Hypertension grade 3: risk 3 and 4, symptoms, risk factors, treatment
The content of the article:
- Hypertension 3 degrees - what is it?
- Varieties of the disease
- Risk factors for grade 3 hypertension
- Target organs, stages and risk of hypertension
- Treatment
- Complications of third degree hypertension
- Disability with hypertension
- Video
Hypertension grade 3 is characterized by an increase in pressure over 180/110 mm Hg. Art. This severity of the disease is the maximum possible, the vessels, heart and other internal organs are at the same time experiencing extreme stress.
3 degree of hypertension - the most severe form of the disease
Hypertension 3 degrees - what is it?
Hypertension is the commonly used name for arterial hypertension, a pathological condition in which blood pressure persists.
The third degree of the disease is diagnosed not by symptoms, the presence of complications or the length of the disease: the fundamental factor that determines the degree of hypertension is the numbers of blood pressure (blood pressure).
What pressure is typical for grade 3? In this case, the value of systolic blood pressure exceeds 180, and diastolic - 110 mm Hg. Art. The pressure builds up to individually high numbers, that is, the maximum limit in this case is not set.
With a given degree of illness, the patient's condition is often unsatisfactory: worried about rapid fatigue, superficial, shallow sleep, poor tolerance of physical and psycho-emotional stress, feeling of "stale head".
In addition to the listed signs, the disease is characterized by a number of symptoms that accompany an increase in blood pressure numbers, but can also appear against a background of relative well-being.
Main manifestations:
- Headache. Pain can bother the patient only during episodes of increasing blood pressure or be persistent aching. Often, patients complain of a feeling of squeezing like a hoop or crown. Pain sensations, as a rule, are localized in the parieto-occipital region, are stopped by taking antihypertensive drugs or antispasmodics. Habitual analgesics in this case are not effective enough.
- Feeling of "creeping", paresthesia, increased skin sensitivity.
- Noise, ringing in the ears.
- Tides. As a rule, this symptom indicates an increase in blood pressure, it is caused by compensatory vasodilation of the skin. At the same time, the neck, face, décolleté area reddens totally or in separate foci. Redness is accompanied by a feeling of heat, lightheadedness.
- Sweating. It develops rapidly, according to patients, they literally "sweat". After normalization of pressure, sweating goes away.
- Unsteadiness of gait. A similar manifestation of the disease often occurs in the third degree, although it may also indicate an abrupt increase in blood pressure figures against the background of a hypertensive crisis. The symptom is due to a change in cerebral blood flow in conditions of increased tension in the vascular bed.
- Memory impairment, distraction, difficulty concentrating.
- Sleep-wakefulness disorder: daytime sleepiness is replaced by insomnia or trouble falling asleep at night.
- Flashing flies before the eyes.
- Pain in the left side of the chest, often stabbing.
- Increased meteosensitivity.
- Irritability, anxiety, aggressiveness.
- Decreased performance.
Varieties of the disease
Arterial hypertension of 3 degrees can be primary (essential) or secondary.
In the first case, the disease develops against the background of complete well-being, acute stress, a breakdown in adaptation in chronic psychoemotional overstrain, and excessive physical exertion can become a triggering factor. The primary reason for this is the failure of internal regulation.
It is extremely difficult or impossible to establish the exact localization of damage to regulatory mechanisms in essential hypertension. In this case, treatment is aimed at achieving control over the disease: the maximum decrease in blood pressure indicators, elimination of the risk of complications, effective therapy of concomitant pathology.
If hypertension is secondary or, as it is also called, symptomatic, the key to normalizing the condition is the successful treatment of the underlying disease. Increased pressure in this case is one of the manifestations of the leading pathology, eliminating which you can achieve a complete cure of hypertension.
Most often, an increase in blood pressure is a symptom of hormonal diseases, lesions of the central nervous system (including those due to trauma), kidney diseases or tumors. In some cases, persistent hypertension can be triggered by taking certain groups of drugs.
Risk factors for grade 3 hypertension
Despite the fact that the exact cause that triggered the mechanism of the formation of essential hypertension usually fails, risk factors have been identified, the presence of which significantly increases the likelihood of the disease:
- Unstable psycho-emotional background. More susceptible to the disease are individuals who are hot-tempered, irritable, characterized by increased anxiety, suspiciousness, and easily excitable. The internal psychological state is the most significant provocateur of the development of the disease.
- Excessive use of table salt. With the systematic salting of food, an excessive amount of NaCl enters the body. As a result, the volume of circulating blood increases due to fluid retention, sclerotic changes in the walls of the arteries develop, and vascular regulation suffers.
- Physical inactivity. A sedentary lifestyle, when there is no physical activity, does not allow the circulatory system to "train". This makes it especially vulnerable to various pathological changes in the heart and blood vessels.
- Smoking. Components of tobacco smoke damage barroreceptors, which read information about the amount of blood pressure on the walls of blood vessels from the inside, thereby disabling the regulatory system.
- Physical or psycho-emotional overload.
- Chronic stress, unable to be realized. In this case, psychological tension is transformed into a painful state.
- Unfavorable heredity for hypertension.
- Male.
- Age over 55.
- Overweight.
Target organs, stages and risk of hypertension
Determination of the stage of the disease is directly related to the concept of "target organ". These are the internal organs that suffer from an excessive increase in blood pressure in the first place: heart, blood vessels, organ of vision, kidneys, brain.
How does target organ damage (OM) manifest:
- A heart. From the need to apply excessive force to push blood into the vascular bed under conditions of constantly increased pressure, the chambers of the heart thicken and increase. In addition, ischemic and sclerotic changes begin to develop in the structures of the myocardium, which is not designed for such a load.
