Hypertension - Causes and Symptoms

Systemic Hypertension or High Blood pressure

Hypertension is a very common disease in developed countries and is a growing problem in developing countries. The overall prevalence in Europe is 44 000 per 100 000 (that is 44% of the entire population) and both sexes are affected equally. The prevalence increases with age from 27% in 35-44-year-olds to 78% in those aged between 65 and 74 years.

Causes of high blood pressure

An underlying cause is established in less than 10% and most patients will be classified with essential hypertension. Pathological changes associated with chronic sustained hypertension are hyaline and hyperplastic arteriolosclerosis.

Sometimes these underlying diseases cause hypertension-

Renal or Kidney diseases causing high blood pressure
Renal parenchymal diseases (glomerulonephritis)
Renal artery stenosis
Chronic pyelonephritis
Polycystic kidney disease
Connective tissue disease (systemic sclerosis)
Diabetic nephropathy

Endocrine diseases causing high blood pressure
Adrenal
Conn's syndrome
Phaeochromocytoma

Cushing's syndrome

Acromegaly

Drugs diseases causing high blood pressure
Glucocorticoids (corticosteroids)
Mineralocorticoids (liquorice)
Monoamine oxidase inhibitors and tyramine
Sympathomimetic agents (salbutamol)

Cardiovascular diseases causing high blood pressure
Coarctation of the aorta




Usual complications of high blood pressure:

Hypertension is a major risk factor for atherosclerosis. Complications involve the eye (hypertensive and arteriosclerotic retinopathy), heart (coronary heart disease, heart failure), brain (stroke) and kidney (nephrosclerosis and hypertensive renal disease).

Symptoms of high blood pressure or, hypertension:

Uncomplicated essential hypertension is asymptomatic and is identified during the course of routine physical examination. Patients with secondary hypertension, however, may complain of symptoms from the underlying disorder. A detailed drug history should reveal any offending drug that can cause hypertension.

In addition to establishing the diagnosis of hypertension (sustained rise in blood pressure above 140/90 mmHg on three or more readings, each at least a week apart), a detailed clinical assessment will also screen for any evidence of complications and attempt to ascertain any underlying cause as mentioned earlier in the article.

Causes and Symptoms of Hypertension
Investigations and Treatment of Hypertension
Choice of drug therapy in hypertension