Arterial hypertension 2 degrees: features of the course, causes of development and characteristic signs

Stage 3 hypertension is a disease characterized by a persistent increase in blood pressure and is a consequence of target organ damage. Hypertension of the third degree is severe, because complications negatively affect the patient’s quality of life. In some cases, death is likely.

• Causes
• Symptoms of stage 3 hypertension
• Diagnostics
• Treatment of stage 3 hypertension
• Nutrition for stage 3 hypertension
• Sample menu for stage 3 hypertension
• Prevention
• Forecast
• Disability due to hypertension 3rd degree

Causes

Causes of grade 3 hypertension include insufficient therapy. If you get an inexperienced doctor and develop a poor treatment regimen, the symptoms may worsen. If the patient himself does not comply with the doctor’s instructions, this can also threaten the worsening of hypertension. Also, the development of the disease is influenced by pathologies that develop in parallel with an increase in blood pressure.

Risk No. 3 with second-degree hypertension exists if the patient is expected to have a 20-30% chance of developing complications from the cardiovascular system. This risk is observed in patients diagnosed with diabetes mellitus. If you have impaired filtration of fluids by the kidneys, as well as atherosclerotic plaques, you are also at risk. In this condition, a person is diagnosed with stable angina pectoris. It determines the 3rd degree of risk, including young patients. A complete cure today is incredible; it is possible to slow down the disease and prevent complications.

At-risk groups

Stage 2 arterial hypertension is divided into 4 risk groups. They increase as symptoms progress. Pathology can lead to a hypertensive crisis, which promotes rapid damage to internal organs affected by hypertension. The nervous system suffers no less; even during night sleep, it cannot fully recover due to stress caused by pressure surges during arterial hypertension of the 2nd degree.

Benign hypertension and malignant hypertension are also distinguished, which mainly depends on the activity of converting hypertension from one stage to another. In the presence of a malignant form with active development, the disease can lead to death, which is associated with thickening of the vessel walls due to increased pressure in the arteries and rapid pumping of blood through them.

Hypertension stage 2, risk 2 . Appears with vascular atherosclerosis, which is accompanied by frequent pain in the chest area. This occurs as a result of a lack of blood flow into the coronary artery.

This pathology of arterial hypertension of the 2nd degree (risk 2) refers to heart diseases of moderate severity, since over time, less than a quarter of patients have the risk of developing a cardiovascular disorder with great danger to life.

The possibility of establishing a diagnosis of stage 2 hypertension (risk 2) in a patient is only possible if at the time of diagnosis the patient did not have diabetes mellitus, stroke, and the endocrine system did not suffer changes. Excess weight of a patient can have dangerous and irreversible consequences for the body.

Hypertension stage 2, risk 3 . It is usually diagnosed in a patient in parallel with atherosclerosis, diabetes mellitus, and deformed vessels, which are usually associated with a developed form of hypertension. Against the background of these diseases, progressive kidney pathology is often detected. With grade 2 hypertension (risk 3), coronary pressure worsens, resulting in ischemia or hypertensive crisis, which, against the background of pathology, leads to emotional instability of the patient. Often, type 2 hypertension (3) can lead to disability.

Hypertension stage 2, risk 4 . In the presence of a complex of diseases, which includes diabetes, ischemia and atherosclerosis, the patient is diagnosed with stage 2 hypertension (risk 4). This diagnosis is also given to people who have experienced a heart attack, regardless of the affected area.

In any case, specialists are able to predict the degree of development of hypertension, which, in turn, leads to the prevention of disease progression in the presence of effective treatment. Timely diagnosis reduces the regularity of the occurrence of hypertensive crises that occur against the background of pathology.

Symptoms of stage 3 hypertension

Symptoms include not only manifestations of hypertension, but also signs of target organ pathology. The pathological process concerns mainly the brain. Ischemic and hemorrhagic strokes are possible. Blood vessels are affected, as are the structures of the central nervous system. Kidney function is also impaired, which further aggravates hypertension and the severity of the disease increases.

