Hypertension. Arterial hypertension (hypertension)

Arterial hypertension ( arterial hypertension) is a long-term increase blood pressure more than 140/90 mm Hg. It can lead to the development of heart attacks and. However, when changing lifestyle, refusing to bad habits and taking medications prescribed by a doctor can normalize blood pressure and reduce the risk of complications.

Causes

Arterial hypertension may be a symptom of certain diseases (secondary arterial hypertension) or independent disease- hypertension.

Exact reasons hypertension unknown, but factors that contribute to its development have been established:

  • Heredity

Some people already have a predisposition to the disease in their genes, but it does not always develop. It can be avoided by controlling the factors below.

  • Excess body weight

We are not talking about weight, but about body mass index (BMI). It is calculated taking into account height and weight. If your BMI is higher than normal, then you should consider losing weight to reduce the risk of hypertension, as well as other diseases.

Eating foods with a lot of salt increases blood pressure.

Smoking leads to thickening of the walls of blood vessels, and also increases the risk of heart attacks and strokes.

  • Alcohol

Increased blood pressure is associated with alcohol consumption. Drinking more than one glass of wine or one bottle of beer per day can lead to high blood pressure.

  • Passive lifestyle

Blood pressure increases in people who move little. Daily half-hour walks may reduce risk arterial hypertension.

  • Stress

Conflicts, worries, work overload, lack of rest and sleep can lead to increased blood pressure.

Secondary arterial hypertension occurs in many diseases:

Tests prescribed by your doctor will help determine the cause of the increase in blood pressure. It could be blood or more complex research. In each case the approach is individual.

Symptoms of arterial hypertension

There is no increase in blood pressure. Flashing spots before the eyes or pain in the back of the head, which are often written about, are not symptoms of arterial hypertension. The only way To identify it is to periodically measure your blood pressure.

Complications

What can you do

It is important not only to take medications, but also to change your lifestyle.

  • Try to adjust your weight in accordance with BMI standards.
  • Give preference to fruits, vegetables, seafood and limit the consumption of animal fats and fast carbohydrates (cakes, cookies, etc.).
  • You should not eat foods with high content salt (smoked meats, canned food, semi-finished products, etc.) You should try to reduce your salt intake to 5 grams per day (half a teaspoon).
  • You need to try to quit smoking.
  • Alcohol should be consumed in moderation.
  • Need to move more. Spend at least 30 minutes a day on physical activity. If possible, go swimming or ride a bike.
  • It is important to avoid, do not forget to rest, get enough sleep.

It is important to take your medicines as directed by your doctor. If you think you have developed any side effects due to your treatment, do not stop it yourself, but tell your doctor.

Continue taking medication after normalization of pressure. After all, it was because of the medication that it returned to normal. The goal of treatment is to support normal pressure, and not reduce the increased.

Don’t forget to come to see your doctor and contact your doctor if you feel any deterioration in your health.

What your doctor can do

The doctor will examine you, determine the type of arterial hypertension, determine its severity and select the necessary treatment.

Arterial hypertension is chronic illness which suffers a large number of modern people.

The difficulty is that many patients neglect preventive measures And in a healthy way life.

It is necessary to know what arterial hypertension is in order to begin therapeutic procedures in a timely manner, avoiding large-scale complications that can lead to death.

The body's vascular system is like a tree, where the aorta is the trunk, which branches into arteries, which are divided into small branches - arterioles.

Their task is to carry blood to capillaries that supply nutrients and oxygen to every cell of the human body. After oxygen is transferred to the blood, they are again returned to the heart through the venous vessels.

In order for blood to flow through the system of veins and arteries, a certain amount of energy must be expended. The force acting on the walls of blood vessels during blood flow is pressure.

Pressure depends on the functioning of the heart and on the arterioles, which are able to relax if it is necessary to lower blood pressure, or to contract if it is necessary to increase it.

Arterial hypertension is a condition defined by a persistent increase systolic pressure up to 140 mm Hg. century or more; and diastolic pressure up to 90 mm Hg. Art. and more.

There are such periods of changes in blood pressure:

  1. decreases from 1 to 5 am,
  2. rises from 6 to 8 am,
  3. decreases from 23 to 00 o'clock at night.

Blood pressure changes with age:

  • indicators in children are 70/50 mm Hg. Art.,
  • indicators in older people are more than 120/80.

Causes of arterial hypertension

In many cases, it is not possible to understand how arterial hypertension arose. In this case they talk about primary. Some doctors believe that the stimulating factors of primary hypertension are:

  • accumulation of salt in the kidneys,
  • the presence of vasoconstrictor substances in the blood,
  • hormonal imbalance.

About 10% of people have severe hypertension due to taking certain medications or developing another disease. Such arterial hypertension is called secondary hypertension.

They highlight the most common reasons hypertension:

  1. Kidney diseases,
  2. Renovascular hypertension,
  3. Adrenal tumor
  4. Pheochromocytoma,
  5. Side effects of drugs
  6. Increased blood pressure during pregnancy.

If the kidneys retain a lot of salt, the volume of fluid in the body increases. As a result, blood pressure and volume increase. The kidneys also produce the enzyme renin, which plays a key role in determining blood pressure levels.

Renin also increases the production of aldosterone, a hormone responsible for reverse suction water and salt.

Severe renovascular hypertension is quite rare and affects the following groups of people:

  • aged people,
  • smokers,
  • Small children.

Renovascular hypertension is diagnosed by administering contrast agent into an artery or vein and subsequent examination of the blood flow in the kidneys using X-ray irradiation.

The adrenal glands are two glands that secrete many hormones, including aldosterone, located at the top of each kidney. Aldosterone, produced by the adrenal glands, regulates salt and water balance in organism.

In extremely rare cases, a tumor of the adrenal glands provokes an increase in the production of aldosterone, which promotes the retention of water and salt in the body, thereby increasing blood pressure. This type of hypertension most often affects women young. There are additional symptoms:

  • strong thirst
  • excessive urination.

Another rare type of hypertension is pheochromytoma, which is caused by another type of adrenal tumor. At the same time, the pancreas produces more of the hormone adrenaline.

Adrenaline is a hormone that helps the body respond fully to stressful situations. This hormone has the following properties:

  1. accelerates heartbeat,
  2. increases blood pressure
  3. promotes blood transport to muscles lower limbs.

