Hypertension (patient information): Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 40: Line 40:
| '''Very Severe Hypertension''' || '''> 210''' || '''> 120'''  
| '''Very Severe Hypertension''' || '''> 210''' || '''> 120'''  
|}
|}
==What are the symptoms of Hypertension?==
Hypertension is usually found incidentally - "case finding" - by health care professionals during a routine checkup. The only test for hypertension is a blood pressure measurement. Hypertension in isolation usually produces no symptoms although some people report headaches, fatigue, dizziness, blurred vision, facial flushing or [[tinnitus]]. <ref>{{cite web|url=http://www.treatment-for.com/high-blood-pressure-symptoms.htm|title=Symptoms of High Blood Pressure}}</ref>
[[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.
Hypertension is often confused with mental tension, stress and anxiety. While chronic anxiety is associated with poor outcomes in people with hypertension, it alone does not cause it. Accelerated hypertension is associated with somnolence, confusion, visual disturbances, and nausea and vomiting (hypertensive encephalopathy). <ref name=health.am>{{cite web | H. Michael MacMay, MD, MPH; Michael Sutters, MD | title =Hypertension symptoms and signs | publisher=Armenian Medical Network | work =Systemic Hypertension - Hypertension Health Center | url=http://www.health.am/hypertension/hypertension-symptoms-and-signs/ | year = 2006}}</ref>




Line 110: Line 103:


==How do I know I have Hypertension?==
==How do I know I have Hypertension?==
There is no specific sign or symptom for Hypertension.It is usually diagnosed while having a blood pressure checked by a health care professional.Some symptoms patient normally see are headaches, anxiety, confusion,fatigue,dizziness and difficulty in vision.
Malignant Hypertension is a severe type where your systolic blood pressure increases above 180 and diastolic more then 120 with development of problems like headaches,difficulty in vision,kidney disease,nausea,vomiting,having a heart attack and brain hemorrhage.


==When to seek urgent medical care==
==When to seek urgent medical care==
There is no specific rule of thumb.But,one should have have blood pressure every 2 years by the primary care doctor if it is below 120/80 and yearly if blood pressure ranges from 120-139/80-89 according to the 2007 United States Preventive Services Task Force (USPSTF)guidelines.
In the setting of blood pressure >120/80 with severe headaches,vision difficulty,dizziness,loss of consciousness,chest pain,leg and arm weakness,nausea,vomiting and fatigue one should seek for urgent medical care .Hypertension is generally associated with a wide variety of symptoms but generally causes problems to the heart,brain,eyes/vision,kidneys,nerves and arm/leg weakness.


==Treatment options==
==Treatment options==

Revision as of 16:26, 7 July 2010

For the WikiDoc page for this topic, click here

WikiDoc Resources for Hypertension (patient information)

Articles

Most recent articles on Hypertension (patient information)

Most cited articles on Hypertension (patient information)

Review articles on Hypertension (patient information)

Articles on Hypertension (patient information) in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Hypertension (patient information)

Images of Hypertension (patient information)

Photos of Hypertension (patient information)

Podcasts & MP3s on Hypertension (patient information)

Videos on Hypertension (patient information)

Evidence Based Medicine

Cochrane Collaboration on Hypertension (patient information)

Bandolier on Hypertension (patient information)

TRIP on Hypertension (patient information)

Clinical Trials

Ongoing Trials on Hypertension (patient information) at Clinical Trials.gov

Trial results on Hypertension (patient information)

Clinical Trials on Hypertension (patient information) at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Hypertension (patient information)

NICE Guidance on Hypertension (patient information)

NHS PRODIGY Guidance

FDA on Hypertension (patient information)

CDC on Hypertension (patient information)

Books

Books on Hypertension (patient information)

News

Hypertension (patient information) in the news

Be alerted to news on Hypertension (patient information)

News trends on Hypertension (patient information)

Commentary

Blogs on Hypertension (patient information)

Definitions

Definitions of Hypertension (patient information)

Patient Resources / Community

Patient resources on Hypertension (patient information)

Discussion groups on Hypertension (patient information)

Patient Handouts on Hypertension (patient information)

Directions to Hospitals Treating Hypertension (patient information)

Risk calculators and risk factors for Hypertension (patient information)

Healthcare Provider Resources

Symptoms of Hypertension (patient information)

Causes & Risk Factors for Hypertension (patient information)

Diagnostic studies for Hypertension (patient information)

Treatment of Hypertension (patient information)

Continuing Medical Education (CME)

CME Programs on Hypertension (patient information)

International

Hypertension (patient information) en Espanol

Hypertension (patient information) en Francais

Business

Hypertension (patient information) in the Marketplace

Patents on Hypertension (patient information)

Experimental / Informatics

List of terms related to Hypertension (patient information)

Editor-in-Chief: Atif Mohammad, MD

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

What is Hypertension?

Hypertension, commonly referred to as "high blood pressure" or HTN, is a medical condition in which the blood pressure is chronically elevated.[1] While it is formally called arterial hypertension, the word "hypertension" without a qualifier usually refers to arterial hypertension. Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure.


Hypertension or high blood pressure is considered to be present when a person's systolic blood pressure is consistently 140 mmHg or greater, and/or their diastolic blood pressure is consistently 90 mmHg or greater.[2] Recently, as of 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure[3] has defined blood pressure 120/80 mmHg to 139/89 mmHg as "prehypertension." Prehypertension is not a disease category; rather, it is a designation chosen to identify individuals at high risk of developing hypertension. The Mayo Clinic website specifies blood pressure is "normal if it's below 120/80" but that "some data indicate that 115/75 mm Hg should be the gold standard." In patients with diabetes mellitus or kidney disease studies have shown that blood pressure over 130/80 mmHg should be considered high and warrants further treatment. Even lower numbers are considered diagnostic using home blood pressure monitoring devices.

