Hypertension: Causes, Symptoms, and Treatment

Definition and Measurement

• Hypertension (high blood pressure) affects over a billion people globally.
• Blood Pressure (BP) is usually represented by two numbers:
  • Systolic BP: Arterial pressure when the heart's contracting.
  • Diastolic BP: Arterial pressure when the heart's relaxing/refilling.
• BP is often measured in the brachial artery (upper arm).

Blood Pressure Categories

• Normal:
  • Systolic: < 120 mm Hg
  • Diastolic: < 80 mm Hg
• Elevated:
  • Systolic: 120-129 mm Hg
  • Diastolic: < 80 mm Hg
• Stage 1 Hypertension:
  • Systolic: 130-139 mm Hg
  • Diastolic: 80-89 mm Hg
• Stage 2 Hypertension:
  • Systolic: ≥ 140 mm Hg
  • Diastolic: ≥ 90 mm Hg
• Isolated Hypertension:
  • Only one of the numbers (systolic or diastolic) is high while the other remains normal.

Causes and Risk Factors

• Primary (Essential) Hypertension: No identifiable cause (90% of cases). Risk factors include:
  • Old age
  • Obesity
  • Salt-heavy diets
  • Sedentary lifestyle
• Secondary Hypertension: Identifiable underlying cause (10% of cases). Conditions include:
  • Conditions limiting renal blood flow (e.g., atherosclerosis, vasculitis)
  • Diseases like fibromuscular dysplasia and tumors that produce excess aldosterone

Hypertension Effects on Blood Vessels

• High BP causes wear and tear on endothelial cells lining blood vessels.
• Can lead to myocardial infarctions, aneurysms, and strokes.

Hypertensive Crisis

• Definition: Extremely high BP
  • Systolic: > 180 mm Hg
  • Diastolic: > 120 mm Hg
• Types:
  • Hypertensive Urgency: No damage to end organs.
  • Hypertensive Emergency: Evidence of damage to end organs (e.g., brain, kidneys, heart, lungs).
• Symptoms: Confusion, drowsiness, chest pain, breathlessness.

Symptoms

• Primary Hypertension: Often asymptomatic (Silent killer).
• Secondary Hypertension: Symptoms related to underlying cause.
• Hypertensive Emergency: Confusion, drowsiness, chest pain, and breathlessness.

Treatment

• First Line: Lifestyle changes (diet, exercise, stress reduction).
• Medications: Various anti-hypertensive drugs may be prescribed.

Quick Recap

• Hypertension affects over a billion people and is a major risk factor for heart disease and stroke.
• Stage 1 Hypertension: 130-139 mm Hg (Systolic), 80-89 mm Hg (Diastolic)
• Stage 2 Hypertension: ≥ 140 mm Hg (Systolic), ≥ 90 mm Hg (Diastolic)
• Treatment: Focuses on lifestyle changes and medication.