Aortic hypertension is a pathological or physiological tendency for a strong or gradual increase in indicators of both systolic and diastolic components of intravascular blood pressure, which occurs as an independent Nosological unit or a manifestation of another disease in patients.
According to world statistics, the epidemiological situation of arterial hypertension is unfavorable, because the percentage of this disease in the disease structure of cardiovascular records reaches 30%. There is a clear correlation dependence of an increase in the risk of developing signs and consequences of arterial hypertension with an increase in the age of the patient, and therefore, the main type of increased risk is the face of mature and elderly.
Causes of artery hypertensionThe appearance of signs of hypertension in patients can occur based on the current chronic diseases and then we are talking about a secondary version or symptoms of arterial hypertension. In the case when arterial hypertension is primary and even after comprehensive patient examination, it is impossible to determine the cause of internal hypertension, so the terms of hypertension, should be used for a form of independent poison.
Nguyen Phat's hypertension is observed in nearly 90% of cases of hypertension and general development of this pathological state is currently being considered. Therefore, there are risk factors that do not change the arterial hypertension, inevitable (sexuality, genetic identification and age), however, these stimulus factors do not dominate in the development of serious arterial hypertension. To a greater extent, the development of Nguyen Phat artery hypertension is affected by human lifestyle (not balanced nutrition, bad habits, inactive, psychological instability). Together, all the stimulus factors are early or then create favorable conditions for the development of diseases of arterial hypertension.
Currently, many theories of pathology about the development of essential arterial hypertension are considered, although these hypotheses have no effect on the patient's tactics and determine the amount of treatment measures. The diseases of the development of secondary artery hypertension should be taken into account at a greater level, because it does not eliminate the cause of the causes of hypertension, in this case you should not wait for the results to be active.
Therefore, with the improvement version of symptomatic artery hypertension, the main link is a kidney stenosis that occurs with atherosclerotic lesions or fiber hair disorders. An extremely rare factor that affects the kidney artery is systemic vasculitis. The consequence of narrowing is the development of ischemic damage of one or both kidneys, causing Renin's hyperplasia, which indirectly affects hypertension.
In the pathology of the development of the hormonal causes of arterial hypertension, there is an increase in the level of hormonal substances that stimulate the internal hypertension, occurs with Celenko-Rush syndrome, Conn Syndrom. Some cardiovascular diseases can act as a background disease for the development of secondary artery hypertension, such as aortic coarctation.
Aortic hypertension symptomsClinical manifestations in the initial development stage of arterial hypertension may be completely non -exist, and the diagnosis in this case is based on data from objective tests and tools.
The complaint is presented by patients with arterial hypertension is quite nonspecific, and therefore, in the launch of essential hypertension, diagnosis is significant difficulties. In most cases, with a period of arterial hypertension, patients are disturbed by headache with localization dominant in the forehead and occipital area, dizziness, especially when changing the body position in the space, pathological noise in the ear. These manifestations are not pathological, so it is not advisable to consider them as clinical criteria for arterial hypertension, as the above symptoms are observed periodically in people who are completely healthy and have nothing to do with hypertension. Clinical clinical manifestations in the form of respiratory disorders, signs of dysfunction of heart activity are only observed in the stage of aortic hypertension.
A number of forms of arterial hypertension have been accompanied by the development of specific clinical symptoms, related to that, an experienced expert that can set an accurate diagnosis during the initial testing process and gather a thorough collection of an Anamnesis disease. For example, with a renovated arterial hypertension, a acute debut of clinical manifestations is always recorded, including the strong and continuous increase of blood pressure indicators mainly due to diastolic components. Renovated arterial hypertension is not characterized by a crisis process, however, the problem of patients with this pathology is extremely serious.
In contrast, endocrine artery hypertension is characterized by the trend of the Paroxysmal process of the disease with the development of classical hypertension crisis. For this pathology, the patient has a clinical Paroxysmal trio, including the development of a sharp headache, sweating and rapid polishing, which is characteristic. Patients in this pathological condition have the ability to stimulate extreme psychology. The development of a hypertension crisis occurs most often at night and the clinical manifestation time does not exceed an hour, then the patient notice the weak and common headache.
Aortic hypertension and stageDetermine the severity and intensity of clinical manifestations of arterial hypertension, as well as the development stage of the disease, which is a prerequisite for adequate treatment. The separation of arterial hypertension is based on both the main genesis and the symptoms, the level of an increase in the systolic component and the diastolic of blood pressure are set.
Patients with 1 -degree hypertension regularly do not pay attention to the significant violations of their own health due to the fact that the data of blood pressure in this situation does not exceed 159/99 mm. RT. Art.
2 levels of arterial hypertension accompanied by clear clinical manifestations and organic changes in target organs and blood pressure indicators in the range of 179/109 mm. RT. Art.
