Hypertension: Causes, Symptoms, and Treatments

Hypertension

(HTN and HT)

Hyper-(high) tension-(blood pressure)

Hypertension is defined as a consistent elevation of systolic or diastolic pressure above 140/90 mm/HG

(Mm/ HG  means)Hg: Symbol for the metallic element mercury. The abbreviation “mm Hg” means millimeters of mercury, the height of a column of mercury, as in a blood pressure reading.

Blood pressures=co×tpr

(CO*TPR – this means that cardiac output a)

Types of blood pressure (bp)

  • Systolic bp-(contraction)
  • Diastolic bp-(relaxation)
  • Normal bp-120mmHG
  • Diastolic bp-80mm HG


Stage-1
130-139mmHg / 80-89 mmHg
Stage-2
>140mmHg/>90mmHg

Cause/types/etiology

Risk factors

Old age, obesity,salt heavy diet, sedentary  lifestyle,heart disease, stock

Treatments

Life style changes,diet, exercise, stress reduction


Pathological changes in primary hypertension

 

The pathophysiology of primary hypertension. A hypothetical scheme for the pathogenesis of essential hypertension, implicating genetic defects in renal excretion of sodium, functional regulation of vascular tone and structural regulation of vascular calibre. Environmental factors, especially increased sodium intake, may potentiate the effects of genetic factors. The resultant increases in cardiac output and peripheral resistance contribute to hypertension. ECF = extracellular fluid. Source: Modified from Kumar V. Robbins & Cotran pathologic basis of disease. 


Pathological changes in secondary hypertension

  1. Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta.

In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes. Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings.

Additionally, renovascular hypertension should be considered in patients with an increase in serum creatinine of at least 50% occurring within one week of initiating angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy; severe hypertension and a unilateral smaller kidney or difference in kidney size greater than 1.5 cm; or recurrent flash pulmonary edema.

Other underlying causes of secondary hypertension include hyperaldosteronism, obstructive sleep apnea, pheochromocytoma, Cushing syndrome, thyroid disease, coarctation of the aorta, and use of certain medications.

Hypertension is common, affecting nearly 30% of U.S. adults and increasing to 65% of persons 60 to 69 years of age.1 The annual cost of treatment for hypertension in the United States is $47.5 billion.

2. Secondary hypertension is a type of hypertension with an underlying and potentially reversible cause. It makes up only a small fraction (5% to 10%) of hypertensive cases.3–5 The prevalence of secondary hypertension varies by age and is more common in younger persons, with a prevalence close to 30% in those 18 to 40 years of age with hypertension.

3. Extensive testing for secondary hypertension is not warranted in all patients with hypertension because of cost, low yield, and the potential for false-positive results; however, testing is recommended in patients younger than 30 years.

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