U01.07.033 Hypertension

Hypertension is defined as a persistent systolic blood pressure (BP) ≥ 130 mm Hg and/or diastolic BP ≥ 80 mm Hg.

Risk Factors

The following factors increase the risk of developing hypertension:

Risk Factor	Impact
Age	Increased risk with age
Obesity	Higher likelihood of hypertension
Diabetes	Increased risk due to insulin resistance
Physical inactivity	Sedentary lifestyle contributes to elevated BP
Excess salt intake	High sodium intake raises BP
Excess alcohol intake	Alcohol can elevate BP
Cigarette smoking	Smoking damages blood vessels
Family history	Genetic predisposition
Race	African American > Caucasian > Asian

Primary (Essential) Hypertension
- Accounts for 90% of cases.
- Related to increased cardiac output (CO) or total peripheral resistance (TPR).
Secondary Hypertension
- Accounts for 10% of cases.
- Often caused by underlying conditions such as:
  - Renal/Renovascular diseases:
    - Fibromuscular dysplasia: Characterized by a “string of beads” appearance of the renal artery, usually seen in women of childbearing age.
    - Atherosclerotic renal artery stenosis: Common in older adults.
  - Primary hyperaldosteronism: Excess aldosterone production leads to sodium retention and increased BP.

Hypertensive Urgency
- Severe hypertension (BP ≥ 180/≥ 120 mm Hg) without acute end-organ damage.
Hypertensive Emergency
- Severe hypertension with evidence of acute end-organ damage, which can include:
  - Encephalopathy
  - Stroke
  - Retinal hemorrhages/exudates, papilledema
  - Myocardial infarction (MI)
  - Heart failure (HF)
  - Aortic dissection
  - Kidney injury
  - Microangiopathic hemolytic anemia
  - Eclampsia

Hypertension predisposes patients to a range of serious health conditions, including: