Degrees of hypertension and risks

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

What is hypertension

Arterial hypertension is a constant increase in blood pressure above an acceptable level (starting from 140/90 mm Hg) under the influence of provoking factors. This diagnosis is called the "silent killer". The pathological process proceeds for a long time in an asymptomatic form, but during an attack the risk of stroke, myocardial infarction and other dangerous diseases significantly increases. Potential complications of GB can be life-threatening, so the disease needs prompt diagnosis and appropriate treatment.

Hypertensive disease develops due to 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, organs of the central nervous system and kidneys. Incorrectly selected therapy can lead to disease progression with increased pain.

Hypertension classification

In 2003, a unified classification of hypertension was defined based on the severity of the disease. The determining factor in this division is considered to be the true indicator of blood pressure, determined by the tonometer in a particular clinical case. Hypertension is also classified by origin (primary, secondary), stages (transient, stable, sclerotic) and risk level of cardiovascular diseases. This classification simplifies the diagnosis, helps to more accurately determine the treatment regimen for each hypertensive patient.

Degrees of arterial hypertension

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

1. 1st degree (mild) hypertensive disease is characterized by unstable blood 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 medications, the patient needs a good rest, the exclusion of stressful situations. Positive emotions, walks in the fresh air are especially useful.
2. 2nd degree arterial hypertension develops rapidly. The blood pressure index ranges from 160/100 to 179/109 mm Hg. Art. , The symptoms of a hypertensive crisis are present (cold sweat, goosebumps, redness of the face). The patient is worried about migraine attacks, dizziness, poor sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decreased blood flow to the organ), increased creatinine in the blood, narrowing of the retinal arteries, hypertrophy (increase in size) of the left ventricle, microalbuminuria (protein detection in urinalysis ). It is not possible to normalize the condition without drugs.
3. Hypertensive disease of the 3rd degree (severe) is accompanied by a sharp decrease in visual acuity, poor memory, tachycardia attacks (increased heart rate). A hypertensive crisis develops. BP indicator - from 180/110 mm Hg. Art. and above. Possible complications include hypertensive encephalopathy, cerebral vascular thrombosis and aneurysm (pathological vessel expansion), heart and renal failure of the left ventricle, hemorrhages (bruises), and swelling of the optic nerve. Pathological changes are irreversible.

Degree of cardiovascular risk

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

• smoking, other bad habits;
• high blood cholesterol;
• sedentary lifestyle;
• obesity, including abdominal (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 by a special test;
• the presence of diseases of the cardiovascular system in relatives;
• male.

The patient has a high degree of cardiovascular risk if, in addition to hypertension, concomitant chronic diseases are present:

• diabetes;
• heart failure;
• violation of lipid (fat) metabolism;
• bronchial asthma;
• extensive damage to the retina;
• coronary artery disease;
• stage 4 renal failure;
• have had a stroke;
• cerebrovascular diseases (damage to brain vessels);
• signs of obliterating diseases of the peripheral arteries of the lower limbs (atherosclerosis);
• damage to other internal organs.

This information helps the doctor predict the clinical outcome of the disease. To determine the cardiovascular risk indicator for each degree of hypertension, it is necessary to familiarize yourself with the following table:

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

Treatment of hypertension

Classification of the WBC according to stages and risks helps to correctly determine the drug therapy regimen, quickly stop a painful attack and extend the period of remission. If primary (isolated) arterial hypertension develops, on the recommendation of the doctor, the prognosis is favorable. The secondary form of the disease often occurs with complications.

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

1. Compliance with a therapeutic diet. It is important to reduce the portions of table salt, enrich the daily diet with foods with potassium and magnesium to strengthen the heart muscle (seeds, nuts, legumes and cereals, vegetables).
2. Refusal of bad habits. This applies not only to drinking and smoking, but also to the need to increase physical activity, leave behind a "sedentary" lifestyle and take walks in the fresh air.
3. Weight control. If a patient with arterial hypertension has obesity, it is necessary to abandon fatty, fried and smoked foods and regularly organize fasting days.
4. Physiotherapy. In order to prevent and prolong the period of GB remission, it is recommended to perform physical exercises of moderate intensity 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 that are important for the body.

Medical therapy

Oral medications depend on the degree of hypertension and associated symptoms. The following are the optimal schemes for the conservative treatment of arterial 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 arterial hypertension of the 2nd degree 4 risk develops, an integrated approach to the problem is required, combining several representatives of different drug groups in a conservative treatment regimen. These are the above medicines in combination with thiazide diuretics.
3. In the complicated course of this disease, in addition to the above drugs, doctors recommend alpha or beta blockers. The need for this arises if high doses of diuretics are poorly tolerated by a weakened body).