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Complication of Hypertension

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Submitted By shahriar07
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Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevatedHypertension is a common disorder and a leading cause of morbidity and mortality worldwide. The majority (90%) of patients have ‘primary’ or ‘essential’ hypertension where no identifiable underlying cause is found. The remaining minority (up to 10%) have ‘secondary’ hypertension where a cause is identified. Complete assessment of the hypertensive patient must include an assessment of overall cardiovascular risk and the identification of potential secondary causes of hypertension. Any decision to treat hypertension should be based on repeated blood pressure readings or the 24 h ambulatory BP measurements monitor. Treatment of hypertension is based on large international trials and extensive meta-analyses, which have now been condensed into established published guidelines. NICE/BHS proposes the ACD rule that recommends drug classes that can be used to control blood pressure depending on the age and race of the patient.Most patients will require two or more drugs and will need to be followed up for side effects and nonadherence. It is important to be vigilant for secondary causes of resistant hypertension. Epidemiology The prevalence of hypertension in the general population is about 20e30% and more frequent with increasing age and in certain ethnic groups. Isolated diastolic or systo-diastolic hypertension is more common in younger people (65 years. Treatment of hypertension convincingly decreases the incidence of both ischemic and hemorrhagic strokes. Hypertension is also associated with impaired cognition in an aging population, Hypertension-related cognitive impairment and dementia may be a consequence of a single infarct due to occlusion of a "strategic" larger vessel or multiple lacunar infarcts

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