enrollment will ECG.

For the diagnosis of hypertension also use a range of methods to study the state of the vessels. The cause of hypertension can be kidney disease, so angiography of renal vessels and renal ultrasound. Early vascular lesions are determined by the method of Doppler ultrasound. Be sure to investigate the activity of the heart using an electrocardiogram in different variations (Resting ECGtreadmill test, Holter monitoring) and echocardiography.

Fundus of the eye, ie the inner membrane of the eye, like a mirror, reflects the state of the blood vessels of the body, so in addition to consulting cardiologist should consult an ophthalmologist who specializes in cardiology.

Principles of treatment

You can often encounter the opinion that the good tolerability of high numbers of blood pressure can not be treated. This is not only fundamentally wrong, but dangerous. Chronically elevated levels of Blood Pressure may contribute to the development of complications such as heart failure, kidney failure, blurred vision, stroke, coronary heart disease. So it is still better to be treated.

Some people believe that, as a rule, in the treatment of hypertension doctors seeking to reduce the pressure to the so-called "Working numbers", that is, those on which the person claims that they are for him "normal." Sometimes some the patient may declare that "working pressure" for him — 160/100 mm Hg. Art., and with such figures he himself "feels fine." This approach is wrong. The doctor certainly will seek to reduce blood pressure to normal numbers. This is a completely unique approach is now recommended by all leading experts. There are, perhaps, the only two exceptions to this rule — marked narrowing of the renal arteries in those cases where it is impossible to immediately conduct a surgical operation to remove this condition and severe renal insufficiency.

Necessary to mention that lowering blood pressure to normal numbers should be gradual. In particular, it can be a dangerous one-stage pressure reduction by more than 25 percent from baseline.

Finally, a few words about how to relate to the treatment of arterial hypertension, smoking, and alcohol intake. Under the order.

Smoking is not conducive to health in general, and in particular pressure normalization. Nicotine constricts blood vessels, which leads to a rise in pressure. Talk about the fact that smoking calms and thus helps to reduce the pressure should not be taken seriously. It turns out that high blood pressure can not smoke. Alcohol in moderate doses (up to 30 ml in terms of pure alcohol per day) may help to reduce vascular tone and accordingly reducing the pressure. Even the beer (of course not in huge doses), contrary to popular belief does not lead to the aggravation of hypertension (of course, you need to have healthy kidneys).

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