3 levels of the disease are distinguished by an extremely serious positive process and the trend of developing complications from brain and heart function is weakened. At the third level, the serious increase in blood pressure exceeds 180/110 mm recorded. RT. Art.
In addition to classifying artery hypertension in severity, in practical activities, cardiologists use the separation of the stadium of this pathology, the criteria are the presence of signs of damage to the target agencies.
In the initial stage of arterial hypertension, both primary and secondary genesis, patients have absolutely no manifestations of organic damage sensitive to hypertension of tissues and organs.
The second stage of the disease is related to the development of detailed clinical symptoms, the intensity of direct manifestations depends on the severity of damage to the internal organs. However, in most cases, this stage of arterial hypertension is established on the basis of certifying the instrument of organ damage in the form of fertile cardiomyopathy of the left ventricular heart of the heart level of creatinine in acute plasma.
The third stage of arterial hypertension is the terminal, in which the patient has the development of irreversible changes in all organs sensitive to hypertension. Regarding the heart in a person suffering from prolonged increased blood pressure, developing ischemic heart muscle damage, manifested in the formation of infarction areas. On the structures of the brain, arterial hypertension has a negative effect in the form of stimulating transient ischemic attacks, hypertension and even the formation of ischemic pain. The increase in long -term systems in intravascular pressure affects extremely negative to the structure of blood vessels, its result is the formation of hemorrhage in the retina and edema of the optical disk.
The final stage of the development of arterial hypertension is characterized by a significant inhibition of renal function, reflected in the degree of creatinine, exceeding the index 177 μmol/l.
Diagnosis of artery hypertensionWhen conducting clinical laboratory and tools for arterial hypertension patients, the main goal should not be too much to establish actual hypertension, but to detect the cause of the development of secondary artery hypertension, showing signs of damage to internal organs.
With the initial contact with a disease lock to establish an accurate diagnosis and identify the next treatment tactics, a thorough collection of Anamnestic data patient is a thorough collection. An objective test of a patient with arterial hypertension allows you to identify the cause of the disease due to detection of specific pathological signs. Therefore, with the existing obesity in patients, combined with hypertension, Hirsutism and the persistent increase in the diastolic component of artery pressure, so assume the endocrine nature of the disease (Iconko-doll syndrome). With pheochromocytoma, accompanied by serious paroxysmal arterial hypertension, the skin's hyperpigmentation in the projection of the armpit cavities is observed. Clinical standard diagnosis of renovated arterial hypertension is the cardiovascular hearing in the projection of the near -bundle.
The mass of the research methods in the laboratory for arterial hypertension includes the patient's lipidogram analysis, identifying uric acid and creatinine, which is the main criterion for kidney dysfunction, analysis of the patient's hormonal condition.
To determine the stage of the disease, an essential condition is to diagnose the damage of the target organs, meaning the organs in which the irreversible changes are developing due to hypertension. Therefore, to study the heart for impaired activity and organic damage, electrocardiogram registration and ultrasound intuitive, which is part of the standard screening test of all patients with arterial hypertension. To detect retinal disease, observed mainly with prolonged severe arterial hypertension, the patient's eye bottom must be checked. Radiation imaging methods should be used such as renal and brain research tools, not included in the list of compulsory diagnostic measures, but facilitating the accurate diagnostic early setting (computer -layer, magnetic imaging).
Aortic hypertension treatmentThe basic modern approach to arterial hypertension therapy is to achieve the maximum risk of developing the complications of the heart records and the degree of death. In this regard, the priority of the doctor attending is to completely eliminate the reverse risk factors available for patients with the stopping of arterial hypertension and clinical manifestations simultaneously. There is a certain standard, including achieving the target boundary of blood pressure, the indicators should not exceed 140/90 mm Hg
In cases where should use anti -hypertension therapy for arterial hypertension? The cardiovascular doctors in their practice use the development classification, which implies that patients are at risk of developing cardiovascular complications. According to this classification, a combined treatment for lifestyle and adjustment of drugs must be subject to people with high risk of heart complications combined with an important increase in the amount of blood pressure. Patients with medium and low risks are subject to dynamic observation for at least three months and only in the case of no effect on the use of non -adjustable methods is treatment with anti -hypertension treatment of the drug.
The principle of regulating medication of arterial hypertension is to gradually reduce blood pressure for the number of targets by using the minimum treatment dose of one or more antihypertensive drugs. In some situations, single -dose single -dose therapy of an antihypertensive drug may have a long -term positive effect on arterial blood pressure. Currently, the pharmaceutical market is filled with a variety of anti -hypertension drugs, however, drug groups combined with prolonged hypotension (up to 24 hours) are the most common.
Because drugs are selected related to the first stage of arterial hypertension, priority for diuretic agents has many positive effects in the form of preventing the development of cardiovascular complications, reducing mortality, as well as preventing the progression of hypertrophic changes in the left ventricular. Pharmacological effect, accompanied by reducing blood pressure, is determined by reducing water and reabsorbing sodium and reducing blood vessel resistance.
