Unfortunately, in the vast majority of cases (90%), it is not possible to identify the exact cause of high blood pressure; in this case, we are talking about primary or essential hypertension. Currently, the main causes of this form of hypertension are recognized to be disturbances in the functioning of the central nervous system. There are many reasons for these disorders: neuropsychic overstrain, stress, obesity, sedentary lifestyle.
The remaining 10% of cases of hypertension can be caused by other diseases - in this case we are talking about secondary hypertension. Most often, secondary hypertension is caused by kidney diseases (renal failure, renovascular hypertension), adrenal tumors, the use of certain medications, and late toxicosis of pregnancy.

Kidney diseases

They account for 4% of all cases of hypertension. Pathologies such as chronic pyelonephritis, glomerulonephritis, polycystic kidney disease can lead to renal failure. As a result of kidney failure, the amount of urine produced may decrease, which leads to an increase in the volume of circulating blood. In some cases, the cause of renal hypertension is a congenital or acquired defect of the renal artery, which consists in the fact that its lumen is narrowed. As a result of this pathology, the kidney senses insufficient blood flow, releasing the enzyme renin into the blood. Renin affects the hormone angiotensin by activating it, this mechanism leads to the fact that angiotensin binds to vascular receptors, causing an increase in arteriolar tone. As a result, the arterioles narrow, the capacity of the vascular bed narrows, and the volume of circulating blood remains stable. According to the laws of hydrodynamics, a decrease in the capacity of a closed vessel with a stable volume of its liquid leads to an increase in intravascular pressure.

Pathology of the adrenal glands and hypertension

In some cases, the cause of hypertension is a violation of the synthesis of special hormones (mineralocorticoids) by the adrenal cortex. These hormones affect the functioning of the filtering part of the kidney. When aldosterone increases, the kidney tries to retain salts, which leads to an increase in circulating blood volume. Aldosterone also promotes constriction of arterioles. These two mechanisms lead to increased blood pressure.

Pheochromocytoma
This benign tumor of the adrenal medulla leads to a sharp increase in the level of adrenaline in the blood. This pathology leads to narrowing of arterioles and increased blood pressure.

Late toxicosis during pregnancy as a cause of hypertension

At present, it has not been possible to determine the exact mechanism of late toxicosis of pregnancy. It is believed that the cause is immunological or hormonal changes in the mother's body during pregnancy. This pathology leads to impaired kidney function and increased blood pressure.

Complications of hypertension, heart attacks, stroke, visual impairment.

Unfortunately, long-term high blood pressure leads to the fact that the walls of blood vessels suffer - they thicken, the muscle tissue of the vessel thickens and may lose the ability to relax. As a result of prolonged vascular spasm, the supply of blood with oxygen and nutrients dissolved in it to the tissues and organs is disrupted. As a result, a decrease in the functional activity of organs and an increased risk of heart attack.

Myocardial infarction

A common complication of hypertension. With a sharp decrease in blood supply to the heart muscle, the ischemic area cannot maintain its performance and viability for a long time. Hypertension contributes to myocardial infarction due to the fact that changes in the walls of blood vessels lead to the vessel becoming fragile, and another increase in blood pressure leads to the fact that in a certain area the vessel bursts and hemorrhage occurs in the tissue of the organ. Hypertension also contributes to the development of atherosclerosis, leading to narrowing of an already stenotic vessel.

Stroke

This disruption of the blood supply to a certain area of ​​the central nervous system leads to the development of a stroke. At the same time, areas in which the blood supply has sharply decreased or stopped altogether lose their viability. A stroke is accompanied by such functional disorders in the central nervous system as: loss of consciousness, disruption of the functioning of internal organs, changes in consciousness, paralysis and paresis. This condition requires immediate medical attention, as it poses a threat to the health and life of the patient.

Loss of vision due to hypertension.

The same occurs as a result of disruption of the blood supply to the retina and optic nerve. Pathologies such as hemorrhage in the retina or vitreous body, ischemic opticopathy may develop. An attack of hypertension can cause spasm of the artery supplying the optic nerve or lead to disruption of the integrity of the retinal vessel. In this case, a hemorrhage in the retina will lead to the formation of a black spot in the field of vision, in the projection of the hemorrhage, and the outpouring of blood into the vitreous body can even lead to complete loss of vision in the affected eye.

Treatment of hypertension, use of diuretics, angiotensin converting factor (ACE) blockers,angiotensin receptor antagonists, calcium channel blockers, beta blockers.

Currently, the pharmaceutical industry produces many antihypertensive drugs of various groups and different mechanisms of action. Thanks to this, it was possible to significantly reduce the incidence of complications of hypertension. However, the disease itself cannot be cured with medication. To do this, you need to completely change your daily routine, reduce psycho-emotional stress, lead a rational lifestyle, and practice daily sports. All these recommendations, as a rule, are completely rejected by the patient and are not followed in most cases - hence the disappointing statistics on morbidity and the number of complications.

However, let us turn our attention to the groups of drugs that lower blood pressure. But before describing the drugs, we should think about how we can reduce the pressure in a closed hydrodynamic system?

To do this, you can reduce the volume of fluid (blood) circulating in the system, or increase the volume of the system’s capacity (circulatory), or reduce the activity of the pumping function of the heart. We can reduce the volume of circulating blood with the help of a salt-free diet, using special diuretics. It is possible to increase the capacity of the vascular bed with the help of drugs that act on vascular receptors and lead to relaxation of vascular muscle tissue, increasing the volume of intravascular space.

Treatment of hypertension with drugs that have a diuretic effect.

As mentioned above, a decrease in blood pressure can be achieved by reducing the volume of circulating blood and diuretics are used for this purpose. The most commonly used diuretics currently are: Ezidrix (hydrochlorothiazide), Lasix (furosemide), Bumex (bumetanide), Demadex (torsemide), Zaroxoline (metolazone), Aldactone (spironolactone).


In order for treatment with diuretics to be safe for the patient, the following rules must be followed:

• Strictly follow the regimen for using the drug that was prescribed by your doctor. If dietary recommendations were given during treatment or medications were prescribed to regulate electrolyte balance, then compliance with these instructions is mandatory.
• Before prescribing diuretics, it is recommended to determine the level of electrolytes in the blood and regularly carry out this test every time you visit your doctor.
• If you notice at least one of the following side effects of diuretins, immediately seek personal advice from your doctor.
• Do not take additional medications during diuretic treatment without telling your doctor.
• It is regularly necessary to diagnose the condition of the kidneys (general and biochemical analysis of urine and blood).

Possible side effects of diuretics

1. Heart rhythm disturbances are a serious complication that requires urgent medical attention. As a rule, it is associated with changes in electrolyte balance and can lead to cardiac arrest.
2. Frequent urination – The natural effect of a diuretic drug will be to produce more urine, which will cause the bladder to fill faster. However, it should be noted that painful and frequent urination, urination in small portions is a sign of inflammation of the urinary tract, which requires personal consultation with a specialist doctor.
3. Electrolyte imbalance - this laboratory symptom is determined by performing a blood ionogram. If it is detected, you must seek personal advice from your doctor to change the treatment regimen.
4. Increased fatigue, asthenia (muscle weakness) and periodic cramps of the arms and legs - if these symptoms increase, you should seek personal advice from your doctor.
5. Dizziness can be caused by an excessive decrease in blood pressure, electrolyte imbalance, or as a result of dehydration. In this case, a personal consultation with your doctor is required.
6. Dehydration of the body is accompanied by a feeling of excruciating thirst, decreased daily urine output, dizziness, and in some cases even loss of consciousness. In this case, it is necessary to stop taking diuretics and seek repeated advice from your doctor.

