Arterial hypertension is one of the most common diseases of heart and blood vessels and affects about 25% of the adult population.No wonder that it is sometimes mentioned as a non -infectious epidemic.High blood pressure with its complications significantly influences the mortality of the population.Estimates show that up to 25% of the death of people over 40 years are caused directly or indirectly by high blood pressure.The probability of complications determines the phases of high blood pressure.How many phases has high blood pressure, how are they classified?Look below.
Important!According to the latest estimates by the 1993 World Health Organization, hypertension in adults is a steady increase in blood pressure to 140/90 mm ed.
Classification of arterial hypertension, determination of the risk of the disease
According to etiology, high blood pressure is primarily and secondarily.
In primary (essential) hypertension (GB), the main organic cause for increasing blood pressure (blood pressure) is unknown.A combination of genetic factors, external influences and violations of internal regulatory mechanisms is taken into account.
External factors:
- Environment;
- excessive use of calories, the development of obesity;
- Increased salt consumption;
- Lack of potassium, calcium, magnesium;
- excessive drinking;
- Repeat stressful situations.
The primary hypertension is the most common high blood pressure in about 95% of cases.
3 water pressure stages are separated:
- Stage I - increased blood pressure without changes in organs;
- Stage II - an increase in blood pressure with changes in organs, but without impaired function (hypertrophy of the left ventricular, proteinuria, angiopathy);
- Stage III - Organs accompanied by an impaired function (left -wing heart failure, hypertensive encephalopathy, stroke, hypertonic retinopathy, kidney failure).
Secondary (symptomatic) hypertension is an increase in blood pressure as a symptom of the underlying disease with the identified cause.The classification of secondary arterial hypertension is as follows:
- Renoparechymal hypertension - occurs due to kidney diseases;Reasons: kidney parenchymal disease (glomerulonephritis, pyelonephritis), tumors, kidney damage;
- Renovascular hypertension - narrowing of the renal arteries with fibromoscular dysplasia or atherosclerosis, kidney vein thrombosis;
- Endocrine hypertension -primary hyperaldosteronism (Conn -syndrome), hyperthyroidism, pheochromocytoma, kushing syndrome;
- Hypertension caused by medicines;
- Pregnancy hypertension - high pressure during pregnancy, after birth, the condition is often normalized.
- Aorta coarcation.
Pregnancy hypertension can lead to congenital diseases of the child, especially retinopathy.2 phases of retinopathy (premature and complete children) are separated ::
- Active - consists of 5 stages of development, can lead to a loss of vision;
- Rubts - leads to the cloudiness of the cornea.
Important!Both stages of retinopathy of early and complete children lead to anatomical disorders!
Hypertensive diseases according to the international system (according to ICD-10):
- Primary form - i10;
- Secondary form - I15.
The high blood pressure also determine the degree of dehydration - dehydration.In this case, the classifier is a lack of water in the body.
Share 3 degrees dehydration:
- Grade 1 - light - deficiency of 3.5%;Symptoms - dry mouth, heavy thirst;
- Grade 2 - average - deficiency - 3-6%;Symptoms - sharp fluctuations in pressure or pressure reduction, tachycardia, oliguria;
- Grade 3 - The third degree is the most serious, characterized by a deficiency of 7-14% water;manifests itself with hallucinations, delirium;Clinic - Koma, Hypovolemic shock.
Depending on the degree and stage of dehydration, decompensation is carried out by introducing solutions:
- 5% glucose + isotonic NACL (mild degree);
- 5% NaCl (average degree);
- 4.2% Nahco3(difficult degree).
Steps of GB
Subjective symptoms, especially with the light and moderate stage, are often missing, so that an increase in blood pressure is often determined at the level of dangerous indicators.The clinical image is divided into 3 levels.Every stage of arterial hypertension has typical symptoms from which the classification of GB comes.
Level I
In 1 phase of high blood pressure, the patient complains of headache, fatigue, quick heartbeat, disorientation and sleep disorder.In 1 level of GB, objective detection, the EKG, the eye background is present in laboratory studies in the normal area.
Level II
Subjective complaints are similar in the second stages of the AH.At the same time there are signs of hypertrophy of the left ventricular.There are signs of hypertensive angiopathy on the retina, microalbuminuria or proteinuria in the urine.Sometimes there is a multiplication of the red blood cells in the precipitation of urine.In 2 stadiums, the symptoms of kidney failure are missing.
Level III
With high blood pressure of the III stage, functional disorders in organs are diagnosed that are part of an increased risk of high blood pressure:
- Damage to the heart - at the beginning the shortness of breath manifests itself, then the symptoms of heart -asthma or pulmonary edema;
- Vascular complications - damage to the peripheral and coronary arteries, the risk of atherosclerosis of the brain;
- Changes to the fundus - have the type of hypertensive retinopathy, neurororinopathy;
- Changes in cerebral blood vessels show through transient ischemic struggles, typical thrombotic or hemorrhagic vascular strings;
- In stage III, a brain strike, brain lesions are diagnosed in almost all patients.
