When is blood pressure high enough to go to the hospital?
High blood pressure is present in many people walking around with this disease without any symptoms or signs that anything is wrong. The hypertension is called the Century XXI Silent Plaque.
High blood pressure is a chronic disease characterized by the continued increase of the blood pressure amount above the limits of cardiovascular risk. Regarding international studies, cardiovascular morbidity and mortality have a direct relationship with the rise of the numbers in the systolic pressure above 139 mmHg. or a diastolic pressure kept at a high of 89 mmHg. for complications of coronary disease and renal insufficiency. HAS, which is
the principal cause of the hypertensive crisis and medical attention, affects nearly a third of the adult population of developing countries. The risk of one cardiovascular event can be doubled. When measured at 115.75 mmHg of arterial pressure for every increment of 20 mmHg of the systolic pressure or 10 mmHg of the diastolic pressure.
According to statistics, a man is more likely to develop Arterial hypertension changes when a woman gets the menopause. A woman has protection with the hormonal balance, which changes when the woman gets menopause.
This means that postmenopausal women are more likely to develop vascular disease and stroke.The arterial pressure is expressed in two sizes; the arterial systolic pressure and diastolic, for example, 120/80 mmHg.
The systolic arterial pressure (first count) is the arteries' blood pressure around the ventricular systole when the blood is expulsed from the heart to the arteries.
The arterial diastolic pressure (the inferior) is the diastolic pressure when the heart is relaxed; the pressure falls. Hypertension is a risk factor for cardiovascular disease; antihypertensive therapy aims to reduce the risk. However, treatment takes into account arterial pressure as well as other cardiovascular risks such as kidney disease, diabetes, or metabolic syndrome.
High blood pressure causes
Some of the environmental factors that contribute to the development of arterial hypertension include obesity, alcohol consumption, genetic issues, and stress. There is a connection between economically stable societies and the increase of hypertension with age.
The excessive consumption of salt induces and keeps arterial hypertension at bay. Hypertension sensitive to salt consists of the exaggerated increase in the pressure and osmotic pressure that keeps water and increases the blood pressure.
The observation that renin, excreted from the kidney, is associated with aldosterone However, arterial hypertension associated with a low level of renin is frequent in black people.
3. Insulin Resistance.
In ordinary people, the stimulation of insulin in the sympathetic nervous system without the elevation of arterial pressure. However, in people with pathological conditions like metabolic syndrome, Insulin resistance is proposed as the cause of the increase in arterial pressure in such patients with metabolic diseases.
Diabetic patients have higher arterial pressure than the rest of the population.
The corporal mass index and blood pressure have a strong relationship. It's convenient to a hypo-caloric diet plan in patients with obesity and hypertension who want to lower their blood pressure.
6. Sleep apnea
It's a common disorder and a possible cause of arterial hypertension. The treatment of this pathology through arterial positive pressure.
Arterial hypertension is one of the complex genetic disorders associated with more than 50 genes. 12 new genes discovered recently in relation to various phenotypesIt found 35 SNPs associated with obesity, Diabetes Mellitus type II, coronary disease, and kidney function, given evidence that those genes connect with arterial pressure with cardiovascular activity.
With age, the number of collagen fibers increases, producing rigidly in the blood vessels and reducing the elastically created blood flow resistance and resulting in a compensatory increase in the arterial pressure.
PATOGENIC FROM HIGH BLOOD PRESSURE
Arterial pressure is a cardiac waste and vascular resistance product. However, the factors that influence cardiac waste as well as the physiology and structure of the small arteries. The high viscosity of the blood has a significant impact on the required work for bumping the amount of blood and can cause arterial pressure to persist.
The malleability of the wall of blood vessels (pulse components) affects the velocity of the blood flow and has an important role in regulating the arterial pressure.
The changes in the wall thickness affect the amplification of the peripheral vascular resistance in the hypertensive patient, due to the relaxing waves in the direction of the aorta artery and opposite to the blood flow, with the increase in the systolic arterial pressure.
The volume of the circulating blood is regulated by the sodium (Na) from the kidney system and the management of water. This phenomenon plays an important role in moderate hypertension in response to sodium concentration in the blood. The associated mechanism of secondary hypertension is evident.
However, it is related to essential hypertension. The cardiac waste is elevated initially in the natural curse with a resistance periphery total (RPT) average but an increase in the total peripheral resistance.
This theory explains the process.
1. The kidney's capacity to excrete sodium results in the apparition of sodium excretion factors like the secretion of atrial natriuretic peptide that promote the excretion of salt with the side effect of the increase in total peripheral resistance.
2. Hyperactive Renin-Angiotensin-Aldosterone system, which causes vasoconstriction and sodium and water retention.The reflex increases the blood volume, which conduces to arterial hypertension.
