Hypertension: Classification, Signs and Symptoms and Complications.

Hypertension: Classification, Signs and Symptoms and Complications.



The term hypertension is made up of 2 words "Hyper" and "Tension"-

Hyper- excessive

Tension- Stress or pressure

It is also termed as high blood pressure. This is a long term medical condition where blood pressure is constantly elevated. As Blood Pressure is usually elevated in atrium; it is also known as atrial hypertension.

Definition-

The term hypertension refers to elevation in systolic and diastolic blood pressure above the normal for the particular age, sex, and environment. Person having systolic blood pressure of 140 mm of Hg or high and diastolic blood pressure 90 mm Hg or higher is termed as Hypertension. 
The term blood pressure refers to  the amount of blood the heart pumps and amount of resistance provided to blood flow in arteries.
More the blood pumped to the narrow arteries more is the blood pressure. Hypertension is one of the major cause of cardiovascular diseases.
Hypertension results due to either increased cardiac output or increased peripheral resistance.

Classification- (on the basis of severity)

(Ranges of Blood Pressure on the basis of severity)

Types of Hypertension-

Hypertension is classified into two-
1. Essential Hypertension
2. Secondary Hypertension

  • Essential Hypertension or Primary Hypertension-

About 90-95% cases of hypertension are of primary hypertension.
Causes-   
1. Genetic Factors
2. Racial and Environmental factor
3. Risk factors

Risk factor predisposing factors include-

1. Age and sex- BP rises with age in both sexes. However men are more prone to have high BP than female.
Normally on an average adult BP is 120/80 mm of Hg. Rise of about 20 mm Hg systolic and 10 mm of Hg diastolic in age group of 35 to 65 yrs is common.
2. Obesity- With increase in body weight BP tends to rise 70% of hypertension in males and 61% hypertension in females are due to abdominal obesity.
3. Smoking- Smoking and tobacco chewing are associated with rise in BP.
4. Socio economic factor- In developing countries high prevalence is seen in high socio economic group, while in developed countries it is higher in low socio-economic group.
5. Physical inactivity- Sedentary life increases the risk of hypertension.
6. High salt diet- High salt intake increases the risk of hypertension.
7. Alcohol intake- Excessive alcohol consumption is associated with with high BP.

  • Secondary Hypertension-

It constitute only 10% of total hypertension due to an identifiable cause and is treatable.

Causes-

1. Renal hypertension-
  • Reno vascular diseases
  • Renal parenchymal diseases(glomerulonephritis, Diabetic Nephropathy)
2. Endocrine hypertension-
  • Excessive intake of oral contraceptive pills.
  • Cushing’s syndrome
  • Pheocromocytoma
  • Primary aldosteronism
  • Hyperthyroidism, Hypothyroidism
3. Other Causes-
  • Coarctation of aorta
  • Polyartritis
  • Neurogenic 
  • Drugs include e.g. Cyclosporine
  • Obesity
  • Pregnancy

Signs and Symptoms



Hypertension is usually identified accidently for other problems.
Main signs and symptoms are-
1. Headache- Persistent headache is the prime and alarming sign. Early morning headache localized to occipital region.
2. Blurred or double vision
3. Vertigo
4. Tinnitus
5. Shortness of breath
6. Fatigue or confusion
7. Chest pain
8. Irregular heart beat
9. Fainting episodes

Complications of Hypertension

Long term Hypertension is a major risk factor for many diseases like:
1. Coronary artery diseases
2. Stroke
3. Heart failure
4. Peripheral vascular disease
5. Retinopathy
6. Renal diseases, renal failure

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