Hypertensive heart disease: causes, stages, symptoms and treatment. Hypertonic disease

The main causes of the disease

Due to the development of hypertensive heart disease, the cardiovascular system ceases to function fully due to vasoconstriction and increased pressure. As medical practice shows, this form of the disease occurs in 19% of cases of persistent high blood pressure. Experts have not been able to find out the main reason that provokes the appearance of hypertensive disease with predominant damage to the heart, but factors influencing this process have been identified. Namely:

excess weight;
systematic experiences;
Unhealthy Lifestyle;
unbalanced diet;
disturbances in the functioning of the heart.

According to experts, the patient’s psycho-emotional state plays a very important role, since it often provokes the development of pathological processes in the arteries and vessels. Quite often, due to atherosclerotic changes in the vessels, hypertensive disease develops. If one of the symptoms of the disease appears, it is important to immediately seek help from a qualified specialist, since self-medication can provoke the development of serious complications. Hypertensive disease with primary damage to the heart is dangerous because it can progress and develop into more complex forms. To avoid death, it is important to prevent the occurrence of complications.

Nutrition for hypertension and heart disease

Posted in Uncategorized | 24 May 2020, 05:15

There are disturbances in the functioning of the heart, kidneys, and brain. In the treatment of hypertension, mainly three categories of plants are used. having a calming effect on the central nervous system; having a direct hypotensive effect; used for the treatment and prevention of complications of the disease.

The number of drugs is determined taking into account the initial level of blood pressure and concomitant diseases. First of all, in order to decide what to do about high blood pressure at a young age, you need to find out exactly what exactly is the cause of hypertension. whether it is secondary (i.e. caused by a vascular anomaly, renal or endocrine disease, or it is not hypertension, but a neuro-vegetative dysfunction of pressure regulation, or early metabolic syndrome - excess body weight, disorders of fat, carbohydrate and salt metabolism in the nutritional system. In the case severe renal dysfunction, the increase in these indicators is respectively 50 and 110 with a doubling of the half-life. The disease often occurs in waves, with periods of exacerbations, in some cases with crises. And the incidence of hypertension in women is growing rapidly, catching up and then overtaking those The same indicators among men.We list the most common symptoms of a hypertensive crisis: a significant increase in blood pressure above 140/90 fatigue headache sweating nausea and vomiting blurred vision insomnia.

An increase in the tone of the muscles of blood vessels (arterioles, which is associated with a rise in blood pressure, occurs in connection with the activation of the renin-hypertensin system (a group of biologically active substances, the interaction between which causes an increase in blood pressure, an increase in the level of the hormone aldosterone in the blood, a change in sodium metabolism, a change in blood circulation in the brain brain, kidney, etc. 6 Complications after removal. Medicines for hypertension act against. With a pronounced and abrupt increase in pressure, a hemorrhagic stroke often occurs, whereas with long-term and continuously increasing hypertension, an ischemic stroke is more often observed. And if during a visit If your doctor discovers that your blood pressure is high, then you will need to visit the doctor regularly to find out how often and by how much your blood pressure rises.

You can drink water infusions of soothing herbal mixtures (if necessary, adding light diuretic herbs, which also reduce it) - instead of tea and coffee. Point three: drugs within the same class, subject to therapeutic doses, usually have approximately the same effect, but in some cases - see point two.

Echocardiography (ultrasound of the heart) to assess the thickness of the left ventricular myocardium (whether there is hypertrophy or not). As a result of constant tension of the nervous system, stagnant foci of excitation arise in the cells of the cerebral cortex, which leads to temporary and then permanent spasms of small arterioles and an increase in diastolic (lower) pressure. Therefore, nature does not protect them as much as women, with the help of estrogens. Quite often you can hear arguments that this decision was made by illiterate people, since sick people really need Corvalol. Vascular complications. For hypertension stages I and II. The day after.

Symptoms of the disease

There are several symptoms that can be used to determine the presence of arterial hypertension. These include:

facial hyperemia;
active sweating;
systematic increase in blood pressure;
the patient feels anxious;
the appearance of breathing problems;
change in heart rate;
migraine.

In frequent cases, there are no symptoms at the initial stage of disease development. The patient feels discomfort only in the second stage of hypertensive disease with primary damage to the heart - in the case of a strong increase in blood pressure.

