Hypertension

General Illness Information


Common Name:

High Blood Pressure

Medical Term: Hypertension.

Description: Hypertension is defined as a sustained elevated blood pressure (systolic blood pressure of 140 mm Hg or greater and/or diastolic blood pressure of 90 mm Hg or greater).

50 million  people in the US have hypertension; 20% of the U.S. population.

It is a strong risk factor for cardiovascular disease.

Even though most patients have no symptoms, treatment of hypertension is most important. The complications of hypertension usually take years to develop, and early treatment is important to prevent these serious complications.

Causes: Over 90% of High Blood Pressure has no identified cause. These are labeled as essential or primary hypertension.

Secondary causes of hypertension include four areas:

  • Renal;
  • Endocrine;
  • Vascular;
  • Medication and chemical induced.

Prevention:

  • Essential hypertension (from unknown causes) cannot be prevented at present. If you have a family history of hypertension, obtain frequent blood-pressure checks;
  • If hypertension is detected early, treatment that includes diet, exercise, stress management, smoking cessation, alcohol reduction, and medication can usually prevent complications.

Signs & Symptoms

  • High blood pressure should be considered asymptomatic ( no symptoms) except in extremes or after related cardiovascular complications develop;
  • Headache can be seen especially with higher blood pressures. This is often present on awakening and occipital in nature.

Because hypertension causes target organ damage in the blood vessels of the  heart, brain, kidneys and eyes, sustained untreated hypertension may manifest with symptoms and signs of disordered function in these organs.

Risk Factors

  • Family history;
  • Obesity;
  • Alcohol;
  • Excess dietary sodium;
  • Stress;
  • Physical inactivity.

Diagnosis & Treatment

Hypertension is a clinical diagnosis. 24 hour ambulatory blood pressure readings may be necessary to make a diagnosis. In addition, the following investigations may be done at the time of diagnosis:

  • CBC (Complete blood count);
  • Complete urinalysis (sometimes reveals proteinuria);
  • Potassium, calcium and creatinine;
  • Cholesterol (total, LDL,and HDL);
  • Fasting blood glucose;
  • EKG, Chest X-Ray Other specialized tests such as renal perfusion scans, echocardiograms and angiograms may be considered.

General Measures:

  • The goal is generally treat to diastolic pressure of higher than 90 mm Hg and systolic pressure higher than 140 mm Hg;
  • Weight reduction for obese patients may lower blood pressures;
  • Smoking cessation is an important part of a cardiovascular risk reduction program;
  • Biofeedback and relaxation exercises may help to reduce blood pressure;
  • Some patients will respond to a reduced salt diet;
  • Reduce alcohol consumption to < 1 oz/day;
  • Decrease saturated fats and increase monounsaturated fats;
  • Some patients will respond to a reduced salt diet;
  • Reduce alcohol consumption to < 1 oz/day;
  • Decrease saturated fats and increase monounsaturated fats;
  • Hypertension has no symptoms. Early and life long treatment is essential to prevent the complications.

Medications:

  • There are many medications for treating hypertension;
  • Your physician will choose the medications appropriate for your condition.

There are four main classes of anti-hypertensive medications:

  • Diuretics;
  • Beta-Blockers;
  • Calcium Channel Blockers;
  • ACE Inhibitors.

These may be used in combination by your doctor.

Each of these has its own unique indications, side-effects, contra-indications, and cautions. If your doctor has prescribed a medication for you, look it up in the medication section of RxMed.

Activity:

  • No restrictions;
  • Exercise is important in the control of hypertension.

Diet:

  • Low-salt diet;
  • Reducing diet if overweight;
  • Low cholesterol diet if lipids found to be elevated.

Possible Complications:

  • Congestive heart failure;
  • Renal failure;
  • Myocardial infarction;
  • Stroke;
  • Retinopathy.

Prognosis

  • The prognosis is excellent, with adequate control of Blood Pressure;
  • Many studies have demonstrated that proper control of hypertension will prevent all the complications.

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