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Hypertension


Description

Hypertension is defined as a sustained elevated blood pressure (systolic blood pressure of 140 mm Hg or greater and/or diastolic blood pressure of 90 mm Hg or greater).

Hypertension is a strong risk factor for cardiovascular disease. Men tend to run higher pressures than females but more importantly have a significantly higher risk of cardiovascular disease at any given blood pressure.

Normal blood pressure is 140/90 or lower.

Borderline hypertension is 140-159/90-94.

Hypertension is160/95 and above.



Causes

Over 90% of hypertension has no identified cause. These can be labeled essential or primary hypertension.

Secondary causes of hypertension include four areas:

Renal parenchymal (Glomerulonephritis; Pyelonephritis; Polycystic kidneys);

Endocrine (Primary hyperaldosteronism; Pheochromocytoma; Hyperthyroidism; Cushing's syndrome);

Vascular (Coarctation; Renal artery stenosis); and

Chemical (Oral contraceptives; NSAID's; Decongestants; Antidepressants; Sympathomimetics; Many industrial chemicals; Corticosteroids; Ergotamine alkaloids; Lithium; Cyclosporine).

Risk factors include: Family history; Obesity; Alcohol; Excess dietary sodium; Stress; and Physical inactivity.



Insulin Resistance and Diabetes Type 2.

Hypertension is strongly associated with diabetes, both type 1 and 2. Kidney damage is generally the cause of high blood pressure in diabetes type 1. Obesity and insulin resistance are the factors associated with hypertension in type 2 diabetes, the more common type. People with type 2 diabetes generally have normal or high levels of insulin, a critical hormone in the metabolism of sugar. However, they are unable to use the insulin, the condition called insulin resistance . Without insulin, blood glucose (sugar in the blood) rises, the hallmark of diabetes.



Low Levels of Nitric Oxide.

The gas nitric oxide can be produced in the body, where it affects the smooth muscles cells that line blood vessels; it helps keep them relaxed, flexible. It may also help prevent blood clotting. Low levels of nitric oxide have been observed in people with high blood pressure (particularly in African Americans) and may be an important factor in essential hypertension



NSAIDs

Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) may injure the kidney and is an important cause of secondary hypertension in the elderly population. Such drugs include aspirin, ibuprofen (Advil, Motrin, Rufen), naproxen (Anaprox, Naprosyn, Aleve), and many others. Of these drugs, aspirin appears to have the least detrimental effect on blood pressure.



Oral contraceptives

Oral contraceptives (the Pill) increase the risk for high blood pressure, particularly in women who are older, obese, smokers, or some combination. Stopping the Pill nearly always reduces blood pressure, although a recent study suggests that oral contraceptives may produce a small but significant increase in diastolic pressure that persists in some older women who have been off the Pill for years.



Coffee and Soda

Caffeine causes a temporary increase in blood pressure, which has been thought to be harmless in people with normal blood pressure. Studies are suggesting, however, that regular, heavy coffee drinking (an average of 5 cups per day) can boost blood pressure, and there is growing evidence that a high intake of coffee may be harmful in people with hypertension and may even increase their risk for stroke. Drinking coffee also increases excretion of calcium, which also may affect blood pressure. (Anyone who drinks coffee should maintain an adequate calcium intake.)

Conventional Labs

Conventional lab tests include: Total, HDL and LDL cholesterol, Triglycerides, Fibrinogen

Cutting-edge markers include: Homocysteine, C-reactive protein, Lipoprotein(a), Apo A-1 and Apo B

 

 

 

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