Hypertension, or essential arterial hypertension, is a chronic disease characterized by a persistent increase in blood pressure (BP). According to international standards, hypertension is diagnosed at blood pressure levels of 140/90 mm Hg and higher. This condition can lead to serious complications such as cardiovascular disease, stroke, renal failure, and others. Hypertension is often asymptomatic, which makes it subtle and dangerous. At the same time, high blood pressure is one of the leading risk factors for premature mortality and disability worldwide.
History of the disease and interesting historical facts
Hypertension has been known to mankind since ancient times. The first mentions of symptoms similar to modern ideas about hypertension can be found in the works of Hippocrates, who described unusual sensations in the head and heartbeat of patients. In the 18th century, the English doctor and physicist S. Harrison developed a method for measuring blood pressure using a portable manometer, which marked the beginning of clinical studies of hypertension. In the 1920s, hypertension began to be perceived as an independent pathology, and in 1930 the concept of "hypertensive disease" was introduced. Scientists continued to study this disease, and in the 1970s, treatment regimens were developed that changed the approach to the therapeutic management of patients with high blood pressure.
Epidemiology
Hypertension is one of the most common chronic diseases in the world. According to the World Health Organization (WHO), more than 1.4 billion adults suffer from this pathology. About 30% of the population over 18 years of age have high blood pressure. In high-income countries, such as the United States and the European Union, the prevalence of hypertension reaches 40-50% among people over 60 years of age. In developing countries, this figure is also growing, which is associated with lifestyle changes, urbanization and increased stress levels. Methods for preventing and controlling this disease are urgently needed in any country, which emphasizes its epidemiological significance.
Genetic predisposition to this disease
Genetic predisposition plays an important role in the development of hypertension. Research shows that close relatives of patients with hypertension have a significantly increased risk of developing this disease. In fact, more than 30 genes are associated with increased blood pressure. The main genes involved in the development of hypertension include genes responsible for the regulation of vascular tone, salt and electrolyte metabolism. Mutations in the ANK3 gene and inherited variations in the ACE and AGT genes also confirm their association with hypertension. To better understand the heredity of the disease, genetic studies are ongoing, aimed at identifying new markers and mechanisms.
Risk factors for the development of this disease
Identifying risk factors that contribute to hypertension is key to preventing it. There are several categories of factors that influence the development of this disease:
- Physical factors: excess body weight, insufficient physical activity, smoking and alcohol abuse.
- Chemical factors: high sodium intake, low potassium intake, certain medications including anti-inflammatory drugs and contraceptives.
- Psychosocial factors: chronic stress, depression, and social isolation.
- Comorbidities: diabetes, cardiovascular disease and chronic kidney disease.
Assessing these risk factors allows us to competently organize a strategy for the prevention and treatment of hypertension.
Diagnosis of this disease
Diagnosis of hypertension is based on a comprehensive approach that includes an assessment of the patient’s medical history, clinical examination, and laboratory tests. The main symptoms that may signal high blood pressure are headaches, dizziness, tinnitus, and shortness of breath. However, many patients experience no symptoms, making regular blood pressure monitoring necessary.
Laboratory tests may include blood tests to measure cholesterol and glucose levels, kidney function, and electrolyte balance. Radiological tests such as echocardiography can help identify changes in heart function caused by hypertension. Other methods, such as 24-hour blood pressure monitoring, provide more accurate information about blood pressure fluctuations throughout the day. Differential diagnosis is important to rule out secondary hypertension associated with other diseases.
Treatment
Treating hypertension requires a comprehensive approach that includes both non-drug and drug treatments. General recommendations include lifestyle changes such as following a low-salt diet, increasing physical activity, losing weight, and quitting smoking.
Pharmacological treatment may include the following classes of drugs:
- Diuretics.
- Beta-blockers.
- Angiotensin-converting enzyme (ACE) inhibitors.
- Angiotensin II receptor blockers (ARBs).
- Calcium antagonists.
In some cases, surgical intervention may be required, for example, in the presence of secondary hypertension caused by kidney pathologies or hormonal disorders.
List of medications used to treat this disease
There are many medications available today to treat hypertension. Some of these include:
- Lisinopril (ACE inhibitor)
- Atenolol (beta blocker)
- Furosemide (diuretic)
- Amlodipine (calcium antagonist)
- Losartan (BRA)
The choice of drug depends on the individual characteristics of the patient and the presence of concomitant diseases.
Disease monitoring
Hypertension monitoring involves regular blood pressure measurements to monitor the effectiveness of therapy and identify complications. Key control steps include:
- Special medical examinations carried out at least twice a year.
- 24-hour blood pressure monitoring in patients with unstable values.
- Pre-prophylactic examinations to monitor concomitant diseases.
The prognosis with adequate blood pressure control is quite favorable, but advanced cases of hypertension can lead to serious complications, including myocardial infarction and stroke.
Age-related features of the disease
Hypertension can manifest itself differently depending on the patient's age. In young people, the disease is often associated with genetic predisposition and lifestyle. In middle-aged patients, hypertension can develop against the background of stress and concomitant diseases. In older people, hypertension is often caused by age-related changes in the vascular wall and atherosclerosis. It is important to promptly identify and control hypertension at any stage of life.
Questions and Answers
- What is hypertension? Hypertension is a chronic disease characterized by high blood pressure.
- What are the main risk factors for hypertension? These include: excess body weight, a sedentary lifestyle, high consumption of salt and alcohol.
- How to diagnose hypertension? Diagnosis includes blood pressure measurements, laboratory tests and radiological examinations.
- How is hypertension treated? Treatment includes lifestyle changes and drug therapy with antihypertensive agents.
- How to control hypertension? Regular blood pressure measurement and monitoring by a doctor are important to control hypertension.
Advice from Dr. Oleg Korzhikov
Dr. Oleg Korzhikov provides several recommendations for people with hypertension:
1. Measure your blood pressure regularly in a calm environment and keep a diary to track your readings.
2. Avoid stressful situations and find time for relaxation, practice meditation and yoga.
3. Eat a balanced diet rich in fruits, vegetables, and whole grains that is low in sodium.
4. Consult a doctor at the first signs of headache or unstable blood pressure to avoid serious complications.
