Hypertensive Disease 1 degree: the mechanism of development, diagnosis and treatment

From this article you will learn about hypertension 1 degree, how it develops, what are the characteristic differences in hypertension 1 degree compared to other degrees of hypertensive disease( abbreviated GB).Causes, symptoms and treatment of hypertension 1 degree, when drugs are used. Forecast for recovery.

Content of the article:

  • Mechanism of development of 1st degree GBD
  • Characteristic differences of grade 1 hypertension from other degrees
  • Difference between degrees and stages of
  • Causes of hypertension of 1st degree
  • Symptoms of
  • Probability of complications development( risk factors)
  • Diagnosis
  • Treatment
  • Forecast

Hypertensive disease -this is a regular increase in systolic( the maximum volume of blood in the vascular bed at the time of contraction of the heart) and diastolic( the minimum volume of blood at the time of cardiac relaxationth muscle) pressure.

The normal blood pressure readings are 120( systolic, or "upper") values ​​for 80( diastolic, or "lower") mmHg. Art. Therefore, with abnormalities we can talk about the appearance of hypertension, the initial stage of which( 1 degree), is characterized by:

  • systolic pressure ranging from 140 to 159 mm Hg.p.
  • diastolic - from 90 to 99 mm Hg. Art.

At the heart of the development of hypertension 1 degree is a genetic defect, inherited - a change in the structure of cell membranes and the violation of electrolyte metabolism( the entry of sodium and potassium ions into the cell and back).This defect becomes the cause of pathological chemical reactions, due to which the steady narrowing of the vascular walls develops, fluid is retained in the body. Pathology progresses gradually, for its stable fixation in 95%, a number of factors are needed( chronic kidney disease, excessive salt intake and others).

Hypertension of the first degree is dangerous due to the development of serious complications - cerebral ischemic stroke, myocardial infarction, retinal hemorrhages, renal and vascular lesions. However, the risk is assessed as low( less than 15% over the next decade).

In 90-95% of cases, hypertension 1 degree can be cured if the cause of its appearance( curable pathologies of the kidneys and adrenal glands, endocrine disorders) is eliminated, and the influence of factors fixing the pathology( excess salt, smoking) is minimized.

Therapist treats pathology.

Mechanism of development of

Normally, the volume and pressure of blood in the vascular bed, constriction or relaxation of the walls, the amount of fluid in the body regulates a complex chain of chemical transformations of some hormones into others - RAAS( renin-angiotensin-aldosterone system).

Because of the genetic defect of the cell membranes through which the sodium and sodium ions enter the cell and back, the RAAS system is malfunctioning, the chain of chemical transformations becomes uncontrollable. The level of substances that cause a steady narrowing of the lumen of the vessels, increase the volume of the fluid( causing the heart to contract intensively), prevent the excretion of sodium from the body, it increases - develops GB of 1 degree.

In the process involved the so-called fixation factors - various chronic diseases and infections of the kidneys and adrenal glands.

Characteristic differences of hypertension 1 degree from other degrees of GB

GB 1 degree - a borderline state, it has significant differences from other degrees of hypertension.

Hypertension soft, 1 degree Hypertension moderate and severe, 2, 3 degrees
Pressure indicators( in mm Hg): systolic from 140 to 159, diastolic from 90 to 99 Pressure indicators( in mm Hg): systolic in the range from 160 to 180( and above), diastolic from 100 to 110( and above)
Pressure "jumps"( increases occasionally, not continuously), with an interval of several days, the diagnosis is confirmed on the basis of monitoring BP indices duringmonth or two( confirm - by monitoring for 6 months) Pressure rises regulationangles( every day, every other day) or stably fixed at high rates. Preliminary diagnosis is based on concomitant symptoms, daily or weekly monitoring of
blood pressure. The risk of serious complications is low, only 15% over 10 years. Risks vary from average( from 20% for 10 years) to high( from 50% and above)
The target organs are not involved( the first ones suffering from pressure changes) - large and small vessels, retina of the fundus, kidneys, heart, brain . Target organs are involved, the disease is accompanied by severe symptoms of kidney damage, brain, cardiofailure
Gives in complete recovery in 90-95%( if you eliminate the cause of) Complete cure is not possible, the goal of treatment - to prevent sudden pressure surges and the development of fatal complications

difference between the degrees and stages

The hypertension 1 degree different from 1 GB stage? These are the types of classification that make it possible to clarify the overall picture of the disease: the degree is established, guided by the indices of blood pressure. When determining the stage, the main factor is how much the target organs are damaged( how complicated the GB was):

  1. For the first stage, there is no damage, pressure rarely increases.
  2. For the 2nd stage - narrowing the vessels of the retina, using ECG to diagnose changes in the left ventricle( thickening of the walls of the chamber), the pressure rises regularly.
  3. For Stage 3 - severe cardiac arrhythmia( heart attack, heart failure), brain( stroke), retina( hemorrhage, decreased vision), kidneys( urine in the urine, elevated creatinine), thickening and bulging of the vascular walls( aneurysmaorta).The pressure is high, it keeps constantly.

