Chronic hypertension history and symptoms: Difference between revisions

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Hypertension is usually found incidentally  by healthcare professionals during a routine checkup. The only test for hypertension is a blood pressure measurement.
Hypertension is usually found incidentally  by healthcare professionals during a routine checkup. The only test for hypertension is a blood pressure measurement.


==History and Symptoms==
==History==
Hypertension in isolation usually produces no symptoms although some people may report either:
*[[Blurred vision]]
*[[Dizziness]]
*[[Facial flushing]] (suspect [[pheochromocytoma]] if this and [[headaches]] are present)
*[[Fatigue]]
*[[Headaches]]
*[[Tinnitus]]


[[Malignant hypertension]] (or accelerated hypertension) is distinct as a late phase in the condition, and may present with [[headaches]], [[blurred vision]] and end-organ damage. Large [[lunula]]e (more than 25% of the thumb nail) are also a sign of high blood pressure.
===Symptoms===
Although the vast majority of patients with hypertension are asymptomatic, symptoms of hypertension are as follows:
*Headache
*Blurry vision
*Dyspnea
*Epistaxis
*Tinnitus
*Fatigue
*Drowsiness
*Other symptoms that might suggest secondary etiologies of hypertension, such as snoring, hair loss, flushing, palpitations etc.


Accelerated hypertension is associated with [[somnolence]], [[confusion]], visual disturbances, and [[nausea]] and [[vomiting]] (hypertensive encephalopathy).


=== Hypertensive Urgencies and Emergencies ===
===Risk Factors===
Hypertension is rarely severe enough to cause symptoms. These typically only surface with a [[systolic blood pressure]] over 240 mmHg and/or a [[diastolic blood pressure]] over 120 mmHg.  These pressures without signs of end-organ damage (such as renal failure) are termed "accelerated" hypertension. When end-organ damage is possible or already ongoing, but in absence of raised [[intracranial pressure]], it is called [[hypertensive emergency]]. Hypertension under this circumstance needs to be controlled, but prolonged hospitalization is not necessarily required. When hypertension causes increased intracranial pressure, it is called [[malignant hypertension]]. Increased intracranial pressure causes [[papilledema]], which is visible on [[ophthalmoscopy|ophthalmoscopic]] examination of the [[retina]].
*Age
*Ethnicity
*Tobacco
*Alcohol
*Dyslipidemia
*Diabetes mellitus
*Known cardiovascular diseases
*Known kidney diseases
*Diet
*Obesity
*Sedentary lifestyle


===Children and Adolescents ===
===Target Organ Damage===
As with adults, blood pressure is a variable parameter in children. It varies between individuals and within individuals from day to day and at various times of the day. The epidemic of childhood [[obesity]], the risk of developing [[left ventricular hypertrophy]], and evidence of the early development of [[atherosclerosis]] in children would make the detection of and intervention in childhood hypertension important to reduce long-term health risks; however, supporting data are lacking.
'''Heart'''
*Angina
*Prior MI
*Prior coronary revascularizations
*Aneurysm
*Symptoms of heart failure
*Symptoms of peripheral vascular disease (PVD)


Most childhood [[hypertension]], particularly in preadolescents, is secondary to an underlying disorder. Renal parenchymal disease is the most common (60 to 70 percent) cause of hypertension. Adolescents usually have primary or essential hypertension, making up 85 to 95 percent of cases. <ref name=aafp>{{cite web | GREGORY B. LUMA, M.D., and ROSEANN T. SPIOTTA, M.D., Jamaica Hospital Medical Center | title =Hypertension in Children and Adolescents | publisher=American Academy of Family Physicians | work =Hypertension in Children and Adolescents | url=http://www.aafp.org/afp/20060501/1558.html | year = 2006}}</ref>
'''Brain'''
*Stroke
*Intracranial hemorrhage
*Transient ischemic attack (TIA)
*Dementia
 
'''Kidneys'''
*Proteinuria
*Hematuria
*Renal failure
 
'''Eyes'''
*Retinopathy


==2013 ESH/ESC Guidelines For The Management of Arterial Hypertension (DO NOT EDIT)<ref name="pmid23771844">{{cite journal| author=Authors/Task Force Members. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A et al.| title=2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2013 | volume= 34 | issue= 28 | pages= 2159-219 | pmid=23771844 | doi=10.1093/eurheartj/eht151 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23771844  }} </ref>==
==2013 ESH/ESC Guidelines For The Management of Arterial Hypertension (DO NOT EDIT)<ref name="pmid23771844">{{cite journal| author=Authors/Task Force Members. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A et al.| title=2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). | journal=Eur Heart J | year= 2013 | volume= 34 | issue= 28 | pages= 2159-219 | pmid=23771844 | doi=10.1093/eurheartj/eht151 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23771844  }} </ref>==

Revision as of 00:16, 5 November 2013

Hypertension Main page

Overview

Causes

Classification

Primary Hypertension
Secondary Hypertension
Hypertensive Emergency
Hypertensive Urgency

Screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Taylor Palmieri

Overview

Hypertension is usually found incidentally by healthcare professionals during a routine checkup. The only test for hypertension is a blood pressure measurement.

History

Symptoms

Although the vast majority of patients with hypertension are asymptomatic, symptoms of hypertension are as follows:

  • Headache
  • Blurry vision
  • Dyspnea
  • Epistaxis
  • Tinnitus
  • Fatigue
  • Drowsiness
  • Other symptoms that might suggest secondary etiologies of hypertension, such as snoring, hair loss, flushing, palpitations etc.


Risk Factors

  • Age
  • Ethnicity
  • Tobacco
  • Alcohol
  • Dyslipidemia
  • Diabetes mellitus
  • Known cardiovascular diseases
  • Known kidney diseases
  • Diet
  • Obesity
  • Sedentary lifestyle

Target Organ Damage

Heart

  • Angina
  • Prior MI
  • Prior coronary revascularizations
  • Aneurysm
  • Symptoms of heart failure
  • Symptoms of peripheral vascular disease (PVD)

Brain

  • Stroke
  • Intracranial hemorrhage
  • Transient ischemic attack (TIA)
  • Dementia

Kidneys

  • Proteinuria
  • Hematuria
  • Renal failure

Eyes

  • Retinopathy

2013 ESH/ESC Guidelines For The Management of Arterial Hypertension (DO NOT EDIT)[1]

Summary of Recommendations on History (DO NOT EDIT)[1]

Class I
"1. It is recommended to obtain a comprehensive medical history and physical examination in all patients with hypertension to verify the diagnosis, detect causes of secondary hypertension, record CV risk factors, and to identify organ damage and other CVDs. (Level of Evidence: C)"
"2. Obtaining a family history is recommended to investigate familial predisposition to hypertension and CVDs. (Level of Evidence: B)"

References

  1. ↑ 1.0 1.1 Authors/Task Force Members. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A; et al. (2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". Eur Heart J. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. PMID 23771844.

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