Can pregnant women take diuretics?
During pregnancy, the use of diuretics is possible only as prescribed by a gynecologist. Self-administration of the drug without the knowledge of your gynecologist is prohibited.

Can I take diuretics while breastfeeding?
Most diuretics pass into mother's milk, so taking these drugs during lactation will adversely affect the child's condition. The possibility of using diuretics can only be determined by your pediatrician.

Can children take diuretics?
Long-term use of diuretics requires careful monitoring of the ionic composition of the child’s blood. Therefore, regular blood tests for electrolytes (ionogram) are necessary.

Treatment with medications that affect vascular tone
All drugs used in the treatment of hypertension with a vascular mechanism of action can be divided into angiotensin converting factor (ACE) blockers and angiotensin receptor antagonists - the mechanism of action of these drugs is similar. Another large group of drugs are beta blockers. Calcium channel blockers have a fundamentally different mechanism for relaxing vascular muscle tissue.

Angiotensin converting factor (ACE) blockers

These drugs block the process of activating angiotensin, a hormone that, when exposed to specific receptors on the surface of the vessel, leads to spam of muscle tissue, narrowing the arterioles. A decrease in the level of angiotensin in the blood leads to a decrease in the tone of vascular muscle tissue and an increase in the volume of the vascular bed.
The most commonly used drugs from the ACE group:

• Capoten (captopril)
• Vasotec (enalapril)
• Prinivil, Zestril (lisinopril)
• Lotensin (benazepril)

Side effects of drugs from the ACE group:

• Cough is the most common side effect. The thing is that drugs in this group often have an irritating effect on the mechanoreceptors of the respiratory tract, causing spontaneous coughing. If the cough becomes unbearable and cough suppressants do not have a positive effect, you should consult your doctor again to change the treatment regimen.
• Skin rash, itching - if these symptoms develop, it is also necessary to consult a doctor to change the treatment regimen.
• Dizziness and general weakness can be caused by an excessive decrease in blood pressure. If these symptoms occur, your blood pressure should be measured regularly. If low blood pressure is detected, a repeated consultation with the attending physician is necessary in order to change the dosage of the drug.
• A feeling of a metallic taste, a decrease in taste sensitivity - as a rule, this side effect occurs at the very beginning of treatment and disappears over time on its own.

Angiotensin receptor antagonists

This group of drugs has a similar effect to ACE drugs - blocking the action of angiotensin, although in this drug it occurs at the level of a specific receptor of the muscle cells of the vessel. By blocking the angiotensin receptor, this drug prevents the hormone from attaching to the receptor and reduces its vascular tonic effect, leading to an increase in the volume of the vascular bed.

The most commonly used drugs:

• Cozaar (losartan)
• Diovan (valsartan)
• Aprovel (irbesartan)

Beta blockers

They have a greater effect on the activity of the heart. By reducing the frequency and force of heart contractions, drugs of this pharmacological group reduce the minute volume of blood pumped by the heart. Accordingly, the pressure in the vascular network decreases. Drugs in this group have found wide use in the combination of hypertension and angina pectoris, in the combination of heart rhythm disturbances and high blood pressure.

The most commonly used drugs from the group of Beta adrenergic blockers:

• Tenormin (atenolol)
• Kerlon (betaxolol)
• Zebeta (bisoprolol)
• Coreg (carvedilol)

Drugs in this group have a number of fairly pronounced side effects:

• Dizziness
• Decreased libido and sexual activity
• Sleep disturbance
• Chronic fatigue and decreased performance
• Feeling of cold hands and feet, chilliness
• Slow heart rate
• Swelling in the knees and feet
• Pulmonary edema in the development of acute heart failure
• Difficulty breathing
• In some cases depression

How to take drugs from the beta blocker group correctly?

• The drug should be taken during meals or immediately after meals, at a strictly defined time of day.
• The frequency of taking the drug and its dosage is determined by the attending physician individually depending on your general condition, the dynamics of the disease and the effectiveness of treatment with beta blockers in the past.
• During the period of use of the drug, it is necessary to determine the heart rate daily; a sharp decrease in this indicator requires a repeated visit to the attending physician to change the treatment regimen.
• The use of any hormonal or cardiac medications during treatment with medications from the beta-blocker group is possible only after a personal consultation with a cardiologist.

Calcium channel blockers

Drugs of this group, acting on the channels through which calcium is exchanged between the cell and the external environment, lead to relaxation of blood vessels. As a result of relaxation of vascular muscle tissue, the volume of the vascular bed increases, which leads to a decrease in blood pressure.

Representatives of calcium channel blockers:

• Norvasc (amplodipine)
• Plendil (felodipine)
• Cardin (nicardipine)
• Adalat (nifedipine)
• Cardizem, Dilacor, Tiazak, (diltiazem)
• Isoptin, Kalan, Verelan, (verapamil)

What are the possible side effects when taking this group of drugs?

• Dizziness is associated with a sharp decrease in blood pressure and redistribution of blood flow.
• Low blood pressure - with an inadequately selected treatment regimen and dosage of the drug, this symptom may develop.
• Problems with heart rhythm - can occur in some cases among patients who had a tendency to slow heart rate, blockages of the afferent pathways.
• Dry mouth
• Swelling in the knees, feet, legs.
• Headache
• Asthenia – decreased performance, drowsiness. As a rule, these symptoms accompany the initial stage of drug use; later they disappear on their own.
• Skin rashes
• Constipation or diarrhea - acting on smooth muscle tissue, the drug acts, along with vascular muscle cells, on intestinal smooth muscle, changing the activity of peristalsis.

How to take drugs from the group of calcium channel blockers correctly?

• The use of these drugs is possible only as prescribed by a general practitioner or cardiologist.
• Carefully read the dosage and regimen of the drug prescribed to you by your doctor. Do not hesitate to ask him clarifying questions about the mode of use of the drugs, the possibility of withdrawal, and specify the period during which a second consultation is necessary to assess the results of the treatment.
• Measure your blood pressure and pulse daily and note the results - the dynamics of changes in these indicators will help your doctor assess the effectiveness of the treatment. And you can identify possible undesirable effects of the drug.
• It is advisable to use this drug at the same time, as prescribed by your doctor. Take the drug during meals or with milk.

Can I drink alcohol while using calcium channel blockers?
Definitely not! Not in any way. The fact is that alcohol changes the activity of the drug used and can cause a number of undesirable reactions: a sharp decrease or increase in blood pressure, indigestion, nausea, vomiting, etc.

Hypertension is the most common pathology of the cardiovascular system, leading to strokes, heart attacks and kidney failure. A third of the world's population suffers from unstable blood pressure. According to medical statistics, 5% of cases are fatal.

The prevalence of the disease among men and women is approximately the same. After 40 years of age, syndromes caused by hypertension appear in every second person. In addition, recently cases of detection of hypertension in adolescents and children have become more frequent.

