Systemic hypertension

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

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

Causes of secondary hypertension:

  • 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: especially 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)
  • accelerated (malignant) hypertension

Accelerated (malignant) hypertension

Defined as a 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, papilloedema, 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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