Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically
elevated. In current usage, the word "hypertension" without a qualifier normally refers to arterial hypertension.  Hypertension can be classified either essential (primary) or secondary. Essential hypertension indicates that no specific medical cause can be found to explain a patient's condition. Secondary hypertension indicates that the high blood pressure is a result of (i.e., secondary to) another condition, such as kidney disease or tumours (pheochromocytoma and paraganglioma). Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure. Even moderate elevation of arterial blood pressure leads to shortened life expectancy. At severely high pressures, defined as mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated. In individuals older than 50 years, hypertension is considered to be present when a person's systolic blood pressure is consistently 140 mm Hg or greater. Beginning at a systolic pressure of 115 and diastolic pressure of 75 (commonly written as 115/75 mm Hg), cardiovascular disease (CVD) risk doubles for each increment of 20/10 mmHg. Prehypertension is defined as blood pressure from 120/80 mm Hg to 139/89 mm Hg. Prehypertension is not a disease category; rather, it is a designation chosen to identify individuals at high risk of developing hypertension. The Mayo Clinic specifies blood pressure is "normal if it's below 120/80". Patients with blood pressures over 130/80 mm Hg along with Type 1 or Type 2 diabetes, or kidney disease require further treatment. Resistant hypertension is defined as the failure to reduce BP to the appropriate level after taking a three-drug regimen. The American Heart Association released guidelines for treating resistant hypertension.
1.9 Secondary hypertension 1.9.1 Renal hypertension 1.9.2 Adrenal hypertension 1.9.3 Cushing's syndrome 1.9.4 Genetic 1.9.5 Coarctation of the aorta 1.9.6 Drugs 1.9.7 Rebound hypertension o 1.10 Pregnancy o 1.11 Children and adolescents 2 Pathophysiology 3 Diagnosis o 3.1 Measuring blood pressure o 3.2 Distinguishing primary vs. secondary hypertension o 3.3 Investigations commonly performed in newly diagnosed hypertension 4 Prevention 5 Drug-free Treatment of Hypertension o 5.1 Lifestyle modification (nonpharmacologic treatment) o 5.2 Investigational Implantable Device Treatment for Resistant Hypertension 6 Drug Treatment of Hypertension o 6.1 Choice of initial medication o 6.2 Advice in the United Kingdom o 6.3 Advice in the United States 7 Prognosis o 7.1 Complications 8 Epidemiology 9 History 10 See also 11 References 12 External links o 12.1 Major studies
Although no specific medical cause can be determined in essential hypertension, it often has several contributing factors. These include obesity, salt sensitivity, renin homeostasis, insulin resistance, genetics, and age.
The risk of hypertension is 5 times higher in the obese as compared to those of normal weight and up to two-thirds of cases can be attributed to excess weight. More than 85% of cases occur in those with a BMI>25.
1 Causes o 1.1 Obesity o 1.2 Sodium sensitivity o 1.3 Role of renin o 1.4 Insulin resistance o 1.5 Sleep apnea o 1.6 Genetics o 1.7 Age o 1.8 Liquorice
 Sodium sensitivity
Sodium is an environmental factor that has received the greatest attention. Approximately one third of the essential hypertensive population is responsive to sodium intake. This is due to the fact that
if corrected. making blood vessels stiffer. This is known as renovascular hypertension.
 Insulin resistance
Insulin is a polypeptide hormone secreted by cells in the islets of langerhans. Thirst/ADH and Aldosterone → Increased Sodium Resorption in the Kidneys (DCT and CD) → Increased Blood Pressure. Its main purpose is to regulate the levels of glucose in the body antagonistically with glucagon through negative feedback loops. Data supporting this view emerge from animal studies as well as in population studies in humans. For the rest (5-10%). This includes diseases such as polycystic kidney disease or chronic glomerulonephritis. Frequently. the American Heart Association says there's no identifiable cause. could bring blood pressure back to normal values. This feature is now widely recognized as part of syndrome X. the increased sympathetic neural activity may override the vasodilatory effects of insulin. under-recognized cause of hypertension.
