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مُساهمةموضوع: Hypertension   Hypertension Emptyالجمعة 17 أكتوبر 2008, 22:04

Alternative names



High blood pressure




Definition




Hypertension means high blood pressure. This generally




means:




Systolic blood pressure is consistently over 140 (systolic is the "top"
number of your blood pressure measurement, which represents the
pressure generated when the heart beats)


Diastolic blood pressure is consistently over 90 (diastolic is the
"bottom" number of your blood pressure measurement, which represents
the pressure in the vessels when the heart is at rest)


Either or both of these numbers may be too high.




Pre-hypertension is when your systolic blood pressure is between 120
and 139 or your diastolic blood pressure is between 80 and 89 on
multiple readings. If you have pre-hypertension, you are likely to
develop high blood pressure at some point. Therefore, your doctor will
recommend lifestyle changes to bring your blood pressure down to normal
range.




Causes, incidence, and risk factors




Blood pressure is determined by the amount of blood pumped by the
heart, and the size and condition of the arteries. Many other factors
can affect blood pressure, including volume of water in the body; salt
content of the body; condition of the kidneys, nervous system, or blood
vessels; and levels of various hormones in the body.




Essential hypertension has no identifiable cause. It may be caused by
genetics, environmental factors, or even diet, such as how much salt
you use.




"Secondary" hypertension is high blood pressure caused by




another disorder. This may include:




adrenal gland tumors


Cushing's syndrome


kidney disorders


glomerulonephritis (inflammation of kidneys)


renal vascular obstruction or narrowing


renal failure


use of medications, drugs, or other chemicals


oral contraceptives


hemolytic-uremic syndrome


Henoch-Schonlein purpura


periarteritis nodosa


radiation enteritis


retroperitoneal fibrosis


Wilms' tumor




Symptoms




Usually, no symptoms are present. Occasionally, you may experience a
mild headache. If your headache is severe, or if you experience any of
the symptoms below, you must be seen by a doctor right away. These may
be a sign of dangerously high blood pressure (called malignant
hypertension) or a complication from high blood pressure.




tiredness


confusion


vision changes


angina-like chest pain (crushing chest pain)


heart failure


blood in urine


nosebleed


irregular heartbeat


ear noise or buzzing




Signs and tests




Hypertension may be suspected when the blood pressure is high at any
single measurement. It is confirmed through blood pressure measurements
that are repeated over time. Blood pressure consistently elevated over
140 systolic or 90 diastolic is called hypertension. Your doctor will
look for signs of complications to your heart, kidneys, eyes, and other
organs in your body.




Systolic blood pressure consistently between 120 and 139 or diastolic
blood pressure consistently between 80 and 89 is called
pre-hypertension. Your doctor will recommend and encourage lifestyle
changes including weight loss, exercise, and nutritional changes.




Tests for suspected causes and complications may be performed. These
are guided by the symptoms presented, history, and results of
examination.




Treatment




The goal of treatment is to reduce blood pressure to a level where
there is decreased risk of complications. Treatment may occur at home
with close supervision by the health care provider, or may occur in the
hospital.




Medications may include diuretics, beta-blockers, calcium channel
blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin
receptor blockers (ARBs), or alpha blockers. Medications such as
hydralazine, minoxidil, diazoxide, or nitroprusside may be required if
the blood pressure is very high.




Have your blood pressure checked at regular intervals (as often as recommended by your doctor.)




Lifestyle changes may reduce high blood pressure, including weight loss, exercise, and dietary adjustments .




Expectations (prognosis)




Hypertension is controllable with treatment. It requires lifelong
monitoring, and the treatment may require adjustments periodically.




Complications




hypertensive heart disease


heart attacks


congestive heart failure


blood vessel damage (arteriosclerosis)


aortic dissection


kidney damage


kidney failure


stroke


brain damage


loss of vision




Calling your health care provider




Even if you have not been diagnosed with high blood pressure, it is
important to have your blood pressure checked at annual exams,
especially if you have a history of high blood pressure in your family.




If you have high blood pressure, you will have regularly scheduled appointments with your doctor.




In between appointments, if you have any of the symptoms listed below
or your blood pressure remains high even with treatment (this assumes
the use of a home blood pressure monitor), then call your doctor right
away.




Severe headache


Excessive tiredness


Confusion


Visual changes


Nausea and vomiting


Chest pain


Shortness of breath


Significant sweating




Prevention




Lifestyle changes may help control high blood pressure:




Lose weight if you are overweight. Excess weight adds to strain on the
heart. In some cases, weight loss may be the only treatment needed.


Exercise to help your heart.


Adjust your diet as needed. Decrease fat and sodium -- salt, MSG, and
baking soda all contain sodium. Increase fruits, vegetables, and fiber.


Follow your health care provider's recommendations to modify, treat, or control possible causes of secondary hypertension
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مُساهمةموضوع: رد: Hypertension   Hypertension Emptyالإثنين 27 أكتوبر 2008, 16:54


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مُساهمةموضوع: رد: Hypertension   Hypertension Emptyالثلاثاء 16 ديسمبر 2008, 00:03

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اقتباس :
Hypertension
I INTRODUCTION

Hypertension or High Blood Pressure, medical condition in which constricted arterial blood vessels increase the resistance to blood flow, causing an increase in blood pressure against vessel walls. The heart must work harder to pump blood through the narrowed arteries. If the condition persists, damage to the heart and blood vessels is likely, increasing the risk for stroke, heart attack, and kidney or heart failure. Often called the “silent killer,” hypertension usually causes no symptoms until it reaches a life-threatening stage.

