Hypertension

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Hypertension, commonly known as high blood pressure, is a chronic medical condition where the force of blood against the arterial walls is persistently elevated. Often referred to as a "silent killer," hypertension can lead to severe complications such as heart disease, stroke, and kidney failure if left untreated. It is classified as either primary (essential) hypertension, with no identifiable cause, or secondary hypertension, resulting from underlying conditions.

Signs & Symptoms

Hypertension often remains asymptomatic, especially in its early stages. However, when symptoms occur, they may include:

  1. Mild symptoms:

    • Headaches.
    • Dizziness or lightheadedness.
    • Nosebleeds.

  2. Severe symptoms (hypertensive crisis):

    • Shortness of breath.
    • Chest pain or pressure.
    • Vision problems, including blurred or double vision.
    • Confusion or altered mental status.

Chronic uncontrolled hypertension may lead to symptoms from target organ damage, such as heart failure or kidney dysfunction.

Anatomy Affected

  1. Cardiovascular system:
    • Increased workload on the heart leads to left ventricular hypertrophy and eventual heart failure.
  2. Kidneys:
    • Chronic hypertension damages renal arteries, impairing filtration and leading to chronic kidney disease.
  3. Brain:
    • Increased risk of stroke and transient ischemic attacks.
  4. Eyes:
    • Hypertensive retinopathy can cause vision impairment or blindness.

Cause/Transmission

  1. Primary (essential) hypertension:

    • No specific cause; likely involves genetic and lifestyle factors.
    • Risk factors include obesity, high sodium diet, stress, lack of physical activity, and family history.

  2. Secondary hypertension:

    • Results from conditions such as:
      • Chronic kidney disease.
      • Endocrine disorders (e.g., hyperaldosteronism, Cushing’s syndrome).
      • Obstructive sleep apnea.
      • Certain medications (e.g., corticosteroids, decongestants).

Treatments

  1. Lifestyle modifications:

    • Dietary changes:
      • DASH (Dietary Approaches to Stop Hypertension) diet, focusing on low sodium, high potassium, and nutrient-rich foods.
    • Physical activity: Regular exercise (150 minutes per week).
    • Weight loss: Reducing body weight to lower blood pressure.
    • Limiting alcohol and tobacco use.

  2. Medications:

    • Diuretics: Promote fluid excretion (e.g., hydrochlorothiazide).
    • ACE inhibitors or ARBs: Relax blood vessels (e.g., lisinopril, losartan).
    • Beta-blockers: Reduce heart rate and cardiac output (e.g., metoprolol).
    • Calcium channel blockers: Dilate arteries (e.g., amlodipine).

  3. Managing secondary causes: Treating underlying conditions like kidney disease or hormonal disorders.

Prevention

  1. Adopt a healthy lifestyle:
    • Maintain a balanced diet low in salt and processed foods.
    • Exercise regularly.
  2. Monitor blood pressure:
    • Regular screenings, especially for individuals with risk factors.
  3. Avoid risk factors:
    • Limit alcohol consumption and avoid smoking.
    • Manage stress effectively.

Prognosis/Outlook

  1. Short-term: With early diagnosis and consistent management, blood pressure can be effectively controlled, reducing risks of complications.
  2. Long-term: If untreated, hypertension can lead to severe complications, including heart attack, stroke, kidney failure, and death.
  3. Mortality rate: Hypertension contributes to approximately 7.5 million deaths globally each year, accounting for about 12.8% of all deaths.

Hypertension management is a cornerstone of preventative medicine, and with proper intervention, patients can achieve a healthy and prolonged life.

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