 Role of renin
Renin is an enzyme secreted by the juxtaglomerular apparatus of the kidney and linked with aldosterone in a negative feedback loop. Liquorice extracts are present in many medicines (for example cough syrups. In 90 percent to 95 percent of high blood pressure cases. or the metabolic syndrome. with genetic heritability averaging 30%. a low blood level of potassium will also be present.
Hypertension is one of the most common complex disorders. In consequence. More than 50 genes have been examined in association studies with hypertension.  Renal hypertension Hypertension produced by diseases of the kidney.
Over time. throat lozenges and peptic ulcer treatments). insulin may stimulate sympathetic activity without elevating mean arterial pressure. the number of collagen fibers in artery and arteriole walls increases. most will probably have an endocrine or renal defect that. In normotensive individuals. some hypertensive patients have been defined as having low-renin and others as having essential hypertension. but other approaches include the Mandibular advancement splint (MAS).
. and may explain why African Americans tend to respond better to diuretic therapy than drugs that interfere with the renin-angiotensin system. or weight loss. if liquorice is the cause of the high blood pressure.increasing amounts of salt in a person's bloodstream causes cells to release water (due to osmotic pressure) to equilibrate concentration gradient of salt between the cells and the bloodstream.
Consumption of liquorice (which can be of potent strength in liquorice candy) can lead to a surge in blood pressure. Some authorities claim that potassium might both prevent and treat hypertension. Most of these studies support the concept that the inheritance is probably multifactorial or that a number of different genetic defects each have an elevated blood pressure as one of their phenotypic expressions. in more extreme conditions such as that of the metabolic syndrome. High Renin levels predispose to Hypertension: Increased Renin → Increased Angiotensin II → Increased Vasoconstriction. and so a raised mean arterial blood pressure. The range of renin activity observed in hypertensive subjects tends to be broader than in normotensive individuals.  Adrenal hypertension
 Sleep apnea
Sleep apnea is a common. Insulin also exhibits vasodilatory properties. it is thought that decreased perfusion of renal tissue due to stenosis of a main or branch renal artery activates the renin-angiotensin system. However. sinus surgery. and the number is constantly growing.
 Secondary hypertension
Only in a small minority of patients with elevated arterial pressure can a specific cause be identified. Insulin resistance and/or hyperinsulinemia have been suggested as being responsible for the increased arterial pressure in some patients with hypertension. It is often best treated with nocturnal nasal continuous positive airway pressure. tonsilectomy. People with hypertension or history of cardio-vascular disease should avoid liquorice raising their blood pressure to risky levels. which are contained throughout the pancreas. increasing the pressure on the blood vessel walls. adenoidectomy. With the reduced elasticity comes a smaller cross-sectional area in systole. UPPP. Hypertension can also be produced by diseases of the renal arteries supplying the kidney. Low-renin hypertension is more common in African Americans than white Americans.
