- Symptoms of Arterial hypertension
- Reasons of Arterial hypertension
- Treatment of Arterial hypertension
Arterial hypertension — permanent increase in arterial pressure from 140/90 mm hg above.
Arterial hypertension — one of the most widespread diseases of cardiovascular system. It is established that an arterial hypertension suffer from 20-30% of adult population. With age prevalence of a disease increases and reaches 50-65% at persons 65 years are more senior.
Symptoms of Arterial hypertension:
Earlier was considered that normal there can be a small distinction in figures of systolic arterial pressure at one person at his measurement on different hands. But the latest data say that the difference in 10-15 mm hg can demonstrate existence if not cerebrovascular diseases then the arterial hypertension promoting development and other cardiovascular diseases of pathology of peripheral vessels. And, though this sign has rather low sensitivity (15%), it is distinguished by very high specificity of 96%. Therefore arterial pressure is valid how it was always reflected in instructions, it is necessary to measure on both hands, to fix distinctions for purpose of additional inspections, to classify pressure by the maximum indicator from two hands. Not to be mistaken, it is necessary to measure in each case pressure on each hand three times with short intervals and to consider true the lowest figures. However, patients at whom pressure sizes with each measurement do not go down meet, and raise.
* Optimum ABP - SAP (systolic arterial pressure)< 120/ ДАД (диастолическое артериальное давление) < 80 мм рт.ст.
* Normal the ABP 120 — 129/80 — 84 mm hg (prehypertensia according to JNC-VII)
* High-normal ABP of 130-139/85-89 mm of mercury. (prehypertensia according to JNC-VII)
* 1 degree of AG — GARDEN 140 — 159/DAD 90-99.
* The 2nd degree of AG — GARDEN 160 — 179/DAD 100 — 109.
* 3rd degree of AG — GARDEN 180 above / DAD 110 above.
* The isolated systolic hypertension — the GARDEN is higher or is equally equal 140/DAD lower than 90.
Reasons of Arterial hypertension:
Believe that one of important etiological factors is the psychological overstrain arising after intensive or long emotional overloads. Primary functional disturbances arise in a cerebral cortex and in the centers of hypothalamic area of a limbiko-reticular complex. Excitability of the hypothalamic vegetative centers, mainly a sympathetic nervous system increases that leads to development of pressor reactions. Minute emission and a vascular tone increases. Decreases renal beds, excretion of sodium and water which collect in a vascular wall decreases, promoting emergence of its puffiness. In parallel the content of the ionized calcium in a wall of vessels increases. Ischemia of a kidney leads to the increased formation of a renin cells of the juxtaglomerular device of a kidney. The renin turns angiotensinogen which is produced in a liver, in angiotensin I. The last under the influence of convertase - the angiotensin-converting enzyme (ACE) turns into angiotensin II which, in turn, stimulates a sympathetic nervous system, promotes increase in noradrenaline in granules and exponentiates vasoconstrictive effect. APF carries out also an inactivation of bradikinin - one of allocation stimulators an endothelium of nitro-ksida (N0) - the major endothelial factor of a relaxation. Thus, APF is one of key regulators of balance between factors of vasoconstriction and a vazodilatation than and the role of polymorphism of a gene of APF (it is localized on a chromosome 17q23) in development of arterial hypertension is caused.
Treatment of Arterial hypertension:
Drug treatment of arterial hypertension
As drugs of the first row it is recommended to use antigiperteizivny means of classes:
3. antagonists of calcium
4. inhibitors of an angiotensin-converting enzyme
5. blockers (antagonists) of receptors of angiotensin II
6. and - adrenoblockers.