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ARTERIAL HYPERTENSION IN DIABETES MELLITUS
Prof. Maria Damyanova


        Arterial hypertension is a disease of the vessels due to the narrowing of the education / open / vessels caused by deposition of fat / lipid / cellular elements, calcium and glycosylated proteins in the wall of arterial vessels. This is the essence of the atherosclerotic process in the body. Risk factors for atherosclerosis include: stress, mental tension, insomnia, smoking, diabetes, obesity, gout, hiperlipedimiya / increased level of body fat, kidney infections and many other reasons. Last but not least is the abuse of salt, especially in hereditary burdened patients with hypertension. Arterial hypertension as a disease of civilization appeared in modern times, when huge volumes of imported salt in the diet became public. It should be noted that the intake of salt is a factor that resulted in people with genetic mutations to Manifesting of arterial hypertension. Arterial hypertension may, however, does not occur if salt intake is not great. Even today there are tribes that live in the wild natural environment in Africa, New Guinea and others who receive a little salt in which their blood pressure increases with age and hypertension is not known.
In the past, salt was very expensive and inaccessible to more people. It is known that some cities such as Salzburg due to its wealth of nearby salt mine.
        Under normal conditions, our blood pressure stays within narrow limits, but is likely to increase in physical activity and emotional arousal. During sleep, its level dropped as low. In women, blood pressure is lower than men.
        The increase in blood pressure is associated with irritation of the nerve centers in the brain in relation to the above mentioned reasons.
        There are two types of hypertension - primary - essential and secondary hypertension, which is a sign of other diseases as hypertension in diabetics. The cause of hypertension in diabetes is most common, or in connection with hereditary point or kidney damage, renal disease are secondary to hypertension.
        In these cases the simple urinalysis is including mikroalbiminury.
        Systemic blood pressure measurement is of great importance. It is defined by two values - systolic and diastolic pressure, which are different for different age groups - children blood pressure was lower, in middle age - higher and for adults - even higher.
        As hypertension is considered systolic pressure over 140 millimeters of mercury and diastolic 90 mm mercury.
        Available from the Bulgarian league Hypertension following definitions and classifications of levels of blood pressure:

                                                    Systolic               diastolic
 Optimal                                         <120                    <80
Normal                                       120-129                 80-84
High normal                              130 -139                85 -89
Іva step. hypertension.             140-159                 90-99
II-step. hypertension.                160 - 179            100-109
III-step.hipert. / heavy/                 > 180                    > 110
Isolated systolic hypertension    <140                     <90
        Isolated systolic hypertension is the result of aging. Other reasons may be different diseases such as aortic insufficiency, hyperparathyroidism, anemia and others.
        Frequent in the course of hypertension is hypertensive crisis - a diastolic pressure above 120 - 130 mm mercury. If this condition is necessary urgent measures for the gradual lowering of blood pressure within minutes to hours. In a small proportion of patients in the case of secondary hypertension, which should therefore be clarified / renal or endocrine.
        There are two main factors that support systemic blood pressure, the volume of extracellular fluid and adrenal system - renin, angiotensin aldosterone.
        Almost all sodium chloride in the body is concentrated the extracellular fluid. This fluid reflects changes in imports of sodium. Extracellular fluid is variabel on magnitude and fluctuates daily, both individually and culturally.
        The kidneys play a central roll in the maintenance of extracellular fluid by adjusting the transmission of sodium in urine sodium according imports: in fall to 0 sodium excretion of sodium also fell for the importation of more sodium emission in the urine increases, and thus restore equilibrium in body.
        Adrenal system is an important regulator of extracellular fluid Acting through renal mechanisms maintained blood pressure.
        Hypertension luckily today is completely curable.
        For that purpose should be avoided overeating and fatigue, do not smoke do not drink hard liquor, to make appropriate physical exercise, avoid stress, of course parallel with the adoption of medication.
        The methods of treatment of hypertension coincide largely with the treatment of diabetes and obesity.
        Blood pressure should be controlled once to twice daily in increased pressure to know what medications need to take.
        Prevention and treatment of disease requires regulation of feeding. In the diet-therapy first place of salt restriction to 3-5 g daily or dietary salt - Low Salt, fruit-vegetable diet, rice-fruit diet magnesium diet and others. High salt intake can reduce the effect of medication. It is recommended that low-calorie diet that normalizes body weight and leads to normalization of blood pressure and improve the metabolic processes. This mode is required at elevated fats in the blood and increased uric acid.
        According to WHO recommendations should be adopted anti-hypertonic following medicines:
Diuretics
Beta blockers
ACE - inhibitors
Calcium antagonists
Angiotensin II receptor
        At the end of the treatment will focus on some facts which are daily in our lives: they are emotions, experiences, grief, anger, fear, stress affecting the compensation of hypertension and diabetes. You should not believe that these factors are only "movements of the soul" which never related to physiology, on the contrary they actually induce specific and not always positive and desirable effects in our body. Our goal should be to avoid them and most importantly make them win!