Hypertension

Hypertension is increase in blood pressure above normal blood pressure. Normal systolic blood pressure is 120mmHg and diastolic blood pressure is 80mmHg. Therefore, normal blood pressure is 120/80mmHg. In hypertension it is more than 120/80mmHg.

Types-

1.      Primary or essential hypertension.

2.      Secondary hypertension.
 

1.      Primary or essential hypertension-
In primary or essential hypertension the cause of hypertension is unknown and 70% of cases have positive family history.

2.      Secondary hypertension-
Secondary hypertension occurs in 15% of cases only. In it the cause is known. Secondary hypertension occurs due to or as a result of a specific disease or abnormality.

Causes-

1.      Coarctation of aorta.
2.      Renal dysfunction like glomerulonephritis, chronic pyelonephritis, renal artery stenosis.
3.      Cushing’s syndrome, acromegaly, hyperthyroidism, congenital adrenal hyperplasia.
4.      Alcoholism.
5.      Side effects of some medicines.
6.      Atherosclerosis.
7.      Aortic regurgitation.
8.      Thyrotoxicosis.
9.      Smoking.
10.  Obesity.
11.  Hyperlipidaemia.
12.  Diabetes mellitus.
13.  Ischaemic heart disease.

Symptoms-

1.      Headache and polyuria.
2.      Usually hypertension is asymptomatic and detected only on routine blood pressure checkup. In acute cases, there may be present headache and vertigo along with hypertension.
3.      Left ventricular hypertrophy in long standing or chronic cases.
4.      Left atrial hypertrophy.
5.      Fourth heart sound.

Investigations-

1.      Routine blood pressure checkup.
2.      Urine test.
3.      Fasting blood glucose test.
4.      Renal function test.
5.      Lipid profile test.
6.      Serum calcium and uric acid.
7.      ECG test.
8.      Chest x-ray test.
9.      T₃, T₄, TSH tests.

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