Hypertension and hypertension - is there a difference between the concepts?

Most people who have problems with high blood pressure do not know the correct name for their condition.
The symptoms of these conditions are identical. An experienced clinician, candidate of med., talks about why hypertension and hypertension occur and whether there are differences between them. Sciences, general practitioner A.Yu. Shishonin. Important!
An unhealthy lifestyle and poor nutrition are the factors that most often provoke the development of heart and vascular diseases.

general information

Hypertension is a pathological condition that affects the functioning of all organs and systems in the body. It is quite problematic to completely get rid of the signs of this disease. The etiology of the disease is mainly associated with impaired fat metabolism, as well as changes associated with the aging of the body.

Most often, hypertension is observed in people over 50. The main factors that provoke the development of pathology include the following:

bad habits (alcohol, drugs, nicotine);
excessive addiction to caffeine;
lack of physical activity;
poor nutrition.

Interesting. The classic features of hypertensive patients include: hyperirritability, short temper, increased emotionality. In residents of large cities and modern megalopolises, hypertension is diagnosed four times more often than in people who live in small cities, towns and villages.

Against the background of hypertension, signs of other diseases are often observed:

thyroid pathology;
encephalopathy;
acute renal failure;
cerebrovascular dysfunction.

Hypertension is often recorded in pregnant women, as well as in those patients who take hormonal contraceptives. In this case, high blood pressure occurs against the background of other pathological changes that are not related to the functioning of the cardiovascular system.

You can get more information about this and many other aspects of health related to blood pressure, osteochondrosis, atherosclerosis, ask your questions to Dr. Shishonin and just chat by joining our community - the Club of Former Hypertensive Patients

Dangerous condition

Arterial hypertension is a leading risk factor for the development of cardiovascular (myocardial infarction, stroke, coronary heart disease, chronic heart failure), cerebrovascular (ischemic or hemorrhagic stroke, transient ischemic attack) and renal (chronic kidney disease) diseases, which make the maximum contribution to population mortality.

How to prevent hypertension? More details

Opinion of a practicing doctor

A.Yu. Shishonin, a general practitioner with many years of experience, often has to answer the question of how hypertension and hypertension differ from each other. So, he notes that these are just different names for the same condition. Also, both of these names are incorrect. In his opinion, these conditions should be called hypertensive syndrome. Why?

The fact is that hypertensive syndrome is a condition that occurs due to the fact that something else is wrong in the body, that is, there are additional problems. A rise in pressure never occurs on its own. There are reasons for everything. In 5% of cases, hypertensive syndrome is observed in patients with tumors in the glands of the endocrine system (adrenal glands, pituitary gland, thyroid gland, etc.).

It should also be noted that these conditions are easily diagnosed in the early stages in any modernly equipped clinic. In the remaining 95% of cases, high blood pressure in people is associated with complicated osteochondrosis. These are the main factors that provoke the development of hypertensive syndrome. You need to understand that a person’s blood pressure cannot rise on its own.

Note.

More than 90% of recorded hypertension occurs with high blood pressure. In other cases, hypertension (in the early stages of pathogenesis) occurs with normal pressure.

How to fight?

To prevent hypertension, it is necessary to promptly identify risk factors (predisposing factors) and act on them. Risk factors include:

overweight, obesity;
excessive sodium intake (>5 g/day);
smoking;
alcohol abuse;
increased levels of glucose and cholesterol in the blood;
physical inactivity.

Lifestyle changes are recommended for all patients with arterial hypertension. Non-drug treatments for hypertension help lower blood pressure, reduce the need for antihypertensive drugs and increase their effectiveness.

You should avoid situations that provoke an increase in blood pressure, always follow the doctor’s recommendations, take medications regularly, keep a diary of self-monitoring of blood pressure levels at home, and discuss with your doctor the principles of first aid in case of a sudden increase in blood pressure.