Hypertension, by medical definition, implies an increase in vascular tone with an increase in blood pressure by several units of mercury. The disease is associated with pathology of the heart, blood vessels, kidneys, and rheological properties of blood.

General concept

Arterial hypertension (AH) is characterized by a persistent increase in blood pressure, which has an upper (systolic value) and a lower (diastolic) limit. The unit of blood on the walls of blood vessels is millimeters of mercury. Blood pressure may rise several times a day and be temporary or persistent.

You can understand the definition of hypertension and understand what it is only by considering its degrees:

• 1st degree

A mild form of the disease, when systolic pressure is between 140-159 mm Hg. Art., and diastolic 90-99 mm Hg. Art. Blood pressure increases abruptly and normalizes without the use of medications.

• 2nd degree

Jumps in systolic pressure reach 160-179 mmHg. Art., and the diastolic reaches 100-109 mmHg. This is a moderate form of the disease, in which the indicators are maintained for a long time and cannot return to normal on their own. Second degree hypertension requires drug treatment.

• 3rd degree

A severe form of the disease, in which diastolic readings exceed 180 mmHg. Art., and systolic reaches 110 mm Hg. Art. This degree of pathology requires systematic monitoring of blood pressure and a serious therapeutic approach.

• 4th degree

Highlighted by some experts. This is a very severe form, indicating a sharp increase in blood pressure and deterioration of the patient's condition. In medical practice it is called a “hypertensive crisis.” If the patient was saved, he will still require long-term rehabilitation.

There is also isolated systolic hypertension (ISH), a form of the disease in which systolic pressure exceeds 140 mmHg. Art., and the diastolic remains normal.

Classification is necessary for correct diagnosis of the disease and selection of effective treatment.

Hypertension is a disease. How much pressure is increased depends on the type and degree of development of the disease. It can appear at any age.

Character of the course

The concept of hypertension is not limited to the strength of its blood pressure. There are classifications based on the progression of the disease:

1. Benign hypertension - characterized by a slow course, correlates with the first three degrees, when pathological processes in the body are not very pronounced.
2. Malignant hypertension is a rapidly progressing stage that begins to develop in childhood. It has a severe course with signs of encephalopathy, epilepsy, and coma.

Hypertension, as defined by WHO, includes not only frequent increases in blood pressure, but also damage to target organs.

Species

The types of hypertension provide a complete picture of the disease. They are divided into two large groups, similar in manifestation, but differing in the principle of treatment.

1. Primary arterial hypertension - doctors cannot determine the causes of increased blood pressure. Most often it is diagnosed in older people, indicating the stage of manifestation:

• The first degree is mild, blood pressure ranges from 140 to 99 mm Hg. Art. There are no hypertensive crises or damage to vital organs (heart, kidneys, brain).
• The second degree is moderate, the pressure exceeds 179-109 mm Hg. Art. Crises often occur, performance is impaired, and lesions are noted in the internal organs.
• The third degree is severe, blood pressure exceeds 180 mm Hg. Art. Crises are accompanied by renal and heart failure.

The first two degrees of arterial hypertension often do not make themselves felt for a long time. The patient seeks help for the first time after the onset of a crisis. Sometimes pathology is discovered by chance - during a medical examination.

2. Secondary arterial hypertension - manifests itself as a consequence of other diseases or is a side effect of medications. The patient's blood pressure is greatly increased, and therapeutic reduction produces insignificant results and a short-term effect.

Secondary can be caused by the following changes in the body:

• endocrine pathologies (failure of the adrenal glands and thyroid gland);
• kidney diseases (pyelonephritis, urolithiasis, glomerulonephritis, neoplasms, nephropathy);
• burdened with hereditary hypercholesterolemia;
• heart failure (defects, atherosclerotic lesions of the aorta);
• diseases and injuries of brain tissue;
• improper use of medications (hormones, central nervous system stimulants).

Unstable blood pressure can be caused by pregnancy, when the load on the kidneys is increased. But after the birth of the child, everything returns to normal.

With atherosclerosis of the renal arteries, renovascular hypertension occurs against the background of obstructed blood circulation.

This type of hypertension can occur in anyone after drinking a cup of strong coffee or energy drink.

Symptoms

Hypertension manifests itself differently in each person, depending on the stage. Sometimes pronounced symptoms occur at an early stage of the development of the disease, and it happens that signs of pathology are practically absent in the chronic form.

The main signs of initial arterial hypertension and chronic hypertension:

• Headaches - occur when the weather changes, after physical exertion, with lack of sleep and overwork, after severe stress and an exacerbation of any disease. The nature of the pain is heaviness and compression in the back of the head, which intensifies when turning the head, coughing, or sneezing. Some patients develop swelling of the face. Severe pain that occurs in the morning after waking up indicates a hypertensive crisis.
• Chest pain - localized in the upper left part, not relieved by heart medications, can last from several minutes to several hours. Occurs as a result of overload and stress.
• Shortness of breath - breathing is impaired mainly as a result of physical activity. In case of vascular disease and hypertension, it is observed even at rest.
• Nosebleeds occur both independently and with a headache. In some cases, after blood loss, patients feel relief.
• Swelling of the extremities may indicate heart failure.
• Visual impairment – ​​“floaters” before the eyes, blurred vision, lack of clarity, double vision of objects.
• Increased emotionality - sudden outbursts of anger, irritability, increased sensitivity to sounds and light.

The full clinical picture of hypertension is also represented by other symptoms that are less common. In some patients, when blood pressure rises, profuse sweating occurs, tinnitus occurs, fingers and toes become numb, and sleep is disturbed. It is impossible to list all the symptoms of hypertension. However, with careful attention to changes in the body, the disease can be suspected at the initial stage of development.

To learn everything about hypertension and treatment methods, you need to consult a doctor. Many patients confuse the disease with pathologies of other organs.

Hypertensive crisis

Hypertension, according to patient management protocols, is classified as a life-threatening disease. Approximately 30% of patients develop an emergency condition with a significant sharp increase in blood pressure. During a hypertensive crisis, target organs are seriously affected, resulting in: strokes, rupture of aortic aneurysm, heart attacks, pulmonary edema, acute renal failure.

The first symptoms indicating the onset of a crisis are:

• severe headache, accompanied by confusion and deterioration of visual functions;
• nausea, continuous vomiting;
• stitching pain in the heart;
• the patient cannot take a deep breath, shortness of breath;
• nosebleeds;
• convulsions and loss of consciousness.

In some cases, the condition is asymptomatic. According to medical statistics, a “silent” crisis often occurs in black men under 25 years of age who suffer from juvenile hypertension.

When the first symptoms appear, the situation should be adequately assessed. If the patient is conscious, blood pressure should be measured in both arms. If it exceeds 180/110 mmHg. Art. You should immediately call a team of doctors, and if necessary, provide first aid: lay the patient on his side, provide an influx of fresh air, if he loses consciousness, give him a sniff of ammonia, give a sedative (Corvalol, Valocordin).

Patients with hypertensive crisis are subject to immediate hospitalization. They require inpatient treatment with skilled nursing care.