The choice of a diuretics depends on diseases and is currently available in patients. Therefore, with arterial hypertension, combined with signs of heart failure and kidney failure, it should be given priority for loop diuretics. Tianzide diuretic agents with prolonged use can cause the development of potassium lowering syndrome, and therefore, it is better to use them in combination with aldosterone antagonists.
In the situation, the patient shows signs of arterial hypertension in combination with tachycardia, angina attacks and symptoms of chronic heart failure of stagnant nature, so a group of water blockers should be used for the first row. The mechanism of the hypotension effect of these drugs is to reduce cardiac release and inhibit renin products. It should be noted that not complying with the dosage of this group can cause a significant reduction in heart rate and bronchial frequency, this is an absolute sign for the cancellation of the three-blocker reception.
It is encouraged for patients with arterial hypertension compared to the platform of proteinuria. An absolute contraindication to the use of medications of the enzyme inhibitor is a two -way nest in the patient. The drugs of Angiotensin II receptor receptor receptor have similar hypotension with the only difference that they do not stimulate the growth of cough and plants of anhionurotic properties, which significantly expand their application scope.
The drugs of the calcium -blocking group have a significant hypotension, which allows for arterial hypertension due to a decrease in calcium content in the wall of blood vessels. The list of this group's prescriptions is mainly older patients, and at the same time suffering from arterial hypertension, observing signs of heart muscle damage due to ischemia, manifested in the development of angina attacks. In cardiovascular practices, prolonged calcium channels are used due to the fact that the short -term calcium antagonist significantly increases the risk of acute myocardial infarction.
In the situation of arterial hypertension in patients, combined with violation of the rhythm of the heart activity, the calcium should be used by phenylaclamin and the derivative of benzotiazepine. An absolute contraindication to the use of this drug is the patient's heart failure, accompanied by reducing emissions below 45%.
Particularly, it is advisable to consider reducing the drug's drug -hypertension crisis, including an important increase in the number of intravascular pressure and acute artery hypertension. In this situation, priority should be given to drugs that have a significant hypotension, because with a prolonged hypertension crisis, the risk of death increases sharply. With the patient's signs of complex hypertension crisis, the path of using injection has a more appropriate hypotension. Most hypotension groups are produced in the form of injection. As a rule, the effect of lowering blood pressure occurs no more than 5 minutes after taking the drug.
In the case of non -complicated hypertension crisis, there is no need to use anti -hypertension drugs, because in this condition, there is no serious increase in blood pressure. The oral amount of anti -hypertension drugs with adequate dosage allows you to reduce pressure within hours and maintain the number of targets in the future. Of course, there are currently many methods of causing hypertension crisis, however, to eliminate the development of complications, anti -hypertension treatment plans should be applied regularly.
In the case when arterial hypertension in patients is secondary in nature and developed due to renal artery stenosis, the basic treatment is to adjust the activity of stenosis and vasoconstriction due to blood vessels. Instructions for operating arterial hypertension (ignoring by shunting, endartertomy) are only used for contraindications to use blood vessels. If the patient shows signs of an arterial hypertension due to severe kidney sclerosis, the only treatment is the surgery to remove the kidneys.
With secondary hormonal hypertension, the combination of surgical treatment (thoroughly removal of the tumor substrate) and anti -hypertension therapy (spironolactone in the daily dose of 200 mg with primary aldosteron, PCentolamine at a dose of 25 hours with the bychromocytoma).
Aortic hypertension preventionFollowing its preventive measures and actions aims to prevent intravascular hypertension, as well as reduce the risk of complications of arterial hypertension, not only can occur with patients with this disease, but also for healthy people showing signs of increased pressure.
The fact that scientifically proven is the direct correlation of hypertension in the human body weight, and therefore, the normalization of a person with arterial hypertension is the main priority prevention event. In addition, compliance with the rules of food behavior adjustment helps prevent the progression of atherosclerotic blood vessels, this is one of the main causes of artery hypertension.
Recent studies in the pharmacological field have demonstrated the beneficial effects of omega-3 fatty acids in restoring blood vessels, which can also be considered an effective method to prevent arterial hypertension. Making these conclusions, you should use olive oil in the daily quantities and strongly limit animal fat.
Of course, if you want to eliminate the manifestations of arterial hypertension, you should give up bad habits in the form of smoking and alcoholic drinks, because nicotine particles and alcohol can increase intravascular blood pressure even in micro tissue.
Those who have noted arterial hypertension stages are secondary precautions should be measured daily with blood pressure, to keep a special diary that reflects the effectiveness of the drug used and if the new clinical manifestations are worse, without disturbing the doctor.
Aortic hypertension - which doctor will help? In the presence or doubt about the development of arterial hypertension, you should immediately seek advice about doctors as a cardiologist, endocrinologist and kidney doctor.
