Hypertension is a serious disease that leads to serious complications of the cardiovascular system. Since it often affects the working population, various classifications have been developed, including special scales for assessing cardiovascular risk. In this article we will tell you what hypertension is, stage 2, risk 3.
Classification
Hypertension has several classifications.
By degree:
- 1st degree - from 140 to 159 mm Hg. st SAD; 90-99 mm Hg. DBP;
- 2nd degree - from 160 to 179 mmHg. GARDEN; 100-109 mm Hg. DBP;
- Grade 3 - above 180 mm Hg. GARDEN; > 110 mmHg DBP.
To assess cardiovascular complications, abbreviated CVC, the SCORE scale has been developed:
- Low risk <1%.
- Moderate risk from 2 to 5%.
- High risk of 5 to 10%.
- Very high risk of more than 10%.
In a clinical situation, the doctor also assesses the stage of the disease:
- Stage 1 indicates that there is no target organ damage (TOD).
- Stage 2 - there is damage to one or two OMs.
- Stage 3 indicates that POM > 2 or associated clinical conditions are present, such as heart attack, stroke, transient ischemic attack.
Stages of hypertension
Depending on the damage to the internal organs with the greatest blood circulation (the so-called target organs or shock organs, which more than others need constant and uninterrupted nutrition), three stages of the disease are distinguished:
- Stage 1 – the patient’s health is normal, high blood pressure is recorded, but no damage to internal organs and systems was detected, as well as their functional insufficiency;
- Stage 2 - pathological changes are observed in the stroma and parenchyma of internal organs, the process of degeneration of shock organs - kidneys, liver, heart and brain - begins. The macroscopic specimen shows hemorrhages in the organs, their functional efficiency decreases. The second stage is characterized by non-critical damage to one or more target organs;
- Stage 3 – severe complications from shock organs are observed, their parenchyma suffers, foci of necrosis appear, which are replaced by connective tissue. Signs of dysfunction from different systems - brain, heart, visual analyzer. The patient’s health is deteriorating, and the risk of complicated hypertensive crises is high. The patient at this stage is required to regularly take medications to maintain normal functioning.
Hypertension of the second degree can be at any stage.
Symptoms
Arterial hypertension has no specific symptoms; most often patients complain of:
- headache;
- dizziness;
- nausea;
- weakness;
- drowsiness;
- increased heart rate;
- extraneous noise in the ears;
- reduced performance.
However, most often the increase in pressure does not cause any symptoms and the patient finds out about arterial hypertension by chance. For example, during medical examinations or during medical examinations. In stages 2 and 3 of hypertension, the symptoms of the affected organs come to the fore.
| Target organs | Symptoms |
| Heart |
|
| Vessels |
|
| Kidneys |
|
| Retinal vessels |
|
| Brain |
|
Consequences and disability
The consequences of hypertension can be quite serious if not treated promptly. Organ damage is more common in grade 3, but can also occur in grade 2 during hypertensive crises, especially complicated ones.
If left untreated, hypertension can have dangerous consequences
It is possible to develop coronary heart disease, which sooner or later will lead to myocardial infarction, the development of acute or chronic heart failure, acute cerebrovascular accident (stroke), the development of renal, hepatic, respiratory failure, the appearance of an aortic aneurysm or other large artery, or its rupture.
In case of hypertension of the 2nd degree with a high risk, you can get a disability; this is decided by a special commission based on the study of the documents provided by the attending physician.
Hypertensive crisis
Hypertensive crisis is an unpredictable complication of hypertension. It manifests itself as a rapid increase in blood pressure to high levels, often leading to cardiovascular disasters. Its symptoms:
- pain in the occipital region of the head
- numbness of fingers;
- panic and fear of death;
- pain in the heart area.
And also read on our website: What is stage 3 hypertension - symptoms, risks, treatment
A hypertensive crisis must always be stopped. Patients suffering from hypertension for a long time should be able to cope with it independently.
To do this, you should always have an emergency medicine in your home medicine cabinet, for example:
- Captopril;
- Nifedipine;
- Moxonidine;
- Furosemide.
If a hypertensive crisis is detected for the first time, call an ambulance. Call your doctor immediately if you experience any of the following complications:
- transient ischemic attack;
- stroke;
- acute coronary syndrome;
- preeclampsia and eclampsia in pregnant women.
