Risk sso 2nd degree what. III

Date: 04.03.2020

Hypertension is a common disease that affects every 5 people in the world.

The disease leads to various complications and consequences. In most cases, the pathology ends in death.

The risks of complications are divided into several types depending on the degree of damage and accompanying symptoms. Last stage hypertensive crisis ends with a heart attack and leads to death.

Pathology is treatable and helps to get rid of characteristic manifestations with the help of antihypertensive drugs, which slows down the progression of the disease.

The disease is usually divided into degrees. There are 4 in total:

Soft (1 degree). This type of hypertension does not require treatment and intervention by a specialist. It has a short-term nature and is 140-160 mm Hg. Art.
Moderate (grade 2). With this type of hypertension, the pressure ranges from 160 to 180 mm Hg. Art. Treatment with antihypertensive drugs is required.
Severe (grade 3). Pressure above 180 mm Hg. Art. Otherwise referred to as malignant hypertension and is difficult to treat with medication.
There are also risks of CVE grade 4 (high). This type of pathology occurs in those who have undergone heart surgery in the past or after heart attacks, strokes and coronary disease.

With a pathology of 3 or 4 degrees, a lesion occurs internal organs and fabrics. The heart and brain are affected first. Negative influence exposed and genitourinary system which eventually leads to kidney failure.

The causes of the development of pathology can be various provoking factors:

abuse of addictions - smoking, alcohol, drugs have a depressing and destructive effect on blood vessels, which leads to a loss of elasticity, a decrease in patency and the formation of blood clots;
elevated level cholesterol - leads to damage vascular system atherosclerosis;
endocrine pathologies;
ecological situation;
hormonal disruptions, including menopause;
age-related changes- especially in people over 50 years of age;
nervous and psycho-emotional disorders.

Congenital or hereditary factors and anomalies in the organs of the cardiovascular system can also contribute to the development of the disease.

In case of hereditary pathologies, it is necessary to be observed monthly by a specialist, since there are high risks of developing cardiovascular pathologies.

Risk classification

Consider possible risks more.

Risks of CCO 1 degree

initial stage disease does not cause serious consequences or complications. Often resolves on its own with subsequent normalization of blood pressure.

Symptoms of the disease:

cardiopalmus;
headache;
noise in ears;
fast fatiguability;
dizziness.

The risks of grade 1 OSR are minimal. However, at the first symptoms, it is necessary to consult a doctor for advice, as the disease can become more severe.

With untimely treatment of hypertension of the 1st degree, the disease gradually progresses and passes into the second stage. This is fraught with consequences and complications, which can ultimately lead to myocardial infarction.

Often, when examining the 2nd degree of the disease, a risk of 2 is assigned. The main symptoms of this category are:

increased sweating;
fog before the eyes;
fatigue;
nausea;
puffiness of the face.

SSO 2 degree has category 3 risk. With this course of the disease, palpitations, shortness of breath, hyperemia, and also a hypertensive crisis are observed. Pathology is often observed in older people.

Hypertension grade 3 is assigned risks 1, 2, 3, 4.

The disease gradually leads to the destruction of blood vessels and arteries - thinning of the walls occurs, elasticity and patency deteriorate, which leads to the formation of blood clots and circulatory disorders.

Symptoms and consequences:

migraine;
throbbing pains;
blurred vision;
loss of strength in the limbs;
hyperemia;
decrease or loss of memory (typical for risks of 3 and 4 degrees).

Grade 3, risk level 3 CVD is accompanied by angina pectoris and is common in people with diabetes. Under influence negative factors atherosclerotic changes occur. It is impossible to completely cure the disease.

overweight;
stressful situations;
sedentary lifestyle;
age over 50;
pregnancy;
malnutrition;
concomitant diseases of the internal organs.

For the 3rd degree of risk, persistent headaches (migraines), flies before the eyes, severe pain in the region of the heart, and in some cases loss of consciousness are characteristic.

Grade 4 CSOs are conditionally divided into primary (essential) and secondary (symptomatic). The disease very often leads to disability or death.

Signs and symptoms:

pain in the region of the heart;
loss of consciousness;
ischemic disease;
thrombus formation;
myocardial infarction;
brain damage (stroke);
fatal outcome.

The disease of the 4th degree is not treatable. Drug therapy can only eliminate the consequences of pathology. In such cases, it is necessary to adjust the lifestyle and follow the recommendations of the cardiologist.

First of all, the internal organs or target organs are affected: the heart, brain, kidneys.

Consequences:

redness and swelling of the face;
blanching of the limbs;
excessive sweating;
migraine;
decrease in intellectual abilities (memory loss);
flies or fog before the eyes;
fatigue, weakness;
loss of visual acuity up to partial blindness;
aneurysm;
heart attack;
hemorrhagic stroke;
fatal outcome.

Due to impaired blood circulation, there is a lack of supply of organs with essential nutrients. Against this background, kidney or heart failure develops.

Several methods and approaches are used to identify and identify the disease. This allows you to choose the most effective therapy.

Examination methods:

physical examination - examination of the heart with a stethoscope for the presence of noise and sounds in the organ;
visual inspection - evaluation skin the patient;
tonometer - measurement of blood pressure using the device;
ECG (electrocardiogram) - determination of the rhythm of heart contractions;
echocardiogram - study of the structure of an organ (heart);
dopplerography - the study of blood flow in the vessels and arteries;
CT scan;
MRI (magnetic resonance imaging);
biochemical blood test - determination of the level of cholesterol or sugar in the patient's blood.

V individual cases additional types of research may be assigned. One of these is a daily mount (Holter). The miniature device allows you to determine the state of the heart during sleep, physical activity, eating, rest, stressful situations.

It is recommended to constantly monitor your blood pressure. For this, a tonometer is used. It is necessary to strictly follow the recommendations of the doctor and take the necessary medications that lower blood pressure.

Arterial hypertension - high pressure A disease characterized by chronically elevated blood pressure in the bloodstream. The disease is directly related to the development of stroke, angina pectoris, coronary artery disease, and often leads to myocardial infarction. This disease, which affects the circulatory system, is one of the most common causes of death in industrialized countries. Consequently, arterial hypertension can be considered as one of the civilizational diseases, its incidence increases in proportion to the achieved level of development of the society's civilization. The most dangerous hypertension of the 3rd degree, in the 2nd place is the syndrome of high pressure in the portal vein.

What is it - hypertension of the 3rd degree?

Blood pressure is the result of the interaction between genetic and hereditary influences, the influence of the environment. Regional differences in blood pressure values are observed in a number of developed countries. Differences between cities and villages are described with a trend towards higher blood pressure in urban areas.

