|
|
Hypertension
(High Blood Pressure)
High blood pressure, or hypertension, is defined
as a consistent elevation in blood
pressure with readings greater than 140/90. The
systolic blood pressure (top number) may be too
high if it is greater than 140 mmHG. The diastolic
blood pressure (bottom number) is too high if it
is consistently greater than 90 mmHG. It has been
shown that patients with a diastolic blood pressure
greater than 90 mmHG will have a significant reduction
in morbidity and mortality with adequate therapy.
On occasion, blood pressure values must be interpreted
in light of the patient’s age, sex, and general
health.
It is not uncommon to see normal systolic blood
pressures greater than 150 in patients over age
70. Stressful situations will raise your blood pressure
as part of a normal physiologic reaction.
Hypertension is a major risk factor in the development
of heart disease and stroke because of its effect
on accelerating atherosclerotic vascular disease.
Chronic hypertension can also lead to kidney impairment,
retinal disease (eyes), and cerebral (brain) hemorrhage.
General Measurement Guidelines
for Adults
|
Level |
|
Diastolic Pressure |
|
Normal |
|
< 85 |
|
High Normal |
|
85 - 89 |
|
Mild Hypertension |
|
90 - 104 |
|
Moderate Hypertension |
|
105 - 114 |
|
Severe Hypertension |
|
115+ |
When the diastolic pressure is below 90:
|
Level |
|
Systolic Pressure |
|
Normal |
|
< 140 |
|
Borderline Hypertension
|
|
140-159 |
|
Systolic Hypertension |
|
160+ |
Causes
Hypertension may occur secondarily to a wide variety
of problems. The most common form is “essential
hypertension” or hypertension that occurs for
reasons unknown. Hypertension may be secondary to
kidney problems (renal artery stenosis), hyperthyroidism,
adrenal gland problems, or heart disease. Below are
some secondary causes of hypertension:
|
• |
Kidney Failure |
|
• |
Chronic Glomerulonephritis |
|
• |
Renal Artery Stenosis (narrowing of the artery
that supplies the kidney) |
|
• |
Some Kidney Tumors |
|
• |
Adrenal Gland Disease (Cushing’s disease)
& Adrenal Tumors |
|
• |
Hyperthyroidism |
|
• |
Hyperparathyroidism |
|
• |
Anabolic Steroids (used by athletes)
|
|
• |
Oestrogen / Progestogen Contraceptives (birth
control pills) |
|
• |
Cocaine / Crack |
|
• |
Amphetamine Use |
|
• |
Alcohol Withdrawal |
|
• |
Preeclampsia |
|
• |
Acute Pain |
|
• |
Acute Stress |
Factors Indicating an Adverse
Prognosis in Hypertension
|
• |
Youth |
|
• |
Male |
|
• |
Persistent diastolic pressure > 115
|
|
• |
Smoking |
|
• |
Diabetes |
|
• |
High blood cholesterol |
|
• |
Obesity |
|
• |
Evidence of organ damage (heart attack, heart
enlargement, congestive heart failure, retinal
disease, impaired kidney function, or stroke)
|
|
Note: The fourth through seventh item above
can be directly controlled by the patient.
Have your blood pressure checked by a physician
regularly. |
Diagnosis
Evaluation by your doctor will include a history and
physical examination. Blood tests (i.e. kidney profile),
ECG, chest x-ray, and urinalysis will be obtained
for baseline information. Special blood tests for
thyroid profile and adrenal gland function will be
done where appropriate.
Treatment
Treatment of some of the milder forms of hypertension
can be accomplished by dietary sodium restriction
alone. Those who suffer from obesity can see normalisation
oftheir blood pressure with weight reduction and exercise.
Medications are available for the treatment of hypertension
that is not responsive to the above measures. Your
doctor will determine which medication will suit you
best.
Do not stop taking your blood pressure medication
without first discussing it with your physician.
RETURN
TO ENCYCLOPEDIA 
|
|
|
|