A hypertensive crisis can lead to cardiovascular disaster. If you can’t stop it on your own, consult a doctor!
Pathology danger levels
There are several levels of disease risk. They determine how high the likelihood of complications occurring is, as well as how far the changes in important organs have progressed, and thus help to develop adequate treatment tactics.
Risk 1 means the chance of complications is low, less than 15%. Changes in the shock organs are minimal or not observed at all. There are no chronic diseases and other factors that can negatively affect the course of the disease and complicate its treatment.
Cardiac symptoms include shortness of breath, palpitations, arrhythmias, weakness and anxiety, a feeling of constriction in the chest, chest pain, and occasionally a nonproductive cough.
The risk of stage 2 hypertension is associated with the presence of at least three risk factors, such as smoking, obesity, a sedentary lifestyle, and diabetes mellitus. Internal organs suffer. The changes also affect the blood system - by performing an analysis, it is possible to determine markers of damage to certain organs in the blood. There are clear symptoms characteristic of arterial hypertension.
Risk of stage 3 hypertension - this condition is widespread in older people. This occurs due to loss of elasticity in the walls of blood vessels. The course of the disease is complicated by other chronic pathologies, for example, coronary heart disease, which combines its negative effects with dilatation or compensatory hypertrophy of the heart parts. Impaired blood flow affects all body functions.
Risk 4, the most severe, is associated with experienced exacerbations of diseases or long-term chronic pathologies, usually reflected in the patient’s medical history. This degree of risk is typical for patients with vascular atherosclerosis at the stage of plaque and lumen obstruction, after myocardial infarction, stroke or transient ischemic attack. Risk 4 requires regular examination by a doctor and medication support.
Diagnostics
Diagnosis of arterial hypertension includes several stages:
- Collection of complaints and medical history.
- Repeated blood pressure measurements at least 2 times during different visits to the doctor.
- Physical examination.
- Laboratory and instrumental examination.
At the first stage, the doctor will find out what symptoms are bothering you and how long ago they appeared. Find out whether you smoke, whether you drink alcohol and in what doses, and whether your relatives have cardiovascular diseases.
Keep a blood pressure diary for 10 days. To do this, it is necessary to measure blood pressure at least 3 times a day. Show your doctor your notes at your next appointment. He will analyze the results obtained and, based on this, decide on the tactics for further examination and treatment.
Physical examination includes auscultation of the heart, determination of its boundaries, and heart rate. The doctor will definitely check your pulse and its tension. Measure your waist circumference, weigh you, and determine your body mass index.
Laboratory diagnostics:
- general blood and urine analysis;
- level of proteinuria and microscopy of urinary sediment;
- biochemical blood test - sugar, ALT, AST, creatinine, K, Na ions, total cholesterol and lipid profile.
Instrumental diagnostics:
- ECG;
- ECG with stress;
- EchoCG;
- Ultrasound of the brachiocephalic arteries;
- Ultrasound of the kidneys;
- chest x-ray;
- Holter monitoring ECG;
- daily blood pressure monitoring;
- consultation with an ophthalmologist, endocrinologist.
Additional examinations that are not included in the standard may be required, for example, a hormonal mirror. In rare cases, hospitalization in a hospital may be required. This is necessary for a more accurate diagnosis. As a result of examinations, the doctor makes a diagnosis and prescribes treatment.
And also read on our website: What to do and what to take for high blood pressure during pregnancy, as well as causes, signs and risk factors
Treatment of hypertension
Stage 1 hypertension is the most favorable for treatment, since the underdeveloped disease has not yet had a strong impact on the patient’s health. Following basic rules of a healthy diet and lifestyle can be effective in preventing the first symptoms.
The treatment of stage 1 hypertension includes two treatment methods:
- traditional, drug treatment;
- treatment with traditional medicine.
Can hypertension be cured? Treatment of stage 2 hypertension not only helps to improve the patient’s quality of life, but also prevents the likelihood of a hypertensive crisis, stroke or myocardial infarction.
The use of a medicinal method for treating stage 2 hypertension includes taking medications that will help fight the primary causes of hypertension. To do this, experts recommend taking neurostimulants or psychotropic drugs to reduce stress and blood pressure; sedatives to normalize tissue metabolism. These include antidepressants and tranquilizers. They often resort to the use of sedatives (valerian), drugs containing bromine, sleeping pills, and drugs containing magnesium.
