Hypertension: Risk Factors and Causes

Hypertension is a heterogeneous medical condition.

With each heartbeat, the exact amount of blood is pumped out from heart round to body to supply oxygen and generate energy.

As the blood moves, it pushes against the sides of the blood vessels.

The strength of this pushing is your blood pressure.

If blood pressure is too high, the condition is known as hypertension, which puts extra strain on your blood vessels and your heart which may lead to heart attacks and strokes.

In most patients it results from unknown cause known as essential or primary hypertension.

Hypertension is termed the “silent killer” because patients with essential hypertension are usually not having any major symptoms.

As patient is not having any major symptoms, will not see the doctor until any major crisis occurs and hence it remains poorly treated.

This form of hypertension cannot be cured, it can be controlled only.

A small percentage of patients have a specific cause of their hypertension which is known as secondary hypertension.

There are many potential secondary causes like medications, kidney diseases, high use of contraceptives, cardiac disease.

If the cause of secondary hypertension can be identified, hypertension in these patients potentially can be cured.

Hypertension simply means persistently high arterial blood pressure (BP).

Blood pressure is defined as force of circulating blood on the wall of arteries.

Every blood pressure reading consists of two numbers or levels. They are shown as one number on top of the other.

The first (or top) number is your systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats.

The second (or bottom) number is your diastolic blood pressure. It is the lowest level your blood pressure reaches as your heart relaxes between beats.

Based on above definition of blood pressure, Hypertension can be defined as either a sustained Systolic Blood Pressure (SBP) of >140 mm Hg or a sustained Diastolic Blood Pressure (DBP) of greater than >90 mm Hg.

It is classified into four categories for the purpose of treatment management.

Hypertension is occasionally secondary to some distinct disease as said above.

More than 90 percent of patients have essential hypertension, a disorder of unknown origin affecting the blood pressure regulating mechanism.

Starting at a BP of 115/75mmHg, risk of cardiovascular disease doubles with every 20/10-mm Hg increase.

Causes

One or more of a ‘mosaic’ of predisposing factors which includes Positive family history, Obesity and Physical inactivity are commonly present in patients with essential hypertension.

A family history of hypertension increases the likelihood that an individual will develop hypertensive disease.

       The incidence of essential hypertension is four-fold more frequent among blacks than among whites.

It occurs more often among middle-aged males than among middle-aged females, and its increases with age and obesity (body mass index≥30 kg/m²).

Environmental factors, such as a stressful lifestyle, high dietary intake of sodium, and smoking, further predispose an individual to the occurrence of hypertension.

The patient may appear very healthy or may have the presence of additional cardiovascular risk factors:

Age (≥55 years for men to 65 years for women) 

Diabetes mellitus 

Dyslipidemia (high cholesterol, total cholesterol or triglycerides) 

Tobacco use 

The primary physical finding is elevated BP.

The diagnosis of hypertension cannot be made based on one elevated BP measurement.

The average of two or more measurements taken during two or more clinical encounters should be used to diagnose hypertension.

There after, this BP average can be used to establish a diagnosis and then to classify the stage of hypertension.