From this article you will learn about what it is and how hypertension of the third degree manifests itself, for which high values of blood pressure( abbreviated blood pressure) are characteristic. Increased pressure is a serious problem due to the high risk of complications due to it, life threatening.
Contents of the article:
- Reasons for pressure increase
- Cardiovascular risk in hypertension 3 degrees
- Symptoms of hypertension 3 degrees
- Treatment of disease
- Forecast
With hypertension of the third degree, blood pressure rises significantly. As a result, the risk of vascular accidents increases and, because of the increased stress on the heart, cardiac insufficiency gradually increases( the inability of the heart to fully fulfill its function).
Arterial hypertension, depending on the pressure numbers, is assigned to one of three degrees. When establishing the category, both systolic and diastolic pressure are taken into account, being guided by the highest index. At grade 3, either the upper indicator is greater than 180, or the lower one is higher than 140 mm Hg. Art. With such significant pressure figures, the risk of complications is assessed as high, even in the absence of other adverse factors, and this condition is dangerous.
Often a significant increase in pressure is accompanied by other cardiovascular diseases, disorders of carbohydrate or fat metabolism, kidney pathology and other health problems. Such hypertension corresponds to 3 degrees of risk 4( very high cardiovascular risk).The degree of risk depends on the indicators of blood pressure and the factors that affect the prognosis. High, medium, high and very high risk levels are identified, denoted by the numbers from 1 to 4.
It is necessary to distinguish the 3 degree of hypertension from stage 3. Degrees indicate levels of elevated blood pressure, and when the stage is established, the progression of the disease, the damage to target organs are taken into account. Stage 3 is characterized by the presence of associated conditions such as a stroke or myocardial infarction, angina pectoris, heart failure, kidney failure, nephropathy, peripheral arterial disease, aortic aneurysm, diabetes, retinopathy.
Treatment of the disease involved mainly cardiologists and therapists. In the development of complications, rescue patients are engaged in resuscitation, in the case of a cerebral stroke, a neurologist prescribes treatment. Cure completely hypertension grade 3 is possible in rare cases. Only if the increase in BP is secondary, lasts a short time, and the cause that caused it will be completely eliminated.
Reasons for increasing pressure
Hypertensive disease affects about 35-40% of the population. With age, the number of patients increases. At the same time, cardiovascular risk is increasing.
Most cases of hypertension refer to hypertension, when it is not possible to pinpoint the pathology that caused the problem. This variant of the disease is called primary( essential) hypertension.
The specific mechanism of disease development is revealed only in 5-10% of cases. Such symptomatic hypertension is considered potentially reversible if the cause of its occurrence can be eliminated.
Many factors and mechanisms are involved in the formation of essential hypertension. The causes of hypertension are internal and external factors, some of which can be affected, while others can only be taken into account:
- Power. Provoke the development of hypertension can excess salt in food, high calorie foods. It is also noted that increases the likelihood of increased blood pressure, a lack of fruit in the diet.
- Obesity, metabolic syndrome, diabetes mellitus.
- Dyslipidemia is a violation of the ratio of useful and harmful blood lipids, which provokes atherosclerosis of the vessels, which promotes the growth of pressure.
- Cardiovascular diseases, renal pathology.
- Age and gender. The older the person, the higher the probability of an increase in the index of blood pressure. Up to 50 years of age, men suffer from hypertension a little more often. After menopause, the number of sick women increases significantly and at some point even exceeds the number of cases of hypertension among men. With age, the pressure numbers also increase, so grade 3 hypertension in the older age group is more common.
- Psychoemotional factors, chronic stress.
- Smoking. Shortly increases the pressure by 10-20 mm Hg. Art.with each smoked cigarette. As a result, during the day the average figures of blood pressure can significantly increase.
- Alcohol. Some studies have shown that the use of small doses of alcohol does not affect the increase in blood pressure, but the risk of alcohol abuse has been shown to increase.
- Genetic factors. They do not always lead to the formation of the disease, but often greatly enhance the response to the impact of other provoking factors. Of particular importance are cases of early development of cardiac pathology in close relatives.
- Hypodynamia. This factor contributes to the development of obesity and cardiovascular pathology, increasing the likelihood of BP growth and the risk of vascular complications.
Several mechanisms are involved in the development of hypertension, which in each case are manifested in different combinations, which determines the individual characteristics of the course of the disease and the various responses to antihypertensive drugs. The main mechanisms of the formation of hypertension:
- Neurogenic, in particular, the activation of the sympathetic nervous system. These mechanisms play an important role in hypertension in obese individuals at the initial stage of diabetes, with heart failure.
- Renal mechanisms. One way to control pressure is to remove sodium by the kidneys. In pathology, this mechanism can be disturbed, because of what the salts are released more slowly than usual, which causes an increase in the volume of plasma and the growth of blood pressure. Often this form of hypertension is caused by genetic factors.
- Vascular mechanisms. The increase in pressure can be connected, first, with a violation of the function of the endothelium - the layer of cells lining the vessels from the inside, and secondly, with the remodeling of the vessels. In the endothelium, various substances responsible for the vascular tone are produced. Dysfunction of endothelial cells leads to disruption of one of the main mechanisms of protection from hypertension. Vessel remodeling usually occurs later than endothelial dysfunction and further exacerbates hypertension. In this case, the thickening of the walls of the vessels and the diminution of their lumen are formed.
- Hormonal mechanisms play an important role in maintaining normal pressure values. In a complex regulatory system, substances produced by special kidney structures, the hormone secreted by the adrenal glands - aldosterone, and some other bioactive substances take part.