Causes of hypertension

Excess weight. People who are prone to obesity are several times more likely to suffer from heart disease. Also, excess weight causes increased levels of calcium and sodium in the blood, disruption of normal kidney function and diseases of internal organs. This, in turn, is an additional factor for the development of hypertension.
Arterial sclerosis. Due to the presence of atherosclerotic plaques on the walls of blood vessels, normal blood circulation stops. The heart has to work harder to increase the pressure in the blood vessels.
Stressful situations. During stress, blood pressure increases due to the release of the hormone adrenaline into the blood. By acting on the heart, adrenaline causes it to beat faster, throwing more blood into the vessels.
Bad habits. Smoking, drinking alcohol, fatty and heavy foods increase pressure in blood vessels, form vascular spasms and lead to their damage.
Age. Over the years, a person's heart wears out. The risk of developing hypertension increases with age if you do not pay due attention to your health. It is necessary to undergo preventive examinations and give up bad habits, if any. High blood pressure often develops in people over 35 years of age.
Genetic predisposition. If first-degree relatives (father, mother, siblings, grandparents) suffer from hypertension, the risk of developing the disease increases.
Sedentary lifestyle. At a low level of stress, metabolism slows down, the nervous system and other body systems are weakened, and immunity is reduced. The risk of developing hypertension increases by 50%.

Arterial hypertension (or hypertension)

11/09/20

Arterial (blood) pressure (BP) is the force with which the blood flow presses on the vessels. The value of blood pressure depends on numerous factors: the force with which the heart pumps blood into the vessels; the amount of blood pushed into the vessels; on the elasticity of blood vessels, which determines the resistance to blood flow; regulation of vascular tone by the central and peripheral nervous system; content and concentration of various components. During heart contraction (systole), maximum pressure develops in the arteries—systolic (“upper”). Increased systolic pressure ≥ 140 mm Hg. During relaxation of the heart (diastole), the pressure decreases, which corresponds to diastolic (“lower”) pressure. Increased diastolic pressure ≥ 90 mm Hg Blood pressure is subject to fluctuations even in a healthy person. It decreases at rest, during sleep, rises sharply in the morning, and also increases with excitement, physical activity, and smoking. In a healthy person, these factors lead only to short-term and minor fluctuations in blood pressure, which quickly normalizes. Blood pressure level is 140/90 mm Hg. and above is considered elevated for adults. What is arterial hypertension? Arterial hypertension (or hypertension) is a chronic disease accompanied by a persistent increase in blood pressure above 140/90 mm Hg. This is the most common cardiovascular disease among the adult population. Factors influencing the development of hypertension. 1. Excess body weight: an extra kilogram increases blood pressure by an average of 1–3 mm Hg. The risk of developing arterial hypertension increases 2-6 times in obese individuals. 2. People who lead sedentary lives are 20-50% more likely to develop arterial hypertension than people who exercise. 3. Smoking (a cigarette smoked can cause a rise in blood pressure, sometimes by 10–30 mm Hg). 4. Abuse of salty, fatty foods and alcohol. How to measure blood pressure? When measuring blood pressure, certain rules must be strictly followed when measuring it. To measure blood pressure, a tonometer is used; for home measurements, it is better to use an automatic device. More accurate is the generally accepted method of measuring blood pressure with a cuff placed on the shoulder. It is important that the cuff matches the volume of the arm and is not too narrow, especially if it has to be worn on a full arm. There are special cuffs for children and larger faces. Blood pressure measurements should be taken in a comfortable environment at room temperature after at least 5 minutes of rest. In the cold, spasms and increased blood pressure may occur. Please note that after eating, drinking a cup of coffee or smoking a cigarette, blood pressure can only be measured 30 minutes later. Blood pressure measurement should be carried out while sitting, always with support on the back of a chair and relaxed. The hand on which blood pressure will be measured must be completely relaxed and held motionless until the end of the measurement, conveniently placed on a table located next to the chair. Hanging your hand is not allowed. The cuff is placed on the shoulder so that between it and the surface of the shoulder there is a distance the size of a finger, and the lower edge of the cuff is 2.5 cm above the ulnar fossa. For the first time, it is recommended to measure blood pressure on both arms, then on the arm where it is higher. If there is no blood pressure asymmetry, measurements are recommended to be taken on the non-working arm. It is recommended to measure blood pressure in case of hypertension 2 times a day: in the morning, after waking up and having a morning toilet, and in the evening, at 21.00-22.00, and, in addition, in cases of poor health and suspected rise in blood pressure. It is advisable to record the measurement results in a diary in order to later consult a doctor regarding treatment. Course of arterial hypertension, clinical manifestations. In many patients, arterial hypertension can be virtually asymptomatic for a long time. With a long-term course of arterial hypertension, the body gradually adapts to high blood pressure numbers, and the health of the sick person can remain relatively good. High blood pressure has a pathological effect on blood vessels and the organs they feed: the brain, heart, kidneys. Due to long-term arterial hypertension, all of the above pathological processes can lead to vascular disasters: stroke, coronary heart disease, myocardial infarction, heart and kidney failure. Without measuring blood pressure, it is impossible to determine the disease. The most common complaints of patients: 1. throbbing headaches, often in the occipital region; 2. short-term dizziness; 3. flashing “flies” before the eyes; 4. sleep disturbance (insomnia, frequent waking up); 5. irritability, fatigue, depressed mood; 6. visual impairment; 7. pain in the heart area.