At hypertension 3 degrees in the foreground in the clinical picture there are manifestations of impaired organ function. A sick patient shows signs of coronary heart disease, left ventricular failure, symptoms of a disturbed central nervous system (headache, insomnia, mood changes). The most important manifestation of grade 3 hypertension resulting from brain damage is cerebral events (cerebral bleeding, ischemia, changes in some parts of the brain). In the final stage of hypertension, symptoms of renal failure may occur, the cause of which is nephrosclerosis.

Important! A serious consequence is a cerebral infarction. How long they live after the incident depends on the timely therapy, the development of complications. As a rule, about 75% of people survive.

Organ damage in the third stage of hypertension:

atherosclerosis of the cerebral arteries - sudden cerebrovascular accidents, psychological changes of various types in atherosclerotic dementia;
eyes - neuroretinopathy: recognized in the fundus, can lead to retinal detachment, blindness;
atherosclerosis coronary artery – clinical picture coronary artery disease, angina pectoris, heart attack, heart failure can lead to sudden coronary death;
atherosclerosis of the arteries of the kidneys - the clinical picture of nephrosclerosis: uremia, a typical picture of kidney damage in hypertension;
arteriosclerosis inferior artery- can lead to amputation.

Stages of hypertension and risk groups (1, 2, 3, 4)

According to WHO, arterial hypertension is divided according to the degree of organ damage into 4 stages:

I - increase in blood pressure without changes in organs;
II - an increase in blood pressure with damage to organs (in particular, left ventricular hypertrophy, microalbuminuria, changes in the aorta or other arteries), but without impaired function;
III - changes are accompanied by organ dysfunction (left ventricular failure, hypertensive encephalopathy, disorders cerebral circulation, hypertensive retinopathy, kidney failure);
IV - malignant hypertension - the most complex form of the disease with severe changes in the fundus, high diastolic pressure, rapid progression of renal failure.

What values did you measure?

Blood pressure, degree of risk	Systolic pressure, mm Hg Art.	Diastolic pressure, mm Hg Art.
Ideal values	120	80
normotension	140 or less	90 or less
Low risk - grade 1 (mild hypertension)	140–179	90–104
Medium risk - grade 2 (moderate hypertension)	180–199	105–114
High risk - grade 3 (severe hypertension)	200 or more	115 and over
Isolated systolic hypertension	160 and over	89 or less

Important! The OVR group (very high risk) includes (grade 4), in which the pressure rises uncontrollably to 300 mm Hg. Art.

In the absence or lack of treatment for stage 3 HD, the risk of stage 4 increases! The risk of CVD (cardiovascular complications) in grade 3 hypertension, the risk in grade 4 also depends on the complications present.

Up to 25% of all deaths over 40 years of age have been reported to be directly or indirectly related to hypertension. The likelihood of cardiac and vascular complications caused by high blood pressure is especially high. People with hypertension > 160/95 aged 65–74 are at about 3 times the risk of cardiovascular complications than normotensives of the same age (BP<140/90), при артериальной гипертонии 3 степени и вторичной (симптоматической) риск повышен в 4 раза!

Cardiovascular risk is related to both systolic and diastolic pressure, but systolic values are more important in determining risk in an individual patient. One reason is that patients with and therefore normal diastolic blood pressure are also at high cardiovascular risk.

Causes

The exact cause of high blood pressure, including severe hypertension (grade 3), is not always known. Common factors contributing to the development of the disease include:

obesity;
excessive salt intake;
smoking;
inheritance;
alcoholism;
stress;
sedentary lifestyle;
diabetes;
age;
kidney disease;
hormonal disorders.

Lifestyle;
quantity and quality of food;
body weight;
bad habits;
physical activity;
stress.

Risk factors that a person can influence:

age;
genetics.

Symptoms

Initially, signs of hypertension, as a rule, do not appear. This means that the disease is asymptomatic. Subsequently, the disease may manifest itself with the following symptoms, which is the basis for establishing a primary diagnosis:

headache (in the forehead and base of the skull);
cardiopalmus;
excessive sweating;
visual impairment;
tinnitus;
fatigue;
insomnia;
nosebleeds;
dizziness;
ankle swelling;
respiratory failure.

In accordance with the symptoms and organ damage grade 3 hypertension. Classification description:

I11 - damage to the heart;
I12 - kidney damage;
I13 - damage to the kidneys and heart.

Treatment of hypertension of the 3rd degree

Drug treatment aimed at reducing systolic pressure by an average of 12 mm Hg. Art. over 10 years, prevents 1 death in 11 cases and generally improves prognosis for survival. Treatment of hypertension involves several factors:

lifestyle changes (more exercise, less stress, quitting smoking);
dietary changes (less salt, less animal fats, more fiber…);
the use of drugs to lower blood pressure - antihypertensive drugs.

Important! Physical activity in hypertension should be consulted with a specialist! A specialized trainer will also help with the choice.

The treatment regimen for hypertension includes monotherapy, a combination of 2 drugs, a combination of 3 drugs.

Monotherapy

When prescribing therapy, the appropriate drug and dosage for the patient should be carefully selected. He should respond well to the drug, show no side effects.

The best drugs for monotherapy:

ACE inhibitors;
diuretics;
β-blockers;
AT1 antagonists.

If within 3 months the treatment does not show effectiveness, a double combination is prescribed.

double combination

This type of therapy uses the mutual potentiation of certain classes of drugs to treat hypertension: a diuretic + a β-blocker, an ACE inhibitor, or an AT1 antagonist.

triple combination

If it is not possible to cure the disease using these 2 methods, it is recommended to take the pills in a triple combination.

Drugs and prevention

To prevent significant damage to the arteries, special antihypertensive drugs used in the treatment are used as monotherapy:

diuretics;
vasodilators;
blockers calcium channels;
β-blockers;
α-blockers;
ACE inhibitors;
AT1 antagonists.

Important! The choice of drug depends on the age of the patient, concomitant diseases and other medications taken. Recommendations for the choice of therapy for each group of patients vary.

Primary and secondary prevention of arterial hypertension

In the primary, it is important to achieve ideal body weight, reduce calorie and fat intake, limit excessive sodium and alcohol intake (> 30 g / day), increase physical aerobic activity. At the same time, other risk factors, such as smoking, are eliminated.

Secondary prevention of the 3rd degree of the disease is early detection existing arterial hypertension (about ⅓ of patients do not know about their disease). This can be achieved by measuring blood pressure at every doctor's visit, taking a history of the disease in high-risk groups (family history of hypertension, patients with diabetes mellitus).

Nutrition in hypertension plays an important role in preventing complications of the disease. Properly formulated diet for a week will help not only reduce symptoms, but also increase efficiency. drug treatment. The diet for hypertension includes the following foods:

white meat: especially poultry and fish containing omega-3, which has an anti-sclerotic effect (weekly consumption of fish should be at least 2 times 200 g each);
high-quality vegetable oils (olive, sesame, linseed oil);
products with large quantity fiber (especially vegetables and fruits);
dark bread, dark pastries, whole grains, natural rice;
freshly squeezed juice of beets, carrots, celery, parsley, spinach, citrus fruits, currants;
garlic (1 clove a day is enough).