Blood Pressure Systolic (mm Hg) Diastolic (mm Hg)
Optimal < 120 < 80
Normal < 130 < 85
High Normal 130-139 85-89
Mild Hypertension 140-159 90-99
Moderate Hypertension 160-179 100-109
Severe Hypertension 180-209 110-119
Very Severe Hypertension > 210 > 120


What causes Hypertension?

Hypertension is generally sub divided into 2 types:

  1. Essential Hypertension
  2. Secondary Hypertension

Essential Hypertension

Essential hypertension is the most prevalent hypertension type, affecting 90-95% of hypertensive patients.Although there is no direct cause or mechanism identified some factors are considered to cause Essential Hypertension.

  • Sedentary Lifestyle
  • Obesity-accounts for 80-85% of Essential Hypertension
  • Increased salt intake
  • Increased alcohol intake
  • Vitamin D Deficiency
  • Family history of high blood pressure
  • Genetic diseases
  • Renin -a hormone produced by the kidneys is thought to activate sympathetic system which functions to control most of body' internal organs under different conditions.
  • High fructose(sugar)corn syrup
  • Metabolic syndrome-in which body develops insulin resistance due to obesity and has high blood pressure, sugar,cholesterol and increased waist circumference.

Secondary hypertension

Secondary hypertension by definition results from an identifiable cause. This type is important to recognize since it's treated differently than essential hypertension, by treating the underlying cause of the elevated blood pressure. Hypertension results compromise or imbalance of the pathophysiological mechanisms, such as the hormone-regulating endocrine system, that regulate blood plasma volume and heart function. Many conditions cause hypertension, some are common and well recognized secondary causes such as

  • Renovascular Hypertension - which is due to fibromuscular dysplasia and renal artery stenosis.In both conditiions, increased blood pressure occurs due to narrowing of arteries supplying to the kidney.
  • Pheochromocytoma - caused by an excessive secretion of norepinephrine and epinephrine which promotes vasoconstriction
  • Hyperaldosteronism (Conn's syndrome) - idiopathic hyperaldosteronism, liddle's syndrome (also called pseudoaldosteronism), glucocorticoid remediable aldosteronism
  • Cushing's syndrome - an excessive secretion of glucocorticoids causes the hypertension
  • Hyperparathyroidism
  • Acromegaly
  • Hyperthyroidism
  • Hypothyroidism
  • Chronic Kidney disease
  • Coarctation of Aorta
  • Drugs- Oral Contraceptives,Steroids, NSAIDs,nasal decongestants with adrenergic effects,MAOIs, adrenoceptor stimulants.
  • Scleroderma
  • Neurofibromatosis
  • Pregnancy-unclear mechanism
  • Obstructive sleep apnea Sleep Apnea
  • Fever- unclear etiology
  • Liquorice
  • White coat hypertension, that is, elevated blood pressure in a clinical setting but not in other settings, probably due to the anxiety some people experience during a clinic visit.
  • Perioperative hypertension is development of hypertension just before, during or after surgery. It may occur before surgery during the induction of anesthesia; intraoperatively e.g. by pain-induced sympathetic nervous system stimulation; in the early postanesthesia period, e.g. by pain-induced sympathetic stimulation, hypothermia, hypoxia, or hypervolemia from excessive intraoperative fluid therapy; and in the 24 to 48 hours after the postoperativ period as fluid is mobilized from the extravascular space. In addition, hypertension may develop perioperatively because of discontinuation of long-term antihypertensive medication.


Who is at risk for Hypertension?

Essential hypertension which is the more common form has several risk factors.Of most importance are

  • Increased salt intake in diet
  • Obesity
  • Smoking
  • Increased alcohol intake
  • Family history where parents are hypertensive
  • High cholesterol diet
  • Certain personality traits like in general people who are more commmonly impatient,suffer from high anxiety state and have hostile attitudes.

There is a debate over Hypertension to be more common among black population as compared to whites.It is seen to be more common though exact though there is no exactt reason or mechanism for it.Currently, healthcare professionals identify it to be more common due to

  • Increased salt intake and cholesterol diet
  • Lower socioeconomic status/stress

How do I know I have Hypertension?

There is no specific sign or symptom for Hypertension.It is usually diagnosed while having a blood pressure checked by a health care professional.Some symptoms patient normally see are headaches, anxiety, confusion,fatigue,dizziness and difficulty in vision.

Malignant Hypertension is a severe type where your systolic blood pressure increases above 180 and diastolic more then 120 with development of problems like headaches,difficulty in vision,kidney disease,nausea,vomiting,having a heart attack and brain hemorrhage.

When to seek urgent medical care

There is no specific rule of thumb.But,one should have have blood pressure every 2 years by the primary care doctor if it is below 120/80 and yearly if blood pressure ranges from 120-139/80-89 according to the 2007 United States Preventive Services Task Force (USPSTF)guidelines.

In the setting of blood pressure >120/80 with severe headaches,vision difficulty,dizziness,loss of consciousness,chest pain,leg and arm weakness,nausea,vomiting and fatigue one should seek for urgent medical care .Hypertension is generally associated with a wide variety of symptoms but generally causes problems to the heart,brain,eyes/vision,kidneys,nerves and arm/leg weakness.

Treatment options

Where to find medical care for Hypertension

Directions to Hospitals Treating Hypertension

What to expect (Outlook/Prognosis)

Possible complications

Sources

Template:SIB Template:WH Template:WS

  1. Template:KMLEref
  2. http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?mode=&index=6693
  3. Chobanian AV; et al. (2003). "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report". JAMA. 289: 2560–72. PMID 12748199.