What is High Blood Pressure?
What is High Blood Pressure?

Hypertension (HTN) or high blood pressure (HBP) is a chronic medical condition in which the systemic arterial blood pressure is elevated.

Symptoms

headache
drowsiness
confusion
vision disorders
nausea
vomiting

Causes

Essential hypertension is the most prevalent hypertension type. Although no direct cause has identified itself, there are many factors such as sedentary lifestyle, smoking, stress, visceral obesity, potassium deficiency (hypokalemia), obesity, salt (sodium) sensitivity, alcohol intake, and vitamin D deficiency that increase the risk of developing hypertension. Risk also increases with aging, some inherited genetic mutations, and having a family history of hypertension. An elevation of renin, a hormone secreted by the kidney, is another risk factor, as is sympathetic nervous system over activity. Insulin resistance which is a component of syndrome X, or the metabolic syndrome is also thought to contribute to hypertension. Recent studies have implicated low birth weight as a risk factor for adult essential hypertension.

Secondary hypertension by definition results from an identifiable cause. This type is important to recognize since it's treated differently to essential hypertension, by treating the underlying cause of the elevated blood pressure. Hypertension results in the compromise or imbalance of the pathophysiological mechanisms, such as the hormone-regulating endocrine system, that regulate blood plasma volume and heart function. Many conditions cause hypertension; some are common and well recognized secondary causes such as Cushing's syndrome, which is a condition where the adrenal glands overproduce the hormone cortisol. In addition, hypertension is caused by other conditions that cause hormone changes such as hyperthyroidism, hypothyroidism (citation needed), and certain tumors of the adrenal medulla (e.g., pheochromocytoma). Other common causes of secondary hypertension include kidney disease, obesity/metabolic disorder, pre-eclampsia during pregnancy, the congenital defect known as coarctation of the aorta, and certain prescription and illegal drugs.

Western Medicine Treatment

Lifestyle modifications. The first line of treatment for hypertension is the same as the recommended preventative lifestyle changes such as the dietary changes, physical exercise, and weight loss, which have all been shown to significantly reduce blood pressure in people with hypertension. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still
recommended in conjunction with medication. Drug prescription should take into account the patient's absolute cardiovascular risk (including risk of myocardial infarction and stroke) as well as blood pressure readings, in order to gain a more accurate picture of the patient's cardiovascular profile. Different programs aimed to reduce psychological stress such as biofeedback, relaxation or meditation. Regarding dietary changes, a low sodium diet is beneficial.

Medications. Several classes of medications, collectively referred to as antihypertensive drugs, are currently available for treating hypertension. Agents within a particular class generally share a similar pharmacologic mechanism of action, and in many cases have an affinity for similar cellular receptors. An exception to this rule is the diuretics, which are grouped together for the sake of simplicity but actually exert their effects by a number of different mechanisms. Often multiple drugs are combined to achieve the goal blood pressure. Commonly used prescription drugs include:

ACE inhibitors
Alpha blockers
Angiotensin II receptor antagonists
Beta blockers
Calcium channel blockers
Diuretics
Direct renin inhibitors

Some examples of common combined prescription drug treatments include:

A fixed combination of an ACE inhibitor and a calcium channel blocker. One example of this is the combination of perindopril and amlodipine, the efficacy of which has been demonstrated in individuals with glucose intolerance or metabolic syndrome.

A fixed combination of a diuretic and an ARB. In the elderly treating moderate to severe high blood pressure decreases death rates in those under 80 years of age however there is no decrease in those over 80 years old. Even though there was no decrease in total mortality, the results showed similarities between cardiovascular mortality and morbidity.

Adopted from Wei Laboratories, Inc.