11/26/2012

Risk of hypertension

on cardiac damage previously said, essential hypertension on the heart, brain, kidney damage is great. From pathogenesis, it on organ damage and caused by a lesion is a lengthy process, hypertension, is in advanced a series of comorbidities, from a large amount of clinical data, hypertension on cardiac damage is to be the first to bear the brunt of, main show is in the following two aspects.

A on cardiac vascular damage, hypertension on cardiac vascular damage is the main coronary arteries and heart, other small artery is rarely involved. Studies have considered, due to increased blood pressure, coronary vascular dilatation, stimulate blood vessel lining of smooth muscle cell proliferation, the arterial wall elastin, collagen and glycosaminoglycan increased, vascular intimal layer and the injury of endothelial cells, cholesterol and low density lipoprotein easily immersed in artery wall, and hyperplasia; in addition, due to smooth muscle cells in the lysosome increased, reduced to the arterial wall cholesterol and other substances to eliminate. Therefore gradually make coronary artery atherosclerosis, and coronary artery stenosis, myocardial blood supply decrease, known as coronary heart disease, or ischemic heart disease.

In recent years, a large number of domestic and foreign research data show that, by caused by hypertension coronary heart disease incidence increased significantly. According to Shanghai, Beijing and other places in the survey, 62.9% to 93.6% in patients with coronary heart disease with hypertension. Some experts to study the proven, effective antihypertensive treatment, can prevent and reduce the complications. But did not reduce the incidence of coronary heart disease, because once the coronary atherosclerosis, the lesion is irreversible. Visible, and hypertension on coronary heart damage is very serious, therefore, people often think of hypertension and coronary artery disease known as one of " twin sister ".

The two is that of the heart damage of hypertension, cardiac involvement, often make cardiac structural and functional change, because blood pressure chronically elevated, increased left ventricular burden, make the long-term involvement, left ventricular hypertrophy, dilation due to decompensation and gradually, formed the hypertensive heart disease. Hypertensive heart disease, mostly in the pathogenesis of hypertension for several years or more than ten years. In cardiac function, except I heart palpitations or shortness of breath, no other symptoms. Compensatory function disorders, can appear left heart failure symptoms, a little activity that palpitations, asthma, cough, sometimes blood-tinged sputum, severe pulmonary edema. Radiographic examination, some can display left ventricular hypertrophy, since ultrasound heartbeat for clinical, ventricular hypertrophy positive rate can be as high as 90% or more.

on brain damage in our country. The elderly three cause of disease are cerebrovascular disease, heart disease and cancer, and cerebrovascular disease ranked first. On brain damage from hypertension, followed by arteriosclerosis. Therefore, hypertension on cerebral damage is a serious threat to human health and the life of the most dangerous factors.

Hypertension on cerebral damage is the main effect of cerebral artery. Hypertensive disease and early, only systemic arteriolar spasm, and there is no apparent vascular organic change. If blood pressure continued to increase over the years, the arterial wall due to hypoxia, malnutrition, arterial intimal permeability, vascular wall occur gradually harden and lose elasticity. Gradual lumen stenosis and occlusion. The organs of vascular lesions in varying degrees, usually in brain, heart, kidney and other lesions are the most serious. Cerebral arterioles of the muscular layer and adventitia were undeveloped, the wall is weak, vascular autoregulation is poor, coupled with the long-term blood pressure, mental tension or improper use of antihypertensive drugs, blood pressure fluctuations, causing cerebral artery spasm and other factors can induce cerebral vascular disease.

The harm to the kidney in human urinary system is like a " drain system ", also known as the "sewer ", in the maintenance of body physiological equilibrium process, plays an important role in. While the kidney and urinary system an important organ, it is like the water treatment system in the central part of the kidney is good or bad, on the body is very important. Harm to the kidney in addition to allergy caused by inflammation and bacterial infection, clinical more common is the essential hypertension.

In general, hypertension on renal involvement is a relatively long process. Pathological study of proof, hypertension on kidney damage, primarily from a small artery begins early, there is no obvious renal morphological and functional changes. The first is the renal arteriolar appear hardening, stenosis, the kidneys were ischemic, some renal unit fibrosis hyalinization, and another some of normal renal unit compensatory hypertrophy, as the disease continues to develop, the kidney surface was granular, thinning, renal unit because of the constant damage, kidney atrophy, and then the occurrence of renal insufficiency and development of uremia.

④ the fundus harm people often say: "the eyes are the window of the soul ", the eye can reflect a person's inner world. However, many people do not know the doctors can also through the eyes of understanding and observation of the internal situations, therefore, eyes still examining disease " window ". Indeed, the body can only in vivo directly observed vascular, is achieved by fundus examination. It not only can clearly observe the fundus and retinal arteriovenous situation, but also to understand to the optic nerve and the fundus of the other changes. Therefore, fundus examination is not only an important basis for diagnosis of diseases in Department of Ophthalmology, and judgment of severity and prognosis of hypertension is important means to check the, then, to which damage caused by hypertension fundus, can cause what change, from the following two aspects are briefly introduced:

A fundus changes: the clinical practice proof, hypertension, fundus examination are normal. When hypertension development to a certain extent, can appear retinal artery spasmodic contraction, arterial diameter stenosis, the center reflector narrows; such as long time increased blood pressure, retinal artery can produce sclerosis, artery occurring silver reaction, arteriovenous cross syndrome; as the disease development, can appear bleeding, exudation, retinal edema, severe optic papilla edema. A long time, the material is deposited on the exudation of retina fundus appearance, radially waxy yellow spot, this can cause the visual impairment, such as blurred vision, visual distortion or smaller.

Two was the fundus lesions and its clinical significance: Based on fundus changes in the extent and a large amount of clinical data, experts usually put the fundus lesions are divided into 4 grades: grade Ⅰfor retinal arteriolar slightly stenosis and mild hardening, others were no exception; level II retinal arteriosclerosis, arterial " silver reaction ", arteriovenous cross syndrome; grade in grade Ⅱwere added based on retinal bleeding, exudation and edema; IV accompanied by papilledema. From the fundus lesions degree classification, enough to reflect the degree of the progress of hypertension. That is to say, the fundus changes in higher levels, hypertension prevalence is longer, the illness is more serious, the retinal artery atherosclerosis and hypertension prevalence in time proportional to the. Especially when retinal bleeding, exudation and papilledema, has prompted the vital organs such as the brain, heart, kidneys were damaged in different degrees. From this point, fundus examination of retinal arterial damage, hypertension is a strong basis for diagnosis.

Clinical hypertension caused by cerebrovascular disease mainly cerebral hemorrhage, hypertensive encephalopathy and lacunar infarction. Cerebral hemorrhage is the most common complication of late hypertension. Cerebral hemorrhage at the lesion site, the amount of hemorrhage and emergency treatment for patient prognosis relations greatly, average fatality rate is high, even the survivors left hemiparesis or aphasia and other sequelae. So the prevention and treatment of cerebral hemorrhage by the key is usually effective control of blood pressure.



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