On the part of the heart, myocardial infarction and hemodynamic instability may develop. Vision also suffers. Some patients experience damage to the vessels of the retina. Arteries can dilate, forming aneurysms. In some cases, encephalopathy develops and hematomas form inside the skull or inside the brain.

general information

Most often, it is not possible to establish the causative factor that led to a long-term increase in the level of pressure in the bloodstream. In this case, a diagnosis of essential or primary hypertension, also called hypertension, is made.

The danger of the disease lies in the fact that over time a person simply gets used to high marks on the tonometer, feeling at the same time satisfactory. With high blood pressure, not only the vascular system is affected, but also the heart, brain, and kidneys. The latent course of the pathology can lead to serious consequences: heart attack, stroke, kidney and heart failure, coronary artery disease.

Diagnostics

Interviewing the patient himself is important for diagnosis. Main complaints:

• nausea
• headache
• sensation of vascular pulsation
• persistent dizziness
• increased heart rate
• swelling
• muscle weakness

Systematic and technically correct blood pressure measurement is important. Over the course of 2 weeks, measurements should be taken by a doctor 2 times to obtain dynamic data. Blood pressure measurements are the physical diagnosis of stage 3 hypertension. It allows you to assess the condition of peripheral vessels for the presence of edema. This technique makes it possible to listen to the lungs and heart, perform percussion of the vascular bundle and determine the configuration of the heart.

In each specific case, the doctor may prescribe studies of the heart and kidneys, because their pathologies are closely related to grade 3 increased blood pressure. Most often they resort to ultrasound diagnostics, which shows the condition of the kidneys, liver, pancreas and endocrine glands.

Types of arterial hypertension

The classification of arterial hypertension is based on various parameters, one of which is the origin. Based on origin, the patient can be diagnosed with:

• Primary arterial hypertension is caused by many factors, which are being elucidated by specialists all over the world. However, it has been reliably established that the basis of this disease is unfavorable heredity in combination with the factors acting on it. The vast majority of patients - about 90% - suffer from this type of arterial hypertension. This disease has a second name – essential hypertension;
• Secondary arterial hypertension manifests itself when organs involved in the regulation of blood pressure are damaged, therefore the disease is otherwise called symptomatic arterial hypertension.

Treatment of stage 3 hypertension

Therapy includes several stages. The patient should lead an active lifestyle. The doctor prescribes dosed physical activity that will be tolerated normally by a particular patient. A person must adhere to a certain schedule of rest and work. The results are visible only after a long time, not immediately. Nutrition is also part of the therapy. A special diet is required. Pay attention to the amount of drinking to maintain a normal water-electrolyte balance.

Self-medication with medications is unacceptable because this is a serious illness. Drug treatment is purely individual. Cardosal and Rasilez are effective. They are effective for essential hypertension. Cardosal is given to the patient once every 24 hours, before, during or after meals. The dosage prescribed in the instructions can be increased several times on an individual basis. This can only be decided by your attending physician.

Rasilez is used for the treatment of grade 3 hypertension as monotherapy or in combination with other drugs that are classified as antihypertensive. The daily dose is 150 mg; medication intake does not depend on food intake. The results of this treatment will be visible after 14 days (on average).

Arterial hypertension: treatment with modern methods

The choice of treatment for hypertension is made by specialists based on research data. Treatment methods for arterial hypertension are divided into non-pharmacological and medicinal.

Patients diagnosed with mild hypertension, in particular stage 1 arterial hypertension, may be exempted by their doctor from taking special medications. The main method of non-drug treatment is changing the patient’s lifestyle:

• rejection of bad habits;
• weight control;
• regular moderate physical activity. Daily activities such as moderate walking or light strength training are effective;
• reducing stress. During stressful situations, a person’s blood pressure may increase; it can be lowered with the help of massage, breathing exercises or meditation;
• including foods rich in macro- and microelements in the diet and reducing salt intake.

