1. Definition
Hypertension is a condition characterized by persistently elevated blood pressure, typically defined as a systolic pressure above 140 mmHg and/or a diastolic pressure above 90 mmHg. It can increase the risk of heart disease, stroke, and other serious health complications if left untreated.
2. Calculation
There is no formula to “calculate” hypertension, as it is determined by measuring blood pressure using a blood pressure monitor.
3. Influencing factors
3.1. Non-modifiable Factors
- Age:
- As people age, arteries become stiffer and less elastic, which can lead to an increase in blood pressure. Hypertension is more common in individuals over the age of 60.
- Genetics and Family History:
- A family history of hypertension increases the risk. Certain genetic factors can make some people more susceptible to high blood pressure.
- Gender:
- Before age 60, men are more likely to develop hypertension than women. However, after menopause, women have an increased risk, and hypertension becomes more common in older women.
- Ethnicity:
- Certain ethnic groups, such as African Americans, have a higher risk of developing hypertension at younger ages and with greater severity compared to other ethnic groups.
3.2. Modifiable Factors
- Diet:
- High sodium (salt) intake: high sodium cause the body to retain water.
- Low potassium intake: Potassium helps balance the amount of sodium in cells. Low potassium intake can lead to higher blood pressure.
- High-fat, high-calorie diet
- Obesity:
- Excess weight increases the workload on the heart, leading to higher blood pressure.
- Alcohol Consumption:
- Drinking excessive amounts of alcohol (more than two drinks per day for men or one drink per day for women).
- Smoking
- Caffeine:
- Some individuals are sensitive to caffeine, which can cause a temporary increase in blood pressure
- Sleep Disorders:
- Conditions like sleep apnea can lead to high blood pressure. Poor sleep quality or short sleep duration can also raise blood pressure.
4. Classification of hypertension
4.1. Primary (Essential) Hypertension
- Definition: High blood pressure with no identifiable cause. It accounts for about 90-95% of all hypertension cases.
- Characteristics:
- Gradual development over many years.
- Influenced by factors like genetics, aging, poor diet (high salt intake), lack of physical activity, obesity, and stress.
- Not directly linked to another medical condition.
4.2. Secondary Hypertension
- Definition: High blood pressure that results from an underlying medical condition. This type accounts for 5-10% of cases.
- Causes:
- Kidney disease
- Endocrine disorders (e.g., hyperthyroidism, Cushing’s syndrome, primary aldosteronism)
- Obstructive sleep apnea
- Medications (e.g., birth control pills, NSAIDs)
- Pregnancy (pre-eclampsia)
- Characteristics:
- Typically appears suddenly.
- Blood pressure can be more severe and difficult to control.
- Treating the underlying cause can often improve or resolve the hypertension.
5. Treatment
5.1. Lifestyle Changes:
- Diet: Low salt (DASH diet), more potassium.
- Exercise
- Weight loss
- Limit alcohol: ≤2 drinks/day (men), ≤1 (women).
- Quit smoking
- Stress reduction
5.2. Medications:
- Diuretics
- ACE Inhibitors
- ARBs
- Calcium Channel Blockers