Hypertension

Definition

Hypertension is an elevation in diastolic and occurs as two major types such as primary hypertension and it occurring in 95% of cases with no identifiable cause and secondary hypertension occurring in 5 % of cases as a result from renal disease. It is a major cause of stroke, heart disease, and renal failure. Men have a higher incidence of hypertension from youth to middle adulthood and thereafter, women - in particular, postmenopausal women have a higher incidence. High blood pressure poses a serious problem in pregnancy. Essential hypertension usually begins insidiously as a benign disease and it slowly progresses to a malignant state.

Causes of Hypertension

If you have primary hypertension, then various causes include:

• Family history
• Advancing age
• Sleep apnea
• Race
• Obesity
• Tobacco use
• High sodium intake
• High saturated fat intake
• Excessive alcohol consumption
• Sedentary lifestyle
• Stress
• Excess renin
• Mineral deficiencies
• Diabetes mellitus.

If you have primary hypertension, then various causes include:

• Chronic renal disease
• Coarctation of the aorta
• Renal artery stenosis and parenchymal disease
• Brain tumor, quadriplegia, and head injury
• Pheochromocytoma, Cushing's syndrome, hyperaldosteronism, and thyroid, pituitary, or parathyroid dysfunction
• Hormonal contraceptives, cocaine, epoetin alfa, sympathetic stimulants, monoamine oxidase inhibitors taken with Tyramine, estrogen replacement therapy, and nonsteroidal anti inflammatory drugs
• Excessive alcohol consumption
• Pregnancy-induced hypertension, also called gestational hypertension or preeclampsia.

Symptoms of Hypertension

Symptoms of this disease include:

• Elevated blood pressure readings on at least two consecutive occasions after initial screening
• Occipital headache with possible nausea and vomiting, epistaxis possibly occur due to vascular involvement
• Bruits that may be caused by stenosis or aneurysm
• Dizziness, confusion and fatigue that may be caused by decreased tissue perfusion due to vasoconstriction of blood vessels
• Blurry vision as a result of retinal damage
• Nocturia may be caused by an increase in blood flow to the kidneys and an increase in glomerular filtration
• Edema may be caused by increased capillary pressure.

If you have secondary hypertension, then symptoms may be related to the cause. For example, Cushing's syndrome may cause truncal obesity and purple striae, whereas patients with pheochromocytoma may develop headache, nausea, vomiting, palpitations, pallor, and profuse perspiration.

Other complications of hypertension include:

• Hypertensive crisis. peripheral arterial disease. dissecting aortic aneurysm. coronary artery disease. angina. myocardial infarction (MI), heart failure, arrhythmias and sudden death
• Transient ischemic attacks, stroke, retinopathy and hypertensive encephalopathy
• Renal failure

Treatment of Hypertension

For treatment of high blood pressure, then it recommends the following stepped-care approach:

• In which the Step 1, it help the patient initiate necessary lifestyle modifications including weight reduction, moderation of alcohol intake, regular physical exercise, reduction of sodium intake, and smoking cessation.
• In the Step 2 - If the patient fails to achieve the desired blood pressure or make significant progress, then continue lifestyle modifications and begin drug therapy. Drug therapy is individualized and guided by associated diseases. Preferred drugs include thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, or betaadrenergic blockers.
• Step 3 - If the patient fails to achieve the desired blood pressure or make significant progress, then you should increase the drug dosage, or add a drug from a different class.