24Mar

Hypertensive disease: causes of development and risk factors

Causes of hypertension are a topic of a separate study, since the list of risk factors for this pathological ailment is wide enough. Among the main ones, genetic predisposition, hypernatremia, excessive drinking of alcohol, fetal bearing, hypodynamia, age changes are distinguished. The issue of noise and vibration remains questionable for the time being.

What are the main causes of hypertension?

The most important risk factor for hypertension is a prolonged psychoemotional stress. However, one can not ignore that most people regularly undergo sometimes significant psychoemotional effects without the development of hypertensive disease. According to the research of KV Sudakov, only with the weakness of( congenital or acquired) mechanisms of stability and adaptation in humans under the influence of stress, there are cerebral disorders. They can manifest themselves in the form of a neurosis or somatic disease, in particular hypertensive disease.

Heredity is of great importance as a factor in the development of hypertension. Numerous data on the high incidence of hypertension among relatives of people with hypertension have been obtained. The important role of heredity in the development of hypertensive disease was investigated by Yu. V. Postnov, who showed that the genetically caused disruption of the function of cell membranes with the formation of "stagnant" over-threshold concentrations of free calcium in the cytoplasm is the platform on which the action of other risk factors is realized.

Consequences of hypernatremia and reduction of sodium stocks

Particular attention attracts as a risk factor for hypertensive disease increased intake from food sodium chloride.

However, it remains unclear to what extent and in whom the excess intake of sodium chloride has a pathological effect on the level of blood pressure. Probably, this factor has a significant effect on the regulation of blood pressure only in persons with a specific hereditary background. Perhaps, there is a weakness of genetic mechanisms that determine the reliability of adaptive-adaptive processes with respect to salt overloads. The systematic and prolonged use of table salt under these conditions leads to a violation of the humoral regulation of the water-electrolyte balance, which is manifested in the inhibition of the functional state of the kallikrein-kinin system, in changes in the renin-angiotensin-aldosterone and sympathic-adrenal system, and in the steroid function of the adrenal glands. The most pronounced shifts concern renal humoral mechanisms of sodium and water transport and a decrease in the content of natriuretic prostaglandins( PGE2), which leads to a delay in this cation in the body.

One of the consequences of hypernatremia is an increase in the volume of circulating blood that does not correspond to the available volume of the vascular bed and thus leads to the development of hypertension. In this case, there is also an increase in the sensitivity of arterioles to pressor agents, which predisposes them to vasospastic reactions. The group at risk of hypertension includes people who overeat salty foods. With excessive consumption of sodium chloride, the equilibrium between the extra- and intracellular sodium content increases towards the increase of the extracellular salt, which in turn can change the transport of calcium through the cell membranes of the smooth muscles of the arterioles and affect its tone a second time.

But at the same time, excessive accumulation of sodium in the body leads to an increase in the threshold of taste sensitivity to salt. This contributes to the loss of control over the consumption of table salt in food and thus closes the vicious circle.

It should be noted that these changes are most pronounced among people who smoke and drink alcohol.

On the contrary, the decrease in sodium stores in the body causes a decrease in the threshold of sensitivity to salt and the exacerbation of taste sensations. This is of great practical importance, since it allows the effective use of the appointment of a salt-free diet, diuretic therapy, etc.

The risk of developing hypertension increases the excess weight of

What else can cause hypertension in people of all ages?

There is every reason to consider overweight a risk factor for hypertension. In prospective observations, it has been established that individuals who gain weight have a greater increase in blood pressure than those who do not change their body weight, then, as with weight loss, a decrease in pressure is detected. It was found that the risk of developing hypertension is 6 times higher for those who were "complete".

The development of arterial hypertension in obese individuals may be associated with excessive sodium intake, increased tubular sodium reabsorption due to the increase in their insulin level in the blood, a disproportion between increased blood volume and vessel capacity, increased activity of the sympathetic nervous system, etc.

Hypodinamia andalcohol as risk factors for the development of hypertension

Hyperdynamics may also be included in the risk factors for the development of hypertension. Long-term restriction of physical activity, especially in middle and old age, can lead to different manifestations of hypertensive syndrome. On the contrary, systematic physical training of hypertensive patients gives an antihypertensive effect. This is explained by a decrease in the level of insulin in the blood plasma in training patients and indirectly increased excretion of sodium by the kidneys. An important role in reducing blood pressure during training is the decrease in the concentration of norepinephrine and adrenaline in the blood plasma, as well as peripheral resistance to blood flow.

The most important risk factor for the development of hypertension is the increase in blood pressure within the "dangerous zone".This is confirmed by the results of our long-term observations.

Alcohol can also be considered as a factor of high risk of hypertension, with the cessation of alcohol consumption sometimes leading to a significant reduction in elevated blood pressure. Many doctors consider alcohol in hypertensive disease unacceptable.