Medicines for arterial hypertension are prescribed to patients when non-drug therapy has proven ineffective within 3-4 months, and there are risk factors. Thus, arterial hypertension 2 risk 3 requires taking special medications. The number of drugs is determined by blood pressure and the presence of concomitant diseases.

Modern doctors prescribe drugs for the treatment of arterial hypertension in accordance with one of the strategies: monotherapy or combination therapy. When drawing up a treatment plan, the question of the admissibility of using one drug is the most pressing for the specialist.

In monotherapy, a patient with grade I is prescribed one drug at the beginning of the course of treatment. An important factor when prescribing a drug is its effectiveness in reducing the risk of complications. Currently, to control blood pressure, doctors use the most studied drugs belonging to two groups: thiazide-like and thiazide diuretics, which have a diuretic effect.

Combination therapy is prescribed to patients with a high degree of risk, as well as with stages II and III of the disease. With this method of treatment, drugs with different mechanisms of action are selected to lower blood pressure and reduce possible side effects.

Experts on the question of how, if a patient has arterial hypertension, how to treat this disease with drugs, prefer to use several groups of drugs:

• beta blockers. For several decades, beta blockers have been used as the mainstay of treatment for hypertension in children and adolescents. However, multiple side effects have now been identified, and therefore their use has become limited. Experts include the main side effects: sleep disturbances, increased blood glucose levels, weakness and mood swings. An important condition when using these funds is an electrocardiogram and regular monitoring of blood sugar;
• Diuretics are prescribed to patients for a long period; they remove excess fluid from the body. Side effects include: fainting, decreased calcium levels in the blood;
• calcium channel blockers. Drugs in this group are used quite widely to treat patients; doctors give preference to drugs with a long period of action. Side effects of blockers include: gastrointestinal disorders, rapid heartbeat, weakness, dizziness and swelling;
• ACE inhibitors. The mechanism of action of these drugs is to block the action of enzymes that are involved in the formation of a vasoconstrictor;
• alpha adenoblockers. The effect of drugs in this group is manifested in a decrease in pressure through blocking receptors located in the artery wall.

Nutrition for stage 3 hypertension

Products useful for hypertension include:

• curdled milk
• cottage cheese (not very fatty)
• boiled beef
• whey
• egg white
• peas
• green onions
• black currants
• lemons
• radish

Some of the above mentioned foods help remove toxins from the body. Salt should be consumed minimally; it is advisable to avoid adding salt to dishes. The body should receive up to ½ tsp of salt per day.

Products prohibited for grade 3 hypertension:

• pickles
• spices
• spicy dishes
• smoked meats

The above products increase blood pressure. It is also better to exclude caffeine (and drinks containing it) and oil-based confectionery products from your diet. Alcohol should be avoided if you have hypertension.

It is recommended to use ginger, which has medicinal properties. It is also used to prevent hypertension. Ginger can be added to tea (or to make an all-ginger tea), main dishes, baked goods and desserts. Ginger relaxes muscles (around blood vessels) and thins the blood.

It is worth giving up semi-finished products, products of unknown origin, and fatty foods. Overeating is prohibited for hypertensive patients.

Characteristics 2nd degree

Pulmonary hypertension is a pathology in which a persistent increase in blood pressure is observed in the vascular bed of the artery. This disease is considered progressive, and ultimately leads to the death of a person. Symptoms of pulmonary hypertension manifest themselves depending on the severity of the disease. It is very important to identify it in time and begin timely treatment.

A rapid heartbeat of 100 beats per minute attracts the attention of doctors, since it exceeds the norm, which for a healthy adult is 60-80 beats. Read more in the article: “heartbeat 100 beats per minute: what to do.”

