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

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[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. 

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sustained elevation of diastolic pressures

because these levels are reliably associated with

(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.. 

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

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[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. 

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“ 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.. 

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Pathogenesis  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.. 

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genetic predisposition  reduced renal salt excretion +/- excess dietary salt intake  increased vascular tone/adrenergic tone  environmental factors(smoking, obesity, physical inactivity)

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

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Hypertension occasionally  is   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.. 

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Renal disease
Chronic renal
diseases
Polycystic kidney
diseases
Acute
glomerulonephritis
Renal artery
stenosis
Renin producing
Endocrine
Adrenocortical
hyperfunction (Cushing
syndrome, primary
aldosteronism, congenital
adrenal hyperplasia)
Exogenous hormones
(Steroids, OCPs )
Acromegaly
Hyperthyroidism
Cardiovascular
Coarctation of the
aorta
Vasculitis
Increased intravascular
volume
Rigidity of the aorta
Neurogenic
Psychogenic
Increased intracranial
pressure
Acute stress eg-
surgery
Other
Pregnancy induced
hypertension, pre-
eclampsia
Drugs and toxins -
Alcohol, cocaine,
NSAIDs etc
Obstructive sleep
apnea

[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. 

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5% of cases rapidly  rising blood pressure    if untreated, leads to death in within 1 to 2 years.  Such  malignant hypertension usually is  severe - BP  >200mmhg SBP or >120  mmhg   DBp ssociated   with renal failure and retinal hemorrhages, with or without papilledema.  It  can arise de novo but most commonly is superimposed on preexisting benign hypertension. 2 types Hypertensive emergency  –	  Rapidly rising high pressure/malignant  								 hypertension  with evidence of impending or  							 progressive  target organ dysfunction . Hypertensive  urgency  -		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….. 

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Inadequate  control of essential hypertension or abrupt discontinuation of antihypertensive medications in essential hypertension. Drug  abuse – cocaine, amphetamine  Endocrine  diseases- Pheochromocytoma , primary  hyperaldostorinism   Acute  glomerulonephritiditis   Renal  artery stenosis  Vasculitis   – Takayasu  arteritis,  polyarteritis   nodosa   CNS  diseases-  Head injury

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

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Hypertension
part 01

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Here we are going to learn about hypertension

avatar

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

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

Those are primary hypertension, secondary hypertension, malignant hypertention

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

• Pathogenesis is multifactorial and complex

• In primary hypertension, most patients will have a near normal cardiac output, but their peripheral resistance is elevated.

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.

Secondary Hypertension occurs secondary to diseases of the kidney, adrenal, Or other endocrine organs

This chart shows the causes for hypertension

Renal causes , endocrine causes and cardiovascular causes, neurogenic causes and other causes are main causes

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.

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.

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

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….

Lets talk about more details of malignant hypertension in next video

Hypertension part 01