Гипертония


  • Гипертония (синонимы артериальная гипертензия, гипертоническая болезнь).

    Это заболевание, которое проявляется длительным и стойким повышением артериального давления от 140/90 мм ртутного столба и выше, зафиксированного минимум в 3-х измерениях, сделанных в разное время и в спокойной обстановке с помощью непрямой сфигмоманометрии (манжетки и тонометра + фонендоскоп). При этом обследуемый не должен принимать лекарства и иные вещества, влияющие на повышение артериального давления.

    В медицине различают две формы гипертонии:

    Эссенциальная (дословно «врожденная», «внутренняя») или первичная гипертензия — при данной форме причин, вызывающих повышение артериального давления много (наследственность, курение, переедание, стрессы…), но при этом ни одна из них не является главной «виновницей» заболевания, то есть заболевание развивается только при их сочетании. Диагноз ставиться только после исключения симптоматических гипертензий. По разным данным от 80 до 90 % всех больных гипертонией страдают именно этой формой болезни.

    Симптоматическая или вторичная гипертензия – при этой форме высокое артериальное давления это всего лишь симптомом (проявлением) другого заболевания, то есть не является «самостоятельным» заболеванием и требует лечения и коррекции основного вызвавшего его состояния.

    Так же каждую из форм делят по её течению:

    Доброкачественную – болезнь прогрессирует медленно без выраженного нарушения функций организма (до определенной стадии недуга), хорошо контролируется — при адекватно проводимой терапии.

    Злокачественную – болезнь плохо поддаётся контролю и лечению, приводит к ранним осложнениям (инсульт, инфаркт миокарда, почечная недостаточность) и смерти больного.

    Есть еще более сложная и специфическая классификация (степень, стадия, риск) которую исползают врачи для формирования диагноза для своих пациентов, о ней будет написано отдельно.

  • Классификация. Степень Стадия Риск

    Классификация.

    Для чего она нужна?

    Для провидения успешной терапии, оценки требуемых затрат и прогноза течения заболевания в медицине профессиональным сообществом врачей всегда разрабатывается и утверждается определённая единая классификация каждой болезни, так же она обеспечивает более правильный подход к терапии пациента в независимости от квалификации доктора.

    Для чего в ней разбираться?

    В современных реалиях все чаще пациенты при обращении за помощью, консультацией к врачу выступают в качестве «деловых партнеров» (соучастников) лечебного процесса, а это уже требует от самих больных владением базовых знаний о своём недуге. Нельзя быть «партнером» (соучастником) в том процессе в котором ничего не понимаешь.

    Как правильно понимать выставленный (написанный в карте, выписке) диагноз? Например, гипертоническая болезнь 2 степень, стадия II, риск 2. Далее в тексте идет разнесение.

    И так степень гипертонической болезни показывает уровень (миллиметрах ртутного столба) повышения артериального давления у пациента, измеренного по методу Короткого, который учитывает два показателя, это систолическое артериальное давление (САД) и диастолическое артериальное давление (ДАД). Ниже приведена таблица для наглядности.

    Категории Систолическое

    Диастолическое
    Оптимальное АД Не больше 120         и Не больше 80
    Нормальное АД 120-129     и/или 80-84
    Высокое нормальное АД 130-139     и/или 85-89
    АГ I степени, «мягкая» 140-159     и/или 90-99
    АГ II степени, «средняя» 160-179     и/или 100-109
    АГ III степени, «тяжелая» Больше/равно 180     и/или Больше/равно 110
    Изолированная систолическая АГ Больше/равно 140         и Меньше 90

    АД – артериальное давление

    АГ — артериальная гипертензия, артериальная гипертония

    Стадия гипертонии отражает уровень развития поражений и нарушений функций в органах «мишенях» – это сердце, головной мозг, сетчатка глаз, почки, крупные магистральные сосуды (аорта, сонные, подключичные артерии).

    I стадия – отсутствуют изменения в органах «мишенях».

    II стадия – присутствие одного или нескольких изменений в тканях (группа клеток) органов «мишеней».

     

    III стадия –присутствие симптомов поражения органов «мишеней», по другому ассоциированные (связанные) клинические состояния.

     

    Под риском при гипертонической болезни понимают сочетание вероятности и последствий наступления сосудистых «катастроф», таких как инсульт или инфаркт миокарда. Уровень риска определиться исходя из степени и стадии гипертонии в сочетание их с факторами риска и ассоциированными (связанными) заболеваниями. Ниже для наглядности представлена таблица:

    Стратификация (дословно «деление») общего сердечно-сосудистого риска у больных с артериальной гипертонией [Рекомендации по лечению артериальной гипертонии ESH/ESC, 2013.]

    Факторы риска, бессимптомное поражение органов-мишеней  или ассоциированное клинические состояния  

     

    Артериальное давление, мм рт.ст.

