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Hypertension

HYPERTENSIONSYMPTOMSCAUSESDIAGNOSISTREATMENT

Also know as high blood pressure.  It is a chronic elevation of a person’s blood pressure.  Normally, your blood pressure is around 120/80.  High blood pressure could be due to primary or secondary causes.  Primary causes, or essential hypertension cannot be explained.  Secondary causes of hypertension include kidney disease or tumors.

Persistent hypertension is a major cause of such problems like stroke, cardiac disease, and chronic renal failure.  The prognosis is very good if detected early and treated. 

Classification :
Usually hypertension is diagnosed with two elevated blood pressures on two separate visits to your doctor’s office.  There are stages of hypertension:

Classification Systolic pressure Diastolic pressure
mmHg mmHg

  Normal

90–119 60–79

  Pre-hypertension

120–139 80–89

  Stage 1

140–159 90–99

  Stage 2

≥160 ≥100

  Isolated systolic hypertension

≥140 <90
  Source: American Heart Association (2003).

Treatment methods will be discussed later.

Signs and Symptoms :
Usually mild hypertension does not have overwhelming symptoms.  Severe hypertension can produce damage of blood vessels, and possibly thickening of blood- leading to complications such as stroke, blindness, heart attack, and eventually even renal failure. 

Sudden increase in blood pressure may cause symptoms like headache, confusion, visual changes, nausea, and vomiting.

Causes :
Essential hypertension, which is the most common cause of known hypertension, has no identifiable cause.  Risk factors for hypertension include family history, sedentary lifestyle, obesity, vitamin D deficiency, sodium sensitivity, alcohol intake and aging.

There are multiple secondary causes of hypertension.  Broad categories include problems with adrenal glands, kidney problems, pregnancy complications, side effect to medications, or problems secondary to sleep disturbance. 

Diagnosis :
A diagnosis is established with two elevated blood pressures taken at two separate occasions. 

Essential hypertension usually does not need any further laboratory testing, but your doctor may also do an ECG or an electrocardiography, chest x-ray, or an echocardiography.

Secondary hypertension may have multiple causes and your physician may do a panel of blood work- including checking serum sodium, potassium, calcium and TSH.  Your doctor may also check BUN, and serum creatinine to check kidney function as well as microscopic urine analysis, and check urine for proteins.  It is also common to check for co-existing diseases like high cholesterol or diabetes- therefore serum glucose and a cholesterol panel may be conducted as well. 

Treatment :
Prior to the start of medication, lifestyle adjustments should be made to see its effects on blood pressure.  Lifestyle modifications include incorporating exercise into ones schedule, as well as weight loss,  starting a low fat, low salt diet,  discontinuing  alcohol and tobacco usage and reducing stress in one’s life.

Medications used for the treatment of high blood pressure are known as antihypertensives.  These drugs act in various methods to lower blood pressure.  Your doctor will discuss which medication is best for you.

Posted By :Dr. Sunitha, NJ, USA   Contact Now





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