Hypertension 1 degree: symptoms, causes, treatment
The content of the article:
- The degrees of hypertension and how they differ
- Symptoms of grade 1 hypertension
- Causes of hypertension 1 degree
- Diagnostics
- Treatment of hypertension 1 degree
- Effects
- Video
Hypertension of the 1st degree is the initial form of the disease, which is still reversible, and therefore it is important that it is detected in a timely manner and treatment is started as early as possible.
Hypertension affects one in three adults, thereby becoming one of the most common pathologies in the world. Arterial hypertension is dangerous due to complications from the most important systems that fail due to constant high pressure. An increase in the hydrodynamic pressure in the vessels, including in the capillary bed, leads to a change in the walls of the vessels, and over time disrupts their ability to fully perform their functions, that is, to supply the body tissues with blood.
Early hypertension is often asymptomatic and accidentally detected
The degrees of hypertension and how they differ
The degrees of hypertension differ from each other in the level of pressure increase, as well as in clinical manifestations. Arterial pressure (BP) in hypertension of the first degree exceeds 140 mm Hg. Art., reaching 159 systolic pressure and 90-99 mm Hg. Art. diastolic. This is how the complex nature of the pathology manifests itself, since the upper, systolic, pressure depends on the cardiac output during a strong impulse produced by the heart muscle. The lower, diastolic, indicates the state of the vessels, their peripheral resistance, the state of the pressure regulation systems - the kidneys and endocrine glands.
By the totality of signs, the following degrees of the disease are determined:
- grade 1 risk, or high normal blood pressure, which is prehypertension and inevitably spills over into disease in the absence of treatment. This stage already requires constant monitoring of pressure, the need for lifestyle changes, and a thorough examination of the cardiovascular system. Highly normal blood pressure ranges from 130-139 / 85-89 mm Hg. Art.;
- hypertension of the 1st degree - pressure in the range of 140–159 and 90–99 mm Hg. Art. accordingly, this form is also called light. The development of the disease continues, the pathology requires correction of pressure, while there is a risk of hypertensive crises, which can occur suddenly. At this stage, it is possible to establish whether the disease is malignant, that is, whether it develops rapidly, whether there is a likelihood of damage to the internal organs that need the greatest blood circulation - heart, brain, kidneys, lungs, what is the risk of grade 2, the speed of its onset;
- hypertension of the 2nd degree - the body undergoes pathological changes, especially from the side of the cardiovascular system. 160-179 / 100-109 mm Hg. Art. - indicators that determine the second degree. This condition leads to changes in the target organs. There is a dilatation of the parts of the heart under the constant influence of high pressure. This means that an irreversible process of wear of compensation resources in the body has been launched; in the absence of treatment, the risk of grade 3 becomes extremely high.
- hypertension of the 3rd degree - pressure exceeds 180/110 mm Hg. Art., changes in the shock organs become irreversible. The patient is under the constant effect of antihypertensive drugs, with a successful outcome and control of the pressure of the phenomenon, signs of heart and renal failure, however, can persist for the rest of his life. Hypertensive crises are threatening.
- grade 4 hypertension means that the patient has absolutely no ability to compensate for this critical condition. This is a terminal condition that is uncommon. The pressure is about 200/120 mm Hg. Art., but persists for a long time, such a long-term effect destroys the vessels.
Depending on the lesion of internal organs, the stages of the disease are distinguished: at stage 1, such lesions are absent, at stage 2 hemorrhages, damage, changes in the structure of organs are noticeable, and at stage 3 there are significant functional disorders. These data do not fully reveal the essence of the disease, but give a general idea of what it is - hypertension, and allow you to develop a treatment tactics.
Symptoms of grade 1 hypertension
The early stage of hypertension often proceeds without visible or tangible disturbances, sometimes elevated blood pressure is determined by chance, during examination for another reason, while the patient does not provide specific complaints about his health condition. But the disease progresses, and sooner or later it will make itself felt, and then the first signs of the disease appear. These include:
- headache - painful sensations that arise suddenly and, most often, are localized in the occipital and temporal parts, as if bursting from the inside. This is a pronounced symptom that appears in almost all patients. The pain is caused by an increase in pressure in the vessels of the meninges, which are very sensitive and have a large number of nerve endings;
- tinnitus - due to pressure, the speed of blood movement in the vessels of the head and neck increases, so its turbulent movement through the arteries becomes audible through the bones, which catches the ear. It may also be a consequence of the effects of arterial hypertension on the central nervous system;
- nosebleeds - small vessels cannot withstand a stable increase in pressure and burst;
- "Flies" before the eyes - various visual impairments are a common disorder in hypertension. Due to pressure, the optic nerve and retina are damaged, and "flies" are a consequence of these disorders;
- a feeling of squeezing in the chest, sometimes chest pain with shortness of breath - classic heart symptoms, do not always appear, but if they appear, they mean heart damage and the manifestation of its functional failure.
- distraction, weakness, dizziness.
These signs are not specific, that is, characteristic only of hypertension, but their appearance serves as a reason for checking the body for high blood pressure. The final diagnosis can only be established based on the results of an examination by a specialist.
Headache is the main symptom of hypertension, and at an early stage is often the only
Causes of hypertension 1 degree
Depending on the cause, hypertension is divided into primary, or essential, and secondary, arising as a result of another, primary disease. Secondary is most often associated with diseases of the heart, kidneys (pyelo-, glomerulonephritis), endocrine system (hypersecretion of thyroxine, adrenaline, aldosterone, vasopressin and other hormones that increase blood pressure). Secondary hypertension is rare, accounting for about 3-5%.
