Hypertension

Hypertension or high blood pressure is a medical condition where the blood pressure in the arteries is chronically elevated. While it is formally called arterial hypertension, the word "hypertension" without a qualifier usually refers to arterial hypertension.

Signs and symptoms

Hypertension

Hypertension is usually found incidentally - "case finding" by healthcare professionals. It normally produces no symptoms.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

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.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

It is recognised that stressful situations can increase the blood pressure; if a normally normotensive patient has a high blood pressure only when being reviewed by a health care professional, this is colloquially termed white coat effect. Since most of what we know of hypertension and its outcome with or without modification is based on large series of readings in doctors' offices and clinics (eg Framingham) it is difficult to be sure of the significance of white-coat hypertension. Ambulatory monitoring may help determine whether traffic and ticket inspectors produce similar sustained rises.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

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.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Hypertensive urgencies and emergencies

Hypertension is rarely severe enough to cause symptoms. These 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 ophthalmoscopic examination of the retina.

Related Topics:
Hypertension - Systolic blood pressure - Diastolic blood pressure - Accelerated hypertension - Intracranial pressure - Hypertensive emergency - Malignant hypertension - Papilledema - Ophthalmoscopic - Retina

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Complications

While elevated blood pressure alone is not an illness, it often requires treatment due to its short- and long-term effects on many organs. The risk is increased for:

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

• Cerebrovascular accident (CVAs or strokes)
• Myocardial infarction (heart attack)
• Hypertensive cardiomyopathy (heart failure due to chronically high blood pressure)
• Hypertensive retinopathy - damage to the retina
• Hypertensive nephropathy - chronic renal failure due to chronically high blood pressure

Pregnancy

See the main article: hypertension of pregnancy

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Although few women of childbearing age have high blood pressure, up to 10% develop hypertension of pregnancy. While generally benign, it may herald three complications of pregnancy: pre-eclampsia, HELLP syndrome and eclampsia. Follow-up and control with medication is therefore often necessary.

Related Topics:
Hypertension of pregnancy - Pre-eclampsia - HELLP syndrome - Eclampsia

~ ~ ~ ~ ~ ~ ~ ~ ~ ~