With pheochromocytoma, adrenaline causes:

  • rapid heartbeat,
  • trembling,
  • heat.

Some drugs and substances can increase blood pressure, for example:

  1. steroids,
  2. antipyretics,
  3. glyceric acid.

Symptoms of arterial hypertension

As you know, arterial hypertension has the second name “silent killer”, since its symptoms for a long time do not show up at all. Chronic hypertension is one of the main causes of strokes and heart attacks.

Arterial hypertension syndrome has the following symptoms:

  1. Pressing headache, which occurs periodically,
  2. Whistling or ringing in the ears
  3. Fainting and dizziness,
  4. "Floaters" in the eyes,
  5. Cardiopalmus,
  6. Pressing pain in the region of the heart.

With hypertension, symptoms of the underlying disease may be expressed, especially for kidney diseases. Only a doctor can choose medications for the treatment of hypertension.

Arterial hypertension largely contributes to the hardening of the arteries. Great pressure on the walls of blood vessels leads to their susceptibility to the accumulation of fatty elements. This process called vascular atherosclerosis.

Over time, the appearance of atherosclerosis provokes a narrowing of the lumen of the arteries and angina pectoris. Narrowing of the arteries of the lower extremities causes the following symptoms:

  • pain,
  • stiffness while walking.

Also, blood clots occur due to hypertension. So, if a blood clot is in coronary artery, then it leads to a heart attack, and if it is in the carotid artery, to a stroke.

Arterial hypertension, treatment of which long time has not been carried out, often leads to the formation dangerous complication– aneurysms. Thus, the wall of the artery bulges. An aneurysm often ruptures, causing:

  1. internal bleeding,
  2. brain bleeding,
  3. stroke.

A persistent increase in blood pressure is the cause of deformation of the arteries. Muscle layer, from which the walls of the arteries are created, begins to thicken, compressing the vessel. This prevents blood from circulating inside the vessel. Over time, thickening of the walls of the blood vessels in the eyes leads to partial or complete blindness.

The heart is always affected due to prolonged arterial hypertension. High pressure stimulates the heart muscle to work harder to ensure adequate oxygen saturation of tissues.

This condition causes an enlargement of the heart. In the early stages, the enlarged heart has more strength to pump blood optimally into the arteries under high pressure.

But over time, the enlarged heart muscle can weaken and become rigid, no longer supplying oxygen fully. Circulatory system must ensure a constant supply of nutrients and oxygen to the brain.

If the human body senses a decrease in the amount of blood that enters the brain, then compensatory mechanisms quickly turn on, they increase pressure, and blood from systems and organs is transferred to the brain. The following changes occur:

  • the heart starts beating faster,
  • blood vessels of the lower extremities and abdominal region contract,
  • More blood flows to the brain.

As you know, with hypertension, the arteries that supply the brain with oxygen can narrow due to the accumulation of fat-like substances in them. This increases the risk of strokes.

If the arteries of the brain become blocked little time, then there is a break in the blood supply to a separate part of the brain. This phenomenon in medicine they call it a microstroke.

Even if the condition lasts only a minute, it requires immediate medical intervention. If treatment is not carried out, this is fraught with the development of a full-fledged stroke. Repeated micro-strokes lead to weakening of brain functions. This is how dementia develops in people with arterial hypertension.

Each kidney is made of millions of small filters called nephrons. Every day, over one and a half thousand liters of blood passes through the kidneys, where waste and toxins are filtered and excreted in the urine. Useful material go into the bloodstream.

High blood pressure causes the kidneys to work harder. In addition, damage to small vessels within the nephrons reduces the volume of filtered blood. After some time, this leads to a reduction in the filtering function of the kidneys.

Thus, the protein is excreted in the urine before being returned to the bloodstream. Waste products that need to be excreted can enter the bloodstream. This process leads to uremia, and then to renal failure, which requires constant dialysis and blood purification.

As mentioned earlier, at the bottom eyeball located a large number blood vessels, which are very sensitive to increased blood pressure. After several years of hypertension, the process of destruction of the retina may begin. Deformation may be due to:

  • accumulation of cholesterol in blood vessels,
  • insufficient blood circulation,
  • local bleeding.

The diagnosis of arterial hypertension, as a rule, is not made after a single pressure measurement, except when it is above 170-180/105-110 mm Hg. Art.

Measurements are taken over a specified period to confirm the diagnosis. It is necessary to take into account the circumstances during which measurements are taken. The pressure gets higher:

  • after smoking or drinking coffee,
  • against a background of stress.

If an adult's blood pressure is more than 140/90 mm Hg. Art., then repeated measurements are usually performed after a year. In people whose blood pressure is from 140/90 to 160/100 mm Hg. st, a repeat measurement is carried out after a short time. With high diastolic pressure from 110 to 115 mm Hg. Art. urgent treatment is needed.

In some cases, older people develop a rare type of arterial hypertension called isolated systolic hypertension. Systolic pressure indicators exceed 140 mmHg. Diastolic pressure remains at 90 mm Hg. st or lower. This type The disease is considered dangerous because it provokes strokes and heart failure.

In addition to measuring blood pressure, the doctor should check changes in other organs, especially if pressure readings are constantly at high levels.

The eyes are the only organ of the human body in which blood vessels are clearly visible. Using a bright stream of light, the doctor examines the fundus of the eye with a special device - an ophthalmoscope, which allows you to clearly see the narrowing or dilation of blood vessels.

The doctor can see small cracks, hemorrhages, which are consequences of high blood pressure.

The inspection also includes:

  1. listening to heart rhythm sounds with a stethoscope,
  2. measuring heart size by palpation,
  3. The use of an electrocardiogram helps to study the electrical activity of the heart and also estimate its size.

Besides instrumental studies, the doctor prescribes:

  • examination of urine to exclude kidney infections,
  • blood sugar test,
  • blood test for cholesterol.

The fundus, kidneys and blood vessels are the target organs for pathological blood pressure.

Treatment of arterial hypertension

Around the 1950s of the last century, the pharmaceutical industry recorded an increase in the production and synthesis of new groups of antihypertensive drugs.

Previously, treatment for hypertension included:

  1. salt-free diet
  2. surgical interventions,
  3. phenobarbital as a stress reducer.

There is information that at the beginning of the 1940s, every third or fourth bed in the hospital was occupied by a patient with hypertension or its consequences. IN last years A large number of studies have been conducted, which has led to an increase in the effectiveness of therapy for arterial hypertension. The number of deaths has now dropped significantly and serious consequences diseases.

