Essential hypertension Definition Essential hypertension refers to high blood pressure with no identifiable cause. Alternative Names Hypertension - essential Causes As blood is pumped through your body, it exerts pressure on the walls of your arteries. The systolic blood pressure is the pressure against these walls when the heart contracts, and the diastolic blood pressure is the pressure when the heart relaxes. When you get a blood pressure reading, you are told the systolic pressure/diastolic pressure. For example, normal blood pressure is below 120/80. High blood pressure, also called hypertension, occurs when the systolic pressure is consistently over 140 mm Hg, or the diastolic blood pressure is consistently over 90 mm Hg. Blood pressure is determined by the amount of blood pumped, by the actions of the heart, and by the size and condition of the arteries. Many other factors can affect blood pressure including the water volume in the body; salt content of the body; condition of the kidneys, nervous system, or blood vessels; and various hormone levels in the body. Prehypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89. If you have prehypertension, you are likely to develop high blood pressure at some point. Therefore, your doctor will recommend lifestyle changes to bring your blood pressure down to normal ranges. African Americans of both sexes and Caucasian males have a higher rate of significant hypertension. While essential hypertension has no correctable cause, some genetic factors have been identified. Symptoms Usually, high blood pressure has no symptoms at all. That is why it is often called the quot;silent killer.quot; Millions of people have high blood pressure and many do not even know they have this serious condition. Rarely, you may experience a mild headache when your blood pressure is elevated. If your headache is severe, or if you experience any of the symptoms below, you must be seen right away because these may be a sign of dangerously high blood pressure (called malignant hypertension) or a serious complication (like a heart attack). Fatigue Confusion Visual changes Nausea and vomiting Anxiety Perspiration Pale or red skin An angina-like pain, crushing chest pain Note: There are usually no symptoms. Exams and Tests Blood pressure measurements are repeated over time. Systolic blood pressure consistently over 140, or diastolic blood pressure consistently over 90, is considered hypertension. Your doctor will look for signs of complications to your heart, kidneys, eyes, and other organs in your body. Multiple systolic blood pressure readings between 130 and 139 or diastolic blood pressure readings between 80 and 89 is called prehypertension. Your doctor will recommend and encourage lifestyle changes including weight loss, exercise, and nutritional changes. Tests for suspected causes (called secondary hypertension) may be performed. Essential hypertension is diagnosed when NO causes can be found. Treatment You should have your blood pressure regularly checked by your doctor. Your doctor will tell you how often you need it checked. You may want to consider a home blood pressure monitor as well. Bring the readings to your doctor when you go for your visits. Necessary lifestyle changes to help bring your blood pressure down include: Weight loss if you are overweight Regular exercise Follow a low fat diet rich in fish, chicken, whole grains, fruits and vegetables, and very light on red meats Reduced salt intake. Talk to your doctor or nutritionist about how best to do this Many different medicines are used to control blood pressure. Some of them are listed below. Aliskiren (Tekturna), a drug that blocks a substance produced by the kidney that is linked to blood pressure Angiotensin converting enzyme (ACE) inhibitors Angiotensin receptor blockers (ARBs) Beta-blockers Calcium channel blockers Diuretics Many people need two or more medications to control blood pressure. Outlook (Prognosis) Essential hypertension is controllable with proper treatment. It requires lifelong monitoring, and treatment may require periodic adjustments. Possible Complications Untreated hypertension can lead to: Heart attacks Congestive heart failure Other heart damage Blood vessel damage (atherosclerosis) Kidney damage Stroke Loss of vision When to Contact a Medical Professional Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked at annual exams, especially if you have a history of high blood pressure in your family. If you have high blood pressure, you will have regularly scheduled appointments with your doctor. In between appointments, if you have any of the following symptoms call your health care provider right away: Severe headache Excessive tiredness Confusion Visual changes Nausea and vomiting Chest pain Shortness of breath Significant sweating Prevention Prevention is based upon lifestyle changes that include: Weight loss, if you are overweight. Excess weight adds to heart strain. In some cases, weight loss may be the only treatment needed to lower your blood pressure. Exercise to improve cardiac fitness. Dietary adjustments to lower fat and modify sodium in your diet. Salt, MSG, and baking soda all contain sodium. References US Food and Drug Administration. FDA Approves New Drug Treatment for High Blood Pressure. Rockville, MD: National Press Office; March 6, 2007. Release P07-38. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Rockville, Md. National Heart, Lung, and Blood Institute, US Department of Health and Human Services; August 2004. National Institutes of Health Publication No. 04-5230. Whelton PK, He J, Appel LJ, et al. Primary prevention of hypertension: Clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002;288(15):1882-8. --------------------------------------... Review Date: 3/29/2007 Reviewed By: Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Glenn Gandelman, M.D., M.P.H., Cardiologist, White Plains, NY. Review provided by VeriMed Healthcare Network. (August 2005) A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC s accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M. s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
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