Treatment with folk remedies also includes the use of herbs for hypertension.

Bear garlic - relatively quickly lowers blood pressure, cleanses blood vessels, counteracts arteriosclerosis.
Mistletoe - leaves infused in alcohol are used. The tincture lowers blood pressure slowly, special mechanism therefore it is suitable as an adjunct to antihypertensive drugs. slow action natural remedy especially suitable for the elderly.
- flowers, fruits and young buds of this shrub are used. The most effective tincture, gently reducing pressure, stabilizing fluctuating pressure, eliminating palpitations, arrhythmia, cardiac neuroses.

Important! If you have high blood pressure and are taking medication, always check with your doctor before using herbs. This will help prevent excessive pressure reduction or other serious complications.

Forecast and prevention

The prognosis of grade 3 hypertension is associated with the course of the disease itself and the development of organ changes and vascular complications. These include:

heart failure;
myocardial infarction;
stroke of thrombotic or hemorrhagic etiology;
renal failure (premature or accelerated atherosclerosis of the renal artery, nephrosclerosis, etc.).

Effective control of high blood pressure is the main requirement for a favorable effect on the prognosis of the disease. The main problems of successful control include, in addition to finding vulnerable and sick people, the problem of their long-term monitoring and ongoing effective treatment.

Preventive measures

In the case of hypertension, prevention is the best way treatment. There are a number of principles that should be observed to prevent disease.

Nutrition

Improper nutrition is the most important causal factor in hypertension. Changing eating habits can significantly reduce the frequency arterial hypertension. A varied diet with plenty of fruits, vegetables, fiber, regular food intake, preferably in smaller quantities is recommended. It is also advisable not to eat within 2 hours before going to bed.

Motion

Movement is also one of the most important elements in the prevention of hypertension. Because the disease is common in people who are obese, weight loss is important. Recommended aerobic sports: running, cycling, swimming. Sometimes a regular brisk walk is enough.

Smoking

Some substances contained in cigarettes contribute to the formation of free radicals in the body. They affect the fatty particles in the blood, changing them somewhat. Altered fats are more easily stored in blood vessels, contributing to the development of atherosclerosis. Alcohol also has a negative effect on the walls of the vessel. V high doses it causes vasoconstriction (narrowing of the blood vessel) which leads to an increase in pressure.

Salt

The harm of salt lies in the ability to bind water, therefore, its retention in the body. Insofar as a large number of sodium, a part of salt, is found in the blood, increased salt intake affects the amount of blood. Large blood volume = higher blood pressure.

Stress

Stress is the body's normal response to overexertion. However, if it is prolonged and frequent, the benefits of this reaction are reversed against the person. During stress, a certain part is activated nervous system, which affects the vessels, causes them to narrow.

Conclusion

Hypertension 3 degrees - serious problem with health, requiring specialized treatment. Otherwise, the disease leads to serious complications. The effects of high pressure can be divided into hypertensive and atherosclerotic.

Hypertensive effects: left ventricular hypertrophy, heart failure, CNS bleeding, renal failure, retinal disturbance, malignant hypertension, hypertensive crisis, encephalopathy - brain damage, aneurysm rupture.

Atherosclerotic effects: ischemia, cerebrovascular arrhythmia, aortic aneurysm, peripheral arterial disease of the lower extremities, kidney disease.

Hypertension is a chronic, very common disease with severe consequences in the absence of appropriate therapy!

Arterial hypertension is a syndrome of persistent increase in pressure in the arteries, when the systolic pressure is above 139 mm Hg. Art., and diastolic above 89 mm Hg. Art.

Normal arterial blood pressure healthy person an indicator of 120 and 80 mm Hg is considered. Art., (systolic / diastolic, respectively). There are two types of hypertension: primary (essential) hypertension and symptomatic arterial hypertension (it is also secondary).

Probably every person at least once in his life faced with high blood pressure, experienced it for yourself or learned about it through complaints from relatives and friends. Not only is hypertension dangerous in itself, but besides, it is a catalyst and the cause of a number of other, much more dangerous diseases, which are not uncommonly fatal.

Research scientists have shown that changes in blood pressure by 10 mmHg increase the risk of serious pathologies. The heart, blood vessels, brain and kidneys suffer the most. It is these organs that take the hit, which is why they are also called “target organs”. It is impossible to completely cure this disease, but blood pressure can be kept under control.

Reasons for development

What is it and what are the risk factors? The causes of hypertension are varied. The division of hypertension into primary and secondary is based on the etiology of this disease.

The primary episode occurs spontaneously against the background of certain risk factors. These include:

Heredity. Unfortunately, this is the most common cause of the development of the disease. It is especially regrettable that no medications can modify this risk factor and reduce its impact on human health.
Floor. More often, hypertension affects women, which is explained by the corresponding hormonal background.
Age. Age 55 for women and age 60 for men are already considered risk factors for developing hypertension.
Obesity. Excessive body weight affects the work of the heart and leads to a rapid depletion of the energy reserves of the myocardium (heart muscle).
Diabetes.
Excessive exposure to stress;
Physical inactivity. Disease of the 21st century - disruption of work various organs and systems due to a sedentary lifestyle.

Risk factors increase blood pressure gradually, leading to the development of hypertension.

Arterial hypertension 1, 2, 3 degrees

In medicine, it is customary to classify hypertension by degree.

at 1 degree, blood pressure, as a rule, does not leave the limits of 140-150 / 90-99 mm Hg. pillar.
2 degree is characterized by such indicators: 160-179 / 100-109 mm Hg. pillar.
3 degree of development is manifested in exceeding the mark of 180 mm Hg. Art. at 110 mm Hg. Art. and is a very worrying sign.

It should be noted that the severity of arterial hypertension is determined only taking into account all possible factors risk of developing cardiovascular disease.

Symptoms of arterial hypertension

The clinical picture depends on the stage and form of the disease.

An increase in pressure in the case of arterial hypertension may not be accompanied by any symptoms and may be detected by chance, when measuring blood pressure. In some cases, there may be a headache, dizziness, flies before the eyes, pain in the heart.

Severe arterial hypertension can occur with severe cardiovascular, neurological, kidney symptoms or damage to the retina (for example, clinically manifested atherosclerosis of the coronary vessels, heart failure, hypertensive encephalopathy, renal failure).

