Hypertension

Overview

Hypertension is when the blood pressure rise persistently beyond 140/90 mmHg taken at least twice on two separate occasions. This shows that the pressure inside the arteries are elevated and this may cause harm to the arteries and make the heart pump harder.

Signs and Symptoms

Asymptomatic usually, Shortness of breath , Chest pain, Severe headache, Dizziness, Confusion, Fatigue, Irregular heartbeat, Blood or protein in the urine, Vision changes or vision loss

Common Causes

Primary/ Essential hypertension : No known cause Secondary cause: Thyroid disease, Kidney disease, Obstructive sleep apnea, Renovascular disease, Primary Aldosteronism, Adrenal gland tumours, Congenital defects in the blood vessels, Usage of certain medications such as oral contraceptive pills and decongestants, Use of illegal drugs such as amphetamines and cocaine

Risk Factors

Increasing age, High sodium diet, Lack of exercise, Being overweight or obese, Family history of hypertension, Microalbuminuria/Proteinuria, Estimated GFR <60 mL/min/m2 Smoking or exposure to secondhand smoke, Excessive alcohol intake , Some medical conditions such as diabetes, kidney disease, and obstructive sleep apnea

Investigation Techniques

Medical history, Physical examination, Ambulatory (24-hour) blood pressure monitoring, Home blood pressure monitoring, Blood test including cholesterol test, Urinalysis to look for signs of kidney disease, Electrocardiogram to measure electrical activity of the heart, Echocardiogram to check for signs of heart complications

Treatment and Prevention

Lifestyle changes such as eating a healthy diet and exercising regularly, Oral medications such as angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers, diuretics, alpha blockers, alpha-beta blockers, aldosterone antagonists, renin inhibitors, vasodilators, central-acting agents, Treat underlying cause

Psychological Issues

Stress