The rest of the cases are associated with dysregulation of the systems that maintain blood pressure at an optimal level. Such hypertension is based on a vicious circle of pathogenesis, in which the release of angiotensin II, which is synthesized from renin secreted by the kidneys, plays the main role. This powerful vasoconstrictor triggers a cascade of reactions that maintain a persistent increase in blood pressure - endothelial edema, aldosterone release, etc.
The causes of dysregulatory disorders are:
- Stress and emotional overstrain, which lead to an excessive load on the nervous system, it is depleted, as a result of which the regulation of some parameters of homeostasis, including pressure, suffers. Prolonged stress is accompanied by the release of glucocorticoids, which have a negative effect on blood pressure and wear out compensatory resources.
- Improper nutrition, obesity and cholesterolemia - a large amount of fat and bad cholesterol in free circulation contributes to the occurrence of atherosclerotic changes in the vessels, the appearance of plaques and narrowing of their lumen. The blood supply to the organs deteriorates, the cells die. In addition, increased body weight overloads the heart and the entire circulatory system.
- A sedentary lifestyle - in the absence of regular physical activity, the ability of the vessels to adapt decreases, the vasomotor center is no longer so effective in reducing and relaxing smooth muscle elements, since it also becomes passive. Strengthening of heart shocks is not compensated, the pressure rises.
- Heredity is one of the dominant risk factors. Hypertension is associated with a specific set of genes, many of which have already been identified as candidate genes, i.e., capable of causing disease. If you have a blood relative with essential hypertension, you should take your blood pressure as seriously and control it as possible.
- Diabetes mellitus is a metabolic disease that leads to disruption of most metabolic processes in the body, affecting the pressure maintenance systems and other parameters of homeostasis. About a third of all patients with hypertension have problems with glucose absorption.
- Violation of water-salt metabolism - excessive consumption of salt (namely, sodium, which is part of it), leads to fluid retention in the body, an increase in the volume of circulating blood. To maintain a normal blood pressure level, it is necessary to consume a sufficient amount of fluid, as well as normalize the metabolism of minerals with the help of potassium, a competitor of sodium in osmotic processes.
Diagnostics
The examination includes examination and collection of anamnesis, threefold measurement of blood pressure in two hands. The arbitration method is daily pressure monitoring - the patient wears a mobile tonometer for 24 hours, then, based on the collected data, the degree and type of arterial hypertension is established.
An ECG (electrocardiogram) is performed to determine the condition of the heart and identify possible failure. This study allows you to assess the hypertrophy of the heart, their dilatation, conduction and contractility disorders.
An examination of the fundus is carried out by an ophthalmologist - with increased pressure, the retina suffers, the vessels of the fundus change, they form crosshairs and wriggle strongly, their walls thicken.
Laboratory methods include a general analysis of blood and urine, as well as a biochemical blood test for the presence of markers of damage to organs and blood vessels.
Diagnosis of hypertension includes examination of the fundus
Treatment of hypertension 1 degree
How to treat early hypertension? First of all, it is necessary to abandon self-medication, consult a specialist. In some cases, you can do without drug therapy, it is enough to correct the lifestyle. In others, the doctor will prescribe adequate drugs that will have a pathogenetic effect.
Drug treatment of hypertension is carried out by the following groups of drugs:
- diuretics - lower blood pressure due to the elimination of fluid from the body by increasing diuresis. This effect is achieved by influencing different ions (excretion of sodium with water, potassium retention). This group includes Hydrochlorothiazide, Furosemide, Manitol, Spironolactone, Lasix;
- beta-blockers - have a complex vasodilating effect, and also normalize the work of the heart (Metoprolol, Bisoprolol, Nebivolol, Anaprilin).
- ACE blockers (angiotensin converting enzyme) - are highly effective, affecting the main mechanism of increasing pressure (Captopril, Lisinopril, Enap);
- calcium channel blockers are modern drugs with fewer side effects. These include calcium antagonists (Nifedipine, Amlodipine) and renin antagonists (Rasilez).
In addition, drugs that affect the central nervous system - sedatives, tranquilizers - have related effects.
You can also use folk remedies in the role of supportive therapy. For example, chokeberry, viburnum, cool mint tea with lemon, apple cider vinegar compresses, and valerian preparations are excellent for reducing pressure.
Effects
Complications of early stage hypertension appear only when there is no proper treatment, and the patient does not adjust his lifestyle. However, this does not happen so rarely.
First of all, the heart suffers. The patient feels irregular contractions, strong tremors in the chest, sometimes chest pain and shortness of breath. The feeling of temporary cardiac arrest and squeezing accompanies an increase in the phenomenon of heart failure due to an overload of the heart with blood pressure.
Headaches can develop into transient ischemic attacks (what the people call a microstroke), and then into a full-fledged violation of cerebral circulation. This is fraught with paresis and paralysis, loss of performance. There are pathologies on the part of the vascular bed - the development of aneurysm of large vessels.
The question often arises whether it is possible to be drafted into the army with first-degree hypertension. During the medical commission, the category of fitness is determined, which will be indicated on the military ID. A comprehensive examination includes measuring blood pressure, so if at the time of the examination the pressure is increased, the conscript may be recognized as unfit for military service, although in practice this is rare. A risk of 2 degrees or higher, documented, is a reason for exemption from military service.
Disability is given starting from grade 2, but sometimes it can be obtained from the first one if the hypertension is malignant and damage to shock organs progresses, there are obvious functional disorders, and the patient needs care.
Video
We offer for viewing a video on the topic of the article.
Nikita Gaidukov About the author
Education: 4th year student of the Faculty of Medicine No. 1, specializing in General Medicine, Vinnitsa National Medical University. N. I. Pirogov.
Work experience: Nurse of the cardiology department of the Tyachiv Regional Hospital No. 1, geneticist / molecular biologist in the Polymerase Chain Reaction Laboratory at VNMU named after N. I. Pirogov.
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