Management of Essential Hypertension

Topics: Hypertension, Blood pressure, Myocardial infarction Pages: 7 (1927 words) Published: June 13, 2013
Hypertension
Hypertension is one of the most common worldwide diseases afflicting humans. Because of the associated morbidity and mortality and the cost to society, hypertension is an important public health challenge. Over the past several decades, extensive research, widespread patient education, and a concerted effort on the part of health care professionals have led to decreased mortality and morbidity rates from the multiple organ damage arising from years of untreated hypertension. Hypertension is the term used to describe high blood pressure. Blood pressure is a measurement of the force against the walls of your arteries as the heart pumps blood through the body. Blood pressure readings are measured in millimeters of mercury (mmHg) and usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. The top number is your systolic pressure.

* It is considered high if it is over 140 most of the time. * It is considered normal if it is below 120 most of the time. The bottom number is your diastolic pressure.
* It is considered high if it is over 90 most of the time. * It is considered normal if it is below 80 most of the time. Pre-hypertension may be considered when your:
* Top number (systolic blood pressure) is between 120 and 139 most of the time, or * Bottom number (diastolic blood pressure) is between 80 and 89 most of the time If you have pre-hypertension, you are more likely to develop high blood pressure. If you have heart or kidney problems, or if you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions. See also: Blood pressure

Causes
Many factors can affect blood pressure, including:
* How much water and salt you have in your body
* The condition of your kidneys, nervous system, or blood vessels * The levels of different body hormones
You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. High blood pressureincreases your chance of having a stroke, heart attack, heart failure, kidney disease, and early death. You have a higher risk of high blood pressure if you:

* Are African American
* Are obese
* Are often stressed or anxious
* Eat too much salt in your diet
* Have a family history of high blood pressure
* Have diabetes
* Smoke
Most of the time, no cause is identified. This is called essential hypertension. High blood pressure that is caused by another medical condition or medication is called secondary hypertension. Secondary hypertension may be due to: * Alcohol abuse

* Atherosclerosis
* Autoimmune disorders such as periarteritis nodosa
* Chronic kidney disease
* Coarctation of the aorta
* Cocaine use
* Diabetes (if it causes kidney damage)
* Endocrine disorders, such as adrenal tumors (pheochromocytoma, aldosteronism), thyroid disorders, andCushing syndrome * Medications
* Appetite suppressants
* Birth control pills
* Certain cold medications
* Corticosteroids
* Migraine medications
* Renal artery stenosis
Symptoms
Most of the time, there are no symptoms. Symptoms that may occur include: * Confusion
* Ear noise or buzzing
* Fatigue
* Headache
* Irregular heartbeat
* Nosebleed
* Vision changes
If you have a severe headache or any of the symptoms above, see your doctor right away. These may be signs of a complication or dangerously high blood pressure called malignant hypertension. Exams and Tests

Your health care provider will perform a physical exam and check your blood pressure. If the measurement is high, your health care provider may think you have high blood pressure. The measurements need to be repeated over time, so that the diagnosis can be confirmed. If you...

References: Wolff T, Miller T. Evidence for the reaffirmation of the U.S. Preventive Services Task Force recommendation on screening for high blood pressure. Ann Intern Med. 2007;147:787-791.
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