The disease can occur without symptoms in the compensation stage. Because of this, it is most often discovered when a severe form has begun to develop. Initial manifestations are observed when the pressure in the pulmonary artery system is increased two or more times compared to normal. As the disease progresses, symptoms such as weight loss, shortness of breath, fatigue, hoarseness, cough and palpitations appear.

Table. Stages of hypertension

Since the signs of pulmonary hypertension are not very specific, it is difficult to make an accurate diagnosis based on subjective complaints. Therefore, it is very important to conduct a thorough diagnosis and pay attention to all symptoms that somehow indicate problems with the pulmonary artery or other systems in the body, a failure in which can lead to the development of hypertension.

Many people associate a trip to the dentist with the unpleasant procedure of removing nerves in a tooth. The word “arsenic” evokes even greater fear. However, medicine does not stand still and is constantly evolving. Read more in the article: “tooth hurts after arsenic.”

Sample menu for stage 3 hypertension

Day 1. In the morning we have breakfast with meat soufflé and porridge cooked in milk. You can drink tea. There is no feeling of heaviness in the gastrointestinal tract after such a breakfast, but satiety is present. After a few hours, eat 1-2 apples. Lunch: chicken broth soup and rice with chicken. For dessert you can have compote. Next meal: crackers with sugar and rosehip infusion. You can make crackers yourself. For dinner, fish with carrot garnish is suitable. Before going to bed, drink kefir or yogurt.

Day 2. Have buckwheat for breakfast and drink tea with milk. Second breakfast: carrot juice (freshly squeezed) or a decoction of dried black currants. Lunch: borscht with a decoction of wheat bran and pilaf with dried apricots. For lunch, you can give the patient a rosehip decoction as a drink. You can have fruit juice in the afternoon. No dinner (or any fermented milk product). Before going to bed, it would be a good idea to drink a rosehip decoction.

Day 3. For breakfast, a good option would be buckwheat or oatmeal mixed with chopped apple or carrot. Your favorite tea is suitable for drinking. Second breakfast: soaked dried apricots or dates. For lunch you can serve borscht, fried meat, cabbage salad, blackcurrant jelly (you can add other berries and fruits). Afternoon snack: fresh apples. For dinner they make carrot cutlets and cottage cheese soufflé; drink: tea with lemon (or jam). Before going to bed, you can drink ½ glass of rosehip decoction.

Day 4. For tomorrow, serve cottage cheese with stale bread or crackers, butter, jam/preserve and black/green tea. It is better to avoid strong brewed tea, which has a direct effect on blood pressure. On the fourth day, you can serve boiled fish, vegetable puree or stew for lunch. Fresh carrot juice is suitable as a drink (you can use carrot-apple or carrot-celery). Apples are given for afternoon snack. Buckwheat and yogurt are suitable for dinner. Half an hour before bedtime, you can drink 200-250 ml of kefir.

Day 5. For breakfast, any porridge with milk or a bun (preferably whole grain or dark flour) is suitable. Fruits are suitable for a second breakfast. For lunch on the 5th day, you can offer noodle soup and turkey meatballs. As a snack after 1.5-2.5 hours, you can eat a baked apple with the addition of a small amount of sugar or honey. On the 5th day, kefir or yogurt without additives is given as an afternoon snack. Lazy dumplings and tea with milk are prepared for dinner. In the evening, you can take a rosehip decoction.

Day 6. For breakfast, boil 1-3 chicken eggs. They eat it with stale bread (preferably dark) and milk with honey. Juice from fruits and/or berries is suitable as a second breakfast. Vegetable soup and cottage cheese soufflé are served for lunch. You can also prepare a vinaigrette or other vegetable salad seasoned with vegetable oil. Plum compote is suitable as a drink. As an afternoon snack, an excellent option would be to serve fruit jelly or fruit and berry mousse. For dinner, give boiled potatoes and lean ham in the amount of 50-70 grams.

