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Hypertension (1)

Con il termine di ipertensione arteriosa si intende un aumento della pressione arteriosa che rappresenta la forza con cui circola il sangue.
Essa è legata alla spinta che il sangue riceve dal cuore. Si distingue una pressione massima o sistolica che è la pressione sanguigna nel momento della sistole cardiaca cioè quando il cuore spinge il sangue nelle arterie, and a minimum or diastolic pressure representing blood pressure when the cardiac diastole is when the heart fills with blood and not make a push.
Blood pressure tends to vary with age, during the day and can increase in cases of physical and emotional stress.

is generally considered a normal blood pressure values \u200b\u200bbelow 140/90. There is talk of mild hypertension for values \u200b\u200bbetween 140-159/90-99, of moderate hypertension with values \u200b\u200bbetween 160-179/100-109 and severe hypertension for values \u200b\u200bhigher than 180/110.
should also consider that the only increase in minimum pressure constitutes a framework of hypertension.
Even in the presence of the minimum values \u200b\u200bof between 85-110 it comes to light hypertension and severe when the minimum exceeds 110 mm Hg.

Hypertension is divided into two categories:
's essential hypertension el' secondary hypertension.

Qundo specific diseases are responsible for the increased pressure is talking about secondary hypertension. In all cases where it is not possible to identify the cause of hypertension it comes to essential hypertension.
secondary causes of hypertension will be addressed in a subsequent article. Generally

hypertension has no symptoms. In the case of high values \u200b\u200bcan occur, however, headache, ringing in the ears, dizziness, loss of blood from the nose.

It would be a good idea to check blood pressure regularly because hypertension could be inserted without the person has problems.

E 'should be considered in suspected high blood pressure that first one should be in suitable condition. The subject must be relaxed and calm. It would be useful to measure the pressure in sitting and standing and also perform at least three measurements after a few minutes of each other. It could also be utile misurare la pressione a livello di entrambe le braccia.
In caso di dubbio si può effettuare una misurazione continua della pressione arteriosa per 24-48 ore mediante apparacchi tascabili ( Holter pressorio ) che danno un'informazione precisa sull'andamento della pressione arteriosa nel corso della giornata e in associazione con le diverse attività dell'individuo.

Le complicanze dell'ipertensione arteriosa sono molto serie poichè può causare grave danni ad organi vitali: cuore, cervello, retina, reni, vasi arteriosi.
Il cuore può andare incontro ad ipertrofia cioè aumenta la massa cardiaca con aumento del rischio di ischemia. Si possono verificare alterazioni rhythm, chest pain (expressions transient reduction in blood flow to the heart) until you reach a state of heart failure. The changes in the brain
related to the movement of the brain damage that may occur with paintings such as acute stroke and a slow loss of some functions such as memory, attention, orientation, time-space. The retinal damage
ovuti are a progressive arteriolar narrowing with ischemic areas and progressive vision loss. On
kidney hypertension causes a progressive decrease in function up to kidney failure. A load of
arteries of a person with hypertension and atherosclerosis are determined over time microaneurysms.

Once established hypertension should also effettuara of laboratory tests to exclude secondary hypertension that is linked to other diseases.

Laboratory tests essential or recommended

• creatinine: all'azotemia preferable to assess renal function.
• potassium: hypokalemia that suggests the hypertension by mineralocorticoids (hormones that regulate fluid and electrolyte balance), and allows to evaluate the effects of diuretic therapy. Hyperkalaemia is a sign of kidney failure.
• Blood sugar: fasting (and possibly two hours after the meal) indicates the risk factor for diabetes.
• Cholesterol: hypercholesterolaemia indicates another important cardiovascular risk factor.
• Hemoglobin: anemia may indicate kidney failure.
• Hematocrit: suggests changes in plasma volume.
• Electrocardiogram criteria and overload left ventricular hypertrophy, left atrial hypertrophy, myocardial infarction and angina pectoris.
• radiograph of the thorax: cardiac outline, size of the aorta.

Excluding other possible causes is referred to as essential hypertension . The drugs used are from different classes that include:

• I diuretics that increase urine output and therefore reduce the liquid content in the vessels
• I acting beta-blockers freuenza decreasing the rate and force of contraction of the heart The calcium
• determining vasodilation
• The ACE inhibitors act on the mechanisms of renal regulation of blood pressure
• The alpha-blockers producing vasodilation

These generally are the drugs most commonly used. It begins with a single drug and if necessary, add more.
In combination with drug therapy can help a non-drug treatment that may be the only step necessary to normalize blood pressure in patients with mild hypertension (diastolic blood pressure repeatedly between 90 and 95 mmHg).

• Reduction of body weight in overweight subjects.
• diet modification: a reduction of salt diet rich in fish oil, increased ratio of dietary polyunsaturated fat / saturated.
• Abolition of alcohol and smoking.
• regular exercise.