Hypertension

Hypertension is a serious disease which may be asymptomatic. According to JNC-7 normal blood pressure is 120/80 mmHg and a blood pressure equal to or more than 140 mmHg systolic and 90 mmHg diastolic is hypertension.

• Etiology is unknown in 90 – 95% cases.
• Greater than normal tension or tone.

Hypertension Definition Classification

2. In adults, a condition in which the blood pressure (BP) is higher than 140 mm Hg systolic or 90 mm Hg diastolic on three separate readings recorded several weeks apart.

Normal blood pressure: systolic <120 mmHg and diastolic <80 mmHg Prehypertension: systolic 120-139 mmHg or diastolic 80-89 mmHg Hypertension:

•         Stage 1: systolic 140-159 mmHg or diastolic 90-99 mmHg Stage 2: systolic ≥ 160 or diastolic ≥ 100 mmHg

Optimal blood pressure: systolic <120 mmHg and diastolic <80 mmHg Normal: systolic 120-129 mmHg and/or diastolic 80-84 mmHg High normal: systolic 130-139 mmHg and/or diastolic 85-89 mmHg Hypertension:

•         Grade 1: systolic 140-159 mmHg and/or diastolic 90-99 mmHg Grade 2: systolic 160-179 mmHg and/or diastolic 100-109 mmHg Grade 3: systolic ≥ 180 mmHg and/or diastolic ≥ 110 mmHg Isolated systolic hypertension: systolic ≥ 140 mmHg and <90 mmHg

Arterial pressure is regulated by :

• Peripheral and central adrenergic systems .-
• Renal
• Hormonal
• Vascular factors

1. Average prevalence is >50% in non-whites.
2. Frequency of hypertension is more in men.
3. In females, prevalence increases after age of 50 years.
4. In the upper class of society blood pressure increases with age.

Hypertension Definition Classification

• Essential Hypertension is arterial hypertension with no definable cause.

Secondary hypertension :

• When a specific organ or defect is responsible for hypertension, it is called secondary hypertension. The causes are many, in­volving different organs.

Classification of arterial hypertension

1 Systolic hypertension with wide pulse pressure

• Arteriosclerosis
• AR
• Thyrotoxicosis Hyperkinetic circulation Fever
• AV fistula
• PDA

2. Systolic and diastolic hypertension

•  Renal causes
  • Chronic pyelonephritis
  • Acute and chronic glomerulonephritis
  • Polycystic renal disease
  • Renovascular stenosis
• Arteriolar nephrosclerosis Diabetic nephropathy
• Renin producing tumors
•  Endocrinalcauses ‘e
  • Oral contraceptives
• Adrenocortical hyperfunction
  • Cushing’s disease and syndrome
  • Primary hyperaldosteronism
  • Congenital or hereditary adreno geni­tal syndromes
• Pheochromocytoma
• Myxedema
• Acromegaly
•  Neurogenic causes
  • Psychogenic
• b Familial dysautonomia (Riley-Day syn­drome)
  • Increased intracranial pressure
•  Miscellaneous causes
  • Coarctation of aorta
  • Polyarteritis nodoses
  •  Hypercalcemia
  • Drugs like glucocorticoids, cyclosporine
•  Unknown etiology
• • Essential hypertension
  • Toxaemia of pregnancy
  • Acute intermittent porphyria