SPECIAL HYPERTENSION
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Hypertension, or more correctly arterial hypertension , is a clinical condition in which the blood pressure in the arteries of the systemic circulation is high . Blood pressure is summarized by two measures , systolic and diastolic blood pressure , which depend on the fact that the heart muscle contracts ( systole ) and relax (diastole ) between beats the other. The normal blood pressure at rest is between 100 and 140 mm Hg systolic and between 60 and 90 mm Hg diastolic . Hypertension is considered if there is a constant pressure equal to or higher than 140/90 mmHg . Hypertension leads to an increase of work for the heart
Hypertension is classified as either primary or secondary. We speak of primary hypertension where there is high blood pressure with no obvious medical causes of base : this occurs in 90-95 % of cases ; of secondary hypertension , if the cause is to be found in other diseases that affect the kidneys , arteries , heart or endocrine system : 5-10 % of cases.
Hypertension is a risk factor for stroke, for myocardial infarction, heart failure , for aneurysms of the arteries , for peripheral arterial disease and is a cause of chronic kidney disease . Even moderate elevation of arterial blood pressure are associated with a reduction in life . Changes in diet and lifestyle are able to significantly improve the control of blood pressure and reduce the risk of health complications . However, drug treatment is often necessary in people for whom lifestyle changes prove ineffective or insufficient.
HISTORY
He was the physician William Harvey (1578-1657) , first described the circulation of blood in his book " De motu cordis " . While the English clergyman Stephen Hales described the first measurement of blood pressure in 1733 . Nevertheless hypertension as a clinical entity was founded in 1896 with the introduction of the mercury sphygmomanometer , designed by Scipione Riva- Rocci , who allowed the measurement.Historically, the treatment , hypertension was called the "disease of the wrist hard" and was to reduce the amount of blood through the practice of bloodletting or by applying sanguisughe.Nel during the nineteenth and twentieth century, before the introduction of medications for hypertension, three remedies were used , all with numerous side effects : severe restriction of sodium in the diet, sympathectomy ( surgical ablation of certain areas of the sympathetic nervous system ) and pyrogenic therapy (injection of substances that cause fever and indirectly reduce blood pressure ) . Many other drugs have been developed after the Second World War , the most popular and reasonably effective of which were tetramethylammonium chloride and its derivatives. Starting from 1958 , with the discovery of the first well-tolerated oral medications , including chlorothiazide and thiazide diuretics , there has been considerable progress .
SPREAD
After the year 2000 , nearly one billion people in the world, about 26% of the adult population suffers from hypertension. Hypertension is widespread both in industrialized countries ( 333 million ) than in those in developing countries ( 639 million ) