Hypertension essential: symptoms, causes, diagnosis, treatment

Essential arterial hypertension is a pathology of a chronic type. Morphological changes against the background of the disease are different, it all depends on the nature of its occurrence. Next, consider what is hypertension essential of all degrees of severity.

General information

The main clinical sign of the pathology is the persistent increase in the pressure indices. The diagnosis is based on the exclusion of all other forms of the disease. Hypertension essential is fixed from the moment of depression depressor renal function. First of all, morphological changes extend to the heart and blood vessels.

Variant of the norm

In a healthy state, the pressure is formed against a background of contraction in the left ventricle. Thus the blood flow is thrown out into the aorta, and then goes to small arteries. The level of pressure is established in accordance with the blood volume in the vessels, the degree of tension of the arterial walls. Value also has a tonus of arterioles (the smallest channels). Hypertension is an increase in arterial vessels of a large range of hydrostatic pressure. Normally, indicators can fluctuate according to the condition of a person. So, during sleep they go down, but with psychoemotional or physical activity they go up. However, as a rule, the pressure returns to normal - from 100/60 to 140/90. If the indicators above are given, then they establish hypertension. The reasons for which essential arterial hypertension arises are different.

Risk factors

Essential hypertension is considered the most common type of hypertension, but the provoking factor can not always be identified. However, in patients suffering from pathology, certain characteristic relationships are found. For example, essential hypertension occurs only in those groups where the level of salt intake exceeds 5.8 g / day. Experts note that in fact such an excessive reception can become an important risk factor. Especially predisposed to the development of hypertension is the elderly, people with kidney failure, obesity. There is also a genetic factor.

Diabetes

The history of the disease is of primary importance in diagnosing. Essential hypertension often accompanies diabetes mellitus. In the pancreas there are cells of the islets of Langerhans. They produce a hormone insulin. It controls the concentration of glucose, contributes to its transition to structural elements. Along with this, insulin also has some vasodilating action. Normally, the hormone is able to stimulate the sympathetic activity. At the same time, blood pressure does not change. But in severe cases, for example, against the background of diabetes mellitus, sympathetic stimulating activity can prevail over the vasodilating effect.

Genetic factor

Specialists consider it to be one of the most important in the development of pathology. Nevertheless, the genes responsible for the appearance of hypertension have not been detected. Today, researchers are working to study the factors that affect the renin-angiotensin system. It is involved in the synthesis of a biologically active compound - renin - which promotes increased pressure. This system is located in the kidneys. Hypertension essential in about 30% of cases is due to genetic factors. For example, the incidence is higher for African Americans than for Europeans or Asians. In addition, those with one or both parents suffering from hypertension are more prone to develop pathology. In rare cases, essential hypertension becomes a consequence of a genetic disease from the adrenal glands.

Vascular pathology

Many patients with hypertension have high resistance (decreased elasticity) of arterioles. These vessels pass into the capillaries. With loss of elasticity, pressure begins to increase. The reason for such a violation from the arterioles is not completely clear. However, it has been established that a decrease in vascular elasticity is characteristic of persons with hypertension due to genetic factors, aging, excessive salt intake, and hypodynamia. A certain role in the development of pathology belongs to inflammatory processes. In this regard, the identification of a C-reactive protein compound in the blood can act as a prognostic factor.

Obesity

This is another significant factor for the onset of essential hypertension. With an overweight body, the probability of a pathology appearance is 5 times higher. For example, in the United States, about two-thirds of all cases of hypertension are associated with obesity. In more than 85% of patients, the mass index exceeds 25.

Sodium

This compound also has a significant role in the development of hypertension. In about a third of all cases, hypertension is associated with excessive intake of sodium in the body. The development of the disease is based on the ability of the compound to retain water. With excess content in the bloodstream of the fluid, the pressure rises.

Renin

The effect of this biologically active compound is associated with an increase in vascular tone. This causes an increase in pressure. Hypertension may be accompanied by both low and high levels of renin. For example, reduced levels of compound content are characteristic of African Americans. In this regard, in the treatment of more effective are diuretics.

Other factors

It was found that the development of hypertension is significantly affected by snoring. Age is quite common and significant provoking factor. Over the years, an increase in the number of collagen fibers is found in the vascular walls. Because of this, their thickening and loss of elasticity, a decrease in lumen.