Main article: Hypertension of pregnancy Both adrenal glands can overproduce the hormone cortisol or it can arise in a benign or malignant tumor. Three theories have been proposed to explain this:
Inability of the kidneys to excrete sodium. resulting in natriuretic factors such as Atrial Natriuretic Factor being secreted to promote salt excretion with the side-effect of raising total peripheral resistance. is secondary to an underlying disorder. with total peripheral resistance (TPR) normal. making up 85 to 95% of cases.  Rebound hypertension High blood pressure that is associated with the sudden withdrawal of various antihypertensive medications.Hypertension is a feature of a variety of adrenal cortical abnormalities. In primary aldosteronism there is a clear relationship between the aldosterone-induced sodium retention and the hypertension. More than 80% of patients with Cushing's syndrome have hypertension. supporting data are lacking. Renal parenchymal disease is the most common (60 to 70%) cause of hypertension. The increase in blood volume leads to hypertension. Follow-up and control with medication is therefore often necessary. Hypertension results from the interplay of several pathophysiological mechanisms regulating plasma volume. Licorice (Glycyrrhiza glabra) inhibits the 11-hydroxysteroid hydrogenase enzyme (catalyzes the reaction of cortisol to cortison) which allows cortisol to stimulate the Mineralocorticoid Receptor (MR) which will lead to effects similar to hyperaldosteronism. especially NSAIDs (Motrin/Ibuprofen) and steroids can cause hypertension. An overactive sympathetic nervous system. It varies between individuals and within individuals from day to day and at various times of the day. HELLP syndrome and eclampsia.  Cushing's syndrome
Medications commonly associated with rebound hypertension include centrally-acting antihypertensive agents.  Genetic Hypertension can be caused by mutations in single genes. thereby giving the body enough time to adjust to reduction in dose. and are outlined at secondary hypertension. inherited on a mendelian basis. 
Most of the secondary mechanisms associated with hypertension are generally fully understood.  Drugs Certain medications. While generally benign. However. it may herald three complications of pregnancy: pre-eclampsia. such as clonidine and betablockers. rebound hypertension may result in a hypertensive emergency. however. peripheral vascular resistance and cardiac output. Most childhood hypertension. which results in peripheral vasoconstriction and cardiac stimulation. The epidemic of childhood obesity. over time cardiac output drops to normal levels but TPR is increased. Adolescents usually have primary or essential hypertension.
 Children and adolescents
As with adults. Depending on the severity of the increase in blood pressure.  Coarctation of the aorta The congenital abnormality aortic coarctation can result in hypertension. which itself is a cause of hypertension.
. Rebound hypertension is avoided by gradually reducing the dose (also known as "dose tapering"). particularly in preadolescents. leading to increased stress responses. This diagnosis is confirmed by demonstrating increased urinary excretion of epinephrine and norepinephrine and/or their metabolites (vanillylmandelic acid). the risk of developing left ventricular hypertrophy. all of which may be increased. In patients with pheochromocytoma increased secretion of catecholamines such as epinephrine and norepinephrine by a tumor (most often located in the adrenal medulla) causes excessive stimulation of adrenergic receptors. those associated with essential (primary) hypertension are far less understood. The increases in blood pressure may result in blood pressures greater than when the medication was initiated. Although few women of childbearing age have high blood pressure. blood pressure is a variable parameter in children. 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. What is known is that cardiac output is raised early in the disease course. up to 10% develop hypertension of pregnancy. An overactive renin / angiotensin system leads to vasoconstriction and retention of sodium and water.
the person taking the measurement should be careful to inflate the cuff suitably above anticipated systolic pressure. and. which can then be inspected by a doctor. if the elevation is extreme. "You may have what's called 'white coat hypertension'. Obtaining reliable blood pressure measurements relies on following several rules and understanding the many factors that influence blood pressure reading. Routine measurements done in medical offices of patients with known hypertension may incorrectly diagnose 20% of patients with uncontrolled hypertension  Home blood pressure monitoring can provide a measurement of a person's blood pressure at different times throughout the day and in different environments. A stethoscope should be placed lightly over the brachial artery. Often. or end-organ damage is present then the diagnosis may be applied and treatment commenced immediately. Monitoring at home will help you measure your true blood pressure and can provide your doctor with a log of blood pressure measurements over time. it is part of the metabolic "syndrome X" in
. that means your blood pressure goes up when you're at the doctor's office. Automated machines are commonly used and reduce the variability in manually collected readings  . and the higher pressure arm preferred for subsequent measurements. The bladder should encircle and cover two-thirds of the length of the (upper) arm. The patient should be sitting upright in a chair with both feet flat on the floor for a minimum of five minutes prior to taking a reading. Usually this requires three separate measurements at least one week apart. Exceptionally. This is helpful in diagnosing and preventing potential health problems. The readings should then be averaged. Cuff size is also important. Analysis of this is rare at present. When taking manual measurements.
