Because of the different types of hypertension and different stages of the development of the disease, there are different severity and complex clinical manifestations.
The clinical symptoms of early patients are often not obvious, and hypertension is only found during physical examination. The blood pressure of the first patients increased at the same time, and the fluctuation of most patients was large, and it was often affected by mental and tired factors, and could be recovered to normal range after proper rest. The common clinical symptoms are headache, dizziness, tinnitus, forgetfulness, insomnia, fatigue, palpitation and other neurological disorders. The severity of symptoms is not proportional to the level of blood pressure.
When the condition develops continuously, the blood pressure increases in the middle and late stage, and it tends to be stable in a certain range, especially the increase of diastolic pressure is more obvious. Because of the long-term spasm of the whole body fine artery and the deposition of lipid in the wall of the tube, the wall hardening can cause ischemic lesions of the heart, brain, kidney and other important organs. Due to the different degree of damage and compensatory function of these organs, in addition to the above early general symptoms, the following clinical manifestations of one or several organs can also appear.
Heart: the blood pressure increases for a long time, and the left ventricular is compensatory. When the hypertension heart disease develops further, it may lead to the insufficiency of left heart function, and even the right heart hypertrophy and right heart dysfunction.
Kidney: it is mainly because of arteriosclerosis, which gradually reduces renal function, and there are many urine and nocturia. During urine examination, there are a small amount of red blood cells, tubular type and protein, and the proportion of urine is reduced. With the development of the disease, it can eventually lead to renal failure, and azotemia or uremia.
Brain: if the cerebral vessels have sclerotic or spastic space, it often leads to cerebral ischemia and hypoxia, and produces headache, dizziness, eye flower, numbness of limbs or temporary aphasia and paralysis. The cerebral vessels can be further developed and cause stroke on the basis of the above pathology, among which cerebral hemorrhage and cerebral artery thrombosis are the most common.
Fundus: in the early stage, the small retinal artery spasm or mild and moderate sclerosis can be seen, and in the late stage, there are bleeding and exudates, and optic nerve papilla edema can be seen.
Most of the patients with hypertension are developing slowly, and they are called slow-moving (benign) hypertension.
In a few patients, sudden hypertension may occur, especially diastolic pressure lasting from 17.33 to 18.66kpa or higher. The disease develops rapidly. Due to the severe spasm of the whole body arterioles, cellulose like necrosis of the wall of multiple organs of fine arteries may occur in a short time, or elastic fibers and collagen fibers proliferate, which may cause the obstruction of the lumen and the organic lesions of the heart, brain, kidney and other organs, which may lead to the heart and kidney dysfunction and even failure. Or the hypertension, stroke, prognosis is poor, need to be actively treated or rescue. This part of the patients are clinically called acute (malignant) hypertension.
The systemic fine artery is temporarily strong convulsion, and the blood pressure rises sharply, accompanied by severe headache, dizziness, nausea, palpitation, vision disorder, even coma, convulsion, etc., which is called hypertension crisis.
If the arterioles are severe and persistent spasm, they can cause stenosis of cerebral artery, cerebral thrombosis and small embolism, cerebral blood circulation disorder, and lead to cerebral ischemia, hypoxia, brain edema and intracranial pressure increase. The clinical manifestations are sudden onset, such as high blood pressure, severe headache, dizziness, vomiting, palpitation, vision disorder, unconsciousness, coma, convulsion, temporary hemiplegia, bleeding and exudates in retinal vessels, optic nerve papilledema, unequal size and round pupil on the second side, which is called hypertensive encephalopathy.
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