At the same time, there is no conclusive evidence of smoking as a cause of hypertension. However, given that smoking, of course, is involved in the pathogenesis of coronary heart disease, obliterating atherosclerosis of the arteries of the lower limbs, etc., it is necessary to consider this harmful habit as a factor significantly burdens the prognosis of patients with essential hypertension.

Hypertensive disease and pregnancy

The possibility of bearing and giving birth to a healthy child for a woman suffering from hypertension is most dependent on the stage of hypertension.

With the third( severe) stage of hypertension, pregnancy is absolutely contraindicated.

Of course, pregnancy is not the cause of the development of hypertension, but any stage of hypertension can affect the course of pregnancy. Therefore, a pregnant woman should immediately apply not only to the gynecologist, but also to the cardiologist and regularly visit him. Cardiologic examination of a pregnant woman with hypertension includes regular measurement of blood pressure, conducting an ECG study, once every two weeks urine tests are done to determine the protein.

With hypertension in 60% of cases, pregnancy is complicated by late toxicosis with severe leaks. A pregnant woman suffers from a headache, she may have visual disturbances. The most formidable complications of arterial hypertension during pregnancy are cerebral hemorrhage and retinal detachment. However, to prevent the development of complications of hypertension in pregnancy is possible with constant and careful observation of the cardiologist and obstetrician-gynecologist, who leads the pregnancy.

With a rise in blood pressure, the emergence of hypertensive crises, signs of late toxicosis, persistent deterioration of well-being, a pregnant woman with hypertension should immediately be sent for treatment.

Blood pressure elevations can occur in women during pregnancy, which can lead to serious complications during childbirth. To promote the development of hypertension can atherosclerosis of cerebral vessels, especially if it affects certain departments that control the vascular tone.

General recommendations are the same: complete or almost complete elimination of table salt from the diet, full and easy food with natural products, regular walks, moderate physical activity, adequate rest and sleep, favorable home environment.

Hypertensive illness in people in old age

A very serious risk factor for developing hypertension is age. Hypertensive illness in elderly people is diagnosed more often than in young people.

A small increase in blood pressure in young people is largely "physiological", and subsequently they have relatively rare hypertension. Individuals of older age groups( over 40 years), even with a slight increase in blood pressure, considering the high probability of developing hypertension in the elderly, need active preventive measures.

It also turned out that in cases where there is a combination of two or more factors, the degree of risk of hypertension is increasing.

Possible risk factors for hypertension

To date, the role of noise and vibration as a risk factor for developing hypertension is not entirely clear. Noise and vibration are not the causes that predispose to the development of hypertension. But these factors increase the risk of developing hypertension in people with prehypertensive condition. In this regard, it is inappropriate to allow persons with AD in the "dangerous zone" to work associated with significant noise and vibration. Thus, the specific professional activity of the adult population is a risk factor for the development of hypertension.

Hypertensive disease, also called essential hypertension, is a disease characterized by an increase in blood pressure. It is believed that this is due to the sum of genetic and external factors and is not associated with independent lesions of organs and systems. Hypertonic disease differs from psychogenic diseases in that, psychogenically arising, continues to develop in its own mechanisms, regardless of the existence of the initial traumatic situation. Changes in the psyche in hypertensive disease are diverse and depend on personality characteristics, severity and the stage of the most hypertensive disease. Of course, personality features and the response of the nervous system to external influences are important.

Early detection of psychopathological disorders, their timely correction are important factors that determine the success of rehabilitation activities in patients with essential hypertension.

Patients with hypertensive disease with cardialgia are also more expressed psychopathological symptoms mainly in the form of hypochondriacal, anxious and hysterical syndrome.

In persons with occupational arterial hypertension and hypertensive patients, the following features of the character are most often revealed: increased excitability, psychological asthenic, demonstrative and, less often, seclusion, gloominess, propensity to depression.

What else can cause hypertension?

Possible risk factors for hypertension can be eating disorders;has the meaning of sex, age.

In the pre-diagnostic stage( when the diagnosis of hypertension is not yet set and an increase in blood pressure is not detected), asthenic symptoms can be observed, which the patient usually describes after he has detected an increased blood pressure. Often the most hypertensive disease is preceded by a long traumatic situation, causing asthenic disorders, which can initially have a psychogenic character.

For individual patients, especially if they already have an idea about this disease, if their relatives were sick or died of hypertension, with an alarming-hypothetical character, the detection of high blood pressure is perceived as a tragedy or a catastrophe, the collapse of all hopes.

This is fundamentally the wrong approach, which requires clarification from the attending physician and, if necessary, contacting a psychologist.

So, we sum up: , the main causes of hypertension are psychoemotional overstrain, pregnancy, weighed weights, increased intake of sodium chloride with food, overweight, AD in the "danger zone", age over 40 years. Less important factors are such factors as hypodynamia, alcohol consumption, noise and vibration. These factors require consideration when constructing an individual plan for primary prevention of hypertension and rehabilitation of patients.