measured in each arm. For instance. if there is a discrepancy of more than 5 mmHg. The person should inflate the cuff to 200 mmHg and then slowly release the air while palpating the radial pulse. where the sound is abruptly muffled. After one minute. In elderly patients who particularly when treated may show orthostatic hypotension. a simple and cheap way is simply to manually record values with pen and paper. Systolic pressure is the pressure reading at the onset of the sounds described by Korotkoff (Phase one). An initial measurement should include both arms. 30 minutes after smoking or strenuous exercise and without any stress. Diastolic pressure is then recorded as the pressure at which the sounds disappear (K5) or sometimes the K4 point. The American Heart Association states. Systolic hypertension may be due to reduced compliance of the aorta with increasing age. These charting methods provide printouts for the patient's physician and reminders to take a blood pressure reading.
Over 91% of adult hypertension has no clear cause and is therefore called essential/primary hypertension. the cuff should be reinflated to 30 mmHg higher than the pressure at which the radial pulse was no longer palpable. The BP should at some time have been
 Distinguishing primary vs." Some home blood pressure monitoring devices also make use of blood pressure charting software. and archetypes used to record the data should include the time taken. secondary hypertension
Once the diagnosis of hypertension has been made it is important to attempt to exclude or identify reversible (secondary) causes. Home monitoring of blood pressure can also assist in the diagnosis of white coat hypertension. such as at home and at work. If systolic blood pressure is elevated with a normal diastolic blood pressure. as may the effectiveness of treatment. Systolic hypertension is defined as an elevated systolic blood pressure. The patient should not be on any adrenergic stimulants. Home monitoring may assist in the diagnosis of high or low blood pressure. it is called isolated systolic hypertension.
 Measuring blood pressure
Main article: Blood pressure Diagnosis of hypertension is generally on the basis of a persistently high blood pressure. such as those found in many cold medications. However. Two measurements should be made at least 5 minutes apart. It may also be used to monitor the effects of medication or lifestyle changes taken to lower or regulate blood pressure levels. BP varies with time of day. a third reading should be done. measurements in control of hypertension should be at least 1 hour after caffeine.It is also known that hypertension is highly heritable and polygenic (caused by more than one gene) and a few candidate genes have been postulated in the etiology of this condition. The cuff should be at the level of the heart and the cuff should be deflated at a rate of 2 to 3 mmHg/s. measuring lying sitting and standing BP may be useful.
combined hyperlipidemia and central obesity. which is rich in fruits and vegetables and low fat or fat-free dairy foods. Further information might be found on the talk page. Primary or essential hypertension is more common in adolescents and has multiple risk factors. age and gender are outside the realm of change. (September 2008) Prevention of hypertension only goes as far as the cause. Electrolytes (sodium. Regular mild exercise improves blood flow and helps to reduce resting heart rate and blood pressure. The heart is a muscle too.for evidence of the heart being under strain from working against a high blood pressure. Low-sodium and low-fat diets can reduce cardiovascular risks and keep arteries clear of plaque and blood volume at normal levels.again for signs of cardiac enlargement or evidence of cardiac failure. These steps are highly effective in reducing blood pressure. one can adjust lifestyle related causes but
Weight reduction and regular aerobic exercise (e. dropping systolic pressures several points. 