Complications

The majority of the population does not fully understand what hypertension is and what consequences the lack of treatment can lead to. In fact, as a result of the disease, serious complications often develop that threaten the patient’s life:

• Stroke - in the medical history of some patients, this diagnosis is recorded as a cerebrovascular accident. With this complication, brain damage occurs due to blockage of the vessel or its rupture. As a result, the patient’s many vital functions are disrupted, and in severe cases, death occurs.
• Cerebral edema - the pathophysiology of this condition involves a reaction to vasospasm. In the process of necrosis of small vessels, nearby brain tissue is affected.
• A heart attack occurs as a result of a circulatory disorder, as a result of which a small area of ​​the heart muscle becomes necrotic. A heart attack in 30% of cases ends with the sudden death of the patient.
• Angina pectoris is a common complication of arterial hypertension. It is characterized by severe chest pain radiating to the shoulder blade and cervical region. Angina is considered a pre-infarction condition.

Hypertensive complications can be prevented. This requires regular medical examination and timely prevention of diseases of the cardiovascular system.

Diagnostics

Collecting an anamnesis for arterial hypertension allows us to find out not only the presence of the disease itself, but also the cause of its development. This allows the doctor to decide on treatment methods and improve the patient’s quality of life.

Diagnostics, which allows you to draw up a treatment plan, consists of the following stages:

1. Pressure measurement - using a tonometer, blood pressure is measured at different times of the day over several days. All symptoms and complaints of the patient who seeks help are taken into account.
2. Physical examination - the doctor palpates, examines the patient’s skin, measures temperature and body weight, identifies or excludes neurological disorders, finds out what medications the patient has taken over the past few months and for what diseases he was treated. These methods help determine secondary blood pressure and identify pathologies of internal organs.
3. Laboratory and instrumental methods - blood and urine tests, biochemical blood tests (allows you to evaluate coagulability, the presence of cholesterol, and identify a tendency to diabetes mellitus and atherosclerosis). ECG, ultrasound of the heart and chest x-ray help identify pathologies in the myocardium.

Hypertension is diagnosed only after all studies approved by medical standards have been carried out.

If difficulties arise in making a diagnosis, additional procedures are sometimes performed: ultrasound of the kidneys and thyroid gland.

Treatment

To prevent the development of a crisis, hypertension must be treated at an early stage. To draw up a treatment plan, doctors conduct a series of studies on the patient, on the basis of which they make a conclusion. But, unfortunately, such events are impossible in some situations. For example, detecting hypertension at the age of 20 is very difficult. Young patients rarely seek medical help, since the malaise caused by high blood pressure is correlated with ordinary fatigue.

When any form of hypertension is detected, treatment methods begin to be selected immediately. The main goal is not only to lower blood pressure, but also to maintain it at the desired level. To do this, they combine the use of dosage forms with the correction of risk factors.

• Medical nutrition

For hypertension, regardless of the mechanism of development, table No. 10 is indicated. This diet limits salt and water intake, and foods should be fortified with potassium. Strong tea and coffee, fatty meats, smoked foods and preservatives, and spicy foods are excluded from the diet. The patient is recommended to eat more vegetables, cereals, beans, lean meat, and sea fish.

• Active lifestyle

Light physical activity is beneficial for everyone, especially people who lead a sedentary lifestyle. It is ideal if the patient visits the exercise therapy room for the first time.

The medical specialist will draw up a training plan and determine the load. Physical therapy can be done daily or every other day. The duration of one workout is from 30 to 45 minutes.

• Losing excess weight

Propaedeutics of internal diseases names obesity as the main cause of high blood pressure. When treating hypertension, it is important to get rid of extra pounds. However, it is recommended to lose weight gradually. Sudden weight loss can be dangerous to your health.

• Quitting bad habits

Hypertension often occurs against the background of alcohol abuse, smoking and frequent stress. Adequate rest and a healthy lifestyle are 50% of the successful treatment of any ailment.

• Drug therapy

Medicines are prescribed in cases where lifestyle changes have not produced results or the patient requires emergency care. A large selection of drugs in pharmacies allows you to choose what you need in each specific case.

Pharmacotherapy for hypertension is determined only by a qualified physician. Self-medication of hypertension at any stage is unacceptable.

Hypertension is a chronic disease that is characterized by a persistent increase in blood pressure to high levels due to a violation of the regulation of blood circulation in the human body. Terms such as arterial hypertension and hypertension are also used to refer to this condition.

Medical statistics are such that today hypertension is one of the most common diseases. It usually begins to progress in people after 40 years of age, but there is a risk of progression at any age. Thus, the disease is increasingly being detected in patients of working age. It is worth noting that representatives of the fair sex get sick several times more often than men. But it is in men that hypertension is more severe, since they are more prone to the development of blood vessels.

Blood pressure may increase with strong mental or physical stress for a short period of time - this is an absolutely normal phenomenon. A longer increase in blood pressure is observed in a number of diseases of the kidneys, endocrine glands, and also during pregnancy. But in this case, hypertension is only one of the symptoms that indicates changes in the organs. In hypertension, an increase in blood pressure is an independent, primary, painful process.

The pathogenesis of hypertension is such that, under the influence of exogenous and endogenous factors, the tone of the walls of arterioles in the body increases. As a consequence of this, they gradually narrow and the blood flow in the affected vessels is disrupted. During this pathological process, blood pressure on the walls of the arteries increases, which entails further symptoms.

Etiology

The main reason for the progression of hypertension is an increase in the activity of the sympathetic-adrenal system. The vasomotor center is located in the medulla oblongata in humans. From it, certain impulses travel along nerve fibers to the walls of blood vessels, causing the vessels to expand or contract. If this center is in a state of irritation, then only impulses will flow to the vessels, increasing the tone of their walls. As a result, the lumen of the artery narrows.

Arterial hypertension is characterized by a simultaneous increase in systolic and diastolic pressure. This is observed under the influence of various unfavorable factors.

Exogenous risk factors:

• severe nervous tension is the most common cause of progression;
• physical inactivity;
• poor nutrition. Non-compliance with the diet and consumption of large quantities of fatty and fried foods;
• excessive consumption of alcoholic beverages;
• smoking;
• drug use.

Endogenous risk factors:

• burdened heredity;
• atherosclerosis of the coronary vessels of the heart;
• increased blood viscosity (the heart cannot fully transport it through the vessels);
• kidney ailments such as,;
• metabolic disorder;
• the presence of endocrine pathologies;
• increased calcium concentration in the blood;
• the effect of adrenaline on the heart during stressful situations;
• increased sodium concentration in the blood.

Classification

Over the entire period of studying the disease, scientists have developed more than one classification of hypertension - according to the appearance of the patient, according to the etiology, according to the level of increase in pressure, the nature of the course, etc. Some have long been out of date, while others, on the contrary, are being used more and more often.

Degrees of hypertension (by pressure level):

• optimal – indicators 120/80;
• normal – upper from 120 to 129, lower – from 80 to 84;
• increased normal - upper indicators - from 130 to 139, lower - from 85 to 89;
• stage 1 hypertension – DM from 140 to 159, DD – from 90 to 99;
• stage 2 hypertension - systolic pressure increases to 160–179, and diastolic pressure increases to 100–109;
• stage 3 hypertension - systolic pressure increases above 140, and diastolic pressure increases above 110.

WHO stages of hypertension:

• stage 1 hypertension – blood pressure rises, but no changes in internal organs are observed. It is also called transient. The pressure will stabilize after a short period of rest;
• Stage 2 or stable. At this stage of hypertension, blood pressure increases constantly. The main target organs are affected. During the examination, damage to the heart, fundus vessels, and kidneys can be noted;
• Stage 3 or sclerotic. This stage of hypertension is characterized not only by a critical increase in DM and DD, but also by pronounced sclerotic changes in the blood vessels of the kidneys, heart, brain, and fundus. Dangerous complications develop - angioretinopathy, etc.