An early symptom of high blood pressure is an IV heart sound. Retinal changes may include narrowing of arterioles, hemorrhages, exudation, and, in the presence of encephalopathy, nipple edema optic nerve. Changes are divided into four groups in accordance with the increase in the probability of a bad prognosis (there are classifications of Keys, Wegener and Barker):

Stage 1 - constriction of arterioles;
Stage 2 - constriction and sclerosis of arterioles;
stage 3 - hemorrhages and exudation in addition to vascular changes;
Stage 4 - swelling of the nipple of the optic nerve.

The main method for diagnosing arterial hypertension is the detection of elevated blood pressure.

When should you visit a doctor?

It is very important to make an appointment with your doctor if you are concerned about these symptoms:

frequent headaches;
dizziness;
pulsating sensations in the head;
"flies" in the eyes and noise in the ears;
tachycardia (rapid heartbeat);
pain in the region of the heart;
nausea and weakness;
swelling of the extremities and puffiness of the face in the morning;
numbness of the limbs;
inexplicable feeling of anxiety;
irritability, stubbornness, throwing from one extreme to another.

It should be remembered that hypertension, which is not given due attention, can make life much shorter.

Arterial hypertension grade 3 risk 3 - what is it?

When formulating a diagnosis, in addition to the degree of hypertension, the degree of risk is also indicated. Risk in this situation refers to the likelihood that a given patient will develop cardiovascular disease within 10 years. When assessing the degree of risk, many factors are taken into account: the age and gender of the patient, heredity, lifestyle, the presence of concomitant diseases, the state of target organs.

Patients with arterial hypertension are divided into four main risk groups:

The chances of developing cardiovascular disease is less than 15%.
The frequency of development of diseases for such patients is 15-20%.
The frequency of development reaches 20-30%.
The risk in this group of patients is above 30%.

Patients diagnosed with arterial hypertension of the 3rd degree belong to 3 or 4 risk groups, since this stage of the disease is characterized by damage to internal target organs. Group 4 is also called the very high risk group.

This dictates the need to immediately carry out intensive treatment when establishing a diagnosis of hypertension grade 3 risk 4. This means that for patients of risk groups 1 and 2, it is permissible to monitor the patient and use methods non-drug treatment, then patients with 3 and 4 risk groups require immediate antihypertensive therapy immediately after diagnosis.

Arterial hypertension grade 2 risk 2 - what is it?

At grade 2, risk factors may be absent or there will be only one or two such signs. At risk 2, the probability of irreversible changes in organs in 10 years, fraught with heart attacks and strokes, is 20%.

Therefore, the diagnosis of "arterial hypertension of the 2nd degree, risk 2" is made when the indicated pressure lasts for a long time, there are no endocrine disorders, but one or two internal target organs have already begun to undergo changes, atherosclerotic plaques have appeared.

Prevention

Preventive measures should be taken to reduce the risk of hypertension. Mainly:

Prevention of bad habits: drinking alcohol, drugs, smoking, overeating.
Active lifestyle. hardening. Dosed physical activity (skating, skiing, swimming, running, cycling, walking, rhythm, dancing). For boys 5-18 years old, the norm of physical activity is 7-12 hours a week, for girls - 4-9 hours.
Rational nutrition that prevents overweight. Restriction of salt intake.
Increasing resistance to stress, favorable psychological climate in the family.
Mandatory measurement of blood pressure at various periods of life.

Diagnosis of arterial hypertension

When collecting an anamnesis, the duration of arterial hypertension and the highest blood pressure numbers that were previously registered are specified; any indication of the presence or manifestations of PVS, HF, or other comorbidities (eg, stroke, renal failure, peripheral arterial disease, dyslipidemia, diabetes mellitus, gout), as well as a family history of these diseases.

Life history includes physical activity level, smoking, alcohol use, and stimulant use (prescribed by a physician and self-administered). Nutritional characteristics are specified in relation to the amount of salt and stimulants consumed (for example, tea, coffee).

The main tasks of diagnosing this pathological process are to determine a stable and elevated degree of blood pressure, exclude or identify symptomatic arterial hypertension, and assess the overall risk of S.S.S.

Necessary:

spend biochemical analysis to determine the concentration of glucose, creatinine, potassium ions and cholesterol.
be sure to undergo an ECG, Echo KG.
undergo an ultrasound of the kidneys.
check renal arteries, peripheral vessels.
explore the fundus.

Also, monitoring of pressure throughout the day is considered an important diagnostic method of examination, providing the necessary information about the mechanisms of cardiovascular regulation with daily variability in blood pressure, nocturnal hypertension or hypotension, and the uniformity of the antihypertensive effect of drugs.

Treatment of arterial hypertension

In the case of arterial hypertension, it is necessary to start treatment with a change in your lifestyle and non-drug therapy. (The exception is the syndrome of secondary hypertension. In such cases, the treatment of the disease, the symptom of which was hypertension, is also prescribed).

The treatment regimen includes therapeutic nutrition (with restriction of fluid intake and table salt, with obesity - with a restriction of daily caloric content); restriction of alcohol intake, smoking cessation, compliance with the regime of work and rest, physiotherapy exercises, physiotherapy (electrosleep, medicinal electrophoresis, warm - coniferous or fresh, radon, carbon dioxide, hydrogen sulfide baths, circular and fan showers, etc.).

Recommendations include regular outdoor exercise for at least 30 minutes a day 3-5 times a week; weight loss to achieve a BMI of 18.5 to 24.9; high blood pressure diet rich in fruits, vegetables, low fat foods with a reduced amount of saturated and total fats; sodium intake.

Medical treatment

With an increase in blood pressure to 160/100 mm Hg. Art. and higher;
With blood pressure less than 160/100 mm Hg. Art. in case of ineffectiveness of non-drug treatment;
With the involvement of target organs (hypertrophy of the left ventricle of the heart, changes in the fundus, changes in urinary sediment and / or an increase in the level of blood creatinine);
In the presence of two or more risk factors for coronary heart disease (dyslipidemia, smoking, etc.).

For treatment, the following groups of drugs can be used:

Diuretics (diuretic);
Alpha-blockers;
Beta-blockers;
angiotensin-converting enzyme (ACE) inhibitors;
Angiotensin-II antagonists;
calcium antagonists;

Choice specific means for the treatment of hypertension depends on the degree of increase in blood pressure and the risk of developing coronary artery disease, as well as age, gender, comorbidities and individual features the patient's body.

Forecast

Despite the fact that high blood pressure is a major risk factor for serious complications, the prognosis for an individual patient can be quite favorable.

Hypertension, like any other disease, requires considerable attention and respect. Early detection this disease, carrying out adequate treatment, as well as accurate and consistent compliance by the patient with all the appointments of the attending physician, significantly improve the prognosis.