Typically, 1 degree of hypertension corresponds to stage 1( a rare, irregular increase in pressure ranging from 140/90 to 159/99 mm Hg, unchanged from the internal organs).

Causes of

One of the main causes of increased blood pressure( BP) is the deviation in the chain of transformations of renin( renal hormone) into angiotensin and aldosterone( vasoconstrictor hormones), resulting in a persistent vasospasm, increased fluid volume in the body and increased heart function.

Disorders can be triggered:

  • with acute and chronic renal pathologies( pyelonephritis, arterial stenosis);
  • adrenal diseases( pheochromocytoma);
  • pathologies of the brain( violations of inhibition and excitation of the central nervous system, regulation of hormonal mechanisms of blood pressure control).

Pathology develops against a background of numerous risk factors:

  • heredity( the presence of GB in close relatives);
  • permanent nerve tension;
  • salt sensitivity( the body's reaction to the excessive amount of salt in food, in 50% - the fixing factor for the initial GB);
  • lipid metabolism disorders( balance between cholesterol and triglycerides);
  • impaired glucose tolerance( insufficient utilization of the substance from the blood plasma) and diabetes mellitus;
  • drug and alcohol intoxication( with oral contraceptives, drugs affecting the production of hormones of the kidneys and adrenal glands, endocrine glands);
  • hypokalemia( lack of potassium);
  • age( in men from 55, in women from 65 years of age);
  • of overweight;
  • hypodynamia;
  • smoking.

GB 1 degree - the initial stage, preceded by other, more severe manifestations of the disease. It is with her that any hypertensive disease begins. Therefore, the causes and factors contributing to the appearance of the disease are the same for any degree of GB.

Click on photo to enlarge

Symptoms

Hypertensive disease of the 1st degree in most cases( 85%) proceeds easily, the symptoms of the pathology are poorly expressed and manifest only at the time of pressure increase, temporarily reducing mental and physical ability to work( with headache).After the normalization of blood pressure, the symptoms recede.

Physical activity causes a slight increase in cardiac output, may cause a pressure shock. In general, pathology does not impair the quality of life and does not interfere with any physical action.

The most characteristic sign for hypertension of the 1st degree is a bright, severe headache localized in the temporal or occipital region of the head.

In 45% it is joined by other manifestations:

  1. Noise in the ears.
  2. Weak dizziness.
  3. The flashing of flies in front of the eyes.
  4. Nasal bleeding.
  5. Sensation of constriction, chest pain.
  6. Decreased mental capacity.

Often( in 70%) the disease occurs against a background of various sleep disorders( from anxious, superficial, often interrupted sleep to insomnia).

The appearance of complications in 1st degree GB is more likely to be an exception than the rule, although in 15% of cases it can lead to the development of:

  • transient ischemic attacks( short episodes of acute cerebrovascular accident);
  • of hemorrhagic and ischemic cerebral stroke( acute cerebrovascular accident);
  • myocardial infarction( acute impairment of blood supply to the heart muscle);
  • renal failure( impaired renal blood supply);
  • vascular hemorrhage in the fundus.

In hypertension 1 degree, the symptoms are not constant, combined with an increase in pressure, which rises from time to time, with intervals of several days or even weeks.

Probability of complications development( risk factors)

The presence of risk factors several times increases the likelihood of complications( infarction, stroke) even with hypertension of 1 degree.

Risk factors Development of complications( infarction or stroke) with 1 degree of hypertension
None Risk 1( up to 15%, low)
1-2 factors other than diabetes Risk 2( 15 to 20%, average)
More than 3 factors( in combination with diabetes mellitus and target organ damage or separately) Risk 3( 20 to 30%, high enough)
The presence of multiple co-morbidities and factors( hyperlipidemia, smoking, hypodynamia, age, target organ damage) Risk 4( from 50%, very high)

Thus, with 1 degree hypertension, the risk of 1 means that any factors that can trigger the progress of pathology are absent, and the probability of complications in the next decade is low, not more than 15%.

For hypertension 1 degree 1 stage, risk 2 - despite rare increases in pressure and absence of changes on the part of target organs, against the background of 1 or 2 permanently present risk factors( enough of one hypodynamia), the probability of a heart attack or stroke within 10 years increases to 20%.

