Hypertension is a serious cause of illness, mortality and a cost to society. There is good evidence that hypertension is inheritable, although the precise genetic pattern is not known. Many studies have also confirmed a positive correlation between body weight and high blood pressure. Patients who lose weight can reduce their blood pressure. The pathophysiological mechanisms under scrutiny currently involve: a) Salt sensitivity, b) Rennin-angiotensin-aldosteron system and c) Sympathetic nervous system.

There is no universal agreement on the definition of hypertension, but most authorities accept that an “at rest” sustained blood pressure of more than 140/90 mmHg is a borderline hypertension. Furthermore, diastolic pressure between, 95 and 104 mmHg is categorized mild, 105 and 114 mmHg is categorized moderate and 115 mmHg and above severe. Up to 90% of people who have elevated blood pressure have no obvious cause for their condition. However, the key feature in all patients is an increased total peripheral vascular resistance.

Hypertension has also been classified according to the clinical and pathological consequences of the blood pressure elevation. Essential or benign is often without symptoms. Malignant hypertension needs prompt treatment as it is a serious condition and can cause organ damage or risk of sudden death cerebral hemorrhage if left untreated.

Benign hypertension produces hypertrophy of the left ventricle due to increased cardiac overload and peripheral vascular resistance. Longstanding hypertension creates disease of small arteries and the development of atherosclerosis. There are a number of other diseases that precipitated or accelerated by hypertension such as aortic aneurysm and cerebral hemorrhage.

Malignant hypertension is a pathological syndrome that present a marked raise of diastolic blood pressure over 130 – 140 mmHg, leading progressively to renal disease. Malignant hypertension can occur in previously fit individuals, but in most cases occur in individuals with benign hypertension. Consequences of malignant hypertension include: Ventricular (left) hypertrophy, cardiac failure, retinal hemorrhage, blurred vision, blood in the urine, kidney failure, cerebral hemorrhage and severe headaches.

Hypertension may result from several other underlying conditions such as: Renal hypertension – the possibility of renal disease should be considered with every patient with hypertension. Endocrine causes – Cushing's syndrome adrenal tumors can cause hypertension but are not common. Aorta problems (coarctation) – hypertension is one of the common features here. Death can result from cardiac failure, aneurysm or cerebral hemorrhage. Drug therapy – many drugs such as anti-inflammatory, corticosteroids, some non-steroidal drugs and the contraceptive pill can induce hypertension. Age – A progressive rise in blood pressure with increasing age is observed.

Regulation of normal blood pressure is a complex process. An accurate measurement of blood pressure is the key to diagnosis. Several options and most importantly such as medication and lifestyle changes- weight bearing exercise such as walking for 30 minutes four to five days a week, practice meditation and Thi-Chi and quit smoking. Embrace a diet that includes foods rich in potassium, magnesium and calcium to help with blood regulation and prevent or treat vascular disease. Additionally, some natural blood pressure remedies and supplements such coenzyme Q10, garlic supplements, hawthorn supplements and folic acid may help in the reduction of high blood pressure in some patients.

Michael Russell
Your Independent guide to Hypertension

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