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Degrees of hypertension

In medical practice, there is such a classification of GB according to the degree of the disease:

I degree is called easy. At this stage of the disease, blood pressure indicators constantly jump: they can rise sharply, after which they independently return to their original level. As a rule, hypertension of the first degree occurs due to strong feelings, stress and nervous disorders.
II degree is called moderate. Blood pressure rises more often, more difficult to go astray and normalize at the target level. Pressure parameters very rarely normalize on their own. In addition, the period normal indicators lasts a little. The main symptoms are pressing headaches, weakness.
III degree is called severe. Arterial hypertension of this degree exceeds the highest blood pressure parameters. This period is characterized by a persistent increase in blood pressure.

Hypertension of the 3rd degree is also characterized by unpleasant symptoms, such as pain behind the sternum, poor short-term memory, the patient cannot concentrate and concentrate on anything.

Hypertension of the 4th degree is characterized by dangerous complications that, developing, worsen the prognosis successful treatment AG by 30%. In this category of patients, the risks of developing a heart attack, stroke, and cerebral hemorrhage increase sharply if the systolic pressure becomes more than 180.

In this case, it is necessary to immediately begin treatment with antihypertensive drugs. Since complications may develop in the form of acute left ventricular failure or hypertensive encephalopathy.

As a rule, the treatment of GB is aimed at improving the patient's condition, lowering blood pressure at least to high normal - 130-139 / 85-90.

Definitely, ideally, the pressure should be 130/85, but when hypertension is diagnosed, it is almost impossible to achieve such indicators.

Stages of arterial hypertension

The classification of arterial hypertension is accepted as a division into stages, modern medical practice is based on the systematization of the disease proposed by Myasnikov. There are such stages of development of arterial hypertension:

At the first stage of hypertension, blood pressure indicators do not exceed the parameters of 159/99.
In stage II GB, blood pressure fluctuates up to 179 - the systolic indicator, the lower indicator is up to 109.
At stage III, there may be an increase in blood pressure up to 180/110.

The first stage of hypertension is characterized by increased pressure, which can last for several days. You can significantly reduce the parameters by ordinary rest and the exclusion of nervous tension. At more severe stages, it is no longer possible to lower blood pressure with this method.

First stage arterial disease does not highlight certain symptoms that from high performance target organs are inhibited. In this regard, in the vast majority of cases, the disease proceeds without any symptoms. Rarely, symptoms such as sleep disturbance, migraine, chest pain can be observed.

At the first stage, hypertensive crises are very rare, as a rule, they can develop under the influence of external factors, for example, a strong conflict or changes in atmospheric pressure.

The first stage of hypertension is the initial one, in view of this, the treatment helps to cope with pressure surges, the prognosis is very favorable, the pressure can be lowered to 130/90.

Brief description of the second stage of GB:

Rest does not help to normalize the pressure to 130/90, as well as the exclusion of stressful situations.
The patient has symptoms such as headache, shortness of breath, insomnia, dizziness, angina pectoris.
The first symptoms of complications from target organs occur. Usually, such signs do not affect their functionality in any way.
There are no bright symptoms that would greatly disturb the patient.
In the second stage of GB, a hypertensive crisis often develops, with the threat of serious complications leading to a stroke.
Treatment is carried out in without fail you have to take pills every day.

Stage III hypertension is characterized by the most severe course, an extensive group of violations of the functioning of internal organs. First of all, the work of the kidneys, brain, blood vessels, and the cardiovascular system is disrupted.

Blood pressure indicators are persistently elevated, even taking pills, it is difficult to return to normal level blood pressure. Stage 3 hypertension has its own symptoms:

Headaches, dizziness.
Persistent blood pressure.
Shortness of breath on exertion.

Together with the listed items, kidney failure can develop, the state of a person’s memory worsens, the rhythm of the heart is disturbed, and vision decreases.

Stage 3 GB is especially dangerous in that all pathological processes adversely affect the heart. In almost all cases of stage III AH, the contractility and conduction of the myocardium is impaired.

The first and second stages of hypertension are not contraindications for independent childbirth This means that a woman can give birth herself. Definitely, some problems may arise, but modern medicine deal with them successfully.

At stage III of hypertension, the ability to conceive drops sharply, and even if a woman becomes pregnant, in most cases, the pregnancy ends in a miscarriage or death of the fetus inside the mother's womb.

Degrees of risk of arterial hypertension

Arterial hypertension stage III means that blood pressure indicators are kept at a high level, treatment helps, but therapeutic effect insufficient. In order to predict how hypertension will develop, there is a special systematization, which is based on determining the prevalence of complications related to internal organs.

Allocate the following degrees risk of hypertension:

I degree of risk is called low or insignificant.
II degree of risk is called medium.
III degree of risk is designated as high.
The IV degree of risk is very high.

Once the degree of risk is determined and the diagnosis is made, appropriate treatment can be prescribed, which includes several drugs of various effects.

The lowest risk for first-degree complications occurs in women over 65 and men under 55 who are diagnosed with stage I hypertension.

During the first 10 years, the risk of developing serious pathologies of the cardiovascular system is revealed only in 15% of patients. As a rule, all patients are treated by a general practitioner, treatment by a cardiologist is not prescribed.

When a doctor believes that hypertension carries a certain risk for a particular patient, it means that you need to adjust your lifestyle. If such treatment, as a diet, refusal of salt, etc., did not bring positive results, medical treatment is recommended.

The diagnosis of arterial hypertension of the 2nd degree implies several factors that increase the risk of complications:

Genetic predisposition, smoking.
Overweight, sedentary lifestyle.
Improper nutrition (the patient does not follow the rules of nutrition, does not adhere to a special diet).

In 20% of cases, chronic heart failure (CHF) can develop. As a rule, treatment does not involve taking medications, the patient is given a chance to change his lifestyle, go on a diet, and in this way normalize blood pressure. Usually, if you follow all the recommendations, then the development of CHF can be avoided.

The diagnosis of arterial hypertension of the III degree has its own risks. It includes patients diagnosed with stage 1 and 2 hypertension. Also, the risk takes into account the disruption of the internal organs, the development of angina, regardless of the class of functionality (FC), an increase in the concentration of creatinine in the blood.

Sometimes the risk and its factors at the III degree may be absent, but the patient is still referred to this degree. The risk of developing serious complications increases by 30%:

The risk of CVD (cardiovascular pathologies).
The risk of developing angina pectoris of any fc.

With AH of the last degree, we can talk about unfavorable prognosis, which means that the risk of CVD increases by almost 40%. It is easy to determine this condition, the main therapy is carried out in a hospital, it is mandatory to include various medications.

special diet

With increased pressure, doctors recommend that all patients pay attention to their diet. There are a number of products that can and should be consumed under pressure. The diet for hypertension includes the following nutrition:

Minimal intake of animal fats.
The diet involves the rejection of easily digestible carbohydrates.
Limiting fluid intake.
Exclusion of salt or its restriction to 5 grams per day.

In fact, a high blood pressure diet is no longer a treatment, it is a lifestyle that every hypertensive patient should have.