Another group for drug treatment of stage 1 hypertension is diuretics. They help reduce retained fluid in the body and remove salts from it.
Since the main problem associated with stage 1 hypertension is high blood pressure, it is often necessary to use a group of drugs designed to effectively reduce levels. They belong to the group of vasodilator drugs and have a peripheral effect, preventing the progression of the disease caused by portal hypertension.
If there is a lack of effective use of the above medications, doctors resort to the use of antihypertensive drugs. They are prescribed to stabilize blood pressure and prevent the progression of diseases of the cardiovascular system. These include:
- beta blockers;
- thiazide diuretics;
- calcium channel blockers;
- ACE inhibitors.
The use of thiazide diuretics reduces the risk of developing cardiovascular diseases. Doctors often prescribe thiazide diuretics such as the medications Torasemide, Furosemide, Amiloride, Chlorthalidone, Indapamide, and Hydrochlorothiazide.
The use of beta blockers reduces blood pressure by reducing heart rate and blood output. Usually prescribed in the presence of ischemic disease. These drugs can normalize blood pressure in case of cardiac arrhythmia, heart failure, tachycardia, and angina. These include:
- "Labetalol";
- "Acebutolol";
- "Sotalol";
- "Pondolol";
- "Bisoprolol";
- "Nebivolol".
The functions of ACE inhibitors include a decrease in angiotensin-converting enzymes. This treatment is prescribed when the patient has suffered a myocardial infarction, heart failure, body problems that accompany diabetes, or vascular pathology that causes portal hypertension. These drugs are especially recommended if the patient has stage 3 hypertension.
Before taking medications belonging to any of these groups, be sure to consult a specialist to prescribe the correct dosage. Doctors advise using complex therapy with constant monitoring of blood pressure.
Diet is one of the basic principles of treating stage 1 hypertension, since the treatment regimen requires, at a minimum, to reduce the level of salt in the blood.
Based on this, nutritionists recommend completely avoiding eating salty, fatty and fried foods, as well as foods containing light carbohydrates.
Treatment does not imply a reduction in the patient’s active lifestyle. Light physical activity, used in physical therapy, promotes better absorption of medications by the body. It is worth sticking to a proper sleep schedule, avoiding stressful situations and giving up bad habits.
Traditional methods of treatment, which our ancestors resorted to, are herbal remedies with a sedative effect that help fight high blood pressure. A large number of infusions with mint, hawthorn, yarrow, with the addition of green tea, rose hips and lemon are used, which are excellent remedies for hypertension.
Treatment
Five groups of drugs are used in the treatment of hypertension:
ACE inhibitors - Captoril, Lisinopril, Perindopril.- Angiotensin receptor antagonists - Valsartan, Irbesartan, Telmisartan.
- Diuretics - Indapamide, Veroshpiron, Hypochlorothiazide.
- Beta blockers - Bisoprolol, Nebivolol, Metoprolol.
- Slow calcium channel inhibitors - Diltiazem, Verapamil, Amlodipine.
These drugs are used as basic therapy for hypertension. They can be used both in monotherapy and in combination regimens. However, ACE inhibitors and antiotensin receptor antagonists, as well as beta blockers and slow calcium channel inhibitors cannot be combined!
Only a doctor, based on research results, prescribes this or that drug.
Traditional methods
Traditional medicine recipes are still used today. Before using them, consult your doctor to help you evaluate the benefits and risks.
Traditional recipes only complement the main treatment, without replacing it!
Red rowan
Red rowan has long been used as a blood pressure reducer. Eat 100-150 g of rowan berries daily for 2-3 weeks, then take a break for 1-2 months. If necessary, repeat the course of treatment.
Rosehip infusion
Take 150-200 g of dry rose hips, pour 450-500 ml of boiling water. Let it brew for 1-1.5 hours. Strain, consume 150-200 ml 3 times a day after meals for 1-2 months. A break of 3-4 months, after which the course is repeated.
Rosehip not only reduces blood pressure, but also strengthens the walls of small-caliber vessels, and also saturates the body with vitamin C, preventing capillary fragility.
