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  • 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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    olur.

    Hyaluronik asit doğada »Nem Mıknatısı» olarak
    da bilinir. Kendi büyüklüğünün 5000 katı kadar su tutar ve cildin ihtiyacı olan nemi sağlayarak gün boyu nemli kalmasını sağlar.

    HC Hyaluronic Acid Serum içeriğinde; cildin yüzeyinden ilk
    katmanına çok daha kolay nüfus edebilmesi için gözenek boyutundan çok daha küçük formda
    özel moleküllü Hyaluronik Asit kullanılmış ve
    bu sayede etkisi maksimum oranda arttırılmıştır.

    HC Hyaluronic Acid Serumunu atopik kuruluk yaşayan ciltlerde, kırışıklık
    önlemeye yardımcı olarak ve anti-aging serum olarak kullanabilirsiniz.

    Hyaluronic Acid Serum

  160. Kırışıklık Kremi

    KIRIŞIK KREMİ

    Yeniden diriliş bitkisi, tek bir damla su olmadan uzun süre
    hayatta kalabilmek için eşsiz ve büyüleyici bir
    kabiliyete sahiptir. Bu süre Sahra Çölü’nde 100 yılı
    bulabilir. Bu süre zarfında diriliş bitkisi tamamen kurur ve yaşadığına dair herhangi bir belirti göremezsiniz.
    Bitkinin yaprakları küçülür, solmuş ve ölü görünür.
    Ancak görünüşler aldatıcıdır; her seferinde yağmurlar başlar başlamaz bitki adına yakışır şekilde yeniden canlanır.

    Kırışıklık kremi Yağmurlar durduktan sonra, tekrar kurur ve bir sonraki diriliş mucizesini bekler.

    HC Yaşlanma ve Kırışıklık Karşıtı ürünlerde kullanılan Glycoin® natural,
    yeniden diriliş bitkisinin büyüleyici varlığını ve hayatta kalma stratejisini sağlayan yapı taşıdır.
    Tam kuruma sırasında, Glycoin® natural bitkinin yapısını hasara karşı korur.
    Yağmurlar geldiğinde bir enerji yükseltici görevi görür ve bitkinin yeniden yeşillenmesini
    etkinleştirir.

    Kırışıklık Kremi

  161. C Vitamini Serumu

    HC Vitamin-C Serum, özel olarak geliştirilmiş yüksek stabilite özelliğine
    sahip Lipozomal Vitamin-C kompleksi ve en ileri düzeyde konsantre
    edilmiş saf Hyaluronik Asit ile formülize edilen yoğun bakım serumudur.

    Liposomal C Vitamini Serumu , Saf Hyalüronik Asit, Yeniden Diriliş Bitkisi (Glyceryl Glucoside), Pentavitin (Saccharide Isomerate) ve Anadenanthera Colubrina Bark Extract içeren formülü ile ciltte oluşabilecek lekeleri minimuma indirmeye ve kırışıklıkları önlemeye yardımcı olur.
    Çevresel faktörlere karşı etkili korumayı destekler.

    Yoğun nemlendirici ve tazeleyici özelliği sayesinde cildin sıkılığını arttırır ve aydınlanmasını destekler.
    Ciltteki ton eşitsizliklerine karşı mücadele
    eder.

    Kozmetik piyasasında bulunan C vitamini serumu bir çoğunda Askorbik
    Asit’in stabil olmayan %15’lük formu kullanılmaktadır. Bu
    ürünler stabil olmadıklarından zamanla okside olur, rengi koyulaşır ve doğal olarak da zamanla etkinliğini kaybeder.

    HC Vitamin-C Serum içerisinde stabil formda ve lipozomal kapsül şeklinde %3′ lük Etil Askorbik Asit kullanılmıştır.

    Lipozomal taşıyıcı sistemler, hedef noktaya aktif maddeyi taşımak için geliştirilen üst düzey teknolojidir.
    Ürün içindeki aktif madde (C VİTAMİNİ) cilt altına indikten sonra çözülür ve daha kısa sürede maksimum etki gösterir.

    Bu sayede hem uzun raf ömrü boyunca stabilitesini kaybetmeden etkisini sürdürür, hem de etkisi diğer formlara
    göre çok daha başarılıdır.

    c vitamini serumu

  162. fresh

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