Multiple factors and concomitant diseases of the heart, kidneys, and vessels increase the risk of complications by more than 50%( risk 4).

Diagnostics of

Diagnostics of 1st degree GB has several nuances:

  • a preliminary diagnosis is made on the basis of BP monitoring data for a month or two( because the pressure fluctuations are unstable, repeated at large intervals of several days);
  • the basis for the preliminary diagnosis is 3-5 cases of pressure increase to the characteristic values ​​of blood pressure( increase in systolic pressure from 140 to 159, diastolic - from 90 to 99 mm Hg) for a month.

In some cases, the diagnosis requires confirmatory blood pressure monitoring for 6 months( rare pressure drops).

Typical Diagnostic Signs of Type 1 Hypertension:

  1. When examining the fundus, minor constrictions and an increased tortuosity of the retinal vessels are detected.
  2. As a result of ultrasound examination of peripheral vessels, a slight decrease in renal blood flow is noted.
  3. There are no abnormalities on the radiograph of the heart and large vessels.
  4. In the echocardiogram of changes in the left ventricle( thickening of the chamber walls, characteristic for severe GB) is not present.
  5. Ultrasound of the abdominal cavity is prescribed to identify possible causes of pathology.

Additional laboratory tests:

  • extended blood test with formula;
  • lipidogram( ratio of lipid levels, coefficient of atherogenicity);
  • determination of potassium and blood glucose level;
  • creatinine in urine.

Treatment of

Hypertension 1 degree can be cured in 90-95% of cases, if the cause of its appearance is eliminated in time, minimize the influence of risk factors( for example, salt intake).

Unlike other degrees of GB, when you need to constantly take a complex of angiotensin drugs, at grade 1 medication is rarely prescribed, rather, as an exception to the rule.

Treatment of mild GB in most cases begins with the appointment of light sedatives, tranquilizers and physiotherapy methods. Simultaneously normalize the regime of the day and diet, eliminate the factors that contribute to the appearance of the disease( smoking).

Elimination of risk factors

For the normalization of blood pressure for hypertension 1 degree in 50% of cases it is sufficient to abandon the excessive use of salt, reducing the daily rate to 4-4.5 grams per day. In the presence of other risk factors:

  • change diet, introducing in the diet low-fat protein foods, vegetable fiber, foods rich in potassium, calcium, magnesium, vitamins, limit the consumption of animal fats;
  • reduce weight( with obesity);
  • reasonably increase physical activity;
  • refuse to drink alcohol and smoke;
  • uses any medicines under control and after the appointment of a doctor.

Physiotherapy methods

Hypertension 1 degree is effectively cured by physiotherapy methods:

  1. Diadynamic therapy( treatment with electric currents).
  2. Hyperbaric oxygenation( oxygen treatment in a pressure chamber with increased pressure).
  3. General medical massage.
  4. Laser therapy( strengthening of vessels by a source of optical radiation).
  5. Phytotherapy( sedatives with St. John's wort, Melissa, Leonurus, valerian in composition).
  6. Acupuncture and reflexology( effect on biologically active points of the body).

Individual psychotherapy sessions help to relieve nervous tension and stress.

Prescribing medicines

Medication is necessary in cases where:

  • pressure is regularly fixed at 150/95;
  • increases the risk of developing vascular complications.

Since GB 1 degree is an uncomplicated form of the disease( no target organs are involved),

  • prefers sedatives and tranquilizers( reduce stress, have a calming effect, normalize sleep) - diazepam, magnesium preparations, valerian;
  • diuretics( drugs that enhance the removal of fluid from the body) - veroshpironu, laziksu, gipotiazidu;
  • adrenoblockers( reduce the sensitivity of receptors to hormones that have vasoconstrictive effect, reduce blood pressure) - atenolol, prazosin, bisaprolol;

All pressure-reducing agents are prescribed in minimum dosages for a quarter or half of the tablet, so as not to cause a sharp drop in pressure.

Forecast

GB 1 degree - the initial, mild form of the disease. It does not greatly affect the ability to work and does not worsen the patient's quality of life, so it is often diagnosed accidentally.

In 90% of cases, it is successfully cured if the cause of the onset and factors influencing the fixation of GB( excess salt in the diet) are detected and eliminated in time.

The timing of therapy is determined individually, in some cases they depend on the attendant risk factors( obesity, smoking), it may take time to eliminate them.

The risk of developing severe complications in hypertension 1 degree is low - only 15% over the next 10 years, so it is considered the safest form of the disease.