Symptoms
In 90% of cases before the onset of complications, high blood pressure is practically not manifested. Occasionally, with malignant hypertension (very high pressure), pulsating headaches, nausea and blurred vision may occur. In the absence of treatment, high blood pressure causes damage to internal organs and the development of complications (in 20% of patients): heart and kidney disease, retinal destruction or stroke. If the hypertension is a consequence of some other disease, its symptoms are superimposed on the picture of the underlying pathology. Hypertension is an extremely common disease affecting 10-15% of the population. Complications of high blood pressure (CD) are the main cause of death. The development of the disease is associated with such risk factors as:
• age - the level of CD usually increases with age, but it should not be regarded as the norm for high CD figures in old age;
• weight - CD is higher in persons with excessive body weight;
• race - Americans of African descent, for example, hypertension, are more likely than those with European roots.
Essential hypertension
More than 90% of patients with high blood pressure suffer from essential hypertension, which develops for no apparent reason. A certain role in this is played by family history, obesity, alcohol abuse, and environmental factors.
Other reasons
• Malignant hypertension is caused by a particular type of blood vessel damage, known as fibrinoid necrosis.
• Pregnancy. High CD complicates about 5-10% of pregnancies and, being a component of a severe syndrome with placenta damage, presents a high risk for the mother and fetus.
Hypertension may be a secondary symptom with:
• pathology of the kidneys;
• tumors of the endocrine glands that secrete hormones that affect water-salt metabolism in the body or release substances like adrenaline;
• taking certain medications;
• congenital anomalies.
Blood pressure is measured by a sphygmomanometer. This device registers two pressure values in millimeters of mercury (mm Hg): the first - at the height of the heart contraction - in systole, the second - with its relaxation - in the diastole. When diagnosing hypertension, both variables are taken into account. Only about a third of cases of hypertension can be detected and diagnosed. For the diagnosis is sufficient three-fold registration of high blood pressure under different conditions.
Other surveys include:
- urine analysis for protein;
- blood test for parameters of kidney function;
- chest X-ray and ECG to detect cardiac enlargement.
There are errors in measuring blood pressure. False-high values can be obtained in a cold room, with a full bladder or a too small cuff. Patients who require emergency treatment include:
• patients with blood pressure of about 250/140 mm Hg. art. with malignant hypertension. They may experience severe changes in the fundus and renal insufficiency with uremia (the presence of an excessive amount of urea and other nitrogenous products in the blood);
• Patients with a secondary lesion of the internal organs (heart, kidneys) and a pressure level of approximately 220/110 mm Hg. Art.
Non-pharmacological methods
Patients with moderate hypertension (diastolic pressure up to 95-110 mm Hg) are not directly at risk, so you can try to achieve the target CD values without drugs using other methods:
• weight loss;
• restriction of salt intake;
• restriction of fatty foods;
• restriction of alcohol consumption;
• refusal of oral contraceptives;
• increased physical activity.
If the desired result is not achieved within three months, it may be necessary to prescribe drugs. To control blood pressure, diuretics and calcium channel blockers are used.
Benefits of treatment
Treatment should be long-term, and perhaps, lifelong. Often people take medicines for 30-40 years. The benefits of rational therapy include:
• Decrease in mortality, especially among smokers of young people with severe hypertension;
• reducing the risk of heart failure and cerebral hemorrhage;
• reducing the risk of developing kidney failure.
However, even with good control of symptoms, hypertension may feel bad, especially if it experiences side effects of drugs, namely:
- fatigue - when taking beta-blockers;
- dry cough - with the use of ACE inhibitors;
- retardation;
- problems with potency, which can be a side effect of many drugs.
Pressure monitoring
Often, patients mistakenly believe that they can easily keep blood pressure under control. Achieving stable target values is rather difficult. Despite the existence of a number of drugs, only in 20% of cases it is possible to achieve a diastolic pressure value of less than 90 mm RT. Art. In 60% of patients, blood pressure fluctuates at a moderate level (diastolic pressure 90-109 mm Hg), and another 20% have bad results (more than 110 mm Hg).
When the blood pressure is stabilized, the nurse can re-write the medicines. The effects of hypertension can be prevented with early diagnosis of the disease. In the absence of treatment, high blood pressure increases the risk of premature death (before 70 years). However, with adequate treatment, most patients have a normal life span without complications. The main causes of death in hypertension are stroke (45%) and myocardial infarction (35%). The groups of people who have a less favorable prognosis include: young patients; men. Women taking oral contraceptives are more at risk of stroke or myocardial infarction, especially if they smoke.
Preventive measures
Analysis of data on the treatment of mild hypertension showed that a decrease in diastolic pressure by 5-6 mm Hg. Art. leads to the following results:
• a 38% reduction in the risk of stroke;
• a 16% reduction in the risk of coronary heart disease.
To exclude hypertension, all adults up to the age of 80 should regularly (five times per year) carry out a blood pressure measurement. When identifying borderline values or a single increase in blood pressure, careful monitoring is necessary.