What Is Hypertension?

Hypertension is the medical name for high blood pressure. The term “blood pressure” is used to describe the pressure within the arterial walls that moves blood from the heart and around the body. When the arterial walls narrow, it makes it harder for the blood to flow through them. The heart has to pump harder to get the blood flowing through and increases the blood pressure, hence the name high blood pressure.

Hypertension is a common medical condition and the most chronic condition in the United States, affecting about twenty-five percent of the adult population. Because hypertension causes very few symptoms, a considerable amount of people have hypertension and do not know it until it has reached a progressive state. This is why it is so important to have your blood pressure checked on a regular basis. But once you are diagnosed with hypertension, you will have it for the rest of your life and will have to take medicine every day to control it.

If hypertension is left untreated, it can open the door to many health problems such as heart disease, stroke, kidney disease, vision impairment, dementia, and early death by about twenty-five years. It can also cause plaque accumulations around the arterial walls of the heart, decreasing blood flow and possibly causing a heart attack. Although having untreated hypertension can have these medical problems, fifteen percent of the adult population who know they have hypertension will still doing nothing about it.

The chance of being diagnosed with hypertension increases as a person gets older and also depends on a person’s race. For example:

African Americans have about a 33% chance of getting hypertension.
Caucasians have about a 23% chance.
American Indians have about a 21% chance.
Hispanics have about an 18% chance.
Asians or Pacific Islanders have about a 16% chance of getting hypertension.

As with many diseases, family history also plays a role in developing hypertension. If there is a family history of hypertension, it will automatically increase a person’s chance of getting hypertension. Sex should also be taken into consideration; men have a higher chance of developing hypertension if they’re under the age of fifty-five, while women have a higher risk if they’re over the age of fifty-five.

Other factors that may play a role in developing hypertension is being overweight or obesity, diabetes, smoking, drinking an excessive amount of alcohol every day, low potassium levels, heart disease, or even sleep apnea.

There are two types of hypertension- essential hypertension and secondary hypertension. Essential hypertension, or primary high blood pressure, is hypertension with no cause. Causes may be related to genetics or lifestyle. Secondary hypertension is high blood pressure that is caused by another disease such as diabetes, kidney disease, preeclampsia, or a thyroid disorder.

A small percentage of people with hypertension will develop malignant hypertension, a condition in which the blood pressure is so high that it will start to damage the organs.

Malignant Hypertension: Causes, Symptoms, and Treatment

Malignant hypertension is a rare but serious form of hypertension, or high blood pressure, which needs to be treated quickly. It is defined as the systolic (the top number) and diastolic (the bottom number) numbers being higher than 240 and 120. If this condition is treated on a prompt basis, it can cause complications in the eyes, brain, lung, and/or kidneys.

Eyes- If hypertension is left untreated, it can affect the eyes in that there will be flame-shaped hemorrhages in the retina, or there will be small, soft exudates. This is called hypertensive retinopathy. Malignant hypertension differs from hypertensive retinopathy in that there is papilledema, or swelling around the optic nerve.

Brain- While headaches are uncommon in hypertension; it is very common in malignant hypertension if the blood pressure is extremely high. Brain involvement with malignant hypertension can sometimes cause convulsions.

Lungs- Malignant hypertension can cause congestion in the lungs and results from fluid being forced into the lungs from heart failure as a result from the blood pressure being too high.

Kidneys- Malignant hypertension can also cause kidney or renal failure by obstruction of the arteries, causing less blood to flow to the kidneys.

Symptoms from malignant hypertension include blurry vision, vomiting, chest pains or a crushing sensation on the chest, decreased urine output, and/or tingling or numbness in the face, neck, arms, hands, or feet.

Like hypertension overall, the exact cause of malignant hypertension is uncertain. While little is still known about this condition, there are a few things that are known. Younger people are more likely to get malignant hypertension than older people which is the opposite of general hypertension. Those of African descent are more likely to get malignant hypertension, as well as those who already have a history of kidney failure and pregnant women that have gestational hypertension.

There are two hypertensive conditions that are still of some concern such as hypertensive urgency and hypertensive emergency. With hypertensive urgency, the blood pressure will be high with no serious symptoms. This means that people could be at risk for developing malignant hypertension if left untreated. In hypertensive emergency there can be organ damage and bringing the blood pressure down is crucial. The systolic number in hypertensive emergency will usually be greater than 220.

People with malignant hypertension need to treated quickly and should always be admitted into the hospital for close observation. In some cases, people may be admitted into the ICU (Intensive Care Unit). With hospital stays, intravenous drugs are the main focus of therapy because they work in the body quicker than medicines taken orally. Two drugs that are commonly used to bring high blood pressure down are nitroglycerin and nitroprusside. Several blood tests will be done several times a day to evaluate the organs. If treated promptly, malignant hypertension has a good outlook. After the hospital stay, it is common and recommended that people be prescribed medicines such as beta blockers or ACE inhibitors to avoid malignant hypertension in the future.