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HYPERTENSIONKongxiangqingMD
DEFINITIONNormalbloodpressureincreaseswithageandvariesthroughoutthedayaccordingtofactorssuchasstressandexertion.Thedefinitionofhypertensionthereforeisthatlevelofbloodpressureassociatedwithanincreasedriskofcomplications.
BloodPressureClassification80and120Normal80~89or120~139Prehypertension90~99or140~159Stage1Hypertension100or160Stage2HypertensionDBPmmHgSBPmmHgBPClassification
CauseofhypertensionOver95%casesofhypertensionareidiopathicandthisistermedprimaryhypertension,oressentialhypertension.Secondarycausesofhypertension,althoughrareareimportanttoexcludebecausetheymaybecurable.
CauseofsecondaryhypertensionClassificationofcauseexamplerenalRenalvasculardisease,renin-producingtumorsendocrineAdrenal—Cushing’ssyndrome,congenitaladrenalhyperplasiaHyper-orhypothyrodismOralcontraceptivepillAcromegalycarcinoidvascularCoarctationoftheaortadrugsOralcontraceptivepills,corticosteroids,monoamineoxidaseinhibitorpregnancyPregnancyinducedhypertensionneurologicalIncreasedintracranialpressure,sleepapnoea,acuteporphyriaalcoholAcommoncause
MechanismNosingleorspecificcauseisknownformosthypertension.Multiplefactorsmayaffectthedevelopmentofhypertension.
RiskfactorsforhypertensionGeneticalteration:cellmembranealterationEnvironmentchanges:excesssodiumintakestress(overactivityofsympathety)obesityendotheliumderivedfactorsreducednephronnumber
ComplicationsofhypertensionIschemicheartdiseaseCardiacfailureLVhypertrophyCerebrovasculardiseasePeropheralvasculardiseaseRenalimpairmentHypertensiveretinopathy
Heartdamage
Braindamage
PresentingcomplaintHypertensivepatientsareoftenasymptomatic.Occasionallytheycomplainheadaches,tinnitus,recurrentepistaxis,ordizziness.Complicationsofhypertension:chestpain,visualdisturbance,ankleedema,etc.
Historyrelatedtohypertens
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