- Vessels. Under the influence of excessive internal stress and the produced biologically active substances, loss of elasticity and deformation of the vascular walls occur.
- Brain. Obstructed venous outflow provokes damage to the smallest structural elements of the central nervous system, not only brain tissue changes, but also its blood supply.
- Eyes. Increased pressure in the vessels of the fundus leads to clouding of internal structures, deterioration of vision, and narrowing of the visual fields. In severe cases, retinal detachment may develop.
- Kidneys. Damage to the smallest vessels supplying blood to the organ leads to a progressive deterioration in its functions.
With hypertension of the third degree, the general condition of the patient suffers significantly
Hypertension of the third degree can have 3 stages:
- There is no target organ damage. At grade 3 of the disease, when the blood pressure numbers are excessively high, the first stage is quickly transformed into the second.
- The lesion of target organs is confirmed by laboratory and instrumental evidence, but clinical manifestations are still absent.
- It is characterized not only by objective signs of OM lesion, but also by a violation of their functions, the presence of clinical manifestations.
Risk is understood as the likelihood of complications associated with hypertension. In total, there are 4 degrees of risk: from 1 (minimal) to 4 (very high).
With the third degree of the disease, either high or very high risks are established for patients:
- if there are no risk factors and there are no lesions of any target organ, they speak of grade 3 hypertension; risk 3 (high);
- if the target organs are affected, risk factors or concomitant pathologies are recorded, risk 4 is established, very high.
Treatment
Disease therapy in this case begins with lifestyle modification, which consists in minimizing the existing risk factors.
- Limiting the consumption of NaCl. This does not mean that you should completely refuse to add salt to food, but means limited salt intake. The maximum daily amount is a teaspoon without top.
- The introduction of systematic physical activity. Sports activities should be strictly dosed and carried out under the direct supervision of a specialist. This is due to the likelihood of deterioration of the state of the untrained cardiovascular system with excessive activity.
- Normalization of body weight. A number of studies indicate that with a decrease in body weight by 10 kilograms in persons with significant overweight, pressure decreased by an average of 10 mm. rt. Art.
- The development of an adequate regime of work and rest, a full night's sleep is required.
- Quitting smoking and alcohol abuse.
Pharmacotherapy of hypertension is prescribed exclusively by a specialist.
Many patients begin taking medication on the recommendation of friends or relatives who do not have the appropriate education. This is strictly prohibited, since the selection of pharmacotherapy should be made taking into account the concomitant diseases that a particular patient has, after assessing his response to previous treatment. It is also necessary to clearly understand the characteristics of each prescribed drug.
The main groups of drugs that are used to correct pressure:
- ACE inhibitors (enalapril, captopril, fosicard, etc.) and angiotensin II receptor antagonists (valsartan, losartan). They help to reduce the production and assimilation of substances that increase vascular tone.
- Beta-blockers (anaprilin, concor). They reduce the pulse, relax the blood vessels.
- Statins (simvastatin, atorvastatin, crestor). They lower the level of "bad" cholesterol in the blood, thereby preventing the development of atherosclerosis.
- Diuretics (veroshpiron, furosemide). Stimulates the elimination of excess fluid.
- Calcium channel blockers (nifedipine, verapamil, diltiazem). Reduce the excitability of the muscle component in the walls of blood vessels, ensuring their relaxation.
Complications of third degree hypertension
For each individual patient, the likelihood of complications, their intensity, and impact on the quality of life are individual. In some cases, hypertension proceeds for a long time without deterioration, in others, complications develop rapidly, within several months.
Nevertheless, we can say with confidence that refusal to take medications, self-medication, irregularity in the implementation of prescriptions, independent change in the therapy regimen, as well as the preservation of the previous, unhealthy lifestyle, significantly worsens the course of the disease.
Major complications:
- acute or chronic heart failure;
- acute coronary syndrome;
- encephalopathy;
- acute violation of cerebral circulation;
- retinal angiopathy;
- aortic aneurysm;
- left ventricular myocardial hypertrophy;
- chronic and acute renal failure.
The most common complication of the disease is a hypertensive crisis. At the same time, the pressure grows rapidly, does not decrease under the influence of the usual drugs. Violent symptoms develop, the condition deteriorates significantly, fear of death appears. The crisis is a medical emergency. If signs of a crisis appear, seek emergency medical attention.
Disability with hypertension
Patients often wonder whether disability is given in the third degree of the disease? In this case, it is possible to issue a disability group, but the decision on its assignment will be made by a special expert commission based on the documents submitted by the attending physician.
Disability in case of hypertension is possible if such a decision is made by an expert commission
A significant role in this is played by the presence and severity of concomitant pathological conditions, the effect of the disease on the quality of life, the length of service and the severity of the symptoms of the disease itself.
To obtain a referral for registration of a disability group, it is necessary to conduct a wide range of laboratory and instrumental studies:
- general blood and urine tests;
- biochemical blood test;
- determination of the filtration and concentration capacity of the kidneys;
- X-ray and ultrasound examination of internal organs;
- ECG, in some cases with exercise;
- fundus examination;
- daily blood pressure monitoring;
- expert advice.
Additional examinations may be prescribed by the attending physician, if necessary.
Based on the data obtained during the examination, a decision is made on the possibility of issuing a referral for examination. In this case, the doctor prepares accompanying documentation, where he presents the results of all studies performed.
The generated package of documents is transferred by the patient or his legal representatives to the ITU bureau, where the submitted data are considered by the commission within up to 30 days, after which a verdict is issued on assigning a disability group or on refusal.
In case of disagreement with the experts' decision, the patient can file a complaint with the ITU Main Bureau, which returns the documents for reconsideration, or with the court.
Video
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
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