Forms of the disease (depending on which organ vessels are affected):

• renal form;
• heart shape;
• brain shape;
• mixed.

Types of hypertension:

• benign and slow-flowing. In this case, symptoms of progression of the pathology may gradually appear over 20 years. Phases of both exacerbation and remission are observed. The risk of complications is minimal (with timely therapy);
• malignant. The pressure increases sharply. This form of hypertension is practically untreatable. As a rule, the pathology is accompanied by various kidney diseases.

It is worth noting that often with hypertension of 2nd degree and 3rd degree the patient experiences. This is an extremely dangerous condition not only for human health, but also for his life. Clinicians identify the following types of crises:

• neurovegetative. The patient is hyperactive and very agitated. The following symptoms of hypertension appear: tremor of the upper extremities, and excessive urination;
• hydropic. In this case, the patient is drowsy and his reactions are inhibited. There is muscle weakness, swelling of the face and hands, decreased diuresis, and a persistent increase in blood pressure;
• convulsive. This option is the most dangerous, as there is a high risk of developing dangerous complications. It is worth noting that it is the least common. It is characterized by the following symptoms: convulsions and impaired consciousness. A complication is cerebral hemorrhage.

Symptoms

The symptoms of the disease directly depend on what stage of hypertension the patient has.

Neurogenic

An increase in blood pressure is usually observed against the background of severe psycho-emotional stress or due to increased physical activity. At this stage, there may be no signs of pathology at all. Sometimes patients begin to complain of pain in the heart area, irritability, headache, tachycardia, and a feeling of heaviness in the back of the head. The indicators of diabetes and diarrhea are increasing, but they can easily be normalized.

Sclerotic

This clinical picture is supplemented by the following symptoms:

• increased headache;
• dizziness;
• feeling of a rush of blood to the head;
• poor sleep;
• periodic numbness of the fingers on the extremities;
• fatigue;
• “flies” before the eyes;
• persistent increase in blood pressure.

It is worth noting that this stage can progress over several years and at the same time patients will be active and mobile. But disruption of the blood supply to certain organs entails disruption of their functioning.

Ultimate

Usually at this stage, doctors detect and, as well as a violation of blood circulation in the brain. The outcome of the disease, as well as the development of complications, is determined by the form of hypertension. Crises often occur.

In the cardiac form, the patient gradually progresses to heart failure. Shortness of breath, pain in the projection of the heart, and swelling appear. With the brain form, a person is bothered by severe headaches and visual impairment.

Hypertension and pregnancy

Hypertension during pregnancy is the most common cause of premature birth of a child or perinatal fetal death. Typically, a woman already has hypertension before pregnancy and then simply becomes more active, because carrying a child is a kind of stress for the body.

Considering the high risk for the mother and the unborn child, if the disease is diagnosed, it is important to determine exactly the degree of this risk in order to decide on further bearing the fetus or terminating the pregnancy. Doctors distinguish three degrees of risk (based on the stage of arterial hypertension):

• Risk level 1 – pregnancy complications are minimal, crises rarely develop. Possible angina. Pregnancy in this case is acceptable;
• Level 2 risk – pronounced. Complications develop in 20–50% of cases. A pregnant woman experiences hypertensive crises, insufficiency of the coronary vessels of the heart, and high blood pressure. Termination of pregnancy is indicated;
• 3 degree of risk. Pregnancy complications occur in 50% of cases. Perinatal mortality is observed in 20% of cases. Possible placental abruption and impaired blood circulation in the brain. Pregnancy poses a danger to the mother's life, so it is terminated.

Patients who continue to be pregnant must visit a doctor once a week so that he can monitor their condition. Treatment of hypertension is mandatory. The following antihypertensive drugs are allowed:

• antispasmodics;
• saluretics;
• sympatholytics;
• clonidine derivatives;
• rauwolfia preparations;
• ganglion blockers;
• beta blockers.

Also, in order to treat illness during pregnancy, doctors resort to physiotherapy.

Diagnostics

When the first signs of illness appear, it is important to immediately contact a medical facility to confirm or refute the diagnosis. The sooner this is done, the lower the risk of progression of dangerous complications (damage to the heart, kidneys, brain). During the initial examination, the doctor must measure the pressure in both arms. If the patient is elderly, then measurements are also taken in a standing position. During diagnosis, it is important to clarify the true cause of the progression of the pathology.

A comprehensive plan for diagnosing hypertension includes:

• taking anamnesis;
• ABPM;
• determining the level of bad cholesterol in the blood;
• X-ray;
• fundus examination;

Treatment

Treatment of hypertension is carried out in an inpatient setting so that doctors can constantly monitor the patient’s condition and, if necessary, adjust the treatment plan. It is important to normalize the patient’s daily routine, correct his weight, limit the use of table salt, and completely abandon bad habits.

The following drugs are prescribed to correct blood pressure:

• alpha-blockers;
• beta blockers;
• calcium channel blockers;
• diuretics. This group of drugs is especially important as it helps reduce sodium levels in the blood, thereby reducing swelling of the walls of blood vessels.

All of these medications should be taken only as prescribed by your doctor. Uncontrolled use of such drugs can only worsen the patient's condition. These drugs are taken according to a certain schedule.

Diet

During the treatment of hypertension, in addition to taking medications, it is important to adhere to a special diet. For hypertension, the patient is prescribed table No. 10. The principles of this diet:

• add seafood to your diet;
• limit salt intake;
• fractional meals;
• limit carbohydrates and animal fats in your diet.

The diet for this pathology implies restriction:

• Sahara;
• bread;
• potatoes;
• pasta;
• cereal dishes;
• animal fats;
• ghee;
• sour cream and so on.

Diet No. 10 is complete and can be followed for a long time. To improve the taste of dishes you can add:

• prunes;
• vinegar;
• jam;
• cranberries;
• lemon.

The diet is indicated not only during treatment, but also after it, so as not to provoke a worsening of the condition. It is worth noting that the diet is developed strictly individually for each patient, taking into account the characteristics of his body. An important point is that while following the diet you should consume no more than 1.5 liters of fluid per day.

Prevention

Prevention of hypertension is quite simple. The first thing you need to do is normalize your diet and lead an active lifestyle. In order for the blood vessels to be elastic, you need to eat more vegetables and fruits, drink up to 2 liters of water per day. You can take vitamin supplements. Also, prevention of hypertension involves avoiding smoking and drinking alcoholic beverages.

Hypertension (HTN) is one of the most common diseases of the cardiovascular system, which only according to approximate data affects a third of the world's inhabitants. By the age of 60-65 years, more than half of the population has been diagnosed with hypertension. The disease is called a “silent killer”, because its signs may be absent for a long time, while changes in the walls of blood vessels begin already in the asymptomatic stage, greatly increasing the risk of vascular accidents.

In Western literature, the disease is called. Domestic specialists have adopted this formulation, although both “hypertension” and “hypertension” are still in common use.

Close attention to the problem of arterial hypertension is caused not so much by its clinical manifestations as by complications in the form of acute vascular disorders in the brain, heart, and kidneys. Their prevention is the main goal of treatment aimed at maintaining normal numbers.

