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Systemic hypertension

Systemic hypertension is defined medically as a blood pressure greater than 140/90 mmHg. Recently the American College of Cardiology (ACC) and American Heart Association (AHA) have changed guidelines to indicate that pressures above 130/80 mmHg will be considered hypertension, however the European Society of Cardiology (ESC) and European Society of Hypertension (ESH) continue to define hypertension as 140/90 mm Hg and recommend targeting a patient's blood pressure to less than 130/80 mmHg only in certain conditions 2.

  • usually asymptomatic
  • may present with complications (see below)

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. Malignant hypertension has a high mortality if untreated. Associated with hyperplastic arteriosclerosis, renal failure, retinal hemorrhages and exudates, papilledema, headache, and seizures.

  • accelerated atherosclerosis: especially ischemic heart disease, stroke, peripheral vascular disease
  • left ventricular hypertrophy
  • diastolic dysfunction (due to increased afterload)
  • aortic dissection (due to medial degeneration)
  • intracerebral hemorrhage (due to medial degeneration, Charcot-Bouchard aneurysms)
  • lacunar infarcts, deep white matter ischemia (due to hyaline arteriosclerosis)
  • chronic renal impairment (due to hyaline arteriolosclerosis)
  • accelerated (malignant) hypertension
  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
  • modification of lifestyle factors
  • antihypertensive medication
  • treat underlying causes
  • treat complications

Article information

rID: 2010
System: Vascular
Synonyms or Alternate Spellings:
  • Arterial hypertension
  • Raised systemic blood pressure
  • Elevated systemic blood pressure
  • Systemic arterial hypertension

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