Hypertension

Post Updated Date: 1 year ago

Introduction

Introduction

Hypertension, commonly known as high blood pressure, is a chronic medical condition in which the force of the blood against the artery walls is consistently elevated. It is a major risk factor
for cardiovascular diseases, including heart attack, stroke, and heart failure. Due to its often asymptomatic nature, hypertension is frequently referred to as a “silent killer.”

Definition

Hypertension is defined as a sustained elevation of arterial blood pressure. According to the American College of Cardiology (ACC) and the American Heart Association (AHA), hypertension is
diagnosed when the systolic blood pressure (SBP) is consistently ≥130 mm Hg or the diastolic blood pressure (DBP) is ≥80 mm Hg.

Types

  1. Primary (Essential) Hypertension: No identifiable cause; develops gradually over many years.
  2. Secondary Hypertension: Caused by an underlying condition such as kidney disease or hormonal
    disorders.
  3. Isolated Systolic Hypertension: Elevated systolic blood pressure with normal diastolic pressure, more
    common in older adults.
  4. White Coat Hypertension: Elevated blood pressure in a clinical setting but normal at other times.
    Masked Hypertension: Normal blood pressure readings in a clinical setting but elevated at other times.

Causes

The exact cause of hypertension is often unknown, and it is typically classified into two main types:

  1. Primary (Essential) Hypertension: This is the most common form, accounting for 90-95% of cases, and has
    no identifiable cause. It is believed to result from a combination of genetic, environmental, and lifestyle
    factors.
  2. Secondary Hypertension: This type is caused by an underlying condition, such as kidney disease, hormonal
    disorders (e.g., hyperaldosteronism, pheochromocytoma), or the use of certain medications (e.g., oral
    contraceptives, corticosteroids).

Risk Factors

Several risk factors contribute to the development of hypertension:

  1. Age: The risk of hypertension increases with age.
  2. Family History: A family history of hypertension increases the likelihood of developing the condition.
  3. Obesity: Excess body weight is strongly associated with hypertension.
  4. Sedentary Lifestyle: Lack of physical activity can contribute to weight gain and increased blood pressure.
  5. Diet: A diet high in sodium and low in potassium, calcium, and magnesium can raise blood pressure.
  6. Alcohol and Tobacco Use: Excessive alcohol consumption and smoking can contribute to hypertension.
  7. Stress: Chronic stress may contribute to hypertension through repeated elevations in blood pressure.

Pathophysiology

Hypertension results from complex interactions between various physiological mechanisms that regulate blood pressure, including:

  1. Cardiac Output: The amount of blood the heart pumps per minute. Increased cardiac output can raise blood
    pressure.
  2. Peripheral Vascular Resistance: The resistance of the blood vessels to blood flow. Increased resistance
    can elevate blood pressure.
  3. Renin-Angiotensin-Aldosterone System (RAAS): Overactivation of this system leads to vasoconstriction
    and sodium retention, contributing to hypertension.
  4. Sympathetic Nervous System: Overactivity can increase heart rate and vasoconstriction, raising blood
    pressure.

Classification

Hypertension is classified into several categories based on blood pressure readings:

S.N. Types SBP DBP
1 Normal Blood Pressure SBP< 120 mm Hg DBP< 80 mm Hg
2 Elevated Blood Pressure SBP120-129 mm DBP< 80 mm Hg
3 Stage 1 Hypertension SBP130-139 mm DBP80-89 mm Hg
4 Stage 2 Hypertension SBP≥ 140 mm Hg DBP≥ 90 mm Hg
5 Hypertensive Crisis SBP> 180 mm Hg and/or DBP> 120 mm Hg, requiring immediate medical attention

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