Degrees of hypertension and risks

Hypertension is the most common cardiovascular disease, whose symptoms 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 drug and non-drug methods.

what is hypertension

Hypertension is a constant increase in blood pressure above an acceptable level (from 140/90 mm Hg) under the influence of provoking factors. This diagnosis is called the "silent killer". The pathological process continues asymptomatically for a long time, 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 timely diagnosis and proper 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, organs of the central nervous system and kidneys. Incorrectly selected therapy can lead to disease progression with increased pain.

Classification of hypertension

In 2003, a unified classification of hypertension was defined according to the severity of the disease. The determining factor in this division is considered the real 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 the level of risk for cardiovascular pathologies. This classification simplifies diagnosis, helps to more accurately determine the treatment regimen for each hypertensive patient.

Degrees of arterial hypertension

With the 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 with non-drug methods. It is important to know that the ideal 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. art. Art. (SAD) and 85-89 mm. art. Art. (DAD). Deviation from these numbers indicates serious pathologies of the body. Doctors distinguish 3 grades of GB:

1. 1st degree (mild) hypertensive disease is characterized by unstable pressure, which for several days ranges 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, excluding 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. , there are symptoms of a hypertensive crisis (cold sweat, chills, redness of the face). The patient is worried about migraine attacks, dizziness, lack of sleep, shortness of breath. Clinical manifestations of hypertension: transient cerebral ischemia (decreased blood flow to the organ), increased blood creatinine, narrowing of retinal arteries, hypertrophy (increase in size) of the left ventricle, microalbuminuria (detection of protein in urine analysis). It is not possible to normalize the condition without medication.
3. Hypertensive disease of the 3rd degree (severe) is accompanied by a sharp decline in visual acuity, poor memory, attacks of tachycardia (increased heart rate). A hypertensive crisis develops. BP indicator - from 180/110 mm Hg. Art. It's higher. Possible complications include hypertensive encephalopathy, cerebrovascular thrombosis and aneurysm (pathological expansion of the vessel), left ventricular heart and kidney failure, hemorrhages (hematomas), and optic nerve swelling. Pathological changes are irreversible.

Degree of cardiovascular risk

To predict the probability of complications in progressive arterial hypertension, the first step is to determine the cardiovascular risk index. This requires expert advice, complex diagnoses. The degree of hypertension causing 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 using 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, there are concomitant chronic diseases:

• diabetes;
• cardiac insufficiency;
• violation of lipid (fat) metabolism;
• bronchial asthma;
• extensive damage to the retina;
• coronary artery disease;
• stage 4 renal failure;
• had a stroke;
• cerebrovascular diseases (damage to the vessels in the brain);
• signs of obliterating 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 need to familiarize yourself with the table below:

General risk factors (RFR)	Blood pressure	Risk of 1st degree hypertension	2nd degree arterial hypertension, risk	Risk of grade 3 hypertension
no risk factors	common risk	short	moderate	high
1-2	short	moderate	moderately high	high
more than 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 other organ involvement or common risk factors	very high	very high	very high	very high

treatment of hypertension

The classification of GB according to stages and risks helps to correctly determine the drug therapy regimen, quickly stop a painful attack and prolong the period of remission. If primary (isolated) hypertension develops, subject to medical advice, the prognosis is favorable. The secondary form of the disease usually occurs with complications.

If the disease is not cured in time, it is difficult to stabilize high blood pressure even with medication. General expert recommendations, if grade 1, 2, or 3 hypertension is diagnosed, are presented below. . It must be supplemented with drugs 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. Rejection 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 go for walks in the fresh air.
3. Weight control. If a patient with high blood pressure has obesity, it is necessary to give up fatty, fried and smoked foods and regularly organize fasting days.
4. Physiotherapy. To prevent and prolong the period of remission of GB, 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 these drugs must contain potassium, magnesium, iron and other trace elements important for the body.

medical therapy

Oral medication depends on the degree of hypertension and associated symptoms. Below are the ideal regimens for the conservative treatment of high blood pressure:

1. In the mild stage of the disease, the patient receives angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers.
2. If risky 2nd degree arterial hypertension develops 4 , an integrated approach to the problem is required, combining several representatives of different pharmacological groups in a conservative treatment regimen. These are the above medications 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).