Degrees of hypertension and risks

Hypertension is the most common cardiovascular disease, the symptoms of which after the age of 60-65 years affect a large part of the population. The diagnosis has several names, including essential hypertension (AH), hypertension (AH). The disease is chronic, the main task of every patient is to avoid exacerbations and prolong the remission period (disappearance of symptoms) using medicated and non-medicated methods.

What is hypertension

Hypertension is a continuous increase in blood pressure above an acceptable level (starting from 140/90 mm Hg) under the influence of provocative factors. This diagnosis is called the "silent killer". The pathological process continues in an asymptomatic form for a long time, but during an attack significantly increases the risk of stroke, myocardial infarction and other dangerous diseases. Possible complications of GB can be life threatening for the patient, so the disease needs timely diagnosis and adequate treatment.

Hypertensive disease develops as a result of dysfunction of the higher centers of neurohumoral regulation, kidneys, blood vessels. In the absence of timely treatment, the pathological process leads to organic and functional disorders of the heart, central nervous system organs and kidneys. Wrongly chosen therapy can lead to disease progression with added pain.

Classification of hypertension

In 2003, a unified classification of hypertension according to the severity of the disease was established. The determining factor in this division is considered to be the real indicator of blood pressure, determined by tonometry in a particular clinical case. Hypertension is also classified according to the origin (primary, secondary), stages (transient, persistent, sclerotic) and the level of risk of cardiovascular pathologies. This classification simplifies the diagnosis, helps to more accurately determine the treatment regimen for each patient with hypertension.

Degrees of hypertension

With increasing blood pressure (BP), there is a suspicion that hypertension is progressing, especially if it is not possible to solve this health problem with non-medication methods. It is important to know that the optimal blood pressure is 120/80 mm Hg. Art. , normal - 120-129 mm Hg. Art. (systolic pressure - SBP) and 80-84 mm Hg. Art. (diastolic - DBP), normal high - 130-139 mm. rt. Art. (SAD) and 85-89 mm. rt. Art. (BABI). Deviation from these figures indicates serious pathology of the body. Doctors distinguish 3 degrees of GB:

1. Grade 1 (mild) hypertensive disease is characterized by unstable pressure, which for several days varies from 140/90 to 159/99 mm Hg. Art The risk of developing a hypertensive crisis is minimal, there are no symptoms of organic damage to internal organs and the central nervous system. To suppress a painful attack, in addition to taking medication, the patient needs a good rest, the exclusion of stressful situations. Positive emotions, walks in the fresh air are especially helpful.
2. Second-degree hypertension develops rapidly. The blood pressure index varies from 160/100 to 179/109 mm Hg. Arti. , there are symptoms of a hypertensive crisis (cold sweat, bumps, redness of the face). The patient is concerned about migraine attacks, dizziness, poor sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decreased blood flow to the body), increased creatinine in the blood, narrowing of the retinal arteries, hypertrophy (increase in size) of the left ventricle, microalbuminuria (detection of proteins in urine analysis. ). It is not possible to normalize the condition without medication.
3. Grade 3 (severe) hypertensive disease is associated with a sharp decline in visual acuity, poor memory, tachycardia attacks (increased heart rate). A hypertensive crisis develops. Blood pressure indicator - from 180/110 mm Hg. Art. and above. Possible complications include hypertensive encephalopathy, thrombosis and cerebral vascular aneurysm (pathological dilation of vessels), left ventricular heart and kidney failure, hemorrhage (bruising), and swelling of the optic nerve. Pathological changes are irreversible.

Cardiovascular risk rate

To predict the possibility of complications in progressive hypertension, the first step is to determine the cardiovascular risk index. This requires specialist advice, complex diagnostics. The degree of hypertension, provocative circumstances of recurrence (physiological and pathological) are taken into account. Common risk factors are:

• smoking, other bad habits;
• high blood cholesterol;
• sedentary lifestyle;
• obesity, including the abdomen (most of the fat is deposited in the abdomen);
• age (women over 65, men over 55);
• fasting sugar index 5, 6-7, 0 mmol / l;
• impaired glucose tolerance, determined using a special test;
• the presence of diseases of the cardiovascular system in relatives;
• man.

The patient has a high degree of cardiovascular risk if, in addition to hypertension, he has chronic comorbidities:

• diabetes;
• infrakt;
• violation of lipid (fat) metabolism;
• bronchial asthma;
• extensive retinal damage;
• coronary artery disease;
• renal failure stage 4;
• suffered a stroke;
• cerebrovascular diseases (damage to brain vessels);
• signs of disappearing diseases of the peripheral arteries of the lower extremities (atherosclerosis);
• damage to other internal organs.

Such information helps the physician to predict the clinical outcome of the disease. To determine the cardiovascular risk indicator for each degree of hypertension, you should be familiar with the following table:

General Risk Factors (RFRs)	Blood pressure	Risk of hypertension 1 degree	Second degree arterial hypertension, risk	Risk of grade 3 hypertension
there are no risk factors	ordinary danger	February	moderate	tall
1-2	February	moderate	moderately high	tall
over 3	low-moderate	moderately high	tall	tall
damage to other internal organs, stage 3 kidney disease, diabetes mellitus	moderately high	tall	tall	very tall
CVD, stage 4 chronic kidney disease with involvement of other organs or common risk factors	very tall	very tall	very tall	very tall

Treatment of hypertension

The classification of GB according to stages and risks helps to accurately determine the regimen of drug therapy, the rapid cessation of a painful attack, and the extension of the remission period. If primary (isolated) hypertension develops, depending on medical recommendations, the prognosis is favorable. The secondary form of the disease often occurs with complications.

If the disease is not cured in time, it is difficult to stabilize high blood pressure even with medication. General recommendations of specialists, if grade 1, 2 or 3 hypertension is diagnosed, are presented below. . It should be supplemented by taking medications prescribed by the attending physician:

1. Compliance with a therapeutic diet. It is important to reduce servings of table salt, enrich the daily diet with foods with potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and cereals, greens).
2. Rejection of bad habits. This applies not only to smoking and smoking, but also to the need to increase physical activity, to leave behind a "sedentary" lifestyle and to take walks in the fresh air.
3. Weight control. If a patient with hypertension has obesity, it is necessary to abandon fatty, fried and smoked foods and regularly organize fasting days.
4. Physiotherapy. To prevent and prolong the GB remission period, it is recommended to perform moderate intensity physical exercises for 30 minutes 5 times a week.
5. Reception of multivitamin complexes. The composition of such medicines should contain potassium, magnesium, iron and other trace elements important for the body.

Medical therapy

Oral treatment depends on the degree of hypertension and the accompanying symptoms. The following are the optimal schemes for conservative treatment of hypertension:

1. In the mild stage of the disease, the patient is prescribed angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
2. If second-degree risk hypertension develops hypertension 4, an integrated approach to the problem is needed, which combines several representatives of different pharmacological groups into a conservative treatment regimen. These are the above drugs in combination with thiazide diuretics.
3. In the complicated course of this disease, in addition to the above medications, doctors recommend alpha- or beta-blockers. The need for this arises if high doses of diuretics are poorly tolerated by a weakened body).