What is hypertension (high blood pressure)? Its types, causes, symptoms and treatment

What is hypertension? Its types, causes, symptoms and treatment :
high blood pressure or sudden rise of bp is generally referred as hypertension. It is most dangerous because it couses of Congestive heart failure, heart attack, Ischemic heart disease, Antheothrombotic stroke, and sudden death.

Hypertension is the (rise of BP) is one of the common cardio vascular disorder of modern times. The normal arterial blood pressure (BP) of an adult is 100-120 mm Hg in systolic and 70-80mm Hg diastolic which is based on cardiac output and peripheral resistance. BP aslo change with the age, state of health and condition under which it is measured.

According to WHO, hypertension is the state of the body in which Systolic blood and is 150 mmHg or more and diastolic blood pressure(BP) is 95 mmHg or more. If one applied strictly WHO definition, one-third of men and two-fifth of women over 40 years of are hypertensive because as age advances, there is pari-passu increase in Blood pressure.when the body fails to adjust the BP on a change of posture i.e. from a horizontal to an erect position, the BP falls. This is known as hypotension or low blood pressure, but in certain conditions, the blood pressure (bp) is persistently raised and if it is more than 140/95 mmHg, the condition is known as hypertension.

hypertension (high blood pressure)- Its types, causes, symptoms and treatment

Epidemiology of hypertension (Blood pressure)

The incident depends on age, race, and gender. Blacks at any age have twice the incidence of hypertension as Caucasians. hypertension is slightly more common in males than in females. Individuals with family history of hypertension are at considerably greater risk of developing high blood pressure and its complications suggesting a genetic transmission of the disease. Other factors strongly associated with high blood pressure are obesity and excessive salt ingestion.

What are blood pressure range?


The blood pressure range is divided into six categories these are :
1. Hypotension
Systolic = 90 or less
Diastolic = 60 or less

2. Medium
Systolic = 90-119
Diastolic = 61-79

3. Pre-hypertension
Systolic = 120-139

Diastolic = 80-89

4. Hypertension stage I
Systolic = 140-159
Diastolic = 90-99

5. Hypertension Stage 2
Systolic = 160 or more
Diastolic = 100 or more

6. Isolated systolic hypertension : High systolic pressure only.

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    Types of hypertension

    There are two major types of hypertension.
    1. Primary or essential hypertension.
    2. Secondary hypertension.

    1. Primary or essential hypertension = Primary or essential hypertension is the first type of hypertension where definite reason for the rise in blood pressure (BP) is unknown.
    This means hypertension of unknown causes. It accounts for 95% of all cases and is subdivided according to the rate at which the disease progresses.

    i. Benign (Chronic) hypertension

    The rise of blood pressure is usually partial to moderate and continues to rise gradually over many years. Sometimes complications, such as heart failure, cerebrovascular accident or myocardial infarction are the first indication of hypertension, but often the condition is symptomless and is only discovered during a routine examination.

    ii. This is quick and aggressive acceleration of hypertensive disease. Diastolic pressure in excess of 120 mmHg is common. The effects are serious and rapidly become apparent. e.g., hemorrhages into the retina, papilloedema (Oedema around the optic disc), encephalopathy and progressive renal disease, leading to cardiac failure.

    2. Secondary hypertension = In secondary hypertension reason for the rise in blood pressure (BP) is known and can be identified in about 6-10% of those with hypertension.
    Secondary hypertension is usually curable.

    What are the main causes of blood pressure (BP) or hypertension?

    As you know causes of primary (essential) type of hypertension is still unknown, About 80 to 90% cases of hypertension belong to primary type of hypertension. Common disorder which causing hypertension are as follows :

    1. Acute or chronic Renal disease –
    -A. Renoparenchymal disease,
    -B. Renovascular disease,
    2. Coarctation of the aorta,
    3. Primary aldosteronism,
    4. Cushing’s syndrome,
    5. Pheochromocytoma,
    6. Latrogenic hypertension,
    7. Renal artery stenosis (atheroma in older age group and fibromuscular hyperplasia in younger age group.

    Causes of hypertension (blood pressure BP)
    Secondary hypertension is the type where etiology is known are :

    A. Genetic (family history of vascular disease),
    B. obesity and glucose intolerance,
    C. High salt intake,
    D. Cigarette smoking,
    E. Hyperlipdaemia,
    F. Increased serum renin levels,
    G. Hypersensitivity of sympathetic system,

    What are the symptoms of hypertension

    The list of signs and symptoms of high blood pressure (BP) are given below :

    1. No Symptoms : Many people are unware they have hypertension until it is accidentally found at a doctor visit or they develop complications of hypertension.
    2. Non-specific symptoms : symptoms of hypertension may be mild and vague.
    3. Headache,
    4. Morning headache,
    5. Tinnitus – Ringing and buzzing in eard,
    6. Dizziness,
    7. Confusion,
    8. Papilloedema,
    9. High blood pressure,
    10. Fatigue etc.

