hypertension(redirected from Essential (Primary) Hypertension)
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Causes and symptoms
- age over 60
- male sex
- salt sensitivity
- inactive lifestyle
- heavy alcohol consumption
- use of oral contraceptives
- normal blood pressure: less than less than 120/80 mm Hg
- pre-hypertension: 120-129/80-89 mm Hg
- Stage 1 hypertension: 140-159/90-99 mm Hg
- Stage 2 hypertension: at or greater than 160-179/100-109 mm Hg
- medical and family history
- physical examination
- ophthalmoscopy: Examination of the blood vessels in the eye
- chest x ray
- electrocardiograph (ECG)
- blood and urine tests.
- reducing salt intake
- reducing fat intake
- losing weight
- getting regular exercise
- quitting smoking
- reducing alcohol consumption
- managing stress
Because of its wide prevalence and its impact on cardiovascular health, hypertension is recognized as a major cause of disease and death in industrialized societies. It is estimated that 24% of the U.S. population, including about 50% of all people over age 60, have hypertension, but that only about one third of these are aware of their condition and are under appropriate treatment. People who have normal blood pressure at age 55 still have a 90% lifetime risk of becoming hypertensive. The treatment of this disorder and its complications in the U.S. is estimated to cost $37 billion annually. Hypertension causes 35,000 deaths each year in the U.S., and is a contributing factor in a further 180,000 deaths. It is associated with a threefold increase in the risk of heart attack and a seven to tenfold increase in the risk of stroke. The prevalence of hypertension and the incidence of nonfatal and fatal consequences are substantially higher in African-Americans. Essential hypertension is currently recognized as a group of syndromes, induced by a complex interaction of genetic and environmental factors, which may also include obesity, abnormal glucose and lipid metabolism, insulin resistance, diminished arterial compliance, accelerated atherogenesis, and renal disease. Some features of the hypertensive diathesis (left ventricular hypertrophy, decreased arterial compliance) may occur even before blood pressure measurements detect significant elevation. Although people with extremely high diastolic pressure may experience headache, dizziness, and even encephalopathy, uncomplicated hypertension seldom causes symptoms. Hence the diagnosis of hypertension is usually made by screening apparently healthy people or those under treatment for another condition. Risk factors for hypertension include a family history of the condition, African-American race, advancing age, the postmenopausal state, obesity, obstructive sleep apnea, excessive use of alcohol, sedentary lifestyle, and chronic emotional stress. Treatment options include lifestyle changes (maintenance of healthful weight; a diet low in saturated and total fat and rich in fruits, vegetables, and low-fat dairy products; at least 30 minutes of aerobic exercise several days a week; limitation of sodium intake to 2.4 g daily and of ethanol to 1 oz daily; consumption of adequate potassium, calcium, and magnesium; and avoidance of excessive emotional stress) and a broad range of drugs, including diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, α-1 adrenergic antagonists, centrally acting α-agonists, and others. One large study found a thiazide diuretic superior to a calcium channel blocker and an ACE inhibitor in reducing cardiovascular mortality in people with hypertension and one additional cardiovascular risk factor. In recent decades, early detection and aggressive treatment of hypertension have reduced associated morbidity and mortality. Control of hypertension lowers the risk of stroke by 30-50%. Current practice standards call for diligent efforts at prevention through avoidance of known risk factors, particularly in people with a family history of hypertension, and control of cofactors known to increase the risk of cardiovascular damage in people with hypertension (smoking, hypercholesterolemia, diabetes mellitus). Some studies suggest that the goal of treatment should be a diastolic blood pressure of 80 mmHg or lower.
hypertension/hy·per·ten·sion/ (-ten´shun) persistently high arterial blood pressure; it may have no known cause (essential, idiopathic, or primary h.) or may be associated with other diseases (secondary h.) .
hypertensionHigh blood pressure Cardiovascular disease An abnormal ↑ systemic arterial pressure, corresponding to a systolic BP of > 160 mm Hg and/or diastolic BP of 95 mm Hg and graded according to intensity of ↑ diastolic BP; HTN affects ± 60 million in the US Workup Evaluation of HTN requires clinical Hx for Pt, family Hx, 2 BP determinations, funduscopy, ID of bruits in neck & abdominal aorta, evaluation of peripheral edema, peripheral pulses and residual neurologic defects in stroke victims, chest films to determine cardiac size and lab parameters to rule out causes of secondary HTN Risk factors Race–blacks more common, ♂, family history of HTN, obesity, defects of lipid metabolism, DM, sedentary lifestyle, cigarette smoking, electrolyte imbalance–eg, ↑ sodium, phosphorus, ↓ potassium, tin Treatment Diet–eg, sodium restriction, ↓ calories, alcohol and cigarettes–the weight gain accompanying smoking cessation tends to offset the minimal ↓ in BP, calcium supplements, lifestyle manipulation–eg, biofeedback, ↑ exercise; antihypertensives–eg, diuretics–benzothiadiazines, loop diuretics, potassium-sparing diuretics, sympatholytic agents–central and peripheral-acting α-adrenergics, β-adrenergics, mixed α- and β-blockers, direct vasodilators, ACE inhibitors–the preferred agent to use ab initio, dihydropiridine CCBs. See ACCT, ACE inhibitor, Borderline hypertension, Borderline isolated systolic hypertension, Calcium channel blocker, Drug-induced hypertension, Essential hypertension, Exercise hypertension, Familial dyslipemic hypertension, Gestational hypertension, Idiopathic intracranial hypertension, Isolated systolic hypertension, Malignant hypertension, MRC, Obetension, Paradoxic hypertension, Pill hypertension, Pregnancy-induced hypertension, Pseudohypertension, Pulmonary hypertension, Refractory hypertension, Renovascular hypertension, SHEP, STOP-Hypertension, TAIM, TOHP-1, TOMHSTyramine hypertension, White coat hypertension.
