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Hypertension differs greatly from any other illness. This disease can be extremely serious, but, as a rule, it does not influence the general state of a person day by day. Hypertension is often called as a silent killer because no symptoms are shown at the early stages of the disease. People with high blood pressure in most cases do not know that they have this disease as they do not measure their blood pressure. If a person does not know about his or her disease it will slowly cause serious damages, and the person is exposed to risk of sudden death from heart attack or stroke.
While the gene of hypertension is not found yet, and researches in this area are still ongoing at the cellular level of organism, a lot of things are clear to scientists. For example, disorder of metabolism of water and electrolytes (sodium, potassium, chlorine) is detected in many patients cells at the early stage of disease. Kidneys and adrenal glands react to this metabolic disorders and the increased amount of biologically active agents, such as renin, aldosterone, etc., which may increase blood pressure indirectly, is released (Khawaja & Wilcox, 2011). Moreover, hypertension initially develops as a result of vessels permeability disorder in certain areas and metabolic disorder at the cellular level. At the initial stages, hypertension is characterized as vegetative-vascular dystonia or the inability of organism to provide the proper metabolism process because of disorders in the state of the autonomic nervous system. If these disorders are not eliminated, they gradually spread within the whole body, and eventually distinctions in vascular reactions erase (Lopez-Jaramillo, Velandia-Carrillo, Alvarez-Camacho, Cohen, Sanchez-Solano, & Castillo-Lopez, 2013).
Quite often the symptoms of primary hypertension coincide with symptoms of general overfatigue. For this reason, people get to know about their disease only when they are in critical condition. The major symptom of hypertension is headache. Headache develops most often in the occipital, temporal and parietal regions. Intellectual and physical activities amplify pain. Especially severe pain accompanies hypertensive crises. Precordial pain is also observed at hypertension. People with high blood pressure may experience heart gripping and aching pain but the short-term pricking pain is also possible. Other symptoms of hypertension, such as strong heart palpitations, sonitus, fainting, and giddiness are also observed. During increase of pressure there can be the feeling of heat, skin on the face and other parts of the body turns red and then they become wet with perspiration. Extremities, on the contrary, get cold (Pedrosa, et al., 2011).
High blood pressure leads to harder work of heart that it has to perform in order to maintain normal blood circulation. Therefore, if hypertension is not treated, walls of the heart thicken; thus, the risk of interruptions in the work of heart increases. Later the walls of the heart become thinner leading to impaired blood supply to the tissues and the heart, which is accompanied by shortness of breath, fatigue, and leg swelling. These symptoms often indicate the development of heart failure. High pressure accelerates the process known as atherosclerosis. It means formation of fatty deposits on the arterial walls, which cause their thickening and reduced vessel lumen. If the coronary arteries, which supply blood flow to the heart, are affected, then angina pectoris can develop (Beckett et al., 2008). With development of the process, one of the arteries may clog completely, then part of a cardiac muscle ceases to receive blood, and the myocardial infarction is developing. If the brain vessels are affected, the cerebral stroke can develop with strong possibility. Thus, understanding, speech, memory, and ability to see can be also affected. With affection of vessels in eyes, kidneys, and lower limbs the high risk of blindness, kidney failure (Khawaja, & Wilcox, 2011), and inability to move one or more limbs on one or both sides of the body can occur (Velasco, & Israili, 2012).
For diagnostics of hypertension, it is necessary to conduct both laboratory tests and instrumental examinations. All patients with hypertension have to pass the following tests: complete blood count, determination of the glucose concentration, determination of total cholesterol, determination of HDL, determination of triglycerides, determination of uric acid, determination of creatinine, determination of potassium ions in the blood, and urinalysis (Khawaja & Wilcox, 2011). Besides, as an additional laboratory tests, doctors examine the content of CRP, urinary albumin excretion, and creatinine clearance, if necessary. As for instrumental diagnostic examination, doctors usually prescribe ECG to all the patients with hypertension. Additional instrumental examinations are prescribed depending on the clinical picture of the patient. For example, high-risk patients or patients with complicated course of the disease are prescribed echocardiography and carotid artery ultrasound. Patients with cerebral complications of hypertension are prescribed to have a CT scan of the brain. Wearing of ambulatory blood pressure monitor is prescribed in the following cases: large blood pressure variability, resistant hypertension, or presence of hypotonic episodes (Beckett et al., 2008).