The best in Russia and European countries medical workers worked on research and confirmed that only drug treatment high blood pressure makes it possible to reduce the risk of:

  1. cardiovascular diseases,
  2. strokes,
  3. fatalities.

However, some people are convinced that arterial hypertension cannot be treated with medications, since it reduces the quality of life and leads to the development of various side effects, including depression.

Almost all drugs have side effects, but studies show that when using medications that lower blood pressure, side effects are reported only in 5-10% of patients.

The existing variety of groups of drugs that lower blood pressure allows the doctor and the patient to choose the most optimal treatment. The doctor is obliged to warn the patient about possible side effects drugs used.

Diuretics or treat blood pressure by increasing the kidneys' excretion of water and salt. This creates relaxation of the blood vessels.

Diuretics are considered the oldest group of antihypertensive drugs. These drugs began to be used in the 50s of the 20th century. They are also now widely used, often in combination with other drugs.

Beta blockers were introduced in the 1960s. The drugs were used to treat angina pectoris. Beta blockers reduce blood pressure by affecting the nervous system. They block the effect of beta nerve receptors on the cardiovascular system.

As a result, the heart rate becomes less active and the volume of blood pumped out by the heart per minute decreases, lowering blood pressure. Beta blockers also reduce the effect of certain hormones, so blood pressure also normalizes.

Because beta blockers can cause peripheral blood vessel narrowing, they are not recommended for people with circulatory problems of the upper or lower extremities.

Calcium channel blockers are part of a group of drugs that block the flow of calcium inside muscle cells. Thus, the frequency of their contractions is reduced. All muscle cells need calcium, if it is absent, then the muscles cannot contract normally, the vessels relax and blood flow improves, which lowers blood pressure.

Angiotensin II receptor blockers are the most modern group drugs. Angiotensin II is an effective vasoconstrictor; its synthesis is carried out under the influence of renin, a kidney enzyme. Angiotensin II has the main property of stimulating the production of aldosterone, which delays the excretion of water and salt by the kidneys.

Drugs that block angiotensin II receptors. Treatment of hypertension cannot be done without these drugs, because they:

  1. prevent further narrowing of blood vessels,
  2. facilitate the removal of excess water and salt from the body.

Treatment with ACE inhibitors is widely used for arterial hypertension. With the help of drugs, the ratio of compounds changes in favor of biologically vasodilating active substances. Medicines in this group are usually prescribed to people with hypertension due to kidney disease or heart failure.

What is arterial hypertension? This is a disease characterized by blood pressure readings above 140 mm Hg. Art. in this case, the patient experiences headaches, dizziness and a feeling of nausea. Eliminate all the symptoms that have arisen can only be specially selected therapy.

Causes

Until today exact reasons The cause of essential hypertension is unknown. There are the following risk factors:

  • heredity;
  • Not proper nutrition;
  • bad habits;
  • violation of fat metabolism;
  • kidney disease;
  • diabetes;
  • stress;
  • inactive lifestyle.

Classification of the disease

During the diagnostic examination it is very difficult to determine the location of the concentration of pathological factors, causing an increase pressure. The pathogenesis also differs depending on the types of the disease. Available next classification arterial hypertension:

  1. Pulmonary essential arterial hypertension is considered one of the types of arterial hypertension that is rare, but poses a great danger to human life. It is very difficult to identify this disease by symptoms, and even more difficult to treat. Pulmonary arterial hypertension is formed due to increased vascular resistance in the lungs and, as a result, insufficient blood flow.
  2. Malignant. Symptoms of such arterial hypertension are presented in the form of elevated blood pressure up to 220/130. there is a radical change in the fundus and disc edema optic nerve. If the diagnosis was made on time, then it is possible to cure this type of arterial hypertension.
  3. Renovascular arterial hypertension. The reasons for the formation of this type of disease are the presence of pathologies such as vasculitis, vascular atherosclerosis, malignant formations in the kidneys. The pathogenesis of the disease comes down to the formation of characteristic pressure, which can be represented in normal systolic and elevated diastolic blood pressure.
  4. Labile arterial hypertension. This type of disease is characterized by periodic normalization of pressure. Patients suffering from this form of arterial hypertension are not called sick, since this condition is not a pathology. In some cases, over a period of time, blood pressure returns to normal.

Symptomatic arterial hypertension and its types

Secondary arterial hypertension is a pathological process that is associated with diseases of organs involved in the normalization of blood pressure. It has the following classification:

  1. Hemodynamic – associated with disturbances of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, coarctation of the aorta, and aortic valve insufficiency.
  2. Neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, and atherosclerosis.
  3. Endocrinopathic. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, and diffuse toxic goiter.
  4. Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs due to the following reasons: inflammation of the kidneys, their compression, kidney stones. Nephrogenic arterial hypertension is accompanied by sudden appearance, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renorenal and parenchymal.
  5. Medicinal. This form of symptomatic arterial hypertension is associated with taking drugs that increase blood pressure.

Symptoms

Before complications of arterial hypertension arise, it occurs without specific manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension boils down to the formation of headaches in the back of the head and forehead, dizziness and uncharacteristic sound in the ears.

Target organ damage

These types of symptoms of arterial hypertension occur first due to hypersensitivity these organs to increase blood pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. Subsequently, the patient experiences weakness, flashing black dots before the eyes, and difficulty speaking. Such symptoms bother a person late stage illness. In addition, complications such as cerebral infarction and hemorrhage may develop.

Heart damage

In this case, the pathogenesis of the disease is reduced to an increase in the LV due to a compensatory reaction aimed at normalizing wall tension. As a result, afterload increases and heart failure occurs. When the heart is damaged, there are not the most favorable forecasts, because such changes in its work are the causes of heart failure, sudden fatal outcome and the development of ventricular rhythm dysfunction. Characteristic symptoms serve:

  • pulmonary edema;
  • difficulty breathing at the time of execution physical activity;
  • cardiac asthma.

In some cases, arterial hypertension in children and adults causes pain in the heart area of a certain nature. They can visit a person in a state of rest or emotional stress without performing physical activity. The main manifestation of these chest pains is the inability to eliminate them with nitroglycerin.