Etiology and pathogenesis

Etiology includes the causes of primary and secondary hypertension. Primary is considered to be a disease that develops independently, without accompanying pathologies. Secondary is a consequence of a serious pathology of internal organs, which causes changes in the tone of blood vessels.

Until now, hypertension is considered a disease of unknown etiology. That is, the exact cause of its occurrence has not been established. But there are known factors that contribute to the development of persistently high blood pressure:

Stress is a constant nervous and mental tension that accompanies a person for a long time. Under certain conditions, stress can cause a sharp hypertensive crisis, leading to myocardial infarction or hemorrhage in the meninges - stroke;
Hereditary factor - a direct connection has long been established between the presence of ancestors who suffered from hypertension and its development in children. Moreover, the more generations of hypertensive patients there are in the patient’s genealogy, the earlier the symptoms of the disease appear;
Overweight - almost all patients with hypertension are overweight, obese people of varying degrees. A pattern has been revealed: for every 10 kilograms of excess visceral fat, blood pressure increases by 2-4 mm. rt. Art. even in people who do not suffer from hypertension;
Occupational factor – constant nervous or physical stress, the need to concentrate for a long time, exposure to noise or a rapidly changing work environment almost inevitably leads to the development of hypertension;
Errors in diet and bad habits - a pattern of development of hypertension with excessive consumption of salty foods has been identified. It is believed that the development of the disease is facilitated by the consumption of alcohol, caffeine, and smoking;
Age-related and hormonal changes - hypertension can develop at a young age as a result of excessive production of male sex hormones - androgens. Almost always, an increase in blood pressure accompanies menopausal changes in women associated with a drop in the level of female sex hormones in the body.

Provoking factors

Stages of pathology development

Hypertensive disease is dangerous because it can progress. Taking into account changes in blood pressure, doctors divided the process of disease development into several stages. The nature of the dysfunction of the cardiovascular system is taken into account.

In the first degree of hypertensive (hypertensive) disease with predominant damage to the heart, the systolic (upper) value of blood pressure increases moderately - within the range of 135-159 mm. rt. Art., the limit of the diastolic (lower) value is from 89 to 99 mm. rt. Art.
The second stage of development of the disease, when pressure can increase to 179 mm. rt. Art.
The third is over 181 mm. rt. Art.

There are several stages of hypertensive (hypertensive) disease with predominant damage to the heart. Namely:

At the first stage there is a minor violation.
On the second, pronounced hypertrophy of the left ventricle of the heart can be detected.
The third stage is characterized by the occurrence of coronary heart disease and heart failure.

In hypertensive disease with primary damage to the heart (ICD 10 code 111.9), there are no congestion. At the initial stage of development of the disease, blood pressure can be normalized with the help of antihypertensive drugs. In the second stage of the disease, blood pressure may fluctuate, so health complications often arise. In some cases, antihypertensive treatment is ineffective. For this reason, therapy is carried out using medications that normalize heart function. At the last stage of the disease, the functioning of the heart is disrupted. Patients experience deteriorating general health and pain in the affected organ.

Symptoms of hypertensive hypertension with predominant damage to the heart

The main criteria for hypertensive predominant heart damage in hypertension include 3 groups of symptoms: headache and/or dizziness, high pressure readings when measured, pain in the heart area.

Headache and accompanying symptoms

The most common symptom of the disease, which occurs in 95% of patients, is headache. It can be isolated or combined with episodes of dizziness and tinnitus. Classic option for hypertension:

pressing and dull, less often burning;
more in the morning, decreases towards noon;
in the back of the head;
pulsation in the crown area;
a feeling of heaviness or fullness in the temples and frontal area;
worsens with stress, mental work and excessive physical activity.

The second type of pain appears during emotional overstrain and decreases with relaxation. More often aching, monotonous.

When the disease is very severe, the third type occurs:

intense, unbearable;
in the back of the head with distribution throughout the entire head area;
accompanied by nausea and vomiting.

As a rule, it occurs when intracranial pressure increases and is dangerous due to the development of cerebral edema.