hypertensionAbnormally high blood pressure. A pressure of 135/85 or less is considered normal. A sustained pressure of 159/99 or over that fails to respond to weight loss, salt reduction, dietary adjustment and smking and stress avoidance, requires drug treatment. Hypertension seldom causes symptoms until an advanced stage is reached in which secondary complications affecting the arteries, kidneys, brain or eyes develop. The condition is, however, potentially dangerous as it can induce a vicious circle of arterial damage resulting in higher blood pressure. Hypertension is a principal cause of STROKE and cardiovascular disease and of DIABETES. Everyone should have regular routine checks of blood pressure. See also KOROTKOFF SOUNDS.
hypertensionabnormally high arterial blood pressure.
hypertensionpersistent raised blood pressure, i.e. >120/80 mmHg (e.g. >150/94 mmHg, recorded over three consecutive occasions)
drug treatment of hypertension Table 1
essential hypertension hypertension without pre-existing renal disease or other known cause
malignant hypertension rapidly progressive, severe hypertension; poor prognosis
Metolazone (Metenix 5)
|Indicated for hypertension in elderly patients|
Tend to exacerbate diabetes, gout, systemic lupus erythematosus
May cause postural hypotension
|Beta-blockers ('.…lol')||Propranolol (Inderal)|
|Should not be used by patients with asthma or bradycardia or hypotension|
Should be avoided in patients with a history of Raynaud's
May cause distal paraesthesia, impotence, dizziness and exacerbation of psoriasis
|Angiotensin-converting enzyme (ACE) inhibitors ('..…pril')||Captopril|
Lisinpril (Carace; Zestril)
|Used only with care in patients taking diuretics, or those with peripheral vascular disease, generalized atherosclerosis and kidney disease|
May cause profound hypotension, persistent cough, renal impairment, angioedema and pruritic rashes
|Angiotensin II receptor antagonists ('.…sartan')||Candesartan (Animax)|
|Used only with caution in patients with aortic or mitral valve stenosis, or renal artery disease|
Tend not to be effective in Afro-Caribbean patients with left ventricular hypertrophy
|Calcium-channel blockers ('.…dipine')||Amlodipine (Istin)|
Nisoldipine (Syscor MR)
|May cause abdominal pain, nausea, flushing, oedema, headache, dizziness, constipation and sleep disturbance|
|Alpha-blockers ('.…zosin')||Doxazosin (Cardura)|
|Should not be used in patients with urinary incontinence|
Tend to cause hypotension, dizziness, vertigo, headache, fatigue
Where antihypertensive drugs are used in combination, a rule-of-thumb guide indicates:
A + C (ACE inhibitors + calcium channel blockers)
B + D (beta-blockers + diuretics)
n an abnormal elevation of systolic and/or diastolic arterial pressure. Systolic level is generally related to emotional stress, sclerosis of the aorta and large arteries, or aortic insufficiency. Diastolic level may result from obscure causes (essential), renal disease, or endocrine disorders. See also blood pressure.
Patient discussion about hypertension
Q. What Is the Treatment for Hypertension? I have a slightly elevated blood pressure. What is the initial possible treatment?
Generic Accupril (Quinapril hydrochloride)
Generic Aldactone (Spironolactone)
Generic Altace (Ramipril)
Generic Avapro (Irbesartan)
Generic Betoptic (Betaxolol)
Generic Bisoprolol (Bisoprolol Fumarate)
Generic Caduet (Amlodipine)
Generic Calan (Verapamil)
Generic Capoten (Captopril)
Generic Lopressor (Metoprolol)
Generic Lotensin (Benazepril)
Generic Lotrel (Benazepril and amlodipine)
Generic Lozol (Indapamide)
Generic Micardis HCT (Telmisartan - hydrochlorothiazide)
Generic Microzide (Hydrochlorothiazide)
Generic Monopril there are still lot more medications used
You can find information the side effects of these drugs at
Q. Does Ameal BP lower high blood pressure?
You may try it and see if it works or not.
Q. What Are the Complications of High Blood Pressure? My wife suffers from high blood pressure. What are the possible complications that are so dangerous? Why is it important to keep high blood pressure under balance?