Risk factors for adverse prognosis in hyperten­sion  with Etiology

• Non-whites
• Youth (young) and Males
• Diastolic blood pressure consistently more than 115 mmHg
• Smoking and Alcoholism
• Diabetes mellitus
• Hypercholesterolemia
• Obesity
• End organ damage
• Cardiac enlargement
• ECG showing ischemia or LVH with strain pattern
• MI (myocardial infarction) 9< CHF (heart failure)
• Eyes – retinal haemorrhages, exudates and papilledema
• Renal – insufficiency and failure
• Nervous system- CVA (cerebrovascular acci­dent).

Etiology of hyperten­sion

1. Essential hyperten­sion – no known cause
2. Secondary hyperten­sion

• – Renal hypertension
• – Endocrine:
  • Adrenal disease
  • Acromegaly
  • Hypercalcemia
  • – Oral contraceptive
• – Coarctation of Aorta.
• Genetics in Hypertension
• There is ‘familial aggregation“.
• There is multifactorial inheritance of hyperten­sion.
• Alcohol intake – More the alcohol intake, more the blood pressure.
• Family size – larger the family size, more the blood pressure.
• Overcrowding and crowds increase blood pressure.
• Environment and hypertension Environmental stress can cause hypertension.
• Occupational stress / Work / Job stress is an important cause of hypertension in modern life.
• Obesity is also part of metabolic syndrome (obesity, hypertension, dyslipidemia, insulin resistance).