As a first course, you can eat milk and vegetable soups. The diet may include various cereals: oatmeal, buckwheat, pearl barley and others.

The diet without fail includes foods that are enriched with potassium and magnesium: you can eat dried fruits, various fresh fruits. What does the diet exclude from the diet:

Smoked meats, marinades.
Fried, salty foods.
Fatty food.

The required diet also implies compliance with a special fluid intake. You can drink a decoction of wild rose, mineral water, but it is necessary to give up coffee, strong tea, carbonated drinks.

Arterial hypertension of the III degree is not a sentence, but it belongs to the category of diseases that have an increased risk of developing serious complications. In view of this, it is necessary to control your pressure, regularly see a doctor, take all the medicines recommended by the doctor, observing the dosage and frequency of administration. What is grade III hypertension can be found in the video in this article.

hypertonia.ru

Definition

Arterial hypertension of the 2nd degree is diagnosed if the readings of the tonometer are 160/100 - 179/109 mm Hg. Art. Moreover, high pressure persists for a long time and is reduced only with the help of medications.

Systolic pressure is of greater importance for diagnostic purposes. A sharp jump in the first digit often leads to strokes.

Recall:

systolic, upper (the first digit in the tonometer readings) - the pressure level during the contraction of the heart muscle (when the blood is forced into the artery with force).
diastolic, lower is an indicator of pressure at the moment of relaxation of the heart.

Clinical signs

The second degree of hypertension does not occur on its own. The patient's blood pressure was already rising. And more than once. Just the malaise was carried "on the legs." Treatment was not carried out. The lifestyle has not changed. The person did not respond to the alarming symptoms.

As a result, hypertension became more complicated - the first degree "outgrew" into the second. The risk of irreversible damage to the main internal organs has increased.

Symptoms of hypertension 2 degrees:

fast fatigue and chronic fatigue, lethargy (associated with involvement in the pathological process of the kidneys);
often sick;
pulsates in different areas of the head (either temples, or forehead);
excessive sweating;
blurred vision;
edematous and swollen face;
redness of certain areas of the skin;
numb fingertips;
hands and feet are cold.

The examination reveals symptoms of damage to internal organs and systems:

pathological changes in the fundus;
narrowing of the lumen of arterioles;
in the analysis of urine - albumin proteins;
signs of target organ disease develop or worsen;
fragility of vessels, arterial plaques, narrowing.

With hypertension of the second degree, the risk of a hypertensive crisis is high. This is a sharp, spontaneous jump in pressure by several tens of units at once. Symptoms depend on the form:

A neuro-vegetative attack is accompanied by palpitations, tremors, and dry mouth. The patient is overexcited. He is haunted by an unreasonable panic fear.
The edematous form is characterized by general lethargy, lethargy, swelling of the eyes.
For convulsive - fainting, convulsions.

Hypertensive crisis is a life-threatening condition. It can result in myocardial infarction or pulmonary edema, brain. It is important to treat high blood pressure promptly.

Arterial hypertension 1, 2 and 3 stages

Diagnosis of hypertension does not end with the determination of the degree. The doctor will also indicate the stage and risk.

Arterial hypertension is 1, 2 and 3 stages. The gradation depends on the nature of the changes in the target organs. These are organs that are densely covered with blood vessels. That is why they suffer the most from the increase in pressure. Moreover, they experience the load even when a person feels relatively well.

With grade 2 hypertension, changes in target organs are almost always noticeable.

Organ	Pathological changes	Complications
Heart	Because of high load left ventricular hypertrophy occurs on the heart muscle.	Increased risk of heart failure sudden death, heart attack.
Brain	Already at the first signs of hypertension, the blood supply to the brain is disrupted. Do not go through treatment - the situation is aggravated. At 2 degrees, local heart attacks are frequent.	Brain weight decreases - worsens intellectual ability, memory. Dementia may develop.
kidneys	Gradual sclerosis of the renal tissue and blood vessels interferes with the excretory function - the level of urea products in the body increases.	kidney failure

Risk assessment

Arterial hypertension carries a certain risk for the body. On this basis, hypertension of the 2nd degree is classified, the diagnosis is clarified.

Evaluation criteria (aggravating factors):

Age. The older a person is, the more often he suffers from hypertension, the more difficult it is to treat him. For a man, a diagnostically significant milestone is 55 years, for a woman - 65.
Amount of cholesterol. Indicators above 6.5 mmol / l are taken into account.
Smoker experience. How more years(even in the past), the higher the risk.
Heredity. Were there hypertension among relatives?
Excess weight. Arterial hypertension of the 2nd degree is more common in the anamnesis of obese people.
Diabetes.
Insufficient activity. Or her absence.

Depending on the number of aggravating factors, the risk is determined.

Risk 1	With hypertension of the 2nd degree, it is not diagnosed.
Risk 2	There are no aggravating factors. Or in the patient's history - 1-2 criteria from the list above.	The probability of developing changes in target organs over the next 10 years is 15-20%.
Risk 3	In the anamnesis - 3 aggravating criteria.	The probability of serious pathologies in target organs is 20-30%.
Risk 4	It is diagnosed in the presence of 4 or more aggravating factors.	The probability of complications is from 30%.

With hypertension of the 2nd degree (risk 4), symptoms of disruption of the target organs are already clearly visible.

Diagnostics

Arterial hypertension is not set only according to the readings of the tonometer. To prescribe adequate treatment, the doctor conducts a full examination. At the 2nd degree of the disease, concomitant changes in the body often occur.

The admission of the patient and the diagnosis begins with the collection of anamnesis. The patient describes the symptoms - the doctor suggests stage 2 hypertension. If a person was previously diagnosed with arterial hypertension of the 1st degree, then 2 (with a deterioration in well-being) is automatically set.

The next step is monitoring blood pressure. It is necessary to measure and fix in the morning and in the evening for two weeks.

If necessary, the physician physical research methods:

blood pressure measurements;
analysis of the state of peripheral vessels;
examination of the skin (if there are swelling, hyperemia);
listening with a stethoscope to the lungs and heart;
manual (tapping with phalanges) determination of the size and position of the heart.

For a detailed study of complications in target organs, instrumental methods:

Ultrasound of the liver, kidneys, organs of the endocrine system;
Ultrasound of the heart to study the condition of the valves, the size of the left ventricle;
EchoCG to assess the level of cardiac decompensation;
ECG to analyze the electrical activity of the muscles of the heart;
dopplerography - assessment of the state of the renal arteries;
laboratory analysis of blood and urine.

Arterial hypertension of the 2nd degree is the result of malfunctions of the kidneys, heart or endocrine glands. Diagnosis reveals the degree of deviations and allows you to prescribe effective treatment.

Features of therapy

When the full picture of the disease is known, treatment is prescribed. With hypertension of the 2nd degree, this is done by the local therapist. Usually.