3. The hyperactivity of the sympathetic nervous system produces high levels of stress. Hypertension is a hereditary disease that is polygenic (caused by more than one gene).The endothelial changes are produced by the persistent elevated arterial pressure.
Organs Affected by High Blood Pressure for Co-lateral Effects
The organs whose structure and function alternated as a consequence of arterial hypertension are called “Diana organs”. For example, an individual between the ages of 40 and 70 when their arterial pressure is between 115/75 and 185/115 mmHg. There is a duplicate risk in the apparition of an increase of 20 mmHg in the systolic pressure or 10 mmHg in the diastolic pressure.
Hypertensive retinopathy, vasospasm, increase in arterial brightness, arteriovenous pathologic cross, hemorrhages, exudates, papilledema, and venous retina thrombosis.
-Central Nervous System.
is affected when systolic pressure is more than 160 mmHg. One systolic or diastolic increase is harmful, or one diastolic pressure of more than 100 mmHg. Other hypertensive crises are manifestations that are due to cerebrovascular disease (stroke), hypertensive encephalopathy, cerebral microvascular damage, and dementia of vascular origin, consequent to multiple infarctions in the central nervous system.
Chronic endothelial dysfunction, progressive arteriosclerosis, atherosclerosis of the great vessels, particularly the cerebral vessels, aorta, coronaries, and lower limb arteries. The complicated aneurysm eventually dissects or ruptures at the level of the thoracic aorta. In the beginning, left ventricular hypertrophy is parietal without any increase in the muscle ventricular that progresses to concentric hypertrophy, which develops the dilate phase (eccentric hypertrophy).
Hypertrophic process develops as the parietal distensible and viscoelastic properties of myocardial contractility deteriorate.
-Coronary microvascular ischemic principally for rarefaction of the capillary red and endothelial dysfunction of the remnant vessels.
-Acute coronary syndrome
Unstable angina or infarct without a Q wave is called an infarction without elevation of the segment S-T. Acute myocardial infarction Ischemic hypertrophy and ventricular fibrosis cause left ventricular diastolic dysfunction. The drop in the ejection fraction from the left ventricle (the percentage of the blood that fills the ventricle in diastole that is effectively pumped out of the cavity) is associated with left ventricular systolic dysfunction.
-Congestive Cardiac Insufficiency (ICC)
As a result of the failed left ventricular, there is a secondary compromise from the right hemi-Cardium with chamber dilatation secondary pulmonary arterial hypertension. What does Pulmonary Arterial Hypertension mean? It means a complication of the insufficiency of the cardiac congestive global, consequently failing from the left ventricular and secondary compromise from the right ventricular, resulting in total cardiac failure.
PAH (Pulmonary Arterial Hypertension) is a leading cause of heart failure and can manifest as ischemic cardiopathy (75%), myocardial infarction, and hypertensive valvulopathy (severe hypertension).
-Ventricular arrhythmia, like a consequence of metro-centric for fibrosis damage or ischemic.
Early signs of nephropathy and an independent risk factor for cardiovascular morbidity Focal and diffuse glomerulosclerosis winloss of nephrons, like the consequence of hypertension intraglomerular chronic.
Chronic renal ischemic due to atherosclerosis kidney acceleration
-Reduction of the glomerular filter
rate due to the loss of the number of functional nephrons, a progressive process that's accelerated in hypertension and more so in the presence of diabetes mellitus.
Chronic kidney insufficiency is a complicated and terminal event. Early
detection with the correct take of arterial pressure The measurement of the arterial pressure in patients with high risk requires taking the right measure incorrectly to avoid false results. With the use of sphygmomanometers and stethoscopes.
HIGH BLOOD PRESSURE DIAGNOSTIC
The clinical records of hypertension patients are detailed and enriched with the provision of information from close relatives, or other medical or paramedical staff from the patient's past.
For example, hypertension is an asymptomatic disease for which there is no record of symptomatology or less specific symptoms (a headache, dizziness, visual disorder, or red flash) in medical records. It defines the motive of the visit.
Some of the cardiovascular symptoms are: dyspnea, orthopnea, dyspnea paroxistic, palpitation, symcope, edema, intermittent claudication) or in a specific mood state, erectile dysfuction, etc.
Complex cardiovascular symptoms: ischemic cerebral transitory, cerebrovacular accidents, chest angina, myocardial infarct, congestive cardiac insufficiency, chronic kidney insufficiency. Early
Detention from Arterial Hypertension
Steps to check blood pressure: sit a person with their back reclined in the chair, and the upper limb should rest over the superfas from the desk, and the forearm in pronation, to the height of the heart. The soles are over the floor without crossing the legs. After some minutes of res (about 5 minutes after the interrogatories), put the wrist BP monitor or aneroid sfingmanometer appropriate in the right conditions in the middle of the forearm portion and take the two thirds of the arm.
