Hypertension

Epidemiology of hypertension:

According to WHO adult(>18 years) is said to be hypertensive on repeated measurement on two different occasions,  his/her systolic blood pressure is equal to or greater than 140 or disystolic blood pressure equal to or greater than 90 such patients are said to be hypertensive.

How hypertension cause premature death?

More than 30% deaths occur due to hypertension. Hypertension is leading cause of premature death world wide. According to WHO in 2021, 1.28 billion people around the world suffer from hypertension out of 46% don’t know that they are suffering from hypertension. Antihypertensive are taken by 42% among them 21% are at goal blood pressure. Mainly have uncontrolled hypertension.

Why hypertension called silent killer?

Majority don’t know they are suffering from hypertension. Hypertension is asymptomatic condition that’s why called silent killer. In majority cases diagnosed accidentally.

Hypertension is the major cause of cardiovascular diseases,  cerebrovascular diseases,  chronic kidney disease,  due to these complications hypertension is responsible for causing premature death through out the world. Out of 1.28 billion patients 2/3 of these patients belonging to low or middle budget countries.

Hypertension increases the risk of cardiovascular disease.  Risk are lowest when the blood pressure is around 115/75. Above this blood pressure every 20/10 mmHg increases or double the risk of cardiovascular disease.

Stages of hypertension:

According to international society of hypertension guidelines hypertension is divided into two stages.

1.    Stage I hypertension

2.    Stage II hypertension

Stage I hypertension:

In stage I hypertension blood pressure is 140-159/90-99.

Stage II hypertension:

In stage II hypertension blood pressure is >160/>100.

Normal blood pressure is 120/80.

What is normal high blood pressure?

Normal high blood pressure:

Normal high blood pressure is 121-139/81-89. This is not categorized as hypertensive patients but they are at greater risk of getting hypertension in future.

Initially they was called pre hypertensive patients but now they are known as people having normal high blood pressure. Because patients think all the time that they are hypertensive so that’s why now we called it normal high blood pressure.

Types of hypertension:

According to etiology hypertension is divided into two types

1.        Primary or essential hypertension

2.        Secondary hypertension

Stages of hypertension may fall into any of the etiological type of hypertension.

Primary hypertension / essential hypertension:

90-95% patients are suffering from primary or essential hypertension and do not have any identifiable cause.

Why primary hypertension is called essential hypertension?

It was thought initially that high blood pressure is necessary for maintenance of life, for the transportation of nutrients and oxygen to various organs , that’s why it was called essential hypertension.

Cause of primary hypertension / Cause of essential hypertension:

In primary hypertension or essential hypertension the cause of hypertension is unknown. So in 95% cases of hypertension the cause or etiology of hypertension is unknown.

Factors of primary hypertension or essential hypertension:

It is thought now that it is interplaced between environmental and genetic factors but the exact cause of primary hypertension is unknown.

Genetic factors of primary hypertension:

De arrangement in blood pressure regulation mechanism i.e. RAAS system leads to hypertension. De arrangement because of genetics susceptibility / inheritance also cause primary hypertension or essential hypertension.

In these patients the RAAS (renin angiotensin Aldosterone system) is genetically hypersusceptible.  The sympathetic nervous system is genetically hyper responsive .

Various enzymes,  hormones,  receptors,  ion channels are involved in regulating the blood pressure and all of these enzymes are protein in nature and proteins are coded by genes so any genetic polymorphism may make the RAAS or sympathetic nervous and their receptors hyper responsive which usually lead to uncontrolled blood pressure and this uncontrolled blood pressure of unknown origin is know as primary hypertension or essential hypertension.

Primary hypertension or essential hypertension is a mixture of genetic and environmental factors. If the parents is suffering from hypertension their individual’s is at greater risk of developing hypertension.

Environmental factors of primary hypertension:

Environmental factors include

·       Salt intake

·       Alcohol consumption

·       Physical inactivity

Why black individuals or Africans are 3 times more at the risk of developing hypertension?

Black individuals (Africans) are 3 times more at the greater risk of developing hypertension than the white individuals and this is genetic. Because they are hypersusceptible to the effect of salt , salt intolerance in a sense.

The other cause in these patients are environmental factors which also make them susceptible because they are

·       More obese

·       Consume more alcohol

·       Unhealthy diet

·       Physically inactive

·       Unhealthy lifestyle

So these factors in combination with genetic factors make them more susceptible to the development of hypertension.

Why elder individuals usually suffer from primary hypertension or essential hypertension?

Elder individuals usually suffer from essential hypertension or primary hypertension because of stiffness of arteries (loss of elasticity) area become less as we know

Area pressure = force / area

Increase area = decrease pressure

Decrease area = increase pressure

Treatment of primary hypertension / Treatment of essential hypertension:

Primary hypertension or essential hypertension is not curable . You can control it but you can’t cure it.

Secondary hypertension:

For secondary hypertension click here

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What is hypertension?

According to WHO what is hypertension?

Epidemiology of hypertension

How hypertension cause premature death?

Who is hypertensive patients?

Why hypertension is called silent killer?

Hypertension is major cause of which diseases?

Stages of hypertension

Stage 1 hypertension

Stage 2 hypertension

What is normal high blood pressure?

How many types of hypertension is there?

Types of hypertension

What is Primary hypertension ?

What is Essential hypertension ?

Why primary hypertension is called essential hypertension?

Cause of primary hypertension

Cause of essential hypertension:

Factors of primary hypertension

Factors of essential hypertension

Genetic factors of primary hypertension

Environmental factors of primary hypertension

Why black individuals or Africans are 3 times more at the risk of developing hypertension?

Why elder individuals usually suffer from primary hypertension or essential hypertension?

Treatment of primary hypertension

Treatment of essential hypertension