Please help improve this section by expanding it. Modifiable factors include diet. including reversal or prevention of HTN. including obesity and a family history of hypertension. thus fight or flight responses which increase heartrate and blood pressure. race. Diabetes and raised cholesterol levels being additional risk factors for the development of cardiovascular disease are also tested for as they will also require management.to identify both underlying renal disease as a cause of hypertension and conversely hypertension causing onset of kidney damage. working out the cardiac muscles makes the heart beat more efficiently. Also may show resulting thickening of the heart muscle (left ventricular hypertrophy) or of the occurrence of previous silent cardiac disease (either subtle electrical conduction disruption or even a myocardial infarction). Blood tests commonly performed include:
Creatinine (renal function) .
patients with insulin resistance: it occurs in combination with diabetes mellitus (type 2). thus pumping blood around the body more effectively.to identify diabetes mellitus Cholesterol
 Drug-free Treatment of Hypertension
 Lifestyle modification (nonpharmacologic treatment)
Additional tests often include:
Testing of urine samples for proteinuria again to pick up underlying kidney disease or evidence of hypertensive renal damage.
 Investigations commonly performed in newly diagnosed hypertension
Tests are undertaken to identify possible causes of secondary hypertension. weight-loss. Stressors can negatively affect blood pressure by activating the sympathetic nervous system. Also a baseline for later monitoring the possible side-effects of certain antihypertensive drugs. with most cases caused by renal disease. jogging) are recommended as the first steps in treating mild to moderate hypertension. Reducing dietary sugar intake Reducing sodium (salt) in the diet may be effective: it decreases blood pressure in about 33 percent of people (see above). Losing even 10% of body weight can have fantastic benefits towards health. This diet is shown effective based on research sponsored by the US National
. although drug therapy is still necessary for many patients with moderate or severe hypertension to bring their blood pressure down to a safe level. Effective management of stress can reduce this particular risk. Secondary hypertension is more common in preadolescent children. Exercise maintains a healthy heart. thus healthy cardiac contractions and functions. Additional dietary changes beneficial to reducing blood pressure includes the DASH diet (dietary approaches to stop hypertension).g. Chest X-ray . Chronic stress can lead to regular and frequent activation of the system and repeated high blood pressure. Electrocardiogram (EKG/ECG) . and seek evidence for endorgan damage to the heart itself or the eyes (retina) and kidneys.. Many people choose to use a salt substitute to reduce their salt intake. potassium) Glucose . exercise and stress management.
There are many classes of medications for treating hypertension. Each added drug may reduce the systolic blood pressure by 5-10 mmHg. Calcium channel blockers such as nifedipine (Adalat) amlodipine (Norvasc). lisinopril (Zestril). but does not produce chronic hypertension. particularly. labetalol. losartan (Cozaar). such as meditation and other mindbody relaxation techniques. hydrochlorothiazide (also called HCTZ)
. diltiazem. which theoretically can offset the effect of sodium and act on the kidney to decrease blood pressure. Note that coffee drinking (caffeine ingestion) also increases blood pressure transiently. which — by varying means — act by lowering blood pressure. A 300 patient randomized controlled trial is currently underway. valsartan (Diovan). and to be less effective than a simple diuretic. enalapril. Doxazosin has been shown to increase risk of heart failure.
Activation Therapy may be approved by the FDA and made commercially available as early as 2010. lifestyle changes such as those discussed in the preceding section are strongly recommended before initiation of drug therapy. together called antihypertensives. candesartan (Amias) Alpha blockers such as prazosin. significantly lowers blood pressure in patients with treatment resistant hypertension. and reduces the likelihood of dementia. and mortality from vascular disease. Toprol-XL). The exact mechanisms are not fully understood. ramipril (Altace) Angiotensin II receptor antagonists: eg. so often multiple drugs are necessary to achieve blood pressure control. Jacobson's Progressive Muscle Relaxation and biofeedback are also used. fosinopril (Monopril). Adoption of the DASH diet is one example of lifestyle change repeatedly shown to effectively lower mildly-elevated blood pressure. Discontinuing tobacco use and alcohol consumption has been shown to lower blood pressure. irbesartan (Avapro). by reducing environmental stress such as high sound levels and over-illumination can be an additional method of ameliorating hypertension. In addition. heart failure. telmisartan (Micardis. for example with relaxation therapy. of coronary heart disease by 15-20%. Besides. or terazosin. Reducing stress. also known as Baroreflex Activation Therapy. but blood pressure (especially systolic) always transiently increases following alcohol and/or nicotine consumption. verapamil Direct renin inhibitors such as aliskiren (Tekturna) Diuretics: eg. One study published on a group of 16 patients reported an average systolic blood pressure reduction of 34 mmHg after three months of treatment and 35 mmHg after 24 months. and lower in certain contexts such as diabetes or kidney disease (some medical professionals recommend keeping levels below 120/80 mmHg). Commonly used drugs include:
 Investigational Implantable Device Treatment for Resistant Hypertension
Published feasibility studies have shown that a pacemaker-like device designed to electrically activate the baroreflex.