Pathogenesis of this pathological process in some patients it comes down to shortness of breath early stage illness after exercise light loads or at rest. All this points to characteristic changes heart muscle and the formation of heart failure. With such a disease, people have swelling of the lower extremities, the cause of which is the retention of sodium and water ions in the body.

If the damage has affected the kidneys, then when taking a urine test, protein is detected in it, and microhematuria and cylindruria are also observed. Very rarely, the pathogenesis of the disease involves the occurrence of renal failure.

Eye damage

Not so often, this arterial hypertension in children and adults affects vision, resulting in decreased light sensitivity and blindness. If there is visual impairment due to high blood pressure, then patients experience black spots in front of the eyes, fog or a veil. The reasons for such changes are impaired blood circulation in the retina. Complications can manifest themselves in the form of diplopia, blurred vision or complete loss of vision.

Headache

This symptom is considered the most common with arterial hypertension. She disturbs the patient at any time of the day or night. It can be bursting in nature and concentrate in the back of the head, and then spread throughout the entire head area. Increased headaches with arterial hypertension occur when coughing or tilting the head. This may be accompanied by swelling of the eyelids and face. When performing a massage in this case, patients suffering from arterial hypertension experience an improvement in the outflow of blood in the veins, and this leads to a decrease pain syndrome until its complete disappearance.

There are cases when headaches against the background of the presented disease are the result of tense soft muscles of the head itself or tendons. The formation of such a pain syndrome occurs after psycho-emotional or physical stress. As a rule, such pain is of a squeezing or tightening nature. A patient suffering from arterial hypertension experiences a feeling of nausea and dizziness. In the presence of prolonged, incessant pain, patients experience irritability and increased sensitivity to sharp sounds, they become hot-tempered.

Stages of the disease

For correct setting The stages of this pathological process must be classified. It depends on the damage to target organs. There are three stages of the disease.

Light

This stage is characterized slight increase Blood pressure 180/100 mm Hg. Art. The pressure level is unstable. During rest in a patient suffering from arterial hypertension, blood pressure levels return to normal. Due to the fixation of the disease, the pressure inevitably increases. Very often people do not complain about the development of any disorders regarding their health. But for mild stage have their own symptoms:

  • headache;
  • noise in ears;
  • poor sleep;
  • decreased mental capacity;
  • dizziness;
  • blood from the nose.

As a rule, there are no manifestations of left ventricular hypertrophy, the ECG has no deviations from the norm, renal function is without pathological changes the fundus is not changed.

Medium

This stage is characterized by the presence of a higher and stable level of blood pressure. It can reach 180–105 mmHg. Art. patients often experience headaches, dizziness, painful sensations in the region of the heart, having angina pectoris in nature.

This stage is characterized by typical hypertensive crises. The pathogenesis of the disease suggests following signs target organ damage:

  • left hypertrophy;
  • weakening of the first sound at the apex of the heart;
  • accent of the II tone on the aorta;
  • in some patients - on ECG symptoms subendocardial ischemia.

Relative to the central nervous system are happening various manifestations vascular insufficiency, cerebral strokes, transient cerebral ischemia. For the fundus, in addition to the reduction of arterioles, the veins are compressed, their enlargement occurs, and hemorrhages and exudates occur. Kidney blood flow and glomerular filtration rate are reduced for this stage. But these manifestations cannot be detected by urine analysis.

Heavy

This stage of the disease is characterized by frequent vascular accidents. They arise due to a significant and stable increase in blood pressure, as well as the progression of arteriosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230–120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In the severe stage, the disease affects the following organs:

  • heart – angina pectoris, circulatory failure, myocardial infarction, arrhythmias are formed;
  • brain - ischemic and hemorrhagic infarctions and encephalopathy are formed;
  • ocular fundus;
  • kidneys - low blood flow and glomerular filtration.

Risk factors

Currently, the severity of the described illness directly depends on the facts of risk. The risk is the formation of cardiovascular complications against the background of high blood pressure. Taking into account the presented complications, the prognosis of the consequences of arterial hypertension is diagnosed. The following risk factors are identified that worsen the course of the disease and its prognosis:

  • age - in men after 50 years, in women after 60 years;
  • smoking;
  • high cholesterol;
  • hereditary factor;
  • obesity;
  • physical inactivity;
  • diabetes.

The presented risk factors can be eliminated (correctable) and may not be correctable. The first type of risk factors is characterized by the presence of diabetes mellitus, high cholesterol levels, smoking, and physical inactivity. Non-adjustable risk factors include race, family history, and age.

Taking into account the degree of arterial hypertension and the contributing factors of the disease, a prognosis is observed with the formation of complications such as heart attack or stroke over the next 10 years.

At mild degree arterial hypertension and the absence of risk factors, the formation of complications of cardio-vascular system reduced to a minimum for the next 10 years. With non-drug therapy for one year and a review of your lifestyle, it is possible to eliminate this degree of the pathological process. If the pressure readings are greater than 140/90 mm Hg. Art., then drug treatment is prescribed.

The average degree of risk is accompanied by the formation of complications due to arterial hypertension over 10 years in a ratio of 20%. Arterial hypertension of the 2nd degree is treated in the same way as the 1st degree, but here they also monitor the dynamics for six months. If there are poor results of blood pressure and its stable preservation, then drug treatment is carried out.

Risk factors high degree are accompanied by the formation of complications within 30%. In this situation, a patient suffering from arterial hypertension is prescribed full diagnostics in combination with non-drug treatment.

At very high risk the patient is prescribed urgent differential diagnosis arterial hypertension and taking medications.

Diagnostic methods

Only after a thorough study can you prescribe effective therapy and eliminate all manifestations of this disease. Diagnosis of arterial hypertension is based on the following types examinations:

  • ECG, analysis of the amount of glucose and general analysis blood;
  • Ultrasound of the kidneys, determination of the level of urea, creatinine in the blood, general urine analysis - are carried out in order to exclude the renal nature of the formation of the disease;
  • Ultrasound of the adrenal glands is advisable to perform if pheochromocytoma is suspected;
  • hormone analysis, ultrasound of the thyroid gland;
  • MRI of the brain;
  • Consultation with a neurologist and ophthalmologist.

Effective therapy

Treatment of arterial hypertension should be carried out under the constant supervision of a physician. It is he who is obliged to deliver accurate diagnosis, execute additional diagnostics, which includes checking:

  • fundus;
  • kidney function;
  • work of the heart.