High Pressure Detection

In some patients, hypertension occurs latently, and periodic headaches do not cause severe discomfort; they are explained by overwork. Therefore, in approximately half of the cases, the detection of indicators from 140/90 mm Hg. Art. is a complete surprise. The diagnosis is made if such episodes are repeated at least twice during a visit to the doctor.

It is important that it is precisely in hypertensive patients that it is difficult to detect a connection between high numbers and well-being. It happens that the patient does not feel readings above 170 units, while other patients already at 150 complain about:

heaviness or pain in the head;
flickering of flies;
increased fatigue;
nosebleeds that bring relief;
cardiopalmus.

For the condition of blood vessels and blood circulation, not only high pressure is important, but also its changes.

Heart pain

Increased pressure leads to a high load on the heart during the contraction phase, and during the relaxation period, not enough blood enters the coronary vessels due to myocardial hypertrophy. Therefore, the heart does not have enough nutrition and oxygen, which causes pain.

They, in contrast to typical angina (ischemia), are characterized by:

short attacks;
can be both at rest and under load;
low or moderate intensity (the patient can continue to move and do normal work);
are felt not in the middle of the chest (behind the sternum), but on the left side (in the area of the projection of the heart);
weaken after normalization of pressure;
are not removed by Nitroglycerin.

In older people, hypertension is often combined with angina, so the nature of the pain may change. For young patients, sharp but short sensations are typical; they radiate under the shoulder blade or to the left arm. Less likely to appear are long-lasting and aching ones due to stress or physical overload.

If hypertension is complicated by heart failure, then the following is added to the pain:

shortness of breath during physical activity;
low load tolerance;
swelling in the legs;
heaviness in the right hypochondrium.

Heart dysfunction

Hypertensive disease with damage to the heart leads to congestion over time. During the development of heart failure, due to loss of elasticity of the heart walls, blood circulation is disrupted, that is, the pumping function of the muscles is weakened. Due to a decrease in blood flow in the arteries and vessels, blood pressure in the heart itself may increase, which becomes the reason for its poor functioning. Under such conditions, the body is not sufficiently supplied with oxygen, just like the heart.

Due to a lack of oxygen, the heart begins to work actively in order to prevent the development of oxygen starvation of the brain. This phenomenon further depletes the heart muscles. As a result, hypertension develops and the risk of a heart attack increases significantly.

Risk group

Alcohol drinkers are also at risk. Many may disagree, since French scientists have long proven the positive properties of red wine on the cardiac system. Everything seems to be correct, but there are small nuances. We are talking about a natural product called dry wine made from grapes, and in very small quantities (no more than one glass a day), and not at all about our favorite feasts, where alcoholic drinks flow like a river. Much has already been said about the dangers of smoking and there are no excuses: smoking is harmful to our heart.

A sedentary lifestyle is the scourge of modern civilization. Our vascular system is naturally tuned to physical activity. If the heart does not feel the load, then it ages faster. So outdoor activity is not a luxury, but a means of improving the functioning of the heart muscle and preventing heart attacks and heart failure.

Diagnostic measures

If one of the symptoms of a hypertensive disease primarily affecting the heart or kidneys appears, it is important to consult a doctor immediately. Treatment at home can be harmful and make the situation worse. Only after a thorough examination of the patient will the doctor prescribe effective medications that will help cure the disease and eliminate the unpleasant symptoms of the disease.

Diagnosis is carried out using a physical examination, CG and ultrasound of the kidneys. The doctor selects treatment depending on the overall clinical picture. The cardiologist takes into account the severity of the pathological process in the heart.

Due to heart failure, the kidneys function poorly and can retain fluid in the body. Under such conditions, the patient may experience swelling and increased blood pressure. Over time, this leads to congestive heart failure. If timely and comprehensive treatment is not carried out to normalize blood pressure, serious complications may arise as the heart quickly depletes. Under such conditions, there is a high risk of heart attack and sudden death.

First of all, your health rapidly deteriorates, your blood pressure quickly rises and your heart stops completely. At stages 2 and 3 of the disease, crises occur. During a crisis, pressure can rise rapidly due to the fact that the heart is not able to provide the necessary blood flow and cope with increased vascular tone. Pulmonary edema develops, which can also be fatal.

Hypertensive disease affecting the kidneys or heart has the same symptoms as hypertension. For this reason, self-medication is not recommended. First you need to diagnose the disease.