Chamomile tea
Pour 100 g of chamomile flowers into 350-500 ml of boiling water. Leave for 30-40 minutes, then strain. Use 200-250 ml after meals 3-4 times a day for 1 month. Take a break for 2-3 months, after which the course is repeated.
Chamomile perfectly calms and increases the body's resistance to stress factors.
And also read on our website: Clinical and diagnostic features of malignant hypertension and methods of treating the disease
Causes
Stage 2 hypertension is one of the most common cardiovascular diseases. According to the World Health Organization, every third adult suffers from it.
The disease tends to progress unnoticed, which is why the diagnosis often becomes an unpleasant surprise for the patient. Before learning about the disease, a person pays attention to periodic mood swings, irritability, and fatigue in the morning. Frequent dizziness and memory impairment indicate the development of hypertension. After a short rest, they disappear for a short time, after which they can become permanent.
Despite the fact that hypertension initially represents a disruption in the regulation of vascular pressure, over time it contributes to the development of diseases of the internal organs, and later portal hypertension may appear. Among diseases leading to rapid death, hypertension occupies a leading position. It provokes angina pectoris and stroke.
Many people associate the causes of stage 2 hypertension with the fact of aging of the body. Many older people actually face this problem, but it can occur not only in older people, but also in fairly young people. High blood pressure may result from:
- genetic predisposition;
- decreased elasticity of the walls of blood vessels and the vascular system;
- sedentary lifestyle;
- drinking alcohol, smoking and other bad habits;
- obesity, overweight;
- unbalanced diet;
- disorders associated with the genitourinary system;
- disorders associated with the functioning of the endocrine system;
- pathologies during pregnancy;
- various tumors;
- excessive salt intake;
- disruption of the vascular system;
- kidney diseases;
- disruptions of the hormonal system;
- low stress resistance.
A mild form of the disease occurs in many residents of industrial cities with a population of over a million, where the accelerated pace of life leads to high blood pressure. It is acceptable to treat grade 2 hypertension with ACE inhibitor drugs, since with high blood pressure the nervous system and most of the internal organs are exposed to stress, which feel a lack or excess of blood flow. This helps treat the symptoms of stage 2 hypertension. Inattention to the signs and untimely treatment can lead to disastrous conditions such as cerebral and pulmonary edema. There is also a high probability of the patient developing a stroke or heart attack. In this regard, many are interested in: how to treat stage 2 hypertension? The method of therapy is identical to that used in stage 1 treatment, but differs in the dosage and number of medications used per day.
Doctors will categorize hypertension according to risk levels. The evaluation criteria include:
- the presence of factors that have a detrimental effect on the patient’s health;
- the likelihood of permanent loss of brain function;
- the possibility of dysfunction in the functioning of the patient’s internal organs when blood pressure changes.
However, there are a number of other factors that provoke the development of hypertension in humans. These are the patient’s age, the amount of cholesterol in the blood, and smoking.
Prevention
Prevention of hypertension involves lifestyle modification. Its scheme includes:
Increasing physical activity
To maintain health, you need to walk at least 10,000 steps daily at a moderate pace. Or do aerobic exercise for 30-40 minutes 3-4 times a week. Contact a rehabilitation specialist or physiotherapist - they will help you choose a set of physical therapy exercises taking into account your clinical condition.
Diet
The menu for hypertension requires serious revision. Be sure to limit your salt intake to 5 g/day. This means that you will have to give up all industrially produced products: sausages, canned food, smoked meats, salted fish, various snacks, since salt is used as the main preservative in their production.
It is important to eat enough vegetables and fruits, at least 400-500 g per day. Avoid fatty meats and add fish to your diet twice a week.
Weight loss
It has been reliably proven that for every 10 kg of weight lost, the SBP level decreases by 5-10 mmHg.
Rejection of bad habits
You should definitely stop smoking tobacco and drinking alcohol.
Arterial hypertension 2 degrees: features of the course, causes of development and characteristic signs
Hypertension is a severe pathological condition of blood vessels and the heart, when elevated blood pressure cannot be stabilized with medications. Arterial hypertension of the 2nd degree - stable high blood pressure in the range of 160-180 mm Hg.
The risk of complications is high. The phenomenon is life-threatening and can lead to myocardial necrosis, heart attack, hemorrhagic stroke in case of serious damage to the vascular wall, inability of the tone to correspond to the level of blood supply.