Cardiovascular risk in hypertension grade 3
With prolonged arterial hypertension or a significant increase in pressure, target organs suffer: myocardium, brain, kidney structures, mesh eyes. As a result, complications of arterial hypertension may develop:
- cerebral stroke;
- attacks of ischemia, myocardial infarction;
- progression of atherosclerosis;
- heart failure;
- kidney pathology;
- retinopathy - retinal lesion of the eye;
- sudden cardiac death.
Symptoms of arterial hypertension 3 degrees
The increase in pressure can proceed unnoticed and can be detected accidentally when measuring blood pressure. This is usually the case with hypertension 1 degree. Manifestations of the disease at the initial stage occur usually at sudden pressure surges.
A more significant increase in blood pressure, characteristic of grade 2 hypertension, is more difficult to tolerate by patients. Headaches, a sense of weakness and other symptoms of hypertension can bother not only during a crisis, but after any fatigue, both physical and psycho-emotional.
At 3 degrees, the pressure rises to high numbers, so the condition worsens, the symptoms increase. In the long course of the disease, patients can get used to high blood pressure and either do not notice the symptoms, or connect them with other causes. But high blood pressure increases the burden on the heart, leading to heart failure and an increased risk of sudden death. Therefore, regardless of the severity of symptoms, one should strive for complete normalization of blood pressure.
Hypertension of the 3rd degree is manifested by the following symptoms:
- headaches,
- periodic dizziness,
- , ringing in the ears,
- fatigue,
- heartache.
With the development of a crisis - a sharp increase in blood pressure, the symptoms are rapidly increasing, new manifestations of the disease. For the uncomplicated crisis, the following complaints are typical:
- Headache.
- Nausea, vomiting.
- Flies before the eyes.
- Heart pain.
- Rapid heart rate.
- Numbness of the tongue, a sensitivity disorder in different areas of the skin.
- Chills, fever, increased sweating.
- Frequent urination.
With a complicated crisis, the symptoms of a developing complication come to the fore: ischemic transient attack, stroke, heart attack, pulmonary edema, exfoliating aortic aneurysm.
Treatment of the disease
Drugs
Complete cure and normalization of pressure are possible with symptomatic hypertension, when as a result of therapy it is possible to completely eliminate the cause of the increase in blood pressure. In the case of hypertension in order to maintain the rate in the norm and reduce cardiac risk, a constant intake of antihypertensive agents is required.
If hypertension of the third degree is detected, drugs for reducing blood pressure are prescribed immediately, while giving recommendations for lifestyle changes. The goal of taking antihypertensive drugs is to reduce the pressure below 140 by 90. With a initially high level of blood pressure, it is advisable to prescribe a combination therapy, since it is usually not possible to reduce the pressure for grade 3 hypertension with the use of only one drug.
The main groups of drugs that reduce blood pressure include:
- beta-blockers( metoprolol, bisoprolol);
- diuretics( hydrochlorothiazide, furosemide);
- calcium antagonists( nimodipine, amlodipine);
- angiotensin-converting enzyme( ACE) inhibitors and angiotensin receptor blockers( lisinopril, losartan);
- alpha-blockers( doxazosin, alfuzosin);
- inhibitors of renin( aliskiren).
Hypertensive disease of the third degree - an indication for the simultaneous administration of 2 or 3 drugs to reduce blood pressure. The most effective combinations are the ACE inhibitor and diuretic or calcium antagonist, beta-adrenoblocker and diuretic.
In addition to antihypertensive therapy, other methods of correction of risk factors for complications are used: antiplatelet drugs, lipid-lowering therapy, hypoglycemic drugs according to indications. Particularly relevant is the implementation of comprehensive measures for hypertension with a risk of 4.
When choosing drugs primarily focus on the effectiveness of a particular group of funds in a particular situation. If there are concomitant pathologies, preference is given to those medicines that will have beneficial effects in view of the associated disease. When prescribing the drug, take into account possible contraindications. For example, beta-blockers are not used in the treatment of hypertension in patients with a pulse rate below 55 per minute, with high-grade atrioventricular block, with severe peripheral circulation disorders.
Selection of drugs for hypertension of the third degree sometimes proves to be a difficult task, since many factors must be taken into account. A separate goal is to convince the patient of the need for constant, in most cases lifelong, administration of several medications.
How to change the way of life
How to change the way of life for treatment to be successful:
- Reduction of salt in the diet( less than 5 g per day).Should be discarded salinity and salting dishes.
- Refusal to drink alcohol or reduce it to 10-20 grams per day.
- Additional dietary recommendations concern increased consumption of vegetables, low-fat dairy products, whole grains, cereals, fruits. Dishes that contain cholesterol and saturated fats are not recommended. Welcome to the diet of fish twice a week and more often.
- Weight loss for obesity. With existing cardiovascular diseases, weight stabilization is recommended, since significant weight loss can worsen the condition of patients. This is especially true for elderly patients.
- Cessation of smoking. The negative influence of the habit consists not only in increasing blood pressure, but also in a significant increase in cardiovascular risk and a detrimental effect on the health of the entire body. Dependence on nicotine in a number of cases is so pronounced that one has to resort to temporary appointment of substitution therapy.
- Physical activity. The best results in reducing blood pressure and cardiovascular risk are given by regular outdoor activities( walking, running, cycling).As for strength training with hypertension, studies have shown better tolerability of dynamic exercises compared to static loads.
Click on photo to enlarge Forecast
The prognosis for hypertension is mainly determined by the degree, not the stage of the disease. But the figures for blood pressure also affect the risk of cardiovascular complications. Accordingly, grade 3 hypertension more often leads to disability and causes death than a disease with a less significant increase in pressure.
Hypertension grade 3 may not be accompanied by additional risk factors and concomitant pathology. Observations show that in this situation complications develop no more often than in 20-30% of cases. If the risk is regarded as very high - risk 4, the likelihood of complications exceeds 30%.
