Overview of Hypertension

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by Mutiat Sunshine Oji

In patients with Heart Failure (HF), Hypertension (HTN) remains a major contributory factor as hypertensive left ventricular hypertrophy can result in the dysfunction of the left ventricles. Till date, the cause of hypertension is unknown, however, there are many possibilities and influences related to hypertension in patients. Notable influences include, high salt intake, the sympathetic nervous system, the renin-angiotensin system obesity and insulin resistance.

Hypertension (HTN) is a persistently abnormal elevated blood pressure which in the long-term, results in end-organ damage and consequently, increases morbidity and mortality. Blood pressure is influenced by the cardiac output balance and systemic vascular resistance. Patients with high blood pressures exhibit either an increase in cardiac output or an increase in systemic vascular resistance, but sometimes, both attributes are noted. In younger patients, it is thought that an increased cardiac output is often the reason for increased blood pressure while in the elderly, it is reasoned that vascular resistance is frequently the problem. 


It is purported that vascular resistance in HTN is a result of an increase of ?-adrenoceptor or emission of angiotensin and endothelins, while elevated cytosolic calcium affects systemic vasoconstriction, and vascular remodeling is caused by augmentation of growth factors. In the elderly patients, widening of pulse pressure, resulting from stiffening of the aorta and elasticity of arteries, causes an increase in the left ventricular afterload, and results impacts LVH dysfunction and manifests as systolic hypertension.  Unlike in the younger patients where low pulse pressure contributes to the improvement of coronary perfusion and exhibits as diastolic hypertension.

HTN is called a silent killer due to the fact that it rarely shows any symptoms until a medical emergency. However, some individuals with HTN report headaches, dizziness, vertigo, syncope and altered vision. 

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120075/,
  2. https://academic.oup.com/bjaed/article/4/3/71/292146 
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