Diagnosis of the patient

To detect damage to the heart muscle due to hypertension, an ultrasound of the heart and an ECG are performed. Ultrasound helps:

identify thickening of the walls and immediately measure them;
calculate myocardial mass using formulas;
determine the relationship between heart volume and body surface area (the most accurate sign of hypertrophy).

When interpreting the ECG, attention is paid to the symptoms of left ventricular enlargement and deterioration of heart nutrition (ischemic changes). Often, to identify them, tests with physical activity (an exercise bike, a treadmill) are needed.

These basic diagnostic methods are necessarily complemented by:

blood pressure measurements in 24-hour monitoring mode, including at night;
blood tests: general, kidney tests, potassium and sodium, glucose, cholesterol and lipids;
urine tests: general, Rehberg test, according to Nechiporenko, Zimnitsky;
examination of the vessels of the fundus (performed by an ophthalmologist);
Ultrasound of the kidneys, and according to indications, the adrenal glands and the thyroid gland;
electroencephalography, examination by a neurologist.

How to carry out therapy?

Hypertensive disease or cardiac hypertension is treated in the same way as hypertension - antihypertensive therapy is carried out. If you normalize blood pressure, the load on the heart will decrease. Additionally, it is necessary to use medications that are used in the treatment of heart failure. At the initial stage of disease development, monotherapy with ACE inhibitors is used. During treatment you should lead a healthy lifestyle.

Treatment is with diuretics, calcium antagonists and beta blockers. There is no universal treatment regimen; the doctor selects it depending on the individual characteristics of the patient and blood pressure values.

Subjective symptoms of the disease

About 65% of patients suffering from cardiac hypertension report the following symptoms:

shortness of breath, increased heart rate;
headache, dizziness;
hyperemia (redness) of the facial skin;
moderate pressing pain in the chest;
fluctuations in blood pressure;
increased anxiety, feeling of fear.

The rest of the patients do not find any manifestations other than periodic or episodic increases in blood pressure. They lead their usual lifestyle until they encounter one of the possible complications of the pathology.

Folk method

For hypertensive disease with predominant kidney damage, it is useful to use traditional methods of therapy, but only as prescribed by a doctor.

So, with the help of rosehip infusion, you can remove fluid from the body, which will reduce the load on the heart and eliminate swelling. To prepare a healing remedy, you need to pour boiling water over the crushed plant and leave for some time. Take half a glass several times a day.

You can use fresh parsley to treat your heart. Doctors recommend including greens in your diet.

Chamomile tea, valerian root and motherwort have a positive effect on heart function.

Carrying out diagnostics and treatment

Each treatment complex is selected purely individually, based on the characteristics of the body, as well as the stage of the disease. Along with taking medications, the patient should change their lifestyle, in particular, eliminate harmful factors.

This is done in order to reduce the load on the vascular system. A special diet prescribed by doctors becomes a huge addition to general therapy. Without a balanced diet, the medications will not have the desired effect.

Life changes - quitting smoking, alcohol, junk food. It doesn't hurt to follow a low-carb, sugar-free diet.

The most important rule in treatment should be to avoid all possible stress on the psyche. Stress itself is characterized by increased blood pressure, and with such an illness this is unacceptable.

Hypertension is treated in a similar manner to hypertension. Special medications and procedures are prescribed. For an accurate diagnosis, doctors prescribe examinations such as:

physical examination;
echocardiogram;
ultrasound examination of the kidneys;
EEG.

Treatment is prescribed based on the severity of pathological changes occurring in the heart. If heart failure is present, medications for the condition are appropriate. At the initial stage of the disease, ACE inhibitors and lifestyle changes are used. If the stages are already advanced, then combination therapy is used.

ACE inhibitors. Diuretics

Diuretics for diabetes should be taken with caution, as the medications can cause spikes in blood sugar. Calcium antagonists. Beta blockers. Folk remedies also play an important role in easing the course of the disease.

Alternative therapy can be used after doctor's approval. Taking it on your own may have the opposite effect.

Folk remedies that alleviate the course of the disease also play an important role. Alternative therapy can be used after doctor's approval. Self-administration may have the opposite effect.