- Benstic nephrosclerosis of the kidney vessels - leads to limited glomerular filtration, an increase in proteinuria, red blood cells, hyperuricaemia and later to chronic kidney failure.
Which stage or high blood pressure is most dangerous?Despite various symptoms, all stages and degrees of arterial hypertension are dangerous and require adequate systemic or symptomatic treatment.
degree
In accordance with the blood pressure indicators (blood) defined at the time of the diagnosis, 3 degrees of hypertension are differentiated:
- Light;
- Average;
- difficult.
There is also a 4. Concept-the-resistant (persistent) hypertension, in which the blood pressure indicators are not reduced below 140/90 mm Hg even when choosing a combination of a combination of blood-pressure-lowering drugs.Art.
A clearer overview of the degrees of arterial hypertension is shown in the table.
Classification AG and stratification of normal blood pressure according to the ESH/ESC guidelines 2007.
| category | Systolic pressure, mm ed. Art. | Diastolic pressure, mm ed. Art. |
|---|---|---|
| Optimal | <120 | <80 |
| Normal | 120–129 | 80–84 |
| Normally increased | 130–139 | 85–89 |
| 1 degree | 140–159 | 90–99 |
| 2 degrees | 160–179 | 100-109 |
| 3 degrees | More than 180 | More than 110 |
| Isolated systolic hypertension | More than 140 | Less than 90 |
The patient's difficulties vary according to the separation of high blood pressure to degrees.The choice of the treatment of the disease depends on the determination of the degree.
I degree
The disease can only be detected with regular blood pressure measurement.Measurements should be carried out at least three times in a certain period of time in a relaxed environment.
This is the only way to evaluate the presence or lack of high blood pressure.Depending on the degree of increase in blood pressure, the clinical image of the disease differs.
II degree
The 2nd high -pressure level is characterized by periods with increased pressure, which changes with a decrease in the indicators or an increase in the only diastolic value.To this extent, high blood pressure, cases of increasing pressure under certain circumstances are typical, especially in patients with an unstable nervous system.
III degree
III degree of the AG is characterized by a critical increase in blood pressure.
The III degree of the GB is characterized by serious complications, which result from the harmful effects of high blood pressure on all organs and systems.First of all, the heart, the kidneys, the eyes, the brain are affected.With hypertension of the III degree, the symptoms and treatment are closely linked - with inadequate or improper treatment, the disease can lead to serious consequences: stroke, encephalopathy, kidney failure, irreversible eyeles, blood vessels.The lack of treatment for the III degree The high blood pressure increases the risk of isolated systolic hypertension.
At this stage of arterial hypertension, the risk degree increases significantly!Disorders of memory, mental activity, more frequent loss of consciousness are shown.
Hypertonic crisis is created as a complication of the III century and is considered IV art.GB.
Risks
In accordance with the classification of high blood pressure due to stages and degrees, the patients are divided into risk groups depending on the severity of the AG.4 categories are distinguished (i.e. as many of them as the high blood pressure levels), which are determined by the principle of the probability of damage to the internal organs in the future.
Risks of the degree of illness:
- Risk less than 15%;
- Risk up to 20%;
- Risk 20-30%;
- The risk is over 30%.
Low, insignificant
A group with low risk includes men up to 55 years and women up to 65 years from I Art. Arterial hypertension.In this group, the risk of cardiovascular pathology in the period of up to 10 years is less than 15%.People who belong to a group with low risk are recommended to change the lifestyle.If there is no therapy with stupidity within 6-12 months, it is advisable to prescribe medicines.
Average
The average risk group includes people from I - II Art. Hyperture, provided there are 1-2 risk factors.The risk increases with high body weight, smoking, an increase in cholesterol, a violation of glucose tolerance, a lack of lack of exercise.Hereditary factors are also important.The risk of cardiovascular complications in these people is higher and is 15 to 20% for 10 years.People who are related to this group are recommended to keep a healthy lifestyle.If there is no pressure acceptance within 6 months, pharmacotherapy is prescribed.
High
The high group includes people from the II century.Hypertension, subject to at least 3 risky factors, including:
- Diabetes;
- Defeat of the target organs;
- Atherosclerotic vascular diseases;
- Left ventricular hypertrophy;
- increased creatinine;
- Changes in the eye vessels.
This group also includes high blood pressure from the 3rd century, which has no risky factors (the risk of cardiovascular diseases is 10 to 10 years 20 to 30%).Representatives of this group are under the supervision of a cardiologist.
Very high
A group of high blood pressure with a very high risk of cardiovascular diseases (more than 30% for 10 years) includes people with III art.High blood pressure, provided there is at least 1 risky factor.In addition, this group includes patients with AH I - II Art. In the presence of a violation of brain circulation, ischemia, nephropathy.This group is controlled by cardiologists and requires active therapy.
Diploma
The problem of arterial hypertension is that the disease has no typical symptoms and is characterized by a variety of clinical formations.Therefore, a person often knows nothing about the presence of the disease.Therefore, a high pressure is determined by chance, during inspection or in the manifestation of complications.When diagnosing high blood pressure, it is important to correctly inform the patient that he can largely influence the course of his illness after a healthy lifestyle.