Don't rely only on your own feelings. Regular measurement of blood pressure is necessary not only if you feel unwell, but also if there are no complaints. This is the most reliable way to detect hypertension in a timely manner. Anyone should know that blood pressure levels are above 140/90mmHg. Art. - this is a sign of a disorder in the functioning of the cardiovascular system, so everyone, especially after 30 years, should regularly measure blood pressure. Complications of the disease (hypertensive crisis and transient cerebrovascular accidents). Hypertensive crisis is a variant of exacerbation of hypertension, accompanied by a sharp rise in blood pressure (on average up to 180/100–220/120 mm Hg, depending on individual tolerance). A hypertensive crisis is always a health- and sometimes life-threatening condition with a high probability of complications. Provoking factors for a sharp increase in blood pressure, and sometimes a crisis, can be: 1. neuropsychic or physical overload; 2. weather changes, magnetic storms (which is typical for weather-sensitive patients); 3. heavy smoking; 4. abrupt withdrawal of certain medications that lower blood pressure; 5. consumption of alcoholic beverages; 6. large meals, especially salty ones and at night; 7. consumption of food or drinks containing substances that increase blood pressure (caffeine - large amounts of coffee, tyramine - chocolate, cheese, caviar, etc.).

A hypertensive crisis always requires emergency medical care. Lack of regular treatment or poorly selected treatment for hypertension can contribute to the development of hypertensive crises. For example, with occasional use of short-acting drugs such as nifedipine or clonidine, significant fluctuations in blood pressure may develop. After the effects of these drugs wear off (after 4–6 hours), blood pressure rises again. Taking long-acting antihypertensive drugs (most modern drugs are taken 1-2 times a day, ensuring daily blood pressure control) allows you to avoid these sharp fluctuations in blood pressure. At the slightest suspicion of the development of a hypertensive crisis, with a significant increase in blood pressure or with the development of a picture of a hypertensive crisis, call an ambulance doctor. "Organs are targets." Hypertension is characterized by selective damage to certain organs and systems of the body, which are called “target organs”, i.e. organs that are most vulnerable to this disease. The target organs for hypertension are the heart, kidneys, brain, blood vessels, in particular the fundus vessels. The more pronounced the damage to target organs, the higher the risk of complications: stroke or heart attack. Healthy eating for arterial hypertension. Principles of healthy eating. Dietary recommendations are aimed, first of all, at normalizing excess body weight, and at normal weight, at correcting lipid metabolism disorders. It is most important for arterial hypertension to limit the consumption of table salt, since it is the accumulation of sodium salts in the walls of blood vessels that has a damaging effect and a negative effect on vascular tone. This is facilitated by limiting table salt and increasing the content of potassium salts in the diet. You need to try to reduce the level of cholesterol and other lipids that are deposited in the walls of blood vessels and form “plaques”. To strengthen the walls of blood vessels, vitamins C and rutin, as well as minerals such as calcium and magnesium, are also important. In order to prevent carbohydrate metabolism disorders, it is necessary to strictly control the content of simple sugars (sweet drinks, jam, honey, preserves and just sugar). How to limit table salt? Low sodium chloride content is found in products of plant origin, cottage cheese, fresh or frozen fish and meat products (up to 0.1 g per 100 grams of product). Ready-made gastronomic products contain much more salt. For example, there is 10-15 times more of it in sausage than in natural meat. The recommended daily intake of sodium is 3.5 g. This amount is contained in approximately 5-5.5 g of table salt (1 teaspoon). Among people with increased blood pressure, there are people with increased sensitivity to salt loads; in them, even a small sodium load causes an increase in mean blood pressure by 10 mm Hg. Art. and more. Recommendations for reducing salt consumption: 1. exclude foods containing a lot of salt (canned, salted, smoked); 2. pay attention to the labeling of products that have undergone special processing and the salt content in them; 3. increase consumption of foods low in salt (vegetables, fruits); 4. reduce the amount of salt added during cooking; 5. Before automatically adding salt to food, you should first taste it, and it is better not to add salt at all. How to enrich your diet with potassium and magnesium? Patients with hypertension should be recommended products containing potassium salts. It is important to consider the ratio of sodium and potassium salts, which should be 1:1. A significant amount of potassium (> 0.5 g per 100 g of product) is contained in apricots, beans, seaweed, prunes, raisins, peas, and potatoes (baked in their jackets). Beef, pork, cod, hake, mackerel, squid, oatmeal, green peas, tomatoes, beets, radishes, green onions, currants, grapes, apricots, peaches contain a large amount of potassium (up to 0.4 g per 100 g of product). . A moderate amount of potassium (up to 0.25 g per 100 g of product) contains chicken meat, pike perch, millet, buckwheat, carrots, zucchini, 2nd grade bread, pumpkin, strawberries, pears, plums, and oranges. It has been established that potassium contained in food reduces the adverse effect of sodium chloride on the vascular wall and reduces vascular hyperreactivity. It is very important to consume foods containing magnesium, which has a beneficial effect on the nervous system and vascular tone. Products rich in magnesium are bran, beans, oatmeal, prunes, seaweed, and millet. What additional recommendations should be made for hypercholesterolemia? 1. Do not consume more than 2 egg yolks per week, including yolks used for cooking. 2. Avoid consumption of all types of sausages, fatty hams, butter and ghee, fatty milks and dairy products. 3. When cooking, replace frying with animal fats by stewing, boiling, steaming, or in the oven; Trim visible fat from meat and remove skin from poultry before cooking. 4. Give preference to fish dishes and seafood. 5. Use low-fat dairy products. 