Institutes of Health. propranolol.
 Drug Treatment of Hypertension
Main article: Antihypertensive Unless hypertension is severe. metoprolol (Lopressor. This has also been shown to be highly effective in reducing blood pressure. Evidence suggests that reduction of the blood pressure by 5-6 mmHg can decrease the risk of stroke by 40%. A drop in systolic blood pressure of at least 20 mmHg was achieved in 12 of 16 (75%) patients at 2 years and 5 of 16 (31%) achieved a systolic BP of less than 140 mmHg at 2 years. although meta-analysis suggests it is not effective unless combined with other relaxation techniques. device-guided paced breathing. lifestyle changes are initiated concomitantly. such as stroke and heart attack. Results published on a separate group of 10 patients from another feasibility trial reported an average systolic blood pressure reduction of 24 mmHg after three months of treatment. If the results from this trial confirm the findings published in the above studies. Beta blockers such as atenolol. If hypertension is high enough to justify immediate use of medications. The aim of treatment should be blood pressure control to <140/90 mmHg for most patients. so is not recommended. abstention from cigarette smoking is important for people with hypertension because it reduces the risk of many dangerous outcomes of hypertension. chlortalidone. an increase in daily calcium intake has the benefit of increasing dietary potassium. Pritor). bendroflumethiazide. quinapril. Particpants must have systolic blood pressure above 160 mmHg despite being on three or more antihypertensive medications. Baroreflex
ACE inhibitors such as creatine captopril.
then drug therapy is initiated. less profitable. The consensus recommendations of thiazide diuretics as first-line therapy for hypertension stand against a the backdrop that all blood pressure treatments have side-effects. dietary habits. and thus rarely promoted by the drug industry. in the revised national guidelines. Detection. consensus guidelines call for medically-supervised lifestyle changes and observation before recommending initiation of drug therapy.
Combination products (which usually contain HCTZ and one other drug)
Choice of initial medication Unless the blood pressure is severely elevated. and overall lifestyle choices. headache . "thiazide-type diuretics are especially safe and effective in the elderly. All drug treatments have side effects. The ALLHAT study showed better costeffectiveness and slightly better outcomes for the thiazide diuretic chlortalidone compared with a calcium channel blocker and an ACE inhibitor in a 33. and much more affordable than other therapies. 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 . the consensus recommendations to prefer use of
thiazides as first line treatment for essential hypertension have been repeatedly and strongly questioned. and impaired glucose tolerance with consequent increased risk of developing Diabetes mellitus type 2.
Advice in the United States
The Seventh Report of the Joint National Committee on Prevention. convulsion due to vasogenic edema in brain due to high blood pressure. it often requires treatment due to its shortand long-term effects on many organs.
The level of blood pressure regarded as deleterious has been revised down during years of epidemiological studies. often requiring more than one agent to effective lower hypertension. this is partly because they are off-patent.357-member ethnically mixed study group. Evaluation. A widely quoted and important series of such studies is the Framingham Heart Study carried out in an American town: Framingham.confusion. The 1993 consensus recommendation for use of thiazide diuretics as initial treatment stems in part from the ALLHAT study results. The thiazide diuretics also deplete circulating potassium unless combined with a potassium-sparing diuretic or supplemental potassium." A subsequent smaller study (ANBP2) did not show the slight advantages in thiazide diuretic outcomes observed in the ALLHAT study.chronic renal failure due to chronically high blood pressure Hypertensive encephalopathy . drug trials to lower moderatelyelevated blood pressure have failed to reduce overall death rates.