After this, the specialist can prescribe antihypertensive treatment and identify various types of complications. As a rule, patients in whom arterial hypertension syndrome has been identified for the first time are hospitalized in order to implement all necessary research and choice of treatment.

Non-drug treatment

  1. To give up smoking. It is very important to change your lifestyle; such changes serve as an excellent prevention of diseases of the cardiovascular system.
  2. Elimination extra pounds. A common cause of high blood pressure is excess weight Therefore, diet plays an important role in this matter. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes mellitus and myocardial hypertrophy.
  3. Reduced amount of table salt consumed. According to ongoing research, a reduced amount of table salt consumed to 4.5 g/day helps reduce systolic blood pressure by 4–6 mmHg. Art.
  4. Minor consumption of strong drinks.
  5. Specially designed diet. Your diet should include vegetables, fruits, foods high in magnesium, potassium, potassium, fish, and seafood. In addition, the diet involves limited consumption of animal fats.
  6. Active lifestyle. Brisk walking for 30 minutes 3-4 times a week is very helpful here. When performing isometric exercises, you can provoke a rise in blood pressure.

Drug treatment

Drug therapy should be prescribed taking into account the following recommendations:

  1. Treatment begins with small doses of drugs.
  2. With absence therapeutic effect it is necessary to replace the use of one drug with another. The interval between degrees must be less than 4 weeks, unless necessary rapid decline HELL.
  3. Use of medications long acting to obtain a 24-hour effect with a single dose.
  4. Application of optimal combination of devices.
  5. Therapy should be permanent. It is not allowed to use the drug in courses.
  6. Effective blood pressure control throughout the year helps to gradually reduce the dose and amount of medications.

Preventive actions

Prevention of arterial hypertension includes the following recommendations:

  1. If family members have this disease and you are over 30 years old, then you need to regularly measure your blood pressure.
  2. Give up smoking and alcohol.
  3. A low-fat and low-salt diet should be followed.
  4. Exercise outdoors.
  5. Avoid various stressful situations.
  6. Support normal weight bodies.

With arterial hypertension, a person may well live a normal life. full life, but subject to compliance with all the described recommendations. Blood pressure control in this case is one of the main components successful treatment illness. Therefore, try not to let the disease progress and visit a doctor in a timely manner to avoid various serious complications.

Symptomatic arterial hypertension– a secondary hypertensive condition that develops as a result of pathology of the organs that regulate blood pressure. Symptomatic arterial hypertension is characterized by persistent course and resistance to antihypertensive therapy, development pronounced changes in target organs (heart and kidney failure, hypertensive encephalopathy, etc.). Determining the causes of arterial hypertension requires ultrasound, angiography, CT, MRI (kidneys, adrenal glands, heart, brain), studies biochemical parameters and blood hormones, blood pressure monitoring. Treatment consists of medication or surgery to address the underlying cause.

General information

Unlike independent essential (primary) hypertension, secondary arterial hypertension serves as symptoms of the diseases that cause them. Arterial hypertension syndrome accompanies the course of over 50 diseases. Among total number hypertensive conditions, the proportion of symptomatic arterial hypertension is about 10%. The course of symptomatic arterial hypertension is characterized by signs that allow them to be differentiated from essential hypertension (hypertension):

  • The age of patients is up to 20 years and over 60 years;
  • Sudden development of arterial hypertension with persistently high blood pressure levels;
  • Malignant, rapidly progressing course;
  • Development of sympathoadrenal crises;
  • A history of etiological diseases;
  • Poor response to standard therapy;
  • Increased diastolic pressure in renal arterial hypertension.

Classification

According to the primary etiological link, symptomatic arterial hypertension is divided into:

Neurogenic(caused by diseases and lesions of the central nervous system):

  • central (trauma, brain tumors, meningitis, encephalitis, stroke, etc.)
  • peripheral (polyneuropathies)

Nephrogenic(renal):

  • interstitial and parenchymal (chronic pyelonephritis, glomerulonephritis, amyloidosis, nephrosclerosis, hydronephrosis, systemic lupus erythematosus, polycystic disease)
  • renovascular (atherosclerosis, renal vascular dysplasia, vasculitis, thrombosis, renal artery aneurysms, tumors compressing the renal vessels)
  • mixed (nephroptosis, congenital anomalies of the kidneys and blood vessels)
  • renoprinic (condition after kidney removal)

Endocrine:

  • adrenal (pheochromocytoma, Conn's syndrome, adrenal hyperplasia)
  • thyroid (hypothyroidism, thyrotoxicosis) and parathyroid
  • pituitary (acromegaly, Itsenko-Cushing's disease)
  • menopausal

Hemodynamic(due to defeat great vessels and hearts):

  • aortosclerosis
  • stenosis of the vertebrobasilar and carotid arteries
  • caorctation of the aorta

Dosage forms when taking mineralo- and glucocorticoids, progesterone- and estrogen-containing contraceptives, levothyroxine, salts heavy metals, indomethacin, licorice powder, etc.

Depending on the magnitude and persistence of blood pressure, the severity of left ventricular hypertrophy, and the nature of changes in the fundus, 4 forms of symptomatic arterial hypertension are distinguished: transient, labile, stable and malignant.

Transient arterial hypertension is characterized by an unstable increase in blood pressure, changes in the fundus vessels are absent, and left ventricular hypertrophy is practically undetectable. With labile arterial hypertension, there is a moderate and unstable increase in blood pressure that does not decrease on its own. There is mild hypertrophy of the left ventricle and narrowing of retinal vessels.

Stable arterial hypertension is characterized by persistent and high blood pressure, myocardial hypertrophy and pronounced vascular changes in the fundus (angioretinopathy of I - II degrees). Malignant arterial hypertension is distinguished by sharply increased and stable blood pressure (especially diastolic > 120-130 mm Hg), sudden onset, fast development, the risk of severe vascular complications from the heart, brain, fundus, determining poor prognosis.

Forms

Nephrogenic parenchymal arterial hypertension

Most often, symptomatic arterial hypertension is of nephrogenic (renal) origin and is observed in acute and chronic glomerulonephritis, chronic pyelonephritis, polycystic and hypoplastic kidneys, gouty and diabetic nephropathy, trauma and renal tuberculosis, amyloidosis, SLE, tumors, nephrolithiasis.