6. Eat more vegetables and fruits. Abuse of alcoholic beverages leads to sharp increases in blood pressure and is life-threatening for patients. The most rational thing for life prognosis, of course, should be considered abstinence from the abuse of alcoholic beverages. You should not consume more than 30.0 g of alcohol (calculated as pure alcohol) per day for men and 15.0 g for women. Physical activity and health Physical activity is “the movement of the body using muscle force, accompanied by the expenditure of energy. A sedentary lifestyle has become a common feature of modern life. At the same time, low physical activity along with smoking, excess body weight, and high cholesterol levels in the blood contribute to increased blood pressure. The goal of increasing physical activity is to expand the body's adaptive capabilities to improve health through achieving a sufficient level of physical fitness, increasing the body's endurance, as well as flexibility, coordination and muscle strength. Physical fitness of a person is most often considered as fitness of the cardiovascular and respiratory systems. The effect of regular aerobic physical activity on health Aerobic exercise increases the absorption of oxygen and the supply of oxygen to human tissues and organs. The more the oxygen delivery system is trained: respiratory muscles, depth of breathing, permeability of the alveoli of the lungs, stroke volume of the heart, blood supply to tissues, the better the organs and tissues are supplied with oxygen. Regular aerobic physical activity is accompanied, first of all, by a training effect on the cardiovascular and respiratory systems. Aerobic physical activity helps reduce body weight, thereby reducing the risk of obesity. Physically active people feel good, are in good mood, they are more resistant to stress and depression, and have healthier sleep. All negative aspects can be avoided if you visit your doctor before increasing physical activity. How to increase daily physical activity? — if possible, refuse public ground transport and partially the elevator, and walk; - do morning hygienic gymnastics and gymnasts in training mode; - start regular exercise in some type of health-improving physical education (walking, swimming, cycling, skiing, slow running, etc.); You need to start carefully, step by step and gradually. For example, perform a complex daily, which, although it does not have a training effect, but meets hygienic goals - 15 minutes of morning exercises. Further, increasing your daily physical activity, you can replace taking the elevator with walking up the stairs, first until shortness of breath appears; further – gradually increasing the load. Replace a trip on a stuffy bus with walking. Goal of treatment and control of hypertension The main goal of treating a patient with hypertension is to reduce the overall risk of cardiovascular complications as much as possible. This involves addressing all identified reversible risk factors, such as smoking, high cholesterol and, most importantly, appropriate treatment of concomitant diseases (diabetes mellitus), as well as correction of high blood pressure. The target blood pressure level is the blood pressure value that should be achieved during treatment in middle-aged patients. The target blood pressure level is <140/90 mmHg. Achieving target blood pressure should be gradual and well tolerated by the patient. If the condition worsens due to drug lowering of blood pressure (this often happens in patients with long-term hypertension, adapted to high blood pressure), the dose of antihypertensive drugs should be increased very slowly. The higher the absolute risk, the more important it is to achieve the target blood pressure level. With regard to other associated risk factors, it is also recommended to achieve their effective control. Basic principles of treatment of hypertension: - strict adherence to the doctor’s recommendations: continuous, regular use of antihypertensive drugs; — elimination of risk factors that provoke increased blood pressure and complicate treatment; -the ability to independently administer medications during a hypertensive crisis as part of pre-medical care; - following precautions when taking antihypertensive medications, for example limiting alcoholic beverages; - a combination of non-drug and drug treatment methods - helps reduce the side effects of drugs; - medicinal effects on other risk factors - taking drugs that normalize cholesterol levels, affect blood clotting, sedatives, etc. The rate of reduction in blood pressure to the recommended normal values is determined by the doctor, taking into account the characteristics of the course and duration of the disease, the presence of target organ damage, and concomitant diseases . What is non-drug treatment? Non-drug treatment methods should be recommended to all patients with hypertension, regardless of the degree of hypertension and the use of medications. 1. Stop smoking. One of the most important factors from the point of view of preventing diseases of the cardiovascular system. 2. Reducing excess body weight. A decrease in excess body weight is accompanied by a decrease in blood pressure, and also has a beneficial effect on some risk factors (diabetes mellitus, hyperlipidemia). 3.Reducing the consumption of table salt. Reducing the consumption of table salt from 10 to 5 g/day leads to a decrease in systolic blood pressure by 4-6 mm Hg. The most pronounced effect is observed in overweight patients and the elderly. 4. Reduce alcohol consumption. The safe dose of alcohol in terms of pure ethanol is no more than 30 g for men (corresponding to 60 ml of vodka, 240 ml of dry wine, 600 ml of beer) and 15 g for women. 5. Comprehensive diet correction. You should increase the amount of vegetables and fruits, foods rich in potassium, magnesium and calcium, fish and seafood, and limit the consumption of animal fats. 6. Increase physical activity. Fast walking and swimming for 30-45 minutes 3-4 times a week are recommended. What are the principles of drug therapy and how to choose an antihypertensive drug? Treatment should be carried out continuously, and not in courses. The patient must constantly take medications and be under the supervision of a doctor. This will reduce the risk of cardiovascular complications. The doctor must choose the medicine, and the patient’s task is to become his ally and strictly follow the doctor’s recommendations.