Hypertension affects 20 percent of people living in the United States. Of these, almost a third are unaware of their condition. Until the age of 55, more men than women have hypertension. After that age, the condition becomes more prevalent in women. Hypertension is significantly more common in African Americans of both sexes than in other racial or ethnic groups.

Physicians use two measurements to describe blood pressure. Systolic pressure measures blood pressure as the heart contracts to pump out blood. Diastolic pressure measures blood pressure as the heart relaxes to allow blood to flow into the heart. An instrument called a sphygmomanometer measures systolic and diastolic pressure using units of millimeters of mercury (abbreviated mm Hg).

Blood pressure is classified in four categories: normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. Normal blood pressure in an adult is less than 120/80 mm Hg, in which 120 describes systolic pressure and 80 describes diastolic pressure. Prehypertension is defined as a systolic pressure of 120 to 139 mm Hg or a diastolic pressure of 80 to 89 mm Hg. People with prehypertension are likely to develop hypertension at some point during their life. Stage 1 hypertension is defined as a systolic pressure of 140 to 159 mm Hg or a diastolic pressure of 90 to 99 mm Hg. Stage 2 hypertension is defined as 160/100 mm Hg or higher.

II HOW HYPERTENSION DEVELOPS

Two factors determine blood pressure: the amount of blood the heart pumps and the diameter of the arteries receiving blood from the heart. When the arteries narrow, they increase the resistance to blood flow. The heart works harder to pump more blood to make sure the same amount of blood circulates to all the body tissues. The more blood the heart pumps and the smaller the arteries, the higher the blood pressure.

The kidneys play a major role in the regulation of blood pressure. Kidneys secrete the hormone renin, which causes arteries to contract, thereby raising blood pressure. The kidneys also control the fluid volume of blood, either by retaining salt or excreting salt into urine. When kidneys retain salt in the bloodstream, the salt attracts water, increasing the fluid volume of blood. As a higher volume of blood passes through arteries, it increases blood pressure.

Scientists do not fully understand the causes of hypertension. In up to 95 percent of cases no clear cause can be identified. This type of high blood pressure is known as essential hypertension, and scientists suspect that genetic factors may play a role in its development. In about 5 percent of cases high blood pressure develops as a result of another medical disorder, such as kidney or liver disease, or as a side effect of certain medications. This type of high blood pressure is known as secondary hypertension. Other factors that may contribute to elevated blood pressure in some people include a diet high in salt, physical inactivity, obesity, and heavy alcohol consumption.

III COMPLICATIONS

If hypertension is not detected and treated, life-threatening complications develop over a course of years. Increased pressure on the inner walls of blood vessels makes the vessels less flexible over time and more vulnerable to the buildup of fatty deposits in a process known as atherosclerosis (see Arteriosclerosis). Weakened portions of the blood vessel wall may balloon, forming an aneurysm. If an aneurysm ruptures, internal hemorrhaging (bleeding) results. Both atherosclerosis and a ruptured aneurysm in the brain can lead to a stroke.

Hypertension forces the heart to work harder to pump adequate blood throughout the body. This extra work causes the muscles of the heart to enlarge, and eventually the enlarged heart becomes inefficient in pumping blood. An enlarged heart may lead to heart failure, in which the heart can not pump enough blood to meet the body’s needs.

Increased blood pressure may damage the small blood vessels within the kidney. The kidney then becomes unable to filter blood efficiently, and waste products may build up in the blood in a condition known as uremia. Without medical treatment, kidney failure will result.

IV TREATMENT

Physicians recommend that people with prehypertension undergo diet and lifestyle changes, such as losing weight and quitting smoking, in order to prevent a rise in blood pressure. Some patients can lower their blood pressure by limiting salt in their diet. Increasing physical activity and reducing alcohol consumption to less than two drinks per day for men and one drink per day for women may also lower blood pressure.

For those with stage 1 and stage 2 hypertension, a physician may prescribe diet and lifestyle changes, as well as one or more drugs known as antihypertensives. Diuretics are antihypertensives that promote excess salt and water excretion, reducing the amount of fluid in the bloodstream and relieving pressure on blood vessel walls. Beta blockers reduce heart rate and the amount of blood the heart pumps. ACE inhibitors prevent the narrowing of blood vessel walls to control blood pressure. Calcium channel blockers slow heart rate and relax blood vessels. Studies show that two drugs are more effective than one drug at lowering blood pressure to less than 140/90 mm Hg.

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مُساهمةموضوع: رد: Hypertension   Hypertension Emptyالثلاثاء 16 ديسمبر 2008, 00:08

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مُساهمةموضوع: رد: Hypertension   Hypertension Emptyالإثنين 05 يناير 2009, 21:36

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مُساهمةموضوع: رد: Hypertension   Hypertension Emptyالثلاثاء 06 يناير 2009, 10:54

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