Hypertension: Description, Causes and Risk Factors: Alternative Names: HBP (high blood pressure). Types: Accelerated hypertension, adrenal hypertension, benign hypertension, borderline hypertension, episodic hypertension, essential hypertension, gestational hypertension, Goldblatt hypertension, idiopathic hypertension, labile hypertension, malignant hypertension, pale hypertension, paroxysmal hypertension, portal hypertension, postpartum hypertension, pregnancy-induced hypertension, primary hypertension, pulmonary hypertension, renal hypertension, renovascular hypertension, secondary hypertension. This disease means high pressure in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. Hypertension does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "prehypertension", and a blood pressure of 140/90 or above is considered high. Causes and Risk Factors: Older Age: This disease tends to rise with age. If you are a male older than 45 or a female older than 55, your risk for the disease is higher. Isolated systolic hypertension (ISH) is the most common form of the disease in older adults. ISH occurs when only systolic blood pressure is high. About 2 out of 3 people over age 60 who have ISH.

• Race/Ethnicity: This disease can affect anyone. However, it occurs more often in African-American adults than in Caucasian or Hispanic American adults.
• Overweight or Obesity: You're more likely to develop pre-hypertension or HBP if you are overweight or obese.
• Unhealthy Lifestyle Habits: A number of lifestyle habits can raise your risk for hypertension, including:
  • Smoking.
  • Drinking too much alcohol.
  • Eating too much sodium (salt).
  • Not getting enough potassium in your diet.
  • Not doing enough physical activity.
• Family History: A family history of hypertension raises your risk for the condition. Long-lasting stress also can put you at risk for this disease. You are also more likely to develop hypertension if you have prehypertension (your blood pressure is in the 120-139/80-89 mmHg range).

Symptoms: This disease usually causes no symptoms. Even if high blood pressure does cause symptoms, the symptoms are usually mild and nonspecific (vague or suggesting many different disorders). Thus, the disease often is labeled "the silent killer." People who have the disease typically do not know it until their blood pressure is measured. Sometimes people with hypertension have the following symptoms: Headache.

• Dizziness.
• Blurred vision.
• Nausea.
• Palpitations or irregular heartbeats.
• Shortness of breath.
• Excessive sweating.
• Ringing or buzzing in ears.
• Erectile dysfunction.
• Anxiety or nervousness

Diagnosis: Medical History: During a formal chat with the patient, the doctor seeks information about the medical history of the patient's parents or relatives, as well as lifestyle habits, diet, exercise and stress. The doctor or nurse will ask the patient if he or she has ever been told they have high blood pressure; if high blood pressure runs in their family; what medications they are taking (certain prescription drugs and over-the-counter medicines can cause hypertension); if they have experienced symptoms such as sweating, palpitations, headaches, dizziness, or weight loss (which can suggest a glandular cause or, rarely, a tumor); and if there are other medical conditions. Physical Examination: Blood pressure is measured with the help of a “sphygmomanometer” (Blood Pressure Cuff) by wrapping an inflatable cuff around the patient's arm. During the physical examination, the doctor usually checks the blood pressure in both arms (rare conditions produce different blood pressures in each arm); feels the thyroid gland in the neck to see if it is enlarged or nodular; listens to the heart for "extra" heart sounds; and listens over the neck, abdomen, and groin area for sounds created by turbulent blood flow through diseased or blocked arteries. The health care specialist may also take a careful look at the back of the eyes with an ophthalmoscope, examining the small blood vessels for signs of damage from chronic high blood pressure. Imaging Studies: Echocardiogram: This painless and harmless non-invasive test uses sound waves to visualize the structure and functioning of the heart.

• Electrocardiogram (EKG): This test is used to detect the electrical activity of the heart and is used to detect and record heart related problems associated with HBP. Doppler studies can also be used to detect abnormalities in heart relaxation (diastolic dysfunction).
• Chest X-Ray: A chest x-ray can rule out (or in) the possibility of an enlarged of heart.

Other Tests: Urine Analysis: Presence of blood cells and albumin in urine indicate a damaged kidney.

• Blood Test: Cholesterol and blood sugar levels.

Treatment: Patients with hypertension should work with their doctors to set blood pressure goals based on individual risk factors. Lifestyle and medication programs need to be planned on an individual basis. Healthy life style changes are imperative for anyone, and are critical for people with even normal blood pressure (120/80 mm Hg) and above. In appropriate patients, aggressive drug treatment of long-term hypertension can significantly reduce the incidence of mental decline and death from heart disease and other serious physical effects of hypertension. In people with diabetes, controlling both blood pressure and blood glucose levels prevents serious complications of that disease. Anti-hypertensive drugs may even prevent mental decline, including in people genetically susceptible to Alzheimer's disease. Nevertheless, only slightly over half of patients with hypertension are treated at all, and only a quarter have adequately controlled pressure. Medicine and medications: Many medications known as antihypertensives are available to lower high blood pressure.

• Diuretics rid the body of excess fluids and salt (sodium) and should be used as initial therapy for most patients.
• Other medications called beta-blockers reduce the heart rate and the heart's output of blood.
• Another class of antihypertensives is called sympathetic nerve inhibitors. Sympathetic nerves go from the brain to all parts of the body, including the arteries. They can cause the arteries to constrict, raising blood pressure. This class of drugs reduces blood pressure by inhibiting these nerves from constricting blood vessels.
• Another group of drugs is the vasodilators. These can cause the muscle in the walls of the blood vessels (especially the arterioles) to relax, allowing the vessel to dilate (widen).
• Other classes of drugs used to treat high blood pressure are the angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers and the calcium antagonists (calcium channel blockers). The ACE inhibitors interfere with the body's production of angiotensin, a chemical that causes the arteries to constrict. The angiotensin II receptor blockers block the effects of angiotensin. The calcium antagonists can reduce the heart rate and relax blood vessels.

Everyone with the disease does not need to be treated with the drugs listed here. Some people may do just as well by reducing weight, eating properly and getting the right amount of physical activity. Don't insist that your doctor use a certain drug because you've read or heard about its effect on other people. You can have a serious side effect if you take a "wonder drug" that isn't right for you. Let your doctor decide what drug, if any, to use. If your doctor recommends medication, remember that people respond very differently to these medications. That's why you might have to go through a trial period to find out which medications work best with the fewest side effects. Your blood pressure is only lowered while you are taking these medications. That's why medication can't be stopped, in most cases, even after blood pressure is lowered. Some treatment must be continued over a lifetime for good results. Treating this disease may require lots of time, patience and care by both doctor and patient. It may be annoying to take pills and possibly have side effects, especially if you felt fine before treatment. Do not be discouraged if you must be treated indefinitely. Some people can reduce their drug dosages after achieving normal blood pressure and maintaining it for a year or more. (You usually can't stop treatment entirely). Coping with the inconvenience of medication is still much better than suffering a stroke or heart attack. Most people who are treated successfully live a long and healthy life. Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.