Systemic hypertension

Systemic hypertension is defined medically as a blood pressure greater than 140/90 mmHg.

Causes
  1. essential hypertension: idiopathic (95%)
  2. secondary hypertension: underlying cause identified (5%)

Causes of secondary hypertension:

Risk factors
  • increasing age
  • obesity, lack of exercise
  • high salt diet
  • alcohol, smoking
  • stress
  • genetic factors, family history
  • secondary causes listed above
  • usually asymptomatic
  • may present with complications (see below)
  • accelerated atherosclerosis: esp. ischaemic heart disease, stroke, peripheral vascular disease
  • left ventricular hypertrophy,
  • diastolic dysfunction (due to increased afterload)
  • aortic dissection (due to medial degeneration)
  • Intracerebral haemorrhage (due to medial degeneration, Charcot-Bouchard aneurysms)
  • lacunar infarcts, deep white matter ischaemia (due to hyaline arteriosclerosis)
  • chronic renal impairment (due to hyaline arteriolosclerosis)
  • malignant hypertension

Malignant (accelerated) hypertension

Defined as rapid rise in blood pressure to greater than 200/120 mmHg. May occur on a background of pre-existing hypertension or as the first manifestation of hypertension. High mortality if untreated. Associated with hyperplastic arteriosclerosis, renal failure, retinal haemorrhages and exudates, papilledema, headache and seizures.

  • modification of lifestyle factors
  • antihypertensive medication
  • treat underlying causes
  • treat complications
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Article Information

rID: 2010
System: Vascular
Synonyms or Alternate Spellings:

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