You may need to consult a cardiologist and a neurologist. These specialists have the right to correct the treatment of the patient.

The traditional choice for high blood pressure is drug method. At grade 2, tablets are taken strictly by the hour.

Treatment includes the following groups of drugs:

Diuretics (diuretics). Removed from the body excess water and sodium. Together with other means (diuretics are not prescribed solo), they reduce pressure.
Beta blockers. They normalize the rhythm of the heart, block the influence of the nervous system on its work. Under the influence of antihypertensive drugs, the heart works more economically.
Alpha blockers. Appointed after the abolition of diuretics. Good effect on the lipid profile of blood plasma.
ACE inhibitors (Captopril, Enalapril, etc.). As a result of the reception, peripheral vessels dilate - blood pressure decreases.
Angiotensin-2 antagonists (Irbesartan, Losartan). If ACE inhibitors prevent the production of the hormone angiotensin-2 (due to which blood vessels narrow), then antagonists block its action. The drugs from the previous group did not cope with their task - the doctor prescribes funds from this group. And they are similar in action.

Treatment of grade 2 hypertension is not limited to one program. This is a very long process. A break in therapy leads to an increase in pressure - the target organs "suffer" again. The risk of a heart attack increases. Often, arterial hypertension becomes the cause of the patient's disability.

Insidious hypertension grade 2 - risk 2

Arterial hypertension is one of the most common diseases among all cardiovascular diseases. Hypertension is chronic disease, which is characterized by a persistent increase in blood pressure above allowable norms(140/90mm Hg). Depending on the indicators of blood pressure, there are three degrees of severity of arterial hypertension:

Hypertension of the first degree BP 140-159 / 90-99 mm Hg.

Hyperthia of the 2nd degree. BP 60-179/100-109 mm Hg

Hyperthia of the 3rd degree. BP 80/110 mm Hg

To date, the severity of arterial hypertension is not determined without "aggravating factors" - doctors call them risk factors. Depending on the risk factors, the forecasts of the consequences of hypertension are also adjusted. In international practice, it is customary to make a diagnosis of hypertension only taking into account risk factors. So, for example, in a person, BP is 165/110 mm Hg st. which has one or two concomitant aggravating factors (risk 2) - in such cases they write hypertension grade 2 risk 2

Risk factors that aggravate the course of hypertension and worsen its prognosis are:

- Patient smoking.

- age for women who are over 65 years old. ; for men - over 55 liters.

— high level cholesterol.

- burdened family history (presence of early cardiovascular pathologies)

- sedentary lifestyle, obesity, diabetes, chronic diseases.

Depending on the risk factors and the degree of hypertension, doctors determine the risk of manifestation of such consequences of hypertension as myocardial infarction and stroke in the next ten years. Thus, in the diagnosis, for example, hypertension of the 2nd degree risk2 (one might say) a prognosis is made. This classification is very convenient and is used in the world practice of diagnosis and treatment of patients with hypertension.

If 1 degree hypertension (mild) is not accompanied by any risk factor, then the risk of developing cardiovascular complications (stroke, myocardial infarction) in the next ten years is low (less than 15%). Such patients are also under medical supervision. With a stable level of blood pressure above 140/90 mm Hg. the doctor must prescribe medication.

Hyperthia 2 degree risk 2 refers to moderate severity and means that the risk of developing cardiovascular pathologies in the next ten years is fifteen to twenty percent. If hypertension is of the second degree, but has a high risk factor (three or four), then this means that in the next ten years the risk of developing complications of cardiovascular complications is 30 percent or even more. In such cases, the patient requires urgent examination and treatment.

Causes and mechanisms of development

genetic predisposition.
Excess consumption of salty foods.
Deficiency of calcium and magnesium in food.
Alcohol abuse.
Tobacco smoking.
Obesity of alimentary and dyshormonal type.
Low physical activity.
Abuse of strong tea and coffee.
Frequent psycho-emotional upheavals.
Social position and obligations.

All these factors lead to the activation of the sympathetic-adrenal hormonal complex, which, with constant activity, causes a persistent spasm of small vessels, which is the primary mechanism for increasing blood pressure. The kidneys are especially affected. Against the background of their ischemia, the renin system begins to function, which provides a further increase in pressure due to additional vascular spasm and fluid retention in the vascular bed. There is a vicious circle with clearly defined links to which modern treatment is directed.

Correct pressure measurement

How to measure blood pressure correctly

An important point in monitoring patients with hypertension and monitoring treatment is the measurement of daily blood pressure parameters. It is natural that medical workers unable to provide ongoing supervision. Therefore, each patient must know and be able to independently carry out the necessary measurements. Today, mechanical and electronic tonometers are used for these purposes. With the latter, it is much easier, since the patient only needs to press certain buttons and the device itself will give out the received numbers. The only disadvantage is not always reliable information. Therefore, it is necessary to carry out 2-3 measurements with an interval of 10-15 minutes. Appreciate average, if the difference between the maximum and minimum does not exceed 20 units.

When measuring pressure with a conventional tonometer, it is necessary to adhere to certain rules In order for hypertension to be correctly diagnosed:

Measurements are taken only in calm state after a short rest;
Position - sitting or lying on your back;
The cuff is applied in turn to each bare shoulder and is located at the level of the heart, which corresponds to the diameters of two fingers above the elbow;
The arm should be bent at the elbow joint;
Putting the stethoscope in the elbow under the cuff;
Gradual air injection;
Smooth release of air with the registration of numbers that correspond to the appearance of a pulsating noise heard through the stethoscope and its cessation.
The result is necessarily recorded in a special diary of hypertension, affecting the treatment.

Issues of classification of hypertension

In this regard, it is necessary to fundamentally distinguish between degrees and stages. The first characterize the level of increase in blood pressure, the second - clinical manifestations and complications. According to the new world concept, the degrees of arterial hypertension are distinguished:

Increase in pressure from 140/90 to 160/100 mm Hg;
The numbers are higher than the above.

As for the staging of the disease, it looks like this:

Complications and structural rearrangements of organs are not observed;
There are signs of changes in internal organs that are associated with high blood pressure: hypertensive heart disease (hypertensive heart), wrinkled kidney, damage to cerebral vessels, changes in the fundus of the eye;
Development dangerous complications in the form of myocardial infarction and cerebral stroke.

Stratification of risk factors

This term in cardiology means determining the risk of developing complications of hypertension in a particular patient. This is necessary to distinguish those patients who need special control of blood pressure parameters. This includes all factors that affect the development, course and prognosis of the disease. There are such groups of patients:

Low risk (risk less than 15%) - male and female patients aged less than 55 years with first degree hypertension without concomitant damage to the heart and internal organs;
Moderate risk (15-20%) - patients with 1-2 degrees of hypertension in the presence of less than three risk factors, but without concomitant structural changes in the internal organs;
High risk (20-30%) - patients with 1-2 degrees of hypertension with three or more risk factors in the presence of structural changes characteristic of the second stage of hypertension;
Very high risk (more than 30%) - patients with 2 degrees of hypertension, multiple causal risk factors and pronounced structural changes in internal organs.