Day 7. For your first breakfast, you can serve buckwheat with a salad based on lettuce or cabbage. Drink for breakfast: coffee/tea with milk. Second breakfast: steamed raisins and fresh vegetables. Lunch: potato soup without meat and rice pilaf. For an afternoon snack, give them soaked dried apricots or dates. For dinner, jellied fish with potato cutlets is suitable; drink: tea with milk. 30-40 minutes before bedtime, drink a glass of kefir or sourdough.

Additional recommendations

The risk of relapse of the disease remains high even after recovery. This risk can be minimized by adhering to certain restrictions. The list is small and will be useful not only for hypertensive patients, but also for people who care about their health.

The bathhouse is a taboo for hypertensive patients. A sharp change in temperature can lead to hypertensive crisis and other consequences

Necessary:

• Quit smoking and alcohol, which negatively affect the condition of blood vessels.
• Introduce regular physical activity into your daily routine, as agreed with your doctor.
• Limit salt intake to a minimum.
• Eliminate stressful situations. If this is not possible, it is necessary to take sedatives that calm the nervous system.
• Minimize the amount of salt in your diet. Exceeding the permissible doses of this product leads to fluid retention in the body, which leads to changes in blood pressure and deterioration of the heart and circulatory system.
• Lose weight. Considering that every excess kilogram adds 2 mmHg. to the numbers on the tonometer. This means that losing weight in this case is not a tribute to the fashion for slimness, but taking care of your own health.
• Be sure to take the hypertensive medications prescribed by your doctor. It is important to do this not only during an exacerbation, but also during remission of the disease.
• When creating a menu, you should pay attention to healthy low-calorie foods rich in vitamins, fiber and microelements. The most beneficial for hypertensive patients are: vegetables, fruits, dried fruits, cereals, low-fat dairy and fermented milk products, lean meats and fish. You should avoid fatty meats, butter and margarine, smoked foods, and preserves.

Hypertension is a disease that does not disappear on its own. Only an integrated approach can achieve lasting results and improve the patient’s condition, bringing it closer to normal levels.

Prevention

To prevent high blood pressure, the following measures are important:

• dosed physical activity (tones the cardiovascular system)
• maintaining weight within normal limits (with obesity, the risk of diabetes and hypertension increases, among the most serious complications is coronary artery disease)
• getting rid of bad habits, including smoking and drinking alcohol (nicotine constricts blood vessels)
• proper rest after a working day and/or physical activity
• active recreation for knowledge workers
• periodic blood tests for sugar levels
• periodic blood pressure measurement
• ECG of the heart 1-3 times a year

Hypertension: general information

With arterial hypertension, a person constantly experiences high blood pressure. This condition occurs due to spasm of blood vessels, as a result of which blood flow through them becomes difficult. The diagnosis of arterial hypertension is made by a specialist when there is a stable increase in systolic pressure above 140 mmHg. Art.

To determine pressure, it is necessary to take at least three measurements at different times. The patient should be in a calm state and not take medications that lower or increase blood pressure.

Forecast

The prognosis depends on the stage of the disease. At the onset of hypertension, the patient is not in serious danger, and the prognosis can be considered favorable. The condition worsens with severe or rapid progression of the disease. If there are sclerotic changes in the vessels, the prognosis is worse. At stage 3, the prognosis is often poor. Severe damage to blood vessels and organs occurs. The prognosis improves with strict adherence to the doctor’s recommendations and implementation of the treatment regimen. It is important to remember that it is complex treatment that matters.

Symptoms

The main symptomatic manifestations of the disease appear at the beginning of the development of hypertension (at stage 1). Blood pressure periodically rises, headaches, a feeling of nausea, tinnitus and black spots before the eyes appear, problems with sleep begin, and the heartbeat quickens from any exertion.

