Arterial Hypertension. Definition. Causes. Symptoms.
The main criterion of arterial hypertension (or hypertension) as a whole group of diseases - stable, that is, detected by repeated measurements on different days, an increase in blood pressure (BP). The question of what kind of blood pressure is considered elevated is not as simple as it may seem. The fact is that among practically healthy people, the range of blood pressure values is quite wide. The results of long-term observation of people with different blood pressure levels showed that starting from the level of 115/75 mmHg, each additional increase in blood pressure by 10 mmHg. it is accompanied by an increase in the risk of developing diseases of the cardiovascular system (first of all, coronary heart disease and stroke). However, the benefits of modern methods of treatment of arterial hypertension were proved mainly only for those patients whose blood pressure exceeded the value of 140/90 mm Hg. For this reason, it was agreed to consider this threshold value as a criterion for the allocation of arterial hypertension.
An increase in blood pressure can be accompanied by dozens of different chronic diseases, and hypertension is only one of them, but the most frequent: about 9 cases out of 10. The diagnosis of GB is established in cases where there is a stable increase in blood pressure, but no other diseases that lead to an increase in blood pressure are detected.
Hypertension is a disease for which a stable increase in blood pressure is its main manifestation. Risk factors that increase the likelihood of its development were established during observations of large groups of people. In addition to the genetic predisposition that some people have, among such risk factors are:
- lack of mobility;
- excessive consumption of table salt, alcohol;
- chronic stress;
In general, all those features that accompany the modern urban lifestyle in industrially developed countries. That is why hypertension is considered a lifestyle-related disease, and its targeted changes for the better should always be considered within the framework of the hypertension treatment program in each individual case.
What other diseases are accompanied by an increase in blood pressure? These are many kidney diseases (pyelonephritis, glomerulonephritis, polycystic, diabetic nephropathy, stenosis (narrowing) of the renal arteries, etc.), a number of endocrine diseases (adrenal tumors, hyperthyroidism, Cushing's disease and syndrome), obstructive sleep apnea syndrome, some other, more rare diseases. Regular intake of medications such as, for example, glucocorticosteroids, nonsteroidal anti-inflammatory drugs, oral contraceptives can also lead to a persistent increase in blood pressure. The diseases and conditions listed above lead to the development of so-called secondary, or symptomatic, arterial hypertension. The doctor makes a diagnosis of hypertension if, during a conversation with the patient, finding out the history of the disease, examination, as well as the results of some, mostly simple laboratory and instrumental research methods, the diagnosis of any of the secondary arterial hypertension seems unlikely.
Elevated blood pressure in itself in many people does not manifest any subjective feelings. If increased blood pressure is accompanied by symptoms, it may be a feeling of heaviness in the head, headache, flashing before the eyes, nausea, dizziness, instability when walking, as well as a number of other symptoms that are quite nonspecific for high blood pressure. The symptoms listed above are much more clearly manifested in a hypertensive crisis - a sudden significant rise in blood pressure, leading to a clear deterioration of the condition and well-being.
It would be possible to continue to list the possible symptoms of GB separated by commas, but there is no special benefit in this. Why? Firstly, all these symptoms are non-specific for hypertension (i.e., they can occur both individually and in various combinations and in other diseases), and secondly, the fact of a stable increase in blood pressure is important to establish the presence of arterial hypertension. And this is revealed not by assessing subjective symptoms, but only by measuring blood pressure, and repeatedly. It means, firstly, that "in one sitting" one should measure blood pressure twice or three times (with a short break between measurements) and take the arithmetic mean of two or three measured values for true blood pressure. Secondly, the stability of the increase in blood pressure (the criterion for diagnosing hypertension as a chronic disease) should be confirmed by measurements on different days, preferably at intervals of at least a week.
In the case of a hypertensive crisis, symptoms will be necessary, otherwise it is not a hypertensive crisis, but simply an asymptomatic increase in blood pressure. And these symptoms can be both those listed above and others, more serious - they are discussed in the section "Complications".
Symptomatic (secondary) arterial hypertension develops within the framework of other diseases, and therefore their manifestations, in addition to the actual symptoms of increased blood pressure (if any), depend on the underlying disease. For example, with hyperaldosteronism, it can be muscle weakness, convulsions and even transient (lasting hours - days) paralysis in the muscles of the legs, arms, neck. With obstructive sleep apnea syndrome - snoring, stopping breathing during sleep, daytime drowsiness.
If hypertension over time - usually for many years - leads to damage to various organs (they are called "target organs" in this context), then this may manifest itself as a decrease in memory and intelligence, stroke or transient violation of cerebral circulation, an increase in the thickness of the walls of the heart, accelerated development of atherosclerotic plaques in the vessels of the heart and other organs, myocardial infarction or angina pectoris, decreased blood filtration rate in the kidneys, etc. Accordingly, clinical manifestations will be caused by these complications, and not by an increase in blood pressure as such.