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Hypertension is one of the most common diseases of the cardiovascular system. It is established that 20-30 % of the adult population suffer from arterial hypertension. With age, the prevalence of the disease increases and reaches 50-65 % in people over 65 years. Hypertension is one of the most common chronic nonspecific human diseases, which in General account for 30% of all deaths according to who. Available statistics for Russia indicate that hypertension affects at least 40% of the population 58% of women and 37% of men suffer from hypertension, only 48% of women and 21% of men are treated, but the target blood pressure reaches only 17.5% of women and 5.7% of men. Moreover, hypertension occurs now even in children. 3.5 % of current children and adolescents in Russia have hypertension.
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Thus, the current prevalence of hypertension is epidemic in nature, and the problem of hypertension can be regarded as a large-scale non-infectious pandemic. The need to combat hypertension is due to the fact that it is one of the leading causes of disability and mortality. Prolonged increase in blood pressure leads to the defeat of target organs and the development of cardiovascular complications (heart failure, myocardial infarction, stroke and kidney failure). Thus, the main indicator of the effectiveness of hypertension therapy is the achievement and maintenance of disease control (achievement of the target blood pressure level). The high prevalence and socio-economic impact of hypertension on the life of society and each patient necessitate the prevention and timely detection of risk factors, the adequacy of therapy, prevention of complications. Objective: Epidemiology of hypertension. Influence of risk factors on the course of hypertension, in particular physical activity. Relevance: despite significant progress in the study of the etiopathogenesis of hypertension (AH), this problem is still one of the most urgent in modern medicine, one of the most significant social problems. The latter circumstance is connected both with the wide spread of this disease, and with the fact that high blood pressure contributes to the development of major cardiovascular catastrophes that lead to high mortality in Russia (myocardial infarction and brain stroke). The proportion of young people in the structure of hypertension morbidity has increased. The high prevalence of hypertension and the severe complications it leads to require further development of methods for early detection and prevention of this disease. What is hypertension? Hypertension-persistent increase in blood pressure from 140/90 mm Hg. V. and above. Essential hypertension (hypertension) is 90-95 % of cases of hypertension. In other cases, secondary symptomatic hypertension is diagnosed: renal (nephrogenic) — 3-4 %, endocrine–0.1-0.3 %, hemodynamic, neurological, stress, due to the intake of certain substances (iatrogenic) and hypertension of pregnant women, in which increased blood pressure is one of the symptoms of the underlying disease.
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The frequency of detection of high blood PRESSURE increases significantly with age. According to large-scale surveys conducted in recent years, the frequency of hypertension in people aged 50-59 years was found in 44 % of cases, in people aged 60-69 years-in 54%, and in people over 70 years — in 65% of cases. All this makes the problem of hypertension extremely relevant. Causes of development there Are a number of predisposing factors: - heredity; inherited polygenic factors that cause high activity of long-acting Pressor mechanisms and / or decreased activity of depressor mechanisms ‒ age (in men older than 45 years, in women older than 65 years); — inactivity; ‒ obesity ‒ increases the risk of hypertension 5-6 times, due to the occurrence of metabolic syndrome. Overweight also contributes to atherosclerosis, which leads to vasoconstriction and increased blood PRESSURE; ‒ increased consumption of sodium chloride (table salt) more than 6 g per day increases blood PRESSURE. Sodium increases osmotic pressure, which increases the volume of circulating blood and cardiac output; - insufficient use of potassium;
excessive consumption of alcoholic beverages violates the Central regulation of blood pressure; - nicotine contributes to damage to the vascular endothelium and activation of local vasoconstrictor factors. - external factors: climate; improper nutrition, especially excessive consumption of salt poor water consumption; harmful working conditions; microclimate of the premises; improper rest; sound and electromagnetic fields, radiation; deficiency of vitamins, essential Bioelements; relationships with people. At present, scientists, since G. F. Lang in Russia and later the famous physiologist G. Selye in Canada, found that an important component of the pathogenetic mechanisms that lead to the development of hypertension and affect the prognosis are working conditions, life, social factors and psycho-emotional stress. An important role is played by long-term mental trauma. Hypertension clinic Complaints when blood pressure rises: headaches in the occipital, temporal areas of a pressing or pulsating nature, heaviness in the head, dizziness, poor sleep, mood instability, decreased mental performance, noise in the head and ears. The flickering of flies or stars before the eyes, the appearance of a mesh or shroud, double vision, blurred contours and outlines of objects, reduced vision. Heartbeat, heart failure, discomfort in the heart, turning into aching or compressing pain, shortness of breath, General weakness, decreased physical performance, the appearance of edema (with prolonged course of the disease). The examination reveals the pallor of the skin, sometimes redness of the face, in the later period of the disease acrocyanosis, pasty or swelling of the legs (feet, then shins), the forced position of orthopnea. The Main method of diagnosing hypertension is the measurement of blood pressure by the method of N. S. Korotkov. In accordance with the obtained figures of blood pressure, the degree of hypertension is determined. Blood pressure is measured using a tonometer. They are mechanical and electronic. Electronic versions are convenient and easy to use, besides counting the pulse. With a daily blood PRESSURE monitor is measured automatically at regular intervals most often-at intervals of 15 minutes. in the daytime and 30 minutes. - at night. Daily blood PRESSURE monitor provides important information about the state of the mechanisms of cardiovascular regulation, in particular, allows you to identify the daily variability of blood PRESSURE, hypotension or hypertension, uniformity of antihypertensive effect of drugs.
Electrocardiogram (ECG) — is an indispensable method of diagnosis, primarily, various cardiac arrhythmias. In addition, ECG allows to determine the so-called left ventricular wall hypertrophy, which is typical for hypertension. In addition to these diagnostic methods, other methods are also used, such as echocardiography (ultrasound of the heart), which allows to determine the presence of defects in the structure of the heart, changes in the thickness of its walls and the state of the valves. Of course, it is impossible to do without a biochemical blood test. It is necessary to clarify the level of cholesterol and lipoproteins. After all, these substances are the basis of atherosclerosis, which in turn serves as fertile ground for the development of hypertension.
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