Rosehip decoction can help the heart function by removing excess fluid from the body. You also need to supplement your diet with parsley, preferably fresh. It has an effect similar to rosehip. Medicinal plants such as chamomile, mint, St. John's wort and valerian will help balance the nervous system. They are best taken at night.

True, in order for traditional medicine to give the desired effect, they must be taken according to the recommended dosage and prepared correctly.

Information about hypertension is provided in the video in this article.

Doctors' recommendations

To prevent the development of a disease that primarily affects the heart, it is important to lead a healthy lifestyle and quit smoking. It disrupts the functioning of the entire body, since nicotine negatively affects vascular permeability.

It is important to do regular light exercise and eat right to avoid problems with excess weight. Drink alcohol in moderation or avoid it altogether.

Forecast

It is determined by the presence and severity of organ damage associated with arterial hypertension - cerebrovascular and coronary insufficiency, hypertrophy and dilatation of the heart, and the development of arteriolonephrosclerosis. With inadequate treatment, the progressive nature of hypertension leads to heart failure and (or) renal failure, which can cause death in patients.

Significant arterial hypertension increases the risk of hemorrhagic stroke, as well as myocardial infarction (in patients with coronary heart disease), which can also be fatal or lead to disability. Systematic adequate antihypertensive therapy significantly improves the vital prognosis and prolongs the working capacity of patients, significantly reducing the incidence of hemorrhagic strokes and slowing down the development of cardiac, renal, and, according to some data, coronary insufficiency.

Effective drugs

Heart disease is treated with the following medications:

Thanks to diuretics, you can eliminate swelling and normalize the functioning of blood vessels. Using “Hydrochlorothiazide”, “Indapamide”, “Chlorthalidone”, “Veroshpiron”, “Metoclopramide”, “Furosemide” eliminates congestion in the circulatory system and kidneys, removes waste and toxins from the body, and normalizes blood pressure.
With the help of "Bisoprolol", "Carvedilol", "Betaxolol" you can normalize the functioning of the heart.
Thanks to angiotensin-converting enzyme inhibitors, it is possible to improve the functioning of blood vessels and cause their dilation. The use of Metoprolol, Captopril, Berlipril, Capoten, Trandolapril, Lisinopril is aimed at restoring the full functioning of the heart and blood vessels.
Reduce the load on the heart with Amlodipine, Corinfar, Nifedipine, Verapamil and Diltiazem. These drugs are called calcium channel blockers.
Effective angiotensin receptor blockers include: Losartan, Valsartan, Telmisartan, Micardis.

If hypertension occurs due to a violation of the regulation of blood pressure by the centers of the brain, then treatment is carried out using Clonidine, Andipal, Moxonitex, Physiotens.

Diuretics

When edema occurs, doctors often prescribe diuretics - diuretics. These include Furosemide. The drug is recommended for edema caused by:

kidney pathology;
hypertension;
cerebral edema;
hypercalcemia.

The dose is strictly prescribed by the attending physician. "Veroshpiron" is a potassium-sparing drug that prevents calcium from leaving the body. Prescribed for the prevention of edema, as well as:

with essential hypertension;
liver cirrhosis;
ascites;
nephrotic syndrome;
hypomagnesemia;
hypokalemia.

And thanks to Indapamide, you can increase the elasticity of blood vessels. The drug does not harm your general health and does not affect blood glucose levels. With the help of the drug, hypertrophy of the left ventricle of the heart is reduced. Prescribed for moderate hypertension and chronic heart failure.

Preventive measures

The best prevention is diet. To prevent the onset of a disease or avoid complications of an existing one, you need to carefully monitor your diet. Food should be healthy, rich in vitamins and microelements. You should not eat fried, salty, fatty or fast food products. In addition, you must:

To refuse from bad habits.
Monitor the daily volume of fluid consumed (no more than 1.2 liters per day).
Limit the amount of salt or completely eliminate it from the menu.
Avoid stressful situations, overwork and physical overload.
Be in the fresh air more often and normalize your sleep pattern.

In heart failure, the prognosis can be either positive or fatal. The most important thing is to see a doctor in time. In this case, the outcome will be favorable, because the correct prescription will help to begin a course of treatment in a timely manner and protect the heart, as well as brain cells, from “death.”

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