An important point is to identify all possible risk factors, as well as elucidating their role in the progression of the disease. The relationship between the degree of hypertension and existing risk factors is displayed in the diagnosis, which simplifies the assessment of the patient’s condition and prognosis.

For most patients, the numbers in the diagnosis after “AH” do not mean anything, although it is clear that the higher the degree and risk index, the worse the prognosis and the more serious the pathology. In this article we will try to understand how and why one or another degree of hypertension is diagnosed and what underlies the determination of the risk of complications.

Causes and risk factors of hypertension

The causes of arterial hypertension are numerous. Gov shouting about us and We mean the case when there is no specific previous disease or pathology of internal organs. In other words, such hypertension occurs on its own, involving other organs in the pathological process. Primary hypertension accounts for more than 90% of cases of chronic high blood pressure.

The main cause of primary hypertension is considered to be stress and psycho-emotional overload, which contribute to disruption of the central mechanisms of pressure regulation in the brain, then humoral mechanisms suffer, and target organs are involved (kidneys, heart, retina).

The third stage of hypertension occurs with associated pathology, that is, associated with hypertension. Among the associated diseases, the most important for prognosis are strokes, heart attack and nephropathy due to diabetes, kidney failure, retinopathy (retinal damage) due to hypertension.

So, the reader probably understands how you can even independently determine the degree of headache. This is not difficult, you just need to measure the pressure. Next, you can think about the presence of certain risk factors, take into account age, gender, laboratory parameters, ECG data, ultrasound, etc. In general, everything listed above.

For example, a patient’s blood pressure corresponds to stage 1 hypertension, but at the same time he suffered a stroke, which means that the risk will be maximum – 4, even if stroke is the only problem besides hypertension. If the pressure corresponds to the first or second degree, and the only risk factors that can be noted are smoking and age against the background of quite good health, then the risk will be moderate - GB 1 tbsp. (2 tbsp.), risk 2.

To make it clearer what the risk indicator in a diagnosis means, you can summarize everything in a small table. By determining your degree and “counting” the factors listed above, you can determine the risk of vascular accidents and complications of hypertension for a particular patient. The number 1 means low risk, 2 means moderate, 3 means high, 4 means very high risk of complications.

Low risk means the probability of vascular accidents is no more than 15%, moderate - up to 20%, a high risk indicates the development of complications in a third of patients from this group; with a very high risk, more than 30% of patients are susceptible to complications.

Manifestations and complications of headache

Manifestations of hypertension are determined by the stage of the disease. In the preclinical period, the patient feels well, and only the tonometer readings indicate a developing disease.

As changes in blood vessels and the heart progress, symptoms appear in the form of headache, weakness, decreased performance, periodic dizziness, visual symptoms in the form of weakened visual acuity. All these signs are not expressed during a stable course of the pathology, but at the time of development the clinic becomes more vivid:

• Strong;
• Noise, ringing in the head or ears;
• Darkening in the eyes;
• Pain in the heart area;
• Facial hyperemia;
• Excitement and feeling of fear.

Hypertensive crises are provoked by traumatic situations, overwork, stress, consumption of coffee and alcoholic beverages, so patients with an already established diagnosis should avoid such influences. Against the background of a hypertensive crisis, the likelihood of complications increases sharply, including life-threatening ones:

1. Hemorrhage or cerebral infarction;
2. Acute hypertensive encephalopathy, possibly with cerebral edema;
3. Pulmonary edema;
4. Acute renal failure;
5. Heart attack.

How to measure blood pressure correctly?

If there is reason to suspect high blood pressure, the first thing a specialist will do is measure it. Until recently, it was believed that blood pressure numbers could normally differ in different hands, but, as practice has shown, even a difference of 10 mm Hg. Art. may occur due to pathology of peripheral vessels, so different pressures on the right and left hands should be treated with caution.

To obtain the most reliable figures, it is recommended to measure the pressure three times on each arm with short time intervals, recording each result obtained. In most patients, the smallest values ​​obtained are the most correct, but in some cases the pressure increases from measurement to measurement, which does not always speak in favor of hypertension.

A large selection and availability of devices for measuring blood pressure make it possible to monitor it in a wide range of people at home. Usually, hypertensive patients have a tonometer at home, on hand, so that if their health worsens, they can immediately measure blood pressure. It is worth noting, however, that fluctuations are also possible in absolutely healthy individuals without hypertension, so a single excess of the norm should not be regarded as a disease, and to make a diagnosis of hypertension, the pressure must be measured at different times, under different conditions and repeatedly.

When diagnosing hypertension, blood pressure figures, electrocardiography data and cardiac auscultation results are considered fundamental. When listening, it is possible to detect noise, increased tones, and arrhythmias. , starting from the second stage, will show signs of stress on the left side of the heart.

Treatment of hypertension

To correct high blood pressure, treatment regimens have been developed that include drugs of different groups and different mechanisms of action. Their the combination and dosage are chosen by the doctor individually taking into account the stage, concomitant pathology, and the response of hypertension to a specific drug. After the diagnosis of hypertension is established and before starting drug treatment, the doctor will suggest non-drug measures that significantly increase the effectiveness of pharmacological drugs, and sometimes allow you to reduce the dose of drugs or abandon at least some of them.

First of all, it is recommended to normalize the regime, eliminate stress, and ensure physical activity. The diet is aimed at reducing salt and fluid intake, eliminating alcohol, coffee and drinks and substances that stimulate the nervous system. If you are overweight, you should limit calories and avoid fatty, floury, fried and spicy foods.

;

Every year the list grows and at the same time they become more effective and safe, with fewer adverse reactions. When starting therapy, one medicine is prescribed in a minimum dose; if it is ineffective, it can be increased. If the disease progresses and the pressure does not remain at acceptable values, then another drug from a different group is added to the first drug. Clinical observations show that the effect is better with combination therapy than with prescribing one drug in the maximum amount.

Reducing the risk of vascular complications is important in choosing a treatment regimen. Thus, it has been noted that some combinations have a more pronounced “protective” effect on organs, while others allow better control of pressure. In such cases, experts prefer a combination of drugs that reduces the likelihood of complications, even if there are some daily fluctuations in blood pressure.

In some cases, it is necessary to take into account concomitant pathology, which makes adjustments to headache treatment regimens. For example, men with prostate adenoma are prescribed alpha-blockers, which are not recommended for constant use to reduce blood pressure in other patients.

The most widely used ACE inhibitors, calcium channel blockers, which are prescribed to both young and elderly patients, with or without concomitant diseases, diuretics, sartans. Drugs in these groups are suitable for initial treatment, which can then be supplemented with a third drug of a different composition.

ACE inhibitors (captopril, lisinopril) reduce blood pressure and at the same time have a protective effect on the kidneys and myocardium. They are preferable in young patients, women taking hormonal contraceptives, indicated for diabetes, and for older patients.

Diuretics no less popular. Hydrochlorothiazide, chlorthalidone, torasemide, and amiloride effectively reduce blood pressure. To reduce adverse reactions, they are combined with ACE inhibitors, sometimes “in one tablet” (Enap, berlipril).

Beta blockers(sotalol, propranolol, anaprilin) ​​are not a priority group for hypertension, but are effective for concomitant cardiac pathology - heart failure, tachycardia, coronary disease.

