Blood pressure is a combination of the strength with which the heart pumps blood into the circulation of the human body and physiological resistance of blood vessels that is present in that moment. The normal values are 120-130 / 80-85 mmHg.
High blood pressure or arterial hypertension is a pathological condition which is characterised by a systolic blood pressure above 140 mmHg and diastolic above 90 mm Hg. Commonly are elevated Both. But it can only be elevated systolic, or just diastolic or systolic to be increased and diastolic decreased.
Reasons
For the occurrence of this pathological condition the multifactorial etio pathogenesis is responsible. Inherited traits play a significant role in the occurrence of this disease. Many patients are genetically encoded and appears predisposed to the high pressure. Besides the genetic code, the increase of pressure occupy an important place factors and habits that are prevalent in today's life such as increased salt intake (through 5 g daily), excessive intake of coffee, alcohol, nicotine and possibly a major factors - obesity (fat intake of foods with high cholesterol, low to the HDL / LDL fat), physical inactivity and chronically elevated levels of catecholamines (adrenaline and noradrenaline) caused from the pace of modern living and stressful situations.
According to the origin and causes high blood pressure can be divided as:
Essential (primary) hypertension whose cause is not actually known, covers 98 % of all hypertension encountered in general medical practices.
Secondary hypertension:
Renal (kidney). Here hypertension is a result of inflammation of the kidneys or stenosis (narrowing) of the renal arteries.
Endocrine hypertension may be a consequence of pheochromocytoma, Cushing's disease, hyperplasia of the adrenal gland and diabetes.
Cardiovascular hypertension is a consequence of the change of the aortic heart failure or change of the aorta.
Neurogenic hypertension - appears in constitutionally predisposed people who vasomotor centre in stressful situations responding with increased secretion of norepinephrine. There is also an opportunity for those people to come to the increased secretion of other hormones causes that lead to tightening of arteriolar and raise blood pressure.
Induced hypertension during pregnancy (special issue),
Hypertension caused by drugs (oral contraceptives, steroids or others)
Meaning of disease
It is a disease of modern man and society and is constantly increasing number of patients. BP is a serious health problem and challenge of modern medicine. High blood pressure is undoubtedly closely related to the risk of occurrence of cardiovascular diseases and many changes in the blood vessels of the brain to the emergence of the heaviest brain complications and occurrence of brain encephalopathy!
Its importance is even greater, knowing the fact that although relatively easy to diagnose, the number of patients diagnosed is as they say "tip of iceberg ". In other words it is considered that 1/2 of patients do not know they suffer from hypertension, 1/4 does not heal despite knowing about this condition while disappointing 1/8 of patients regulate respectively.
Symptoms
Initially there are no subjective difficulties until they develop complications, and the disease rightly gets the name " silent killer ."
Because of this it is very important its early detection and treatment.
Young patients with non-constant high blood pressure (hypertension labile) complain of sweating, anxiety, quickly changing the colour of the face, cold hands and feet, heart beating and sleep disorder.
Old people or sick with fixed hypertension (constantly elevated pressure) often complain of ringing in the ears, morning headache, heart beating, bleeding from the nose and dizziness. When in fixed hypertension comes to damage to the heart, brain and kidneys, it appears difficulty in breathing during the effort and later at rest, nervousness, insomnia, irregular working of the heart, chest pain, muscle cramps, tingling fingers, polyuria (excessive urination) and nocturne (nighttime urination).
Complications
Ignoring or not diagnosing the disease certainly leads to changes in the target organs.
The heart comes to hypertrophy (thickening of the heart muscle), rhythm disturbances and cardiac insufficiency (heart failure), and can also lead to heart attacks.
Complications of brain such as brain hemorrhage, cerebral infarction due to embolus and thrombosis and transient cerebral ischaemia without infarction.
Renal complications occur only in severe hypertension.
Relatively frequent are changes of fundus and that lead to blindness.
Diagnosis
Diagnosis is done by measuring the blood pressure. It is important measuring at home, because in some patients the pressure increases when their doctor measured (effect of " white coat "). Home measured twice in the morning and twice at night four days in a row. Half hour before measuring should not have physical activity. The hand is placed on the height of heart, if measured on both hands higher value is recorded. Then it is determined the mean value of measurement which does not take into account the first day of measurement.
Laboratory examination should be made of the blood (glucose, total cholesterol, HDL- cholesterol, triglycerides, creatinine, uric acid, potassium, hemoglobin, hematokrit and review of urine), fundus examination, ultrasound of kidney and adrenal, renal Doppler, carotid and femoral arteries, EKG heart test and if necessary an ultrasound of the heart. It is important to determine the origin of high blood pressure, according to which will depend on the approach to its treatment.
Therapy
The goal of any treatment is the lowering of the blood pressure values as bring them close to normal values. In most patients, these values are difficult to achieve so that a satisfactory reduction to be below 140/90 mmHg. How do you treat a patient depends on the type and degree of hypertension. Basically there is non-drug and drug therapy.
Non-drug therapy involves changes on those habits that constitute a risk factor for BP and increase the acceptance of new ones that lead to positive action on it. This therapy is included in the prevention of cardiovascular disease occurrence, and it is strongly recommended in patients who are treated with medication for high BP. Specifically for prevention and control of hypertension is recommended:
Moderate, but regular physical activity at least 3 times a week 30-45 minutes. Reduces BP regulates body weight, regulate triglyceride and LDL bad cholesterol and reduces insulin resistance.
Cessation of smoking - cigarette smokers after one cigarette has acute elevated pressure and have accelerated heart rate for a period of 15 minutes. Cessation of smoking is the most effective measure that the patient can take in order to reduce the BP and prevention of cardiovascular diseases.
Diet food and lower intake of salt - recommended change in diet with increased intake of fruits, vegetables, dairy products with low fat, more fish and less meat and fried limited amount of nuts (hazelnuts, walnuts, almonds...). This method reduces the high tension, reduces LDL and increases HDL cholesterol. Also important is diet with less salt (less than 5 g. / Day) is recommended especially in older patients, in patients with diabetes or chronic renal failure.
Reduction of body weight. There is direct evidence that obesity leads to elevated BP. Reduction of weight in patients with elevated BP, leading to a reduction in BP values. The reduction in weight leads to a decline in the values of cholesterol, triglycerides, improved regulation of blood glucose in diabetics.
Consumption of alcohol. In large quantities alcohol increases the tension, increases the risk of heart attack or stroke while at the same time weakens the effect of drugs to reduce hypertension. It is recommended that moderate consumption of alcohol has positive effect of BP. Daily; they consume is about 20-30 g. for men and for for women is 10-20 g.
Drug therapy involves the use of antihypertensive drugs in regular use give good results. Today are used several groups of drugs: ACE inhibitors, diuretics, calcium channel blockers, alpha and beta-receptor blockers... This therapy is exclusively prescribed by doctors and should not be taken at will.
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