The initial stages of these diseases usually occur without arterial hypertension. Hypertension develops with severe damage to the tissue or apparatus of the kidneys. Features of renal arterial hypertension are predominantly the young age of patients, the absence of cerebral and coronary complications, development of chronic renal failure, malignant nature of the course (with chronic pyelonephritis– in 12.2%, chronic glomerulonephritis– in 11.5% of cases).

In the diagnosis of parenchymal renal hypertension, ultrasound of the kidneys and urine examination are used (proteinuria, hematuria, cylindruria, pyuria, hyposthenuria are detected - low specific gravity urine), determination of creatinine and urea in the blood (azotemia is detected). To study the secretory-excretory function of the kidneys, isotope renography and urography are performed; additionally - angiography, ultrasound of renal vessels, MRI and CT of the kidneys, kidney biopsy.

Nephrogenic renovascular (vasorenal) arterial hypertension

Renovascular or vasorenal arterial hypertension develops as a result of unilateral or bilateral disturbances of arterial renal blood flow. In 2/3 of patients, the cause of renovascular arterial hypertension is atherosclerotic damage to the renal arteries. Hypertension develops when the lumen narrows renal artery by 70% or more. Systolic blood pressure is always above 160 mm Hg, diastolic blood pressure is always above 100 mm Hg.

Renovascular hypertension is characterized by sudden onset or sharp deterioration flow, insensitivity to drug therapy, high proportion of malignant course (in 25% of patients).

Diagnostic signs of vasorenal arterial hypertension are: systolic murmurs over the projection of the renal artery, determined by ultrasonography and urography - a decrease in one kidney, a slowdown in the removal of contrast. Ultrasound shows echoscopic signs of asymmetry in the shape and size of the kidneys, exceeding 1.5 cm. Angiography reveals a concentric narrowing of the affected renal artery. Duplex ultrasound scanning of the renal arteries determines a violation of the main renal blood flow.

In the absence of treatment for renovascular arterial hypertension, the 5-year survival rate of patients is about 30%. The most common causes of death in patients: cerebral strokes, myocardial infarction, acute renal failure. In the treatment of vasorenal arterial hypertension, both drug therapy and surgical techniques: angioplasty, stenting, traditional operations.

With significant stenosis long-term use drug therapy is unjustified. Drug therapy gives a short and inconsistent effect. The main treatment is surgical or endovascular. For vasorenal arterial hypertension, an intravascular stent is installed to expand the lumen of the renal artery and prevent its narrowing; balloon dilatation of a narrowed section of a vessel; reconstructive interventions on the renal artery: resection with anastomosis, prosthetics, vascular bypass anastomoses.

Pheochromocytoma

Pheochromocytoma, a hormone-producing tumor that develops from chromaffin cells of the adrenal medulla, accounts for 0.2% to 0.4% of all occurring forms of symptomatic arterial hypertension. Pheochromocytomas secrete catecholamines: norepinephrine, adrenaline, dopamine. Their course is accompanied by arterial hypertension, with periodically developing hypertensive crises. In addition to hypertension, pheochromocytomas cause severe headaches, increased sweating and heartbeat.

Pheochromocytoma is diagnosed when detected high content catecholamines in the urine, by conducting diagnostic pharmacological tests (tests with histamine, tyramine, glucagon, clonidine, etc.). Ultrasound, MRI or CT scan of the adrenal glands allows you to clarify the location of the tumor. By performing a radioisotope scan of the adrenal glands, it is possible to determine the hormonal activity of pheochromocytoma, identify tumors of extra-adrenal localization, and metastases.

Pheochromocytomas are treated exclusively with surgery; before surgery, arterial hypertension is corrected with α- or β-adrenergic blockers.

Primary aldosteronism

Arterial hypertension in Conn's syndrome or primary hyperaldosteronism is caused by an aldosterone-producing adenoma of the adrenal cortex. Aldosterone promotes the redistribution of K and Na ions in cells, fluid retention in the body and the development of hypokalemia and arterial hypertension.

Hypertension is practically not amenable to drug correction; attacks of myasthenia gravis, convulsions, paresthesia, thirst, and nictruria are noted. Hypertensive crises with the development of acute left ventricular failure (cardiac asthma, pulmonary edema), stroke, and hypokalemic cardiac paralysis are possible.

Diagnosis of primary aldosteronism is based on determining plasma levels of aldosterone and electrolytes (potassium, chlorine, sodium). There is a high concentration of aldosterone in the blood and high excretion in the urine, metabolic alkalosis (blood pH - 7.46-7.60), hypokalemia (<3 ммоль/л), гипохлоремия, гипернатриемия. При исследовании крови из надпочечниковых вен обнаруживается 2-3-кратное увеличение уровня альдостерона со стороны поражения. Проведение радиоизотопного исследования и ультразвукового сканирования надпочечников выявляет увеличение пораженного альдостеромой надпочечника или двустороннюю гиперплазию коры надпочечников.

For malignant arterial hypertension caused by aldosteroma, surgical treatment is performed to normalize or significantly reduce blood pressure in 50-70% of patients. Before surgical intervention, a hyposodium diet is prescribed, treatment with an aldosterone antagonist - spironolactone, which relieves hypokalemia and arterial hypertension (25-100 mg every 8 hours).

Itsenko-Cushing's syndrome and disease

Endocrine arterial hypertension develops in 80% of patients with the disease and Cushing's syndrome. Hypertension is caused by hypersecretion of glucocorticoid hormones by the adrenal cortex (hypercortisolism) and is characterized by a stable, crisis-free course, resistance to antihypertensive therapy, and a proportional increase in systolic and diastolic blood pressure. Another characteristic manifestation of the disease is Cushingoid obesity.

With Itsenko-Cushing's syndrome/disease, the level of 11 and 17-OCS, corticotropin, and hydrocortisone increases in the blood. Excretion of 17-KS and 17-OX is increased in urine. For differential diagnosis between corticosteroma and pituitary adenoma, MRI and CT scanning of the adrenal glands, pituitary gland, ultrasound and radioisotope scanning of the adrenal glands, and craniogram are performed. Treatment of hypercortisolism and the arterial hypertension caused by it can be medication, surgery or radiation.

Coarctation of the aorta

Coarctation of the aorta is a congenital malformation of the aorta, manifested by its segmental narrowing, which prevents the blood flow of a large circle. Coarctation of the aorta is a rare form of arterial hypertension.