Clinical picture

How is essential hypertension manifested? Symptoms of pathology are often absent. As the only specific manifestation for a long time only increased pressure. There are boundary values, according to which the diagnosis is established. So, for "upper" (systolic) pressure it is 140-159 mm Hg. For diastolic - 90-94. In a number of cases, essential primary hypertension is accompanied by:

• Headache in the occipital part.
• A rapid heartbeat.
• Doubling in the eyes.
• Noise in the ears.

The intensity of these symptoms increases with a sharp increase in pressure (hypertensive crisis). In the course of time, changes begin in the vessels and in the internal organs of an irreversible nature. As the "targets" are the heart, kidneys, brain.

Stages of pathology

With easy flow, the condition is characterized by a periodic rise in pressure (diastolic - more than 95). In this case, the stabilization of the condition is possible without the use of medicines. The average severity of the pathology is characterized by a steady increase in pressure (diastolic - within 105-114). At this stage, there may be an increase in venules, narrowing of arterioles, hemorrhage of the fundus without other diseases. The heavy stage is characterized by a steady increase in pressure (diastolic - more than 115). Stabilization of the state does not occur even after a crisis. At this stage, changes in the fundus are more pronounced. The condition is also accompanied by the development of arteriolo- and arteriosclerosis, left ventricular hypertrophy, cardiosclerosis. Pathological changes in the internal organs are also found.

Accompanying illnesses

Hypertension may be accompanied by:

• Diabetic nephropathy.
• Angina pectoris.
• Infarct.
• Revascularization of the coronary arteries.
• Transient disorders in the cerebral circulation.
• Hemorrhagic and ischemic strokes.
• Swelling in the optic nerve.
• Hemorrhage or exudate.
• Pronounced retinopathy.
• An exfoliating aneurysm.
• Renal and congestive heart failure.

Diagnostics

It is based on the evaluation of pressure indicators. To clarify the diagnosis, it is necessary to carry out at least three independent measurements. At the same time, a mercury tonometer and the Korotkov method are used. Diagnosis of secondary forms of pathology and determination of the degree of organ damage is carried out with the help of additional studies. In particular, the patient is assigned specific and general tests of urine and blood, ultrasound of internal organs and heart, various tests, ECG and others.

Daily Monitoring

When using this method of research, the patient is put on an automatic tonometer, which fixes the level of blood pressure during the day. The interval between measurements is usually 30-60 minutes per day and 60-120 minutes at night. As a result, dozens of results are obtained. Based on the data, you can determine the average pressure for a day, night, day. In addition to direct indicators, you can get information that indirectly indicate the presence of hypertension. Such information is provided by measuring the rate of increase and decrease of pressure at different times of the day.

Essential hypertension: treatment

There are various methods of stabilizing the state. The choice will depend on the nature of the pathology. Thus, essential and renovascular arterial hypertension have differences in the intensity of manifestations. First of all, therapeutic measures should be aimed at stabilizing the pressure. At the same time, all risk factors need to be adjusted. The patient should give up smoking and other bad habits, revise the diet, normalize weight. For those patients who have been diagnosed with essential hypertension, treatment should be directed to the elimination of concomitant pathologies: diabetes mellitus and others. Particular attention should be paid to physical activity, wakefulness and sleep. In the menu, the amount of table salt and animal fats should be reduced. At the same time in the diet should be present vegetable food, dairy products, cereals, fruits and vegetables. Along with these products, microelements and other useful compounds, vitamins, will enter the body.

Medication effect

Here it should be noted that essential hypertension is easily amenable to elimination. For today, seven classes of drugs are recommended in Russia. Renovascular hypertension (secondary) is difficult to eliminate. In this case, therapy is primarily aimed at combating the underlying pathology. Among the drugs prescribed for the disease, the following are distinguished:

• Diuretics (diuretics). They help to remove excess fluid from the body. These include the funds "Furosemide", "Hypothiazid" and others.
• Beta- and adrenoblockers. The latter are used only with accompanying pathologies. To beta-adrenoblockers include "Nadolol", "Acebutolol".
• Antagonists of calcium. Together with this, additional consumption of magnesium in the diet can also be considered a calcium antagonist.
• ACE inhibitors.
• Imidazaline receptor agonists.
• Angiotensin receptor antagonists (Lozartan).

Selection of medicines is carried out by a doctor.