Spasm of renal vessels in hypertension

Clinical manifestations and diagnosis

Uncomplicated hypertension of the 2nd degree, except for an increase in blood pressure figures and subjective sensations of the patient, does not manifest itself in anything else. These include:

Headaches of a throbbing type in the temples or occiput;
Strong heartbeat and tachycardia, arrhythmia;
Trembling all over body;
Nausea during a crisis;
General weakness.

In the case of the transition of the process to the second stage, instrumental signs of damage to the heart, kidneys, brain, fundus join. To confirm them, an ECG (electrocardiography) is performed, in which symptoms of a hypertensive heart are detected: left ventricular hypertrophy, an increase in size, an increase in the voltage of the base teeth. For additional research it is shown:

ECHO-cardiography;
Examination of the fundus;
Biochemical study of blood and lipid spectrum;
Ultrasound of the kidneys;
Dopplerography of cerebral vessels and renal arteries;
Glycemic profile study.

echocardiography is one of the additional methods research

Therapeutic tactics for hypertension

There should be one approach - as early as possible. It is always necessary to start treatment with the elimination of risk factors that are the causes of the disease. Medical correction Nothing good will come of it without removing them. Early drug resistance may occur, making it difficult to further treatment. The set of activities should include:

Elimination of bad habits in the form of abuse alcoholic drinks and smoking;
Strong tea and coffee are excluded;
Limiting fluid and salt intake;
A sparing diet with the exception of spicy foods, easily digestible fats and carbohydrates, especially those with a high cholesterol content;
Normalization of sleep and wakefulness, physical activity and rest;
Constant self-control in terms of psycho-emotional state. If necessary, please contact medicines(barboval, corvalol, novo-passit, phytosed);
Correction of obesity and diabetes;
Medical therapy.

The last point requires more detailed consideration. It includes the treatment of hypertension itself and its complications. Drugs are prescribed according to the type of stepwise therapy, at the beginning of which weaker drugs are prescribed with a gradual transition to strong ones. Tactics are used, both in the form of monotherapy (with one drug), and combined treatment with compatible groups. The main ones are:

angiotensin converting enzyme inhibitors (ACE inhibitors): enalapril, lisinopril;
Angiotensin receptor blockers: losartan, valsartan;
Adrenoreceptor blockers: metoprolol, bisoprolol;
Calcium channel antagonists: nifedipine, amlodipine;
Diuretics: furosemide, tripas, hypothiazide, veroshpiron;
Combined forms: captopres, Enap N, liprazid, equator, toneorma.

In parallel with the basic one, the treatment of cardiac activity and cerebral circulation is carried out, the parameters of their function are monitored. The most important thing - healing process should be continuous under strict medical supervision and control of blood pressure. The drug must enter the body daily, only its dose is corrected. This is the only way to achieve good results and prevent the development of dangerous complications.

Hypertension 2 degrees and the army

It often happens that conflict situations arise when conscripting into the armed forces or serving military personnel with high blood pressure numbers corresponding to grade 2 hypertension. The army categorically refuses to let go of valuable personnel, and military personnel do not want to serve at the expense of their health.

According to the legislative acts of the Ministries of Health and Defense, hypertension of the 2nd degree is an absolute contraindication to military service, provided it is correctly confirmed. Such personnel are either commissioned or sent for treatment with further consideration of the question of the expediency of military service.

Your age

up to 40 41-49 50-54 55-59 60-64 60 and more

male
female

"Upper" pressure level

up to 120 mm Hg 121-140 mmHg 141-160 mmHg 161-180 mmHg 180 mmHg and more

Do you smoke?

No
Yes

Plasma cholesterol level

up to 4 mmol/l 4-5 mmol/l 5-6 mmol/l 6-7 mmol/l 7-8 mmol/l

Do you have one of these problems:

diabetes;
atherosclerosis;
cardiac ischemia;
with your relatives early age cardiovascular diseases have been identified;
you are obese and lead a sedentary lifestyle.

Your result:

Risk of death
from cardiovascular
diseases:

	below 2% almost no risk of death
	low risk of death
	possible risk of death
	above 5% high risk of death

SCORE Calculator stands for Systematic COronary Risk Evaluation. It was created to calculate the risk of developing a deadly cardiovascular disease in the next ten years. The calculation is based on research data from twelve European countries, including Russia.

SCORE scale

The SCORE scale is presented in the form of a table that can be used if it is not possible to use the online calculator.

The following factors are taken into account in the calculation:

Upper (systolic) blood pressure;
smoking habit;
The content of total cholesterol.

There are variations of the SCORE scale in relation to countries with a low risk of developing cardiovascular diseases and with a high one (which includes Russia).

How to use the calculator

To find out the risk of deadly cardiovascular diseases, it is necessary to fill in the appropriate fields in which to indicate age, gender, upper blood pressure level, total cholesterol level, and the fact of smoking. The calculated figure is expressed as a percentage and indicates the probability of death, which is a consequence of heart and vascular disease in the next decade.

Using the SCORE without a calculator

The corresponding half of the Scale is selected. Right for men, left for women.
There are two columns for each gender, one for smokers and one for non-smokers. The desired one is selected.
The cell corresponding to the age is determined. They are arranged line by line.
Each age cell is divided into rows for upper blood pressure and columns for total cholesterol.
At the intersection of the desired row and column is a number indicating the total percentage of cardiovascular risk.

The value of the result

Less than 1% risk is interpreted as low
1 - 5% - moderate
5 - 10% - high

Over 10% - very high

It must be remembered that a high percentage of SCORE corresponds to a significant risk lethal outcome from a stroke or myocardial infarction, even if at the moment the person does not feel any ailments.

Cases where CV risk is higher than calculated

As a result of ultrasound of the carotid arteries, MCT or electron beam tomography, signs were found that are inherent in subclinical atherosclerosis.
Left ventricular hypertrophy detected by echocardiography or ECG.
Low levels of high-density lipoprotein or "good" cholesterol, impaired glucose tolerance or increased triglycerides.
The body is inflamed.
Sedentary lifestyle, obesity.

When Not to Use the Cardiovascular Risk Calculator

Diabetes mellitus of the first and second type.
The level of total cholesterol is greater than 8.0.
Blood pressure exceeds 180/110.
Established the presence of diseases of the heart and blood vessels.

Only a doctor can reliably determine the state of the cardiovascular system. The Cardiovascular Risk Probability Calculator is only a guess.