Idiopathic hypertensia
Contents:
Description:
Idiopathic hypertensia (essential hypertensia) — a chronic disease which main clinical sign is long and permanent increase in arterial pressure (hypertensia).
Idiopathic hypertensia symptoms:
The idiopathic hypertensia arises usually at the age of 30-60 years, proceeds chronically with the periods of deterioration and improvement. The stage I (easy) is characterized by raising of the ABP within 160-180/95-105 mm hg. This level is unstable, during rest is gradually normalized. Pain and noise in the head, a bad dream, decrease in intellectual working capacity disturb. Occasionally - dizziness, bleedings from a nose. A stage II (average) - higher and the ABP steady level (180-200/105-115 mm hg at rest). Headaches and in heart, dizziness accrue. Hypertensive crises (sudden and considerable raising of the ABP) are possible. There are signs of damage of heart, central nervous system (passing disturbances of cerebral circulation, strokes), changes on an eyeground, decrease in a blood-groove in kidneys. A stage Sh (heavy) - more frequent emergence of vascular accidents (strokes, heart attacks). The ABP reaches 200-230/115-130 mm hg, his independent normalization does not happen. Such load of vessels causes irreversible changes in action of the heart (stenocardia, a myocardial infarction, heart failure, arrhythmias), a brain (strokes, encephalopathies), an eyeground (defeat of vessels of a retina - a retinopathy), kidneys (decrease in a blood-groove in kidneys, decrease in glomerular filtering, a chronic renal failure).
Recognition is carried out on the basis of data of systematic definition of the ABP, identification of characteristic changes on an eyeground, the electrocardiogram. The idiopathic hypertensia needs to be distinguished from the secondary arterial hypertensions (symptomatic) arising at diseases of kidneys, renal vessels, endocrine organs (Itsenko-Cushing's disease, an acromegalia, primary aldosteronism, a thyrotoxicosis), circulatory disturbances (aorta atherosclerosis, insufficiency of valves of an aorta, total atrioventricular block, aorta coarctation).
Idiopathic hypertensia reasons:
* genetic predisposition: approximately the genetic predisposition to EG caused by a mutation in genes of angiotensinogen, receptors of angiotensin II, an angiotensin-converting enzyme, a renin, an aldosteronsintetaza, β-subunits of amiloridchuvstvitelny natrium channels of a renal epithelium, etc. is found in 50% of patients.
* smoking: reduces an endothelium - dependent vasodilation, increases activity of a sympathetic part of the nervous system, is risk factor of development of coronary heart disease.
* excess consumption of table salt: excess of sodium increases the volume of the circulating blood, causes swelling of walls of arterioles, increases sensitivity of a vascular wall to vasoconstrictive factors.
* insufficient receipt with water and food of calcium and magnesium, microelements and vitamins
* alcohol abuse
* obesity, excess body weight
* low physical activity, hypodynamia
* psychoemotional stressful situations
* emergence of arterial hypertension depends on age of the person. At young age, generally - because of smoking, alcoholization, drugs, vertebrobazilyarny insufficiency, congenital anomalies of vessels, kidneys, adrenal glands, a hypophysis. In the middle age - at the expense of the excess body weight, psychological loadings or the postponed diseases with damage of heart, vessels, kidneys. And aged after 40 years is almost always result of sclerous defeat of vessels.
Treatment of the Idiopathic hypertensia:
* refusal of smoking
* normalization of body weight
* increase in exercise stresses
* decrease in consumption of table salt to 5 g/days
* increase in consumption of vegetable food, reduction of consumption of the animal fats, increase in a diet of potassium, calcium which are contained in vegetables, fruit grain, and the magnesium which is contained in dairy products;
* decrease in consumption of alcoholic beverages
Medicamentous therapy:
Now for therapy of AG anti-hypertensive drugs are recommended:
* diuretics (diuretics),
* α and β-adrenoblockers,
* antagonists of calcium (magnesium additive),
* APF inhibitors,
* antagonists of receptors to angiotensin II,
* agonists of imidazolinovy receptors.