With secondary arterial hypertension caused by coarctation of the aorta, there is a difference in blood pressure measured in the arms (high) and legs (normal or low), an increase in blood pressure at the age of 1-5 years and its stabilization after 15 years, weakening or absence of pulsation in the femoral arteries , increased cardiac impulse, systolic murmurs over the apex, base of the heart, and on the carotid arteries. The diagnosis of coarctation of the aorta is based on radiography of the lungs and chest organs, aortography, and echocardiography. If the degree of stenosis is severe, surgical treatment is performed.

Dosage forms of arterial hypertension

The development of medicinal forms of arterial hypertension can cause vascular spasm, increased blood viscosity, sodium and water retention, the effect of drugs on the renin-angiotensin system, etc. Intranasal drops and cold remedies containing adrenomimetics and sympathomimetics in their composition (pseudoephedrine, ephedrine , phenylephrine) may cause hypertension.

Taking non-steroidal anti-inflammatory drugs causes the development of arterial hypertension due to fluid retention and suppression of the synthesis of prostaglandins, which have a vasodilating effect. Oral contraceptives containing estrogens have a stimulating effect on the renin-angiotensin system and cause fluid retention. Secondary arterial hypertension develops in 5% of women using oral contraception.

The stimulating effect of tricyclic antidepressants on the sympathetic nervous system can cause the development of arterial hypertension. The use of glucocorticoids increases blood pressure due to increased vascular reactivity to angiotensin II.

To establish the cause and form of secondary arterial hypertension, the cardiologist needs a detailed collection of the patient’s medical history, analysis of the coagulogram, and determination of blood renin.

Neurogenic arterial hypertension

Arterial hypertension of the neurogenic type is caused by lesions of the brain or spinal cord due to encephalitis, tumors, ischemia, traumatic brain injury, etc. In addition to increased blood pressure, they are typically characterized by severe headaches and dizziness, tachycardia, sweating, salivation, vasomotor skin reactions, abdominal pain, nystagmus, convulsive seizures.

In the diagnosis, cerebral angiography, CT and MRI of the brain, EEG are used. Treatment of arterial hypertension of the neurogenic type is aimed at eliminating the pathology of the brain.

Arterial hypertension (hypertension): causes, signs, treatment, what is dangerous?

Have you ever heard of an illness with no onset? This is hypertension. Indeed, people suffering from this disease cannot remember when and how it all started. This is because it develops in a special way. But first things first.

Once again about the main thing

Arterial is the pressure of blood in the arterial vessels of a person. There are:

  • Systolic (upper) - shows the level of blood pressure at the moment the heart contracts.
  • Diastolic (lower) - shows the level of blood pressure at the moment the heart relaxes.

Stage III – complex changes are observed in the “target organs”, the likelihood of damage to the optic nerve, heart and kidney failure increases.

About primary and secondary

According to its genesis (origin), arterial hypertension can be

  1. – Blood pressure increases in the absence of an obvious cause.
  2. – increased blood pressure is associated with a certain disease and is one of the symptoms.

Arterial hypertension of the essential type occurs in 90-95% of cases. The direct cause of primary hypertension has not yet been identified, but there are many factors that significantly increase the risk of its development. They are very familiar to all of us:

  • Physical inactivity (sedentary lifestyle);
  • Obesity (85% of overweight people have essential hypertension);
  • Heredity;
  • Vitamin D deficiency;
  • Sensitivity to salt (sodium);
  • Excessive alcohol consumption;
  • Smoking;
  • Stress.

As for secondary arterial hypertension, the source of the problem in this case can be identified, since hypertension is a consequence of certain pathological conditions and diseases associated with certain organs involved in the regulation of pressure. It is diagnosed in hypertensive patients in 5-10% of cases.

Symptomatic hypertension can develop for renal, cardiovascular, neurogenic, endocrine and drug reasons.

Chronic pyelonephritis, polycystic kidney disease, urolithiasis, cysts, adhesions, tumors can be the culprits of renal arterial hypertension. , aortic valve insufficiency is provoked by cardiovascular hypertension. , inflammatory diseases of the central nervous system, polyneuritis contribute to the development of neurogenic hypertension.

Endocrine ones develop as a result of Conn's syndrome, Itsenko-Cushing's disease, acromegaly, hypothyroidism, hyperthyroidism, hyperparathyroidism. Drug-induced arterial hypertension is associated with the use of nonsteroidal anti-inflammatory drugs, contraceptives, antidepressants, and amphetamines.

Depending on the cause of the development of secondary hypertension, a number of features in blood pressure are observed. For example, in case of kidney diseases, the diastolic value increases to a greater extent, in case of disturbances in the movement of blood through the vessels, the systolic value increases, and in case of damage to the organs of the endocrine system, arterial hypertension becomes systolic-diastolic in nature.

Pulmonary hypertension

High blood pressure is merciless to the human body. The slightest malfunction in his system is fraught with hypertensive complications. For example, at rest in the trunk of the pulmonary artery, the pressure should not exceed 25 mm Hg. Art. If the indicator is higher, we are talking about pulmonary hypertension (also called pulmonary hypertension).

It has four degrees:

  • Stage I PH – from 25 to 50 mm Hg.
  • II degree of PH – from 51 to 75 mm Hg.
  • III degree of PH – from 76 to 110 mm Hg.
  • IV degree of PH – over 110 mm Hg.
  • It can also be primary and secondary.

Stroke is 7 times more common.

This is why it is very important to visit your doctor if you are concerned about:

  1. Frequent;
  2. Dizziness;
  3. Pulsating sensations in the head;
  4. “Floaters” in the eyes and noises in the ears;
  5. Pain in the heart area;
  6. Nausea and weakness;
  7. Swelling of the limbs and puffiness of the face in the morning;
  8. Numbness of the limbs;
  9. Inexplicable feeling of anxiety;
  10. Irritability, stubbornness, throwing from one extreme to another.

By the way, regarding the last point, arterial hypertension really leaves its mark on the human psyche. There is even a special medical term “hypertensive character”, so if a person suddenly becomes difficult to communicate, do not try to change him for the better. The reason lies in the disease that needs to be treated.

It should be remembered that hypertension, which is not given due attention, can make life much shorter.

How to live further and longer?

It is necessary to begin treatment of arterial hypertension with changes in your lifestyle and non-drug therapy. (The exception is secondary hypertension syndrome. In such cases, treatment of the disease of which hypertension is a symptom is also prescribed).