While elevated blood pressure alone is not an illness.damage to the retina Hypertensive nephropathy . and while the evidence of benefit at higher blood pressures is overwhelming. If an individual conscious of their condition takes the necessary preventative measures to lower their blood pressure.
It is based upon several factors including genetics. which concluded in 2002 that "Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive. Which type of many medications should be used initially for hypertension has been the subject of several large studies and various national guidelines. However as the Merck Manual of Geriatrics notes. Thiazide diuretics are effective. Western Australia have been widely applied. On this basis. recommended as the best first-line drug for hypertension by many experts. Potentially serious side effects of the thiazide diuretics include hypercholesterinemia. If lifestyle changes are ineffective or the presenting blood pressure is critical."
Advice in the United Kingdom
The risk of beta-blockers provoking type 2 diabetes led to their downgrading to fourth-line therapy in the United Kingdom in June 2006. Arguably. They should be preferred for firststep antihypertensive therapy. To the
. they are more likely to have a much better outcome than someone who does not. The results from Framingham and of similar work in Busselton. yet they are not prescribed as often as some newer drugs. and Treatment of High Blood Pressure (JNC 7) in the United States recommends starting with a thiazide diuretic if single therapy is being initiated and another medication is not indicated. and actually showed slightly better outcomes for ACE-inhibitors in older white male patients. Massachusetts.
extent that people are similar this seems reasonable. Bleeding into the brain (stroke). but there are known to be genetic variations in the most effective drugs for particular sub-populations. Certain tests will be given to monitor blood pressure and assess organ damage. blood pressure must be reduced immediately to prevent organ damage. Aneurysm (Bulging blood vessel). it is often when hypertension goes untreated or if the patient does not take his or her medication. He or she will also need to know all medications you are taking including nonprescription and recreational drugs.
Diagnosing Hypertensive Emergency
The health care provider will ask you several questions to get a better understanding of your medical history. When it does occur. Heart attack. Recently (2004).
Headache Seizure Chest pain Shortness of breath Swelling or edema (fluid buildup in the tissues)
Sushruta (6th century BCE) explained hypertension in a manner which matches the modern symptoms of the disease. this is considered a hypertensive emergency. the Framingham figures have been found to overestimate risks for the UK population considerably. organ damage may occur. The reasons are unclear. Also. be sure to tell them if you are taking any herbal or dietary supplements. Chest pain (angina). Whatever organ damage that has occurred is treated with therapies specific to the organ that is damaged. Eye exam to look for swelling and bleeding. Organ damage associated with hypertensive emergency may include:
Changes in mental status such as confusion or coma (encephalopathy). This is done in an intensive care unit of a hospital. but there is no damage to the body's organs as a result and blood pressure can be brought down safely within a few hours with blood pressure medication this is referred to as hypertensive urgency. When blood pressure gets critically high. Reviewed by the doctors at The Cleveland Clinic Heart Center.
Symptoms of Hypertensive Emergency
. hypertensive emergency is rare. including:
Hypertension: Hypertensive Crisis
Hypertensive crisis comprises a spectrum of conditions.
When blood pressure spikes.
When organ damage occurs as a result of severely elevated high blood pressure. Heart failure. Blood and urine testing.
What's the Treatment for Hypertensive Emergency and Associated Organ Damage?
The first goal is to bring down the blood pressure as quickly as possible with intravenous (IV) blood pressure medications to prevent further organ damage. When this occurs. Nevertheless the Framingham work has been an important element of UK health policy. including hypertensive urgency and hypertensive emergency.
Regular monitoring of blood pressure. Fluid in the lungs (pulmonary edema). Eclampsia (occurs during pregnancy).