But if at stage 1 of the disease the upper pressure only sometimes rises to 140-159 mm Hg, and the lower to 90-99 mm Hg, then stage 2 hypertension is a pressure of 160-180/100-110 mm Hg .st. It becomes almost permanent, causing a person a lot of inconvenience and depriving him of the opportunity to live a full life without the help of medications. At the second stage, new symptoms are added to the general symptoms characteristic of phase 1 hypertension. This:

What is a hypertensive crisis

• feeling of chronic fatigue, including immediately after waking up;
• low threshold of emotional excitability;
• nausea, during a crisis turning into vomiting;
• pulsation in the head area;
• heart failure;
• increased sweating;
• hyperemia of the skin of the face and upper body;
• deterioration of vision, development of fundus pathologies;
• swelling of the face, worsening in the morning;
• chills, numbness of fingers and upper extremities;
• albumin proteins appear in the urine (microalbuminuria);
• arterioles narrow;
• the walls of the ventricle become denser, trying to resist blood flow;
• if the disease has caused pathological changes in the functioning of the kidneys, symptoms such as uncontrollable urination at night, swelling of the feet after sleep, cloudy urine or a pink color appear.

At this stage, hypertensive crises occur, during which the pressure rises by 59 units. Attacks last for several hours and threaten serious consequences in the form of a heart attack, cerebral, pulmonary edema or stroke. Signs of damage to target organs (brain, heart, eyes, kidneys) become obvious. Treatment should begin immediately after the first manifestations of the disease are detected. This will help cope with further destruction of organs and systems and improve the patient’s well-being.

Important! The diagnosis of arterial hypertension of the 2nd stage can also be made in patients whose blood pressure falls within the pressure range at stage 1 of the disease. Doctors focus not only on the tonometer readings, but also on the degree of target organ damage. If the brain, heart, eye vessels, kidneys are damaged, the disease progresses to stage 2.

Disability due to hypertension 3rd degree

Assignment of disability for hypertension of the 3rd degree is probable. If severe damage to the heart, kidneys, brain and eyes occurs, the person is considered disabled. Some of the patients are recognized as partially able to work (they can perform their duties at home).

There may be, as we have already noted, severe complications from the kidneys, heart and brain, then a second disability group is assigned, rarely - the first. Patients with hypertension should be constantly monitored at the dispensary. Periodic examinations, special rehabilitation courses and health treatments in sanatoriums can help a person feel much better. But resorts must be selected individually. If a person’s condition is either mild or severe, it is better to refuse treatment at resorts.

Story

The history of the study of arterial hypertension dates back to the 40s of the 18th century. Then the Englishman S. Hales determined the height of the blood column in a glass tube inserted into the carotid artery of animals and humans. 100 years later, Karl Friedrich Wilhelm Ludwig invented a mercury manometer for recording blood pressure, and Goldblatt created a model of chronic arterial hypertension in a dog. In 1922, G. F. Lang created the neurogenic theory of arterial hypertension, and in 1948 he also proposed the term “hypertension.” Diagram of a pressure gauge by Karl Ludwig. copyright Farzan Filsoufi. Arterial hypertension is a socially significant disease and the most important risk factor for cardiovascular complications. The frequency in the Russian Federation is 39% in men and 46% in women. At the same time, in men, arterial hypertension is more often observed under the age of 40, and in women over the age of 50. A. L. Myasnikov called hypertension “a disease of the twentieth century,” there is some truth in this, because in areas of the modern world where primitive features of the economy, there is a low prevalence of hypertension.

Clinic

• Often asymptomatic and turns out to be an incidental finding during a visit to the doctor
• Frequent subjective manifestations are headaches in the occipito-parietal and temporal regions
• Cerebrovascular disorders are also possible - dizziness, tinnitus, spots before the eyes, decreased memory and mental activity
• Neurotic disorders - irritability, discomfort, fatigue, depression, sleep disturbance, uncertainty, anxiety
• 20-40% have cardiac pain syndrome
• Visual impairment
• Accent 2 tones over the aorta, hard pulse, tachycardia
• Changes in the boundaries of the heart, high apical impulse