Calcium channel blockers often prescribed in combination with ACE inhibitors, they are especially good for bronchial asthma in combination with hypertension, as they do not cause bronchospasm (riodipine, nifedipine, amlodipine).

Angiotensin receptor antagonists(losartan, irbesartan) is the most prescribed group of drugs for hypertension. They effectively reduce blood pressure and do not cause coughing like many ACE inhibitors. But in America they are especially common due to a 40% reduction in the risk of Alzheimer's disease.

When treating hypertension, it is important not only to choose an effective regimen, but also to take the drugs for a long time, even for life. Many patients believe that when the pressure reaches normal levels, treatment can be stopped, but they grab the pills by the time of the crisis. It is known that unsystematic use of antihypertensive drugs is even more harmful to health than complete lack of treatment, Therefore, informing the patient about the duration of treatment is one of the important tasks of the doctor.

Content

High blood pressure (BP) or hypertension usually affects pensioners, although recently the disease has increasingly begun to appear among young people. At the same time, people are often unaware of a serious problem; many attribute headaches to poor sleep or bad weather. Untreated high blood pressure can lead to stroke and heart attack. Therefore, for timely detection of the disease, it is necessary to study in detail the main causes of hypertension.

What is hypertension

Arterial hypertension (AH), hypertension or hypertension is a serious chronic disease characterized by a persistent increase in blood pressure (with upper systolic pressure above 140 mmHg and lower diastolic pressure above 90 mmHg). Hypertension is the most common disease of the cardiovascular system. An increase in blood pressure in the vessels occurs due to the narrowing of the arteries and their small branches - arterioles.

The value of blood pressure depends on peripheral resistance and vascular elasticity. When the receptors of the hypothalamus are irritated, renin-angiotensin-aldosterone hormones begin to be produced in greater quantities, which cause spasms of microvessels and arteries, thickening of their walls, and an increase in blood viscosity. This leads to the appearance of arterial hypertension, which becomes irreversible and stable over time. There are two forms of high blood pressure:

1. Essential (primary). Accounts for 95% of cases of hypertension. The reason for the appearance of this form is a combination of different factors (heredity, poor environment, excess weight).
2. Secondary. Accounts for 5% of cases of hypertension. High blood pressure in this form is caused by disturbances in the functioning of the body (kidney, liver, heart disease).

The initial stage of the disease or its latent course can be suspected if a person has:

• memory impairment;
• headache;
• unmotivated feeling of anxiety;
• chilliness;
• hyperhidrosis (increased sweating);
• small spots before the eyes;
• numbness of fingers;
• hyperemia (redness) of the skin of the facial area;
• rapid heartbeat;
• irritability;
• low performance;
• swelling of the face in the morning.

Causes of hypertension

During normal functioning of the body, the heart pumps blood through all vessels, delivering nutrients and oxygen to the cells. If the arteries lose their elasticity or become clogged, the heart begins to work harder, the tone of the vessels increases and their diameter narrows, which leads to high blood pressure. The onset of hypertension is caused by disorders of the autonomic and central nervous systems, which are closely related to emotions. Therefore, when a person is nervous, his blood pressure often begins to rise.

After 60 years, the development of arterial hypertension is associated with the appearance of atherosclerosis (chronic artery disease), when cholesterol plaques block normal blood flow. In this case, the patient’s upper pressure can increase to 170 mmHg. Art., and the lower one remains less than 90 mm Hg. Art. Also, many doctors identify common causes of arterial hypertension:

• impaired circulation of all vital organs;
• psycho-emotional stress;
• spasm of the muscles of the cervical vertebrae;
• genetic pathology;
• decreased elasticity, thickening of blood vessels;
• hypokinesia (sedentary lifestyle);
• hormonal changes;
• diseases of internal organs (liver, kidneys).
• excess salt intake;
• bad habits.

In men

As a rule, men aged 35 to 50 years are susceptible to the appearance of hypertension. High blood pressure is diagnosed in patients who already have a stable form of the disease. This is due to the fact that men ignore the first signs of the disease. Often the reasons for the appearance of high blood pressure in the strong half of humanity are provoked by their work. The disease affects those people whose activities involve heavy physical and mental stress. Responsible workers suffer from the disease, for whom any mistake is always a great stress. Other causes of hypertension in men:

• smoking, alcohol abuse;
• sedentary lifestyle;
• non-compliance with nutritional rules (fast food, sweets);
• kidney diseases (glomerulonephritis, pyelonephritis, urolithiasis);
• taking medications (cold, runny nose, sleeping pills or hormonal medications);
• neglect of physical activity;
• problems with blood vessels (atherosclerosis);
• trauma to the central nervous system (CNS).

In women

The symptoms of arterial hypertension in women and men are not particularly different (shortness of breath, headache, tinnitus, dizziness), but the weaker sex is much more likely to experience this disease. The causes of hypertension in women may differ from those in men, and this is due to hormones. There are even forms of the disease that are not at all typical for the stronger sex - this is hypertension during menopause and pregnancy.

As a rule, in women, hypertension is diagnosed during menopause (after 45 - 50 years). The body undergoes significant changes at this time: the amount of estrogen produced begins to decrease. In addition, the causes of hypertension in women may be the following:

• taking contraceptives;
• stress, overload;
• insufficient amount of potassium in the body;
• physical inactivity (sedentary lifestyle);
• excess body weight;
• poor nutrition;
• childbirth;
• bad habits (alcoholism, smoking);
• diabetes mellitus;
• failure of cholesterol metabolism;
• pathologies of the kidneys, adrenal glands;
• vascular diseases;
• obstructive apnea syndrome (breathing arrest).

At a young age

Hypertension is rarely observed in people under 25 years of age. Often, an increase in blood pressure at a young age is associated with neurocirculatory dystonia (a complex of disorders of the cardiovascular system), when only upper pressure indicators change. The cause of these disorders in children can be heavy workload during school hours. In almost all cases, high blood pressure in a child is a consequence of pathology of the endocrine system, i.e. childhood hypertension is usually secondary. Developing arterial hypertension at a young age may have other causes:

• hereditary factor;
• overeating, consuming large amounts of salt;
• weather conditions;
• diseases of the spinal column.
• electromagnetic, sound radiation;
• nervous overstrain;
• kidney pathologies;
• taking medications that affect blood pressure;
• overweight;
• lack of potassium in the body.
• non-compliance with sleep patterns.

Causes of hypertension

The occurrence of hypertension in 90% of patients is associated with cardiovascular problems (atherosclerosis, diseased heart, etc.). The remaining 10% are classified as symptomatic hypertension, i.e. high blood pressure is a sign of another disease (kidney inflammation, adrenal tumors, narrowing of the renal arteries), hormonal imbalance, diabetes, traumatic brain injury, stress. Risk factors for the development of hypertension are classified according to two indicators:

• Immutable. Reasons that a person cannot influence. This includes:

1. Heredity. Arterial hypertension is considered a disease transmitted through genes. Therefore, if there were patients with hypertension in the family, there is a chance that the disease will appear in the next generation.
2. Physiological factor. Middle-aged men are more susceptible to the disease than the fairer sex. This is explained by the fact that in the period from 20 to 50 years, a woman’s body produces more sex hormones that perform a protective function.