People with heart problems should prefer to use a physical exam gown. Try to use a healthy arm without any compromise to avoid any false results. Precaution in some patients doesn't take the pressure off of a compromised arm with amputation, radical upper surgery history, or the presence of an arteriovenous fistula.
There are diverse diagnostic ways (aneroid sphygmomanometer, writs BP). It's recommended the use of the Tensiometer or mercury that needs to be calibrated regularly. The procedure involves the taking of pressure measurements. This procedure doesn't need to be uncomfortable or painful. The inflow from the inflation bulb needs to be less than 20 mmHg high to achieve the necessary pressure for disappearing the wrist or elbow pulse, which is separated from the pressure of 220 mmHg.
The stethoscope over the arterial deflates slowly until it is audible the first time the Korotkoff sounds (systolic pressure). The early disappearance of the sounds and their subsequent reappearance, called the auscultatory gag breach, is frequent in elderly people, who deflate the inflation bulb slowly until all sounds disappear (phase of Korotkoff diastolic pressure) arm is immobilized.
The measure of the arterial pressure in a standing patient is recommended in an older adult. Leave the standing person around five minutes before to make the measure.
In the first appointment or early detection of the arterial pressure, it's ideal to toke in two arms and clarify which of the limbs was found higher and consequently take the same arm for the arterial pressure.
The doctor needs to teach the patient the importance of taking the right measure of arterial pressure (with heart disease of HA-like complication). The use of these machines in a home is a reliable measure for the control and avoidance of strokes and sudden death. The mean pressure in the house is around 5 mmHg less than in a medical office for both systolic and diastolic pressures. The Clinic
Sings for the Diagnostic of Arterial Hypertension
Eyes for Exploration
Count with the Keith Wagener classification of hypertensive retinopathy (shying arterial cross pathologic arteriovenous (Gunn sing), exudation, hemorrhages, and anomalies of the optic disc and periphery retina). Remember, the incipient hypertensiv retinopathy (relation arteriovenous changes) is specific to the hemorrhages and exude.
Neck inspection of jugular veins
In the neck evaluation, check the palpation and auscultation of the carotid arteries and thyroid glandules. Exhauster exploration cardiopulmonary describes aspects and expansion of the thorax, lung ventilation, impulse max point of the heart, fremitus and cardiac sound, the normal, accessories, and pathologic.
We investigated adipose tissue, visible pulsation, venous circulation, visceromegaly, and tumor. the peripheral pulses (amplitude, pulse wave and symmetry) of the capillary fill, acres of temperature, and venous peripheric nets.
Basic neurologic exploration
Pupils, ocular movements, facial symmetry, equilibrium, coordination, tongue and force sensibility, reflex osteotendinous and musculocutaneous normal and pathologic show signs of damage from the periphery and central nervous system.
For cardiac evaluation, these tests are necessary. Creatinine (ureic nitrogen is necessary in the case of acute cardiac insufficiency).
Serum potassium, glycemia, and lipid profile; Cholesterol total, HDL, triglycerides, uric acid, EGO. We look for microalbuminuria (proteinuria), the possible kidney lesion for the type of risk present risk factor (diabetes mellitus).
For confirmation of the diagnosis, to dismiss secondary causes and determine the lesion of Diana organs and their severity.
It is necessary to use for the diagnosis of left ventricular hypertrophy, arrhythmia evaluation, X-ray of the poster anterior from the thorax, and lateral radiography. check the cardiac shape, aorta, lungs, Helios, mediastinal, bone thorax, and the lung parenchyma and show up evidence of damage. effort
test with an electrocardiogram.
It is useful in assessing the patient's physical condition, pressure response to exercises, and the presence or absence of an ischemic lesion or inducible arrhythmias.
Echocardiogram with Doppler
It's a non-invasive study with great diagnostic value. It is only advised if the patient has hypertension without symptoms, clinical evidence, or cardiac organ damage. Another procedure
Kidney artery Doppler.
In the case of suspicious results, autonomic function studies, vascular mechanic probe, nuclear medicine studies, computerized axial tomography, and nuclear magnetic resonance are used. Diuretic aKd beta-blockers reduce the appearance of site adverse for hypertension arterial related to cerebrovascular disease in the treatment.
However, diuretics are more effective in the reduction of event-related coronary heart disease. The treatment reduces the chances of a hypertensive patient developing risk hypertension or insufficiency congestive heart disease. An older adult patient with a history of systolic hypertension used an alternative one calcium channel inhibitor.
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Complications from Arterial Hypertension