    Высокое нормальное (САД 130-139 или ДАД 85-89) АГ I степени (САД 140-159 или ДАД 90-98) АГ II степени (САД 160-179 или ДАД 100-109)  

    АГ III степени (САД 180 и больше или ДАД 110 и больше)

    Факторов риска нет Не значимый Низкий риск Средний риск Высокий риск
    1-2 факторы риска Низкий риск Средний риск Средний или высокий риск Высокий риск
    3 фактора риска и более Низкий и средний риск Средний и высокий риск Высокий риск Высокий риск
    Поражение органов-мишеней, ХБП III степени или диабет  

    Средний и высокий риск

    Высокий риск Высокий риск  

    Высокий и очень высокий риск

    Клинически выраженные сердечно-сосудистые заболевания, ХБП IV степени или сахарный диабет с поражением органов мишеней или с факторами риска Очень высокий риск Очень высокий риск Очень высокий риск  

    Очень высокий риск

     

    ХБП – хроническая болезнь почек

    Низкий риск – I степень

    Средний риск – II степень

    Высокий риск – III степень

    Очень высокий риск – IV степень

  • Причины

    Причины или факторы риска эссенциальной, первичной артериальной гипертонии.

     

    На которые мы влиять не можем «пока»:

    • Наследственность или генетическая «предрасположенность» — повышенная вероятность возникновения артериальной гипертонии при «положительном» семейном анамнезе (болеет кто-то из родителей).
    • С увеличением возраста повышается риск возникновения первичной гипертензии, у мужчин после 55 лет, у женщин после 65 лет.

     

    Повлиять на которые «мы» в силах:

    • Постоянный, длительный по времени психоэмоциональный стресс или ежедневные стрессовые ситуации дома, на работе, на учебе и т.д. Ночные смены, не нормированный рабочий день, длительные рабочие вахты, командировки, поездки тоже относиться к этой категории причин.
    • Вредные привычки — это переедание, злоупотребление алкоголем, табакокурение, употребление наркотических веществ.
    • Низкая физическая активность так называемая «гиподинамия».
    • Избыточное потребление поваренной соли.
    • Недостаточное поступление в организм кальция и магния, витаминов и микроэлементов.
    • Хронические не леченные воспалительные заболевания почек, легких, печени, поджелудочной железы.
    • Болезни, протекающие с нарушением обмена веществ такие как сахарный диабет, ожирение, атеросклероз.

  • Последствия гипертонии при отсутствие адекватного лечения

    Ускоренное развитие атеросклероза и артериосклероза, приводящее к ишемической болезни сердца, ишемическому инсульту головного мозга, инфаркту миокарда, ишемической нефропатии, хронической ишемии головного мозга, заболеваниям периферических сосудов и ретинопатии (поражение сетчатки глаз).

    Гемодинамические (нарушение нормального кровообращения) осложнения застойной сердечной недостаточности, геморрагические инсульты головного мозга, возникновение аневризм аорты и крупных мозговых артерий, ухудшения прогноза энцефалопатий (дисциркуляторной, сосудистой, органической, дисметоболической).

    Ухудшение качества жизни, инвалидизация, преждевременная смерть.

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  85. HC Retinol Serum: Bir A vitamini formu olan Retinol, ince çizgilerin ve yaşlanma belirtilerinin görünümünü azalttığı klinik
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    Leke Kremi

  94. Takipçi Satın Alma Hizmetleri

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    Bu maratona HC Doping ile bir adım önde başlayın…

    Bitiş çizgisine geldiğinizde saçlarınızdaki değişimi
    ve ne kadar güçlendiğini hissedeceksiniz… Üstelik hergün sadece 2 dakikanızı ayırarak.

    HC Doping’in procapil, follicusan, bitki özleri ve vitaminler içeren formülü, saçlarına ihtiyaç duyduğu
    desteği kazandırmak isteyen her yaş aralığındaki kadın ve
    erkek için uygundur.

    HC Doping’in formülünde, saçlarınızın ihtiyacı olan doğadaki yararlı
    bileşenler mevcuttur.
    Ayrıca bir başka ürün kullanmanızı gerektirmeyecek
    ölçüde zengin içeriği, saçınız için uygun oranlarda formülize edilmiştir.

    Birçok saç bakım ürünün aksine HC Doping oldukça kolay bir kullanıma sahiptir.
    Saçta kalıntı veya kötü koku bırakmaz.
    Uyguladıktan sonra durulamaya veya yıkamaya gerek yoktur.

    saç bakım

  104. SAÇ DÖKÜLMESİNE KARŞI GÜÇLÜ VE ETKİN BAKIM

    Saç dökülmesi ile mücadele bazen zorlu bir maratona dönüşebilir.

    Bu maratona HC Doping ile bir adım önde başlayın…

    Bitiş çizgisine geldiğinizde saçlarınızdaki değişimi ve
    ne kadar güçlendiğini hissedeceksiniz…
    Üstelik hergün sadece 2 dakikanızı ayırarak.

    HC Doping’in procapil, follicusan, bitki özleri ve vitaminler içeren formülü,
    saçlarına ihtiyaç duyduğu desteği kazandırmak
    isteyen her yaş aralığındaki kadın ve erkek için uygundur.

    HC Doping’in formülünde, saçlarınızın ihtiyacı olan doğadaki
    yararlı bileşenler mevcuttur. Ayrıca bir başka ürün kullanmanızı gerektirmeyecek ölçüde zengin içeriği, saçınız için uygun oranlarda formülize edilmiştir.

    Birçok saç bakım ürünün aksine HC Doping oldukça kolay bir kullanıma sahiptir.

    Saçta kalıntı veya kötü koku bırakmaz. Uyguladıktan sonra durulamaya veya yıkamaya gerek yoktur.

    Saç Bakım

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