• Changeable. Factors that depend on the person, his lifestyle and decisions:
  • sedentary lifestyle;
  • excess weight;
  • stress;
  • bad habits;
  • insomnia;
  • consuming large amounts of caffeine, salt, cholesterol;
  • taking medications;
  • lifting weights;
  • weather fluctuations.

Heredity

One of the predisposition factors to arterial hypertension is heredity. These may be anatomical features that are passed on through genes. They are expressed in difficulty in blood flow, which affects the increase in blood pressure. The presence of hypertension in first-degree relatives (mother, father, grandmother, grandfather, siblings) means a high probability of developing the disease. The risk of developing the disease increases if high blood pressure was observed in several relatives at once.

As a rule, it is not hypertension itself that is genetically inherited, but only a predisposition to it; this is due to neuropsychic reactions and metabolic characteristics (carbohydrates, fats). Often the realization of a tendency to pathology by inheritance is due to external influences: nutrition, living conditions, unfavorable climatic factors.

Diseases

Cardiovascular diseases (heart disease, ischemia) can provoke high blood pressure. With these ailments, the lumens of the aorta are partially narrowed, which means the pressure increases. Vascular defects in polyarthritis nodosa also contribute to an increase in blood pressure. Diabetes mellitus is another cause of arterial hypertension. The presence of atherosclerotic plaques narrows the lumen of blood vessels, which is an obstacle to normal blood circulation. The heart begins to work harder, creating increased blood pressure. Diseases that can cause hypertension:

• kidney inflammation;
• pathologies of the lymphatic system and liver;
• cervical osteochondrosis;
• disruption of the pancreas and thyroid gland;
• arterial sclerosis;
• vegetative-vascular dystonia;
• adrenal tumor;
• traumatic brain injuries;
• narrowing of the renal arteries.

Hormonal changes

Disorders of the endocrine organs (thyroid, hypothalamus, pancreas, adrenal glands) are common causes of high blood pressure. These pathological processes slow down the production of sex hormones and their effect on the lower cerebral appendage, especially for women during menopause. Serious causes of increased blood pressure that contribute to excess hormone synthesis are the following diseases:

• Cushing's syndrome;
• thyrotoxicosis (hyperthyroidism) – increased thyroid function;
• neoplasms on the adrenal glands;
• acromegaly (dysfunction of the anterior pituitary gland);
• pheochromocytoma (hormonal active tumor);
• Kohn's syndrome.

Age

Hypertension tends to be more common in older people. This is due to the fact that over time the arteries lose their elasticity, and this has a great impact on blood pressure. In addition, after 40 years of age, people's metabolic processes slow down; due to the consumption of large amounts of high-calorie food and an incorrect attitude towards food, obesity develops, and then hypertension.

Today, the cause of the disease, age, has undergone changes. The disease is becoming noticeably younger, approximately 10% of adolescents are susceptible to the pathology, and as they grow older, the percentage only increases. Every third person over 40 years of age suffers from high blood pressure. Indeed, in addition to the natural decline in the body’s resistance and the influence of heredity, lifestyle changes with age.

Lifestyle

Another cause of arterial hypertension is considered to be lack of physical activity. Sport has a beneficial effect on blood circulation and the body as a whole, but not many people decide to start leading an active lifestyle in order to protect themselves from the development of hypertension. Lack of exercise causes obesity and overweight and, as a result, high blood pressure.

Hypokinesia is a common disease of our time, when a person moves little, and this leads to disruption of the blood vessels. Unhealthy diet, bad habits, and poor lifestyle provoke high blood pressure, since the weakening of muscle tissue and the spine reduces the vascular tone necessary for good blood circulation. Working at a computer also increases the risk of developing the disease.

Nutrition

Another contributing factor to high blood pressure is poor nutrition. Salty, sweet, fried, spicy, smoked and fatty foods often provoke an unplanned rise in blood pressure. After all, to remove excess sodium from the body, the kidneys need a certain time. Until this happens, excess salt retains water, which causes swelling in people suffering from hypertension.

A lack of potassium can increase blood pressure. This element helps the blood vessels to relax and the body to free itself from sodium. There is a lot of potassium in tomatoes, dairy products, cocoa, potatoes, legumes, parsley, prunes, melon, bananas, green vegetables, sunflower seeds. These foods should be included in your daily diet. It is necessary to avoid lard, fatty meats and smoked meats, because... they lead to excess weight and often accompanying high blood pressure. In addition, the following foods are harmful to the body:

• butter;
• canned food;
• offal;
• fat sour cream, cream;
• spicy seasonings;
• flour products;
• caffeinated tonic drinks;
• sweet carbonated drinks.

Bad habits

A high dose of alcohol and the resulting hangover have a negative impact on health. Regular and excessive consumption of alcoholic beverages can increase heart rate, sharply increase blood pressure, and cause a heart attack. Smoking also has a bad effect on blood pressure. Nicotine increases heart rate and rapid wear and tear of the heart, which leads to the development of coronary artery disease and atherosclerosis.

Tobacco and alcoholic beverages have a negative effect on the entire body. When smoking and drinking alcohol, the blood vessels first expand and then sharply contract, resulting in their spasm and worsening blood flow. Hence the increase in blood pressure. In addition, the chemicals contained in cigarettes can disrupt the elasticity of the walls of blood vessels and form plaques that clog the arteries.

Overweight

A common cause of hypertension is obesity and overweight. Excess weight occurs due to a sedentary lifestyle, metabolic disorders, and heavy intake of food high in fat, carbohydrates, and salt. Obese people are always at risk, because their high blood pressure increases along with the load on the blood vessels and heart.

In addition, obesity increases blood cholesterol, which can trigger diabetes. Overweight patients are 3 times more likely to develop hypertension than people with normal body weight. An obese person is more susceptible to atherosclerosis, which is an additional factor in the appearance of high blood pressure. Losing even 5 kg of weight will significantly lower your blood pressure and improve your blood sugar levels.

Ecology

Many people react painfully to changes in weather, i.e. they are weather dependent. Even a completely healthy person who rarely spends time outdoors and leads a sedentary lifestyle can be sensitive to weather changes. As a rule, meteorological crises in people suffering from hypertension appear in unusual climatic and landscape conditions, so before traveling you should prepare a travel first aid kit.

The poor ecology of the city also seriously increases blood pressure, harming the cardiovascular system and developing hypertension. Even short-term exposure to harmful substances that a person inhales every day can trigger the development of hypertension within 3 months. Three common pollutants in all modern cities - nitrogen dioxide, ozone, sulfur dioxide - negatively affect blood pressure and vascular function.

Stress

Neuro-emotional stress (stress, nervous breakdown, excessive emotionality) is the most common cause of exacerbation of hypertension. Any negative, unexpressed and suppressed emotions are dangerous to human health. Experiencing stress for a long time is a constant tension that wears out blood vessels and the heart faster than would happen in a calm environment. The consequence of a nervous breakdown is often increased blood pressure and a hypertensive crisis. Stress is especially harmful when combined with alcohol and smoking, because... This combination sharply increases blood pressure.

As a rule, in a person with hypertension, blood pressure increases and persists longer, even under mild emotional stress. Gradually, with repeated increases in blood pressure, which can last for many months, the apparatus responsible for regulating blood pressure gets used to the load, and blood pressure slowly stabilizes at a certain level.