**Overview of Hypertension**:
– Hypertension is often asymptomatic and requires health screening for identification.
– Lifestyle factors contribute to primary hypertension.
– Hypertension is a major risk factor for various health issues.
– It is classified as primary or secondary hypertension.
– Blood pressure monitoring and control are crucial for health.
**Causes and Risk Factors**:
– Primary hypertension results from genetic and environmental factors.
– Genetic variants and genome-wide studies are associated with blood pressure.
– Secondary hypertension can be caused by kidney disease, endocrine conditions, obesity, and other factors.
– Lifestyle factors like aging, diet, and lack of exercise increase the risk of hypertension.
– Various environmental factors, including arsenic exposure and alcohol consumption, are linked to hypertension.
**Diagnosis and Measurement**:
– Hypertension is diagnosed based on persistently high resting blood pressure.
– Proper measurement technique is essential for accurate diagnosis.
– Additional investigations may include urinalysis, blood tests, and imaging studies.
– Blood pressure monitoring over 12 to 24 hours is the most accurate method.
– Secondary hypertension is more common in preadolescent children.
**Management and Prevention**:
– Lifestyle modifications can significantly lower blood pressure.
– Reduction of blood pressure by 5mmHg can reduce the risk of stroke and heart disease.
– Medications like thiazide-diuretics and ACE inhibitors are used to treat hypertension.
– Stress reduction techniques and self-management strategies can help control blood pressure.
– Screening for hypertension is recommended for adults and routine measurement for children.
**Special Considerations**:
– Hypertension in pregnancy can lead to complications and increase the risk of cardiovascular disease.
– Different blood pressure targets are recommended based on age, diabetes, and kidney disease.
– Resistant hypertension may require combination therapy and addressing underlying causes.
– Refractory hypertension is associated with increased cardiovascular risks and mortality.
– Non-modulating essential hypertension is salt-sensitive and more common in men and with age.
Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. It is, however, a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide.
| Hypertension | |
|---|---|
| Other names | Arterial hypertension, high blood pressure |
 | |
| Automated arm blood pressure meter showing arterial hypertension (shown by a systolic blood pressure 158 mmHg, diastolic blood pressure 99 mmHg and heart rate of 80 beats per minute) | |
| Specialty | Cardiology |
| Symptoms | None |
| Complications | Coronary artery disease, stroke, heart failure, peripheral arterial disease, vision loss, chronic kidney disease, dementia |
| Causes | Usually lifestyle and genetic factors |
| Risk factors | Lack of sleep, excess salt, excess body weight, smoking, alcohol, air pollution |
| Diagnostic method | Resting blood pressure 130/80 or 140/90 mmHg |
| Treatment | Lifestyle changes, medications |
| Frequency | 16–37% globally |
| Deaths | 9.4 million / 18% (2010) |
High blood pressure is classified as primary (essential) hypertension or secondary hypertension. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, physical inactivity and alcohol use. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to a clearly identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.
Blood pressure is classified by two measurements, the systolic (high reading) and diastolic (lower reading) pressures. For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg) systolic and 60–80 mmHg diastolic. For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. Different numbers apply to children. Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement. Hypertension is around twice as common in diabetics.
Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. If lifestyle changes are not sufficient, then blood pressure medications are used. Up to three medications taken concurrently can control blood pressure in 90% of people. The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy. The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit and others finding unclear benefit. High blood pressure affects between 16 and 37% of the population globally. In 2010 hypertension was believed to have been a factor in 17.8% of all deaths (9.4 million globally).