Blood pressure is characterized by the resistance that the vessels exert at the moment when the blood leaves the heart. It is systolic and diastolic, that is, at the time of contraction and relaxation of the heart muscle, respectively.
The persistent increase in blood pressure above 120/80 millimeters of mercury is called hypertension. It must be distinguished from arterial hypertension, in which the increase in pressure figures occurs once, depending on environmental conditions, such as stress, and passes without harm to health.
Hypertension has several degrees of severity:
- The first degree is characterized by an episodic increase in vascular resistance, which may be asymptomatic. Despite the seeming security of this degree, it harbors many pitfalls, in particular the possibility of a hypertensive crisis and a rapid transition to a more severe course;
- The persistent increase in systolic pressure from 160 to 180 and diastolic from 100 to 110 millimeters of mercury is called second-degree hypertension. Periods of normal indices decrease and decrease, with time, without adequate therapy, deterioration of the condition and damage to the target organs begins;
- A severe degree is characterized by an increase in systolic and diastolic pressure greater than 180 and 110 millimeters of mercury, respectively. The level of vascular resistance almost always borders on critical numbers, threatening to turn into a hypertensive crisis and then into a disability.
In the world, the second degree of the disease is the most widespread, since statistically it is more detectable - patients with the first degree do not see a doctor yet. Every person needs to know the symptoms and treatment of hypertension. After all, drug treatment usually helps to prevent it from progressing to the third degree with complications.
You can often hear a diagnosis of grade 2 hypertension from a doctor with a risk of 3, but many do not know what it is. When making a diagnosis, the probability of target organ damage is taken into account, which is a risk. It is divided into four stages:
- The risk is less than 15%;
- Level from 15 to 20%;
- Risk frequency is not more than 30%;
- The number of complications is more than 30%.
These organs include the heart, brain, blood vessels, and kidneys.
Effect on target organs
The defeat of the vessels occurs in the form of chronic spasm, which leads to the filling of its walls with connective tissue. This makes the wall is not elastic, but dense, which contributes to the development of atherosclerotic plaques on it.
Hypertension greatly affects the normal structure of the kidneys, disrupting its functional abilities. This is manifested by the development of chronic renal failure - the loss of the parenchymal function of removing toxins from the body.
If hypertension is not treated, then renal failure will progress and as a result, the patient will need a kidney transplant or hemodialysis.
There are three options for heart damage.
The first is a change in diastole in the left ventricle. This means that after considerable tension in systole, the myocardium cannot relax to the end. This reduces the saturation of the heart muscle with oxygen, ischemia, which can lead to necrosis;
The second is an increase and thickening of the left ventricular wall. This leads to a deformation of the heart, which causes a complication in pushing blood into the bloodstream. The more the disease progresses, the more the wall thickens and, accordingly, the heart function decreases. Body tissues do not receive enough oxygen, resulting in weakness and shortness of breath.
The third - heart failure, develops with constant hard work of the heart in conditions of low oxygen content. This is characterized by a deterioration not only of relaxation, but also of heart contraction. To treat this pathology is quite difficult, much more difficult than hypertension. And if concomitant diseases, such as atherosclerosis or diabetes, join hypertension, the progression of heart failure will accelerate.
Hypertension can cause complications. The patient may develop a stroke. Sometimes hemorrhagic or ischemic. When the former develops cerebral hemorrhage, which occurs due to rupture of the brain vessels. The higher the pressure, the greater the chance of developing this complication. In ischemic stroke, the walls of the vessels are not destroyed, but significantly narrowed, which leads to insufficient oxygenation of the tissue and the death of the affected areas of the brain.
Also, hypertension can cause encephalopathy - this is an acute crisis, when an increase in pressure causes headache and impaired brain function, reversible with adequate therapy.
Additionally, cognitive changes occur - due to prolonged oxygen starvation, brain cells die, the brain volume gradually decreases, signs of dementia and dementia develop.
The main options for the manifestation of hypertension
Hypertension of the second degree has a number of symptoms, in the detection of which it is necessary to consult a doctor for advice and treatment.
For example, a headache in the neck and temples is caused by the development of vasospasm.
The presence in these areas of a multitude of nerve plexuses and fibers causes a reflex development of sharp pain.
Such manifestations are also possible:
- The reddening of the skin of the face is explained by the constant inflow of blood to the vessels, due to increased pressure, with the result that the capillaries are constantly expanded and lose elasticity, shining through the skin. It can also create the effect of the vascular reticulum on the skin of the face and neck.
- Edema, especially of the face and eyelids, is associated with water retention by the body due to a disruption of the kidneys, occurring more often in the morning and visible within a few hours after waking up.
- Chronic fatigue and apathy are caused by permanent ischemia of the tissues, in particular of the brain and skeletal muscles. Due to the lack of oxygen, they actually work for wear, gradually becoming depleted, which leads to the appearance of symptoms - first, fatigue after sleep, a decrease in vigor and efficiency, then a feeling of constant exhaustion.