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    Pathophysiology of hypertension.

    Arterial blood pressure is a highly integrated and complex system regulated by a number of variables. It allows blood pressure to remain within a relatively constant range despite change in posture and wide variations in the demand of blood. Blood pressure is dependent on both cardiac output (CO) and peripheral resistance (PR). Mean arterial pressure (MAP) equals cardiac output (CO) times total peripheral resistance (TPR).

    MAP = CO x TPR

    Cardiac output is in turn defined as the volume of blood in litres pumped by the heart per minut. Its a function of both stroke volume (SV) and heart rate (HR). Thus :
    MAP = SV x HR x TPR

    If any of those factor are increased, an elevation of Blood pressure will result. However in the chronic stage hypertension appears to be principally a disease of increased peripheral resistance resulting in the elevation of both systolic and diastolic blood pressure.

    A variety of humoral changes have been implicated in essential hypertension; among the most important of these are the renin-an-giotensin system, antidiuretic hormonal prostaglandins and the kallik-rein/kinin system. The renin angioensin system (RAS) has arisen from a academical interesting but obscure regulatory mechanism to an important hormonal pathway known to play a key role in the regulation of cardiovascular homeostasis and Na+ balance in normal and hypertensive subject. This system include the following components and source.

    Renin is synthesized by the kidneys and secreted into the circulation where it cleavesthe decapeptide angitensin I from anagiotensinogen until it is cleared by the liver. Angiotensin I is converted to the pctapep-tide angiotensin II by angiotensin converting enzymes (ACE), an enzyme found in high concentrations in the pulmonary vascular bed. The active hormone of RAS is angiotensin II, the action of which are thought to be mediated by specific receptors located on various target organs e.g. Adrenal, cortex, kidney, arterioles and sympathetic nerve endings.

    What are the treatment of hypertension (blood pressure)

    1. Change lifestyle to treat blood pressure.

    Changing your lifestyle and daily routine will reduce high blood pressure. Some points are given below which you will apply you blood pressure will reduce.

    1. Calculate your weight from BMI calculator. If BMI shows obese or overweight then reduce some of body fat, and loss weight.

    2. If you intake nicotine by smoking. Quit it.

    3. Alcohol is good for body, but too much of alcohol rise many problems. So be limited while drinking.

    4. Eat natural food like fruit, vegetable, greens and low fat dairy products.

    5. Do exercise daily. Walk at least 20 minutes in garden with naked foot. Morning walk will also help you to balance blood pressure.

    2. Treatment by the drugs: (Antihypertensive drugs)

    Some of drugs are given below which treat the hypertension.
    These drugs are divided into 7 categories according to their site if actions.
    These are :

    1. Angiotensin converting enzyme (ACE) inhibitors.

  • a. Captopril
  • b. Enalapril
  • c. Lisinopril
  • d. Perindopril
  • e. Ramipril

    2. Angiotensin (AT¹) Antagonists.

  • a. Losartan
  • b. Candesartan
  • c. Irbesartan

    3. Calcium Channel Blocker

  • a. Verapamil
  • b. Diltiazem
  • c. Nifedipine
  • d. Lelodipine
  • e. Amlodipine
  • f. Nitrendipine
  • g. Lacidipine

    4. Diuretics

    A. Thiazides

  • a. Hydrochlorothiazide
  • b. Chlorthalidone
  • c. Indapamide

    B. High ceilings :

  • a. Furosemide.

    C. Potassium (K+) Sparing

  • a. Spironolactone
  • b. Triamterene
  • c. Amiloride

    5. Beta Adrenergic Blocker

  • a. Propranolol
  • b. Metoprolol
  • c. Atenolol

    6. Beta + alpha blocker

  • a. Labetalol
  • b. Carvedilol

    7. Alpha Adrenergic Blocker

  • a. Prazosin
  • b. Terazosin
  • c. Doxazosin
  • d. Phentolamine
  • e. Phenoxybenzamie

    8. Centralsympathetics

  • a. Clonidine
  • b. Methyldopa

    Note: This drugs list are given for educational and informational purpose only. consult with your doctor before administrating any drugs.

    So that was the information about what is hypertension? types, causes, symptoms and treatments of hypertension/blood pressure.
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