hypertension

hypertension or high blood pressure, elevated blood pressure resulting from an increase in the amount of blood pumped by the heart or from increased resistance to the flow of blood through the small arterial blood vessels (arterioles). Hypertension was generally defined as a blood pressure reading of 140 over 90 or higher, but new guidelines issued in 2017 define hypertension as 130 over 80 or higher. Presssures of 120–129 over less than 80 are considered elevated. When the cause is unknown, the hypertension is called primary, or essential, hypertension. When a cause can be identified (e.g., a disorder of the adrenal glands, kidneys, or arteries), the condition is known as secondary hypertension. Factors such as heredity, obesity, smoking, and emotional stress are thought to play a role; the usual immediate cause is an imbalance in the body's vasoconstriction/fluid retention systems, often involving a decrease in the kidney's secretion of the regulatory hormone, renin.

Known as the “silent killer,” hypertension often produces few overt symptoms; it may, however, result in damage to the heart, eyes, kidneys, or brain and ultimately lead to congestive heart failure, heart attack (see infarction), kidney failure, or stroke. African Americans and women are the most affected. Treatment of hypertension includes diets to reduce weight and salt and alcohol intake, increased exercise, quitting smoking, and various drugs, such as diuretics, ACE inhibitors, beta-blockers, calcium-channel blockers or angiotensin-receptor blockers, as well as biofeedback. Many patients require a combination of drugs to control their blood pressure. Treatment for persons with prehypertension includes dietary and other lifestyle changes. Recent research has questioned the importance of dietary salt as a major contributor to hypertension; some studies point to low calcium intake as a cause.