Risk factors
There are 4 degrees of hypertension, taking into account possible complications that pose a threat to the health and life of patients. The stage is determined taking into account:
- age of patients;
- stress on the heart;
- lifestyle;
- hereditary history;
- the presence of characteristic signs, obesity, bad habits.
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With arterial hypertension, the risk of stage 2 development in men who abuse alcohol (smoking) and neglect physical activity is 3 times higher than in women. The main factors for the development of type 2 hypertension:
- elderly age;
- left ventricular myocarditis;
- modification of the heart wall, brain against the background of constantly high blood pressure;
- myocardial hypertrophy;
- pathology of muscle tissue;
- circulatory disorders;
- tissue necrosis;
- proteinuria.
In case of arterial hypertension of the 2nd degree, the target organs are:
- eyes;
- kidneys;
- heart;
- vessels;
- brain.
Pressure indicators increase by 15-20%. Additional provoking factors:
- age - men over 55 years old, women over 65 years old;
- obesity;
- physical inactivity;
- passive lifestyle;
- smoking;
- high levels of cholesterol in the blood, above 6.5 mmol/l;
- the appearance of atherosclerotic plaques in small vessels;
- failure of the kidney filters;
- kidney dysfunction;
- violation of coronary circulation;
- sustained cardiac ischemia.
With stage 2 arterial hypertension, the risk of developing regressive changes in the heart is 2 times higher than at stage 1.
Provoking factors for stage 2 arterial hypertension are not absolute parameters. They only make it possible to assume the likelihood of possible complications developing.
It is no longer possible to change the diagnosis. However, timely treatment and adherence to preventive measures can minimize complications and progression of the underlying disease.
Types of pathology
Types of arterial hypertension:
- Renovascular. Provoking factors are vascular atherosclerosis, kidney tumors, vasculitis.
- Pulmonary essential hypertension is a rare phenomenon, but poses a health threat. The reason is slow blood flow, increased vascular resistance in the lungs.
- Labile arterial pathology is a form of hypertension in which blood pressure levels periodically normalize. The condition is not considered pathological.
- Malignant (at a blood pressure level of 220/130 mm Hg) - the optic disc swells, the fundus of the eye changes. Only timely detection guarantees a favorable outcome of therapy.
Hypertension can be benign or malignant with rapid progression of symptoms and development of complications in the nervous and cardiovascular systems.
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Causes
Stage 2 hypertension is more often diagnosed in older people. With age, blood vessels lose their elasticity and atherosclerotic plaques form in them. The muscle tissue of the heart undergoes pathological changes. Main reasons:
- hereditary factor, when blood relatives suffered from high blood pressure;
- passive lifestyle;
- complicated course of pregnancy, changes in hormonal levels;
- frequent stress, psychosis;
- complication of primary mild form of hypertension;
- diseases of the urinary system;
- non-compliance with a balanced diet, consumption of foods high in cholesterol;
- development of a tumor of any origin;
- failure of the kidneys, slowing down the removal of excess fluid and salts from the body.
Patients with minor pressure surges on the tonometer do not always turn to doctors at an early stage. The discomfort is minor, the body gradually adapts and gets used to new stress. But constantly high levels of pressure suppress many vital systems. Sooner or later, pulmonary and cerebral edema, stroke, myocardial infarction, and hypertensive crisis may develop.
Symptoms
Manifestations of arterial hypertension of the 2nd degree disturb patients from their usual rhythm of life. At first, vague, not bright, periodic symptoms appear:
- swelling of the hands, eyelids, face;
- the appearance of a capillary network on the skin;
- weakness, weakness;
- throbbing pain in the back of the head, temples;
- darkening, flickering of spots, black dots before the eyes;
- redness of the eyes;
- decreased vision;
- dizziness;
- emotional overexcitation.
During diagnosis, thickening of the walls of the heart and left ventricle is observed. Patients develop problems with urination.
Diagnostics
Physical and instrumental examination methods help to identify stage 2 arterial hypertension. The following are taken into account:
- symptoms;
- patient's well-being;
- blood pressure indicators during 2-week monitoring - indicators are measured 2 times a day (morning, evening).
