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
- Essential hypertension – no known cause
- 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).