High blood pressure is not the only cause of hypertension. Hypertension can also be caused by a host of other diseases of various organs and systems. The disease should be differentiated from various kinds of symptomatic hypertension, such as renal (chronic pyelonephritis, chronic glomerulonephritis, renovascular hypertension, etc.) (Khawaja & Wilcox, 2011), endocrine (chromaffinoma, true hyperaldosteronism, Cushings syndrome, etc.), affections of the heart and large vessels (atherosclerotic, inborn, etc.), diseases of the central nervous system (tumors, encephalitis, meningitis, diencephalic syndrome, etc.).
Approximately half of the patients with essential hypertension can maintain normal blood pressure without taking drugs. For this purpose, it is necessary to give up some addictions. Non-pharmacological treatment of hypertension includes low-salt and low-fat diet; normalized physical activity; quitting tobacco and alcohol; auto-training and reflex therapy; acupuncture; herbal medicine; electrically induced sleep, and even treatment by means of classical and relaxing music. At least half of the patients with essential hypertension can achieve the optimum level of blood pressure only using non-pharmacological management of risk factors. In individuals with higher level of blood pressure, the non-pharmacological treatment, which is conducted simultaneously with taking hypotensive drugs, can significantly reduce the doses of drugs and risk of side effects of these drugs (Zhang & Li, 2011).
As for the pharmacological treatment, main groups of hypotensive drugs are determined by their effect on the major pathogenic mechanisms of the blood pressure regulation. Some groups of hypotensive drugs are as follows: diuretics, alpha-blockers and beta-blockers, calcium antagonists, centrally acting drugs, etc. (Gil-Extremera & Cia-Gomez, 2012). Initial diuretic and hypotensive effect is associated with defluvium of fluid by kidneys and, thus, decreases blood volume accompanied by a decrease of blood pressure. Diuretics affect the reduction of both systolic and diastolic blood pressure. Alfa- blockers and beta-blockers cause desensitization of adrenoreceptor apparatus that reduces vasostimulant influence on the vascular tone, decreases vascular resistance and ultimately reduces blood pressure. Moreover, in addition to their primary hypotensive effect, alfa-blockers and beta-blockers may also have an adverse effect on the organism. Alfa-blockers can cause tachycardia, and beta-blockers cause bradycardia and bronchospasm. Calcium antagonists affect the entry of calcium ions into cells by blocking or slowing rowing at hypertension transmembrane calcium flow in smooth muscle cells of the vascular wall structures that ultimately reduces vascular tone, decreases systemic vascular resistance, and decreases blood pressure. Centrally acting agents that stimulate receptors of medulla oblongata and block serotonin receptors of the brain, decrease sympathetic impulses to vessels, which leads to vasodilatation effect (Gradman, Basile, Carter & Bakris, 2010).
Taking into account the fact that hypertension has a destructive effect and even causes fatal outcome, people should do everything for prevention of this disease. One of the most efficient ways of prevention of hypertension is client management, self-care and timely education. In order to provide the early detection of hypertension, people should have the opportunity to assess their blood pressure. For this purpose, patients should be informed on the methods of self/home monitoring of their blood pressure and be provided with the corresponding inventory for assistance in diagnostics. Patients should be informed about their target level of blood pressure and importance of maintenance of this target (Pickering & White, 2008). People should know enough about lifestyle factors because it may influence hypertension management. Dietary risk factors should also be included into hypertension management. Besides, all patients should remember that essential hypertension can be treated by means of herbal medicine and other non-pharmacologic kinds of treatment.