Hypertension part 01

[Audio] Here we are going to learn about hypertension.

[Audio] Hypertension is clinically defined as sustained elevation of diastolic pressures greater than 90 mm Hg or sustained systolic pressures in excess of 140 mm Hg, because these levels are reliably associated with an increased risk for atherosclerosis. (this differs according to the age and other risk factors of the patient.

[Audio] Risk factors for hypertension are stroke, myocardial infarction, vascular disease, and chronic kidney disease..

[Audio] There are three type of hypertension. Those are primary hypertension, secondary hypertension, malignant hypertention.

[Audio] essential or primary hypertension" results from the interplay of genetic polymorphisms and environmental factors, which conspire to increase blood volume and/or peripheral resistance. Hypertension Accounts for 90% to 95% of all cases are primary hypertension.

[Audio] • Pathogenesis is multifactorial and complex. • In primary hypertension, most patients will have a near normal cardiac output, but their peripheral resistance is elevated..

[Audio] Although exact mechanism of development of essential hypertension is not known, several factors like, genetic predisposition , reduced renal salt excretion with or without excess dietary salt intake , increased vascular tone or adrenergic tone and environmental factors like smoking, obesity, physical inactivity , are thought interact and play a part in the development of essential hypertension..

[Audio] Secondary Hypertension occurs secondary to diseases of the kidney, adrenal, Or other endocrine organs.

[Audio] This chart shows the causes for hypertension. Renal causes , endocrine causes and cardiovascular causes, neurogenic causes and other causes are main causes. Renal causes are Acute glomerulonephritis , Chronic renal disease , Polycystic disease , Renal artery stenosis , Renal vasculitis , Renin-producing tumors…. Endocrine causes are Adrenocortical hyperfunction such as Cushing syndrome, primary aldosteronism, congenital adrenal hyperplasia, licorice ingestion or Exogenous hormones like glucocorticoids, estrogen contraceptives, sympathomimetics and tyraminecontaining foods, monoamine oxidase inhibitors , Pheochromocytoma , Acromegaly , Hypothyroidism ( myxedema) , Hyperthyroidism ( thyrotoxicosis)….. Cardiovascular causes are Coarctation of aorta , Polyarteritis nodosa , Increased intravascular volume , Increased cardiac output and Rigidity of the aorta…. Neurologic causes are Psychogenic or Increased intracranial pressure or Acute stress, including surgery Sleep apnea , Pregnancy-induced ( pre-eclampsia) , drug and toxin are other causes..

[Audio] 5% of cases are malignant hypertension cases. A small percentage of hypertensive patients approximately 5% present with a rapidly rising blood pressure that, if untreated, leads to death in within 1 to 2 years. Such malignant hypertension usually is severe if systolic pressures over 200 mm Hg or diastolic pressures over 120 mm Hg and associated with renal failure and retinal hemorrhages, with or without papilledema. It can arise de novo but most commonly is superimposed on preexisting benign hypertension. There are 2 types . One of them is Hypertensive emergency which is Rapidly rising high pressure/malignant hypertension with evidence of impending or progressive target organ dysfunction. Second one is Hypertensive urgency which is Rapidly rising high pressure/malignant hypertension without evidence of impending or progressive target organ dysfunction.

[Audio] Causes of malignant hypertension are Inadequate control of essential hypertension or abrupt discontinuation of antihypertensive medications in essential hypertension , Drug abuse like cocaine, amphetamine , Endocrine diseases like Pheochromocytoma, primary hyperaldostorinism , next one is Acute glomerulonephritiditis , Renal artery stenosis , Vasculitis such asTakayasu arteritis, polyarteritis nodosa and Central nervous system diseases like Head injury…..

[Audio] Lets talk about more details of malignant hypertension in next video. Thank you..