The highest incidence of acute cardiovascular complications (stroke, myocardial infarction, sudden death) is observed in the morning, when there is a sharp rise in blood pressure, which is considered as a trigger for the development of such complications. At this time, blood clotting and arterial tone, including coronary arteries, increase. Therefore, one of the principles of antihypertensive therapy should be to target the morning rise in blood pressure to prevent complications in the early morning hours.

It is necessary to abandon the false idea that you need treatment only when you have a “headache.” Proper treatment of hypertension and elimination of associated risk factors leading to complications reduce the risk of complications.

Signs of arterial hypertension

Often, hypertension has no symptoms at all other than persistent high blood pressure. At the same time, not every person constantly monitors their blood pressure levels, so arterial hypertension is often detected very late.

Contact your cardiologist immediately if you regularly notice signs of hypertension such as:

headaches in the occipital region;
dizziness;
“flies”, a veil before the eyes;
noise in ears;
rapid and increased heartbeat;
unpleasant tightness or pain in the chest;
swelling of the arms and legs, puffiness of the face.

Hypertensive crisis is an emergency condition caused by an excessively high level of blood pressure (for example, up to 200/110 mm Hg and above), it is characterized by: headache, tremor, increased heart rate, chills, nausea, vomiting, sudden fear of death, anxiety , facial redness, swelling, sweating, vision distortion.

1 Ophthalmoscopy in the diagnosis of hypertension

2 Ophthalmoscopy for hypertension

3 Taking tests to diagnose hypertension