Now it is necessary to note one significant nuance. All aspects of non-drug therapy, which will be discussed below, relate to the secondary prevention of arterial hypertension. It is recommended for patients who have already been diagnosed with hypertension in order to prevent complications. If you have no desire to join the ranks of patients with arterial hypertension, then you simply need to engage in primary prevention, which implies the prevention of this insidious disease and includes all the same approaches to non-drug therapy.

Daily moderate physical activity

Regular exercise has been proven to reduce systolic and diastolic blood pressure by 5-10 mmHg. Art. Try to exercise at least 3 times a week for 30-45 minutes. We are not talking about grueling workouts. You can hike, swim in a pond or pool, ride a bike, and even just garden for fun. Such enjoyable activities support the cardiovascular system, stimulate metabolic processes and help lower cholesterol.

Favorable work and rest regime

Very often, doctors recommend alternating physical activity with periods of relaxation and relaxation. Reading your favorite literature, listening to pleasant music, and taking extra naps during the day can bring a lot of benefits. If the regimen is followed, the functions of the nervous system and vascular reactions are normalized.

Quitting smoking and alcohol

For some reason, the example of a poor horse that dies from a drop of nicotine makes few people die from another puff. But this passion really destroys the body. Nicotine causes the heart to beat faster, which leads to... This significantly complicates the functioning of a vital organ. People who smoke are twice as likely to die from cardiovascular problems. This addiction significantly increases the risk of developing. Even if blood pressure has returned to normal, people who continue to smoke remain at increased risk of coronary heart disease. It is simply necessary to break this habit!

You should reconsider your attitude towards alcohol. There is a “calming” opinion that its use dilates blood vessels. Indeed, this happens for a short time, but then a long period of time sets in. This “game of blood vessels” between expansion and contraction significantly complicates the work of the kidneys. They begin to filter worse and cleanse the blood of harmful metabolic products. Think about it, is it worth risking your health?

Weight normalization

You need to keep an eye on him! Scientists have proven a close relationship between increased blood pressure and overweight. It turns out that when you lose 5 extra pounds, systolic blood pressure decreases by 5.4 mmHg. Art., and diastolic - by 2.4 mm Hg. Art. You should limit the intake of salt, fats and easily digestible carbohydrates. The diet should include more plant-based and low-fat dairy products.

There are two ways to normalize weight:

  1. Reduce the calorie content of food;
  2. Increase energy costs.

Only if non-drug therapy is ineffective, it is supplemented with drug treatment.

Important! Only a doctor, based on the results of preliminary diagnosis, can prescribe one or another drug that will help reduce blood pressure and have a beneficial effect on risk factors. The medical principle of Nolinocere (“do no harm”) is also relevant for those who are trying to engage in amateur pharmacological activities.

Medical treatment of arterial hypertension

Diuretics (diuretics)

  • Hypothiazide;
  • Indapamide;
  • Indapamide retard;
  • Xipamide;
  • Triamterene.

These medications have proven themselves to be highly effective drugs that have a positive effect on the cardiovascular system and are easily tolerated by patients. Most often, they begin with the treatment of hypertension, provided that there are no contraindications in the form of diabetes and gout.

They increase the amount of urine the body excretes, which removes excess water and sodium. Diuretics are often prescribed in combination with other drugs.

Alpha blockers

  • Zhoxazosin;
  • Prazosin;
  • Terazosin.

The drugs have a high degree of tolerability. They have a beneficial effect on the lipid profile of the blood plasma, do not affect blood sugar levels, lower blood pressure without a significant increase in heart rate, but have one very significant side effect. The so-called first dose effect, when dizziness and loss of consciousness are possible when moving from a horizontal to a vertical position. To avoid orthostatic hypotension (this is the name of this condition) at the first dose, you must first cancel the diuretics, take the drug in the minimum dosage and try to do it before bedtime.

Beta blockers

  • Atenolol;
  • Betaxolol;
  • Bisoprolol;
  • Carvedilol;
  • Metoprolol;
  • Nadolol;

All of the drugs listed are highly effective and safe. They block the influence of the nervous system on the heart and reduce the frequency of its contractions. As a result of this, the heart rate slows down, it begins to work more economically, and blood pressure decreases.

Angiotensin-converting enzyme (ACE) inhibitors

  • Captopril;
  • Perindopril;
  • Ramipril;
  • Trandolapril;
  • Fosinopril;
  • Enalapril.

These drugs are highly effective. They are well tolerated by patients. prevent the formation of angiotensin II, a hormone that causes vasoconstriction. Thanks to this, peripheral blood vessels dilate, the heart becomes lighter and blood pressure decreases. When taking these drugs, the risk of developing nephropathy due to diabetes mellitus, morphofunctional changes, and death in people suffering from heart failure is reduced.

Angiotensin-II antagonists

  • Valsartan;
  • Irbesartan;
  • Candesartan;
  • Losartan.

This group of drugs is aimed at blocking the above-mentioned angiotensin II. They are prescribed in cases where treatment with angiotensin-converting enzyme inhibitors is not possible, because the drugs have similar characteristics. They also neutralize the effect of angiotensin II on blood vessels, promoting their dilation and lowering blood pressure. It is worth noting that these drugs are in some cases more effective than ACE inhibitors.

Calcium antagonists

  • Verapamil;
  • Diltiazem;
  • Nifedipine;
  • Norvasc;
  • Plendil.

All drugs in this group, by increasing their diameter, prevent the development of stroke. They are very effective and easily tolerated by patients. They have a fairly wide positive range of properties with a small list of contraindications, which makes it possible to actively use them in the treatment of arterial hypertension in patients of different clinical categories and age groups. In the treatment of hypertension, they are most in demand in combination therapy.

For arterial hypertension, non-drug treatment methods should be strictly followed, antihypertensive drugs should be taken daily and blood pressure should be measured.

“Respites” in therapy are not allowed: as soon as the pressure reaches elevated levels again, the “target organs” will again become vulnerable and the risk of heart attack and stroke will increase. Treatment is not limited to one course. This is a long and gradual process, so you need to be patient and strictly follow the recommendations of experts, then the world will again sparkle with bright colors and be filled with new life-affirming sounds.

Video: hypertension in the program “Live Healthy!”

Video: lectures on arterial hypertension