- Flickering of the flies before the eyes, darkening of the eyes after exercise - these symptoms are caused by hypoxia of the optic nerve and narrowing of the retinal vessels. Due to the lack of oxygenated hemoglobin, the sensitive retina begins to atrophy, most quickly this happens with a sharp increase in pressure, for example, under stress. If this process is not controlled, retinal detachment and blindness may occur.
- Tachycardia, or an increase in heart rate, occurs reflexively when pressure rises. This is due to irritation of the receptors of the heart, which lack oxygen, a chain reaction is triggered. Aimed at increasing blood flow velocity for better delivery of substances. This is done by increasing the contraction of the myocardium, which is felt by an unpleasant feeling behind the sternum.
- Problems with memory and concentration of attention are associated with the fact that brain tissues are under constant stress due to ischemia, neural connections are disturbed, and cognitive functions are affected.
- Tinnitus when climbing steps and a quick step is caused by a malfunction of the vestibular apparatus due to insufficient oxygenation. Sensitive hairs atrophy, there is a sensation of noise in the head. Subsequently, this may be complicated by frequent dizziness, loss of consciousness and fainting.
- Irritability and emotional lability occur due to constant unwellness, often arrested along with the treatment of hypertension.
Additionally, there is an injection of the vascular sclera - there is a rupture of the smallest capillaries due to overstretching of the vascular wall.
Primary therapy with elevated pressure
In the implementation of treatment should be used an integrated approach.
For treatment, the physician recommends using several drugs that have a diverse effect on the body.
These are drugs of different groups that will affect different processes in the body. Accordingly, treat the body from different positions.
Apply these groups of drugs: antihypertensive drugs to normalize the pressure figures and the impact on the main cause of the disease; diuretics, for removing excess fluid from the tissues; means to reduce blood density, to facilitate blood flow through narrowed vessels; cholesterol-lowering drugs for preventing the development of atherosclerosis; drugs for the correction of blood sugar levels, if among concomitant diseases there is type 2 / type 1 diabetes.
Antihypertensive drugs include:
- Beta-blockers that reduce heart rate. Due to this, reflex cardiac output decreases and pressure decreases. They are one of the classic groups, they were the first in the treatment of diseases of the heart and blood vessels. A dangerous side effect is the development of bronchospasm, agonizing cough and shortness of breath, so you need to consider the doctor in relation to patients with chronic obstructive pulmonary disease, bronchial asthma or tuberculosis. This group includes tablets such as metoprolol, sotalol, labetalol and their analogues.
- ACE inhibitors - their action is to block the angiotensin-converting enzyme, and reduce the amount of angiotensin, which will join the receptors of blood vessels and increase vascular resistance. They provide effective treatment at the stage of development of chronic heart failure, protecting the heart muscle from necrotizing. Not recommended for use in patients with renal insufficiency and in patients on hemodialysis, since the active substances are excreted by the kidneys and pregnant women, because of the risk of preeclampsia.
- Calcium antagonists, which limit the effect of ion on vascular receptors. Often used as a preventive treatment. Unlike beta-blockers, they have no effect on the respiratory system, therefore they are actively used in patients with bronchial obstruction and have good reviews. This group includes Nifedipine and Diltiazem.
In addition, alpha-blockers are used. They are prescribed to patients who have concurrently developing diseases, such as diabetes, adrenal hypertrophy syndrome and pheochromocytoma. Can dramatically reduce the pressure, so it is necessary to respect the dosage prescribed by the doctor. Doxazosin belongs to this group.
Additive medications in the treatment of hypertension
Diuretics are used along with antihypertensive drugs. They cause an increase in the elimination of fluid from the cells by increasing the amount of urine. They can be different in influence, therefore the choice of the drug is strictly individual. The strongest are loop diuretics. They remove not only water, but also potassium, chlorine and sodium ions, which in heart failure patients will cause the development of a heart attack. These include Furosemide.
Thiazide diuretics, which remove water from the nephron loop together with potassium ions, leaving sodium and chlorine in the intercellular fluid, are considered to be slightly less effective. The main drug of this group is hydrochlorothiazide.
Potassium-sparing drugs are of low efficiency, but are considered the most benign compared to the others. A representative of this group is spironolactone.
In parallel with this treatment, statins are prescribed, which reduce cholesterol levels and prevent the development of atherosclerosis, and sugar-lowering drugs for diabetics.
In addition to the main treatment, doctors recommend adhering to a healthy lifestyle, increase the amount of fruits and vegetables in the diet, if possible pay at least thirty minutes to physical exertion and eliminate tobacco smoking and alcohol consumption. If this is followed, the risk of complications is reduced by 20%, which contributes to a longer life expectancy. It is not worthwhile to engage in self-treatment, since many drugs are contraindicated and can only be prescribed by a qualified specialist, despite the fact that any instructions for using the medication can be downloaded. This is fraught with impaired health.
Information on hypertension grade 2 is provided in the video in this article.