Hypertension

I used 3 sources : Merck,The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) & National Health Morbidity Survey Third (NHMS III)


Causes :
1)High blood pressure with no known cause is called primary (formerly called essential) hypertension.
2)High blood pressure with a known cause is called secondary hypertension. In many of these people, high blood pressure results from a kidney disorder. Then, hormonal disorder (such as Cushing's syndrome, hyperthyroidism, hyperaldosteronism, pheochromocytoma) > use of certain drugs (such as Oral contraceptives)

One of the risk factor of cardiovascular disease (CVD) is microalbuminuria, estimated glomerular filtration rate <60>Blood pressure is written as systolic pressure/diastolic pressure—for example, 120/80 mm Hg (millimeters of mercury). This reading is referred to as "120 over 80."

A hypertensive urgency is blood pressure that is more than 180/120 mm Hg but has not yet produced any organ damage that is apparent to people or their doctors. A hypertensive urgency usually does not produce symptoms.

A hypertensive emergency is a particularly severe form of high blood pressure. Blood pressure is at least 180/120 mm Hg, and there is evidence of progressive damage in one or more vital organs, often accompanied by a variety of symptoms.

Angiotensin II causes the muscular walls of small arteries (arterioles) to constrict, increasing blood pressure. Angiotensin II also triggers the release of the hormone aldosterone from the adrenal glands and antidiuretic hormone from the pituitary gland.

Aldosterone causes the kidneys to retain salt (sodium) and excrete potassium. The sodium causes water to be retained, thus increasing blood volume and blood pressure.

Treatment :
Primary hypertension cannot be cured, but it can be controlled to prevent complications. (Merck)

Usually, potassium-sparing diuretics are not used alone because they do not control blood pressure as well as thiazide diuretics do; however, the potassium-sparing diuretic spironolactone is sometimes used alone. (Merck)

Majority of patients will require two medications to reach goal. (JNC-7)

http://www.acrpm.com.my/documents/nccr_09/handouts/day1/11_PharmacoEpid.pdf


Facts on NHMS III 2006 : Adults aged 30 and above - Diabetic 14.9% & Hypertensive 42.6%