Physical examination methods:
- listening to the cavity of the lung and heart with a stethoscope;
- visual assessment of the skin;
- pressure measurements.
Instrumental methods:
- Ultrasound of the pancreas, liver, kidneys, endocrine glands to assess the condition of organs and identify possible complications;
- EchoCG for visual examination, determination of left ventricular hypertrophy, assessment of the level of cardiac decompensation;
- electrocardiogram to determine the electrical activity of the heart muscles;
- blood and urine tests;
- Doppler examination to detect renal artery stenosis.
Arterial hypertension of the 2nd degree quickly progresses in the case of narrowing of one of the vessels. It develops at lightning speed - renin aldosterone is activated as the body's response to pathology.
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Treatment at different stages
First of all, it is important for patients:
- reconsider your lifestyle;
- limit intake of table salt (liquid);
- reduce the daily caloric content of foods in case of obesity;
- stop smoking;
- dose the work and rest schedule;
- take courses of physiotherapy, exercise therapy;
- regulate physical activity;
- walk more in the fresh air.
Treatment to reduce high blood pressure is medication. Main drugs:
- beta blockers (Atenolol, Metoprolol, Acebutolol, Oxprenolol, Timolol, Bisoprolol, Sotalol) affect the cardiovascular system, unload the heart, slow down the rate of muscle contraction;
- ARB inhibitors (Valsartan, Candesartan, Irbesartan, Eprosartan) suppress angiotensin receptors, regulate the condition of the myocardium and blood vessels;
- ACE - angiotensin-converting enzyme inhibitors (Fosinopril, Cilazapril, Enalapril, Captopril, Trandolapril, Lisinopril) relieve tension in the blood vessels, reduce the rate of production of the hormone that constricts them;
- Renin inhibitors have nephroprotective and cardioprotective effects and reduce renin activity in the blood.
- diuretics (Thiazide) accelerate the removal of excess fluid from the body;
- calcium channel blockers (Verapamil, Diltiazem, Lacidipine, Amlodipine, Nifedipine).
Special attention is paid to diet. Patients with stage 2 hypertension should avoid:
- fatty fish;
- meat;
- confectionery products;
- spicy and spicy dishes.
Must be included in diet
- dried fruits;
- nuts;
- garlic;
- milk and vegetable soups.
Folk herbs with diuretic properties will help with isolated, periodic surges in blood pressure:
- horsetail;
- valerian officinalis;
- swamp cudweed;
- motherwort;
- Potentilla gossamer;
- buckthorn bark;
- yarrow;
- pharmaceutical camomile.
Forecast
Stage 2 arterial hypertension is considered an incurable condition. The prognosis is favorable if patients:
- maintain blood pressure levels within normal limits;
- lead a healthy lifestyle;
- give up bad habits;
- follow a diet.
Otherwise, hypertension progresses quickly and leads to complications:
- myocardial necrosis;
- hemorrhagic stroke;
- decompensation of vascular insufficiency, heart failure.
Mortality is high in cardiovascular pathologies and persistently high blood pressure levels.
The prognosis is disappointing for patients who neglect the recommendations of doctors, do not control blood pressure readings, and ignore complications. In case of heart failure or stroke, the probability of sudden death is 70%.
In stage 2 arterial hypertension, the risk of stage 3 development is high with severe damage to target organs. At stage 2 arterial hypertension, the risk of stage 4 development is 45-60%.
Prevention
Avoiding the development of arterial hypertension from stage 2 to stage 3 means:
- eat rationally;
- fight excess weight;
- limit salt intake;
- dose physical activity;
- avoid stress and unfavorable psychological conditions in the family;
- keep blood pressure levels under control;
- stop bad habits, addiction to drugs, smoking, alcohol, overeating.
Arterial hypertension of the 2nd degree - a steady increase in blood pressure: diastolic over 89 mm Hg, systolic over 139 mm Hg. Blood pressure can increase in every person, regardless of age and lifestyle. But more often, patients with a hereditary factor suffer from hypertension and even an increase of 9-10 mm Hg. may already indicate the development of serious pathologies.
The disease cannot be cured completely, although it is possible to regulate blood pressure levels and keep them under control. If you identify arterial hypertension at an early stage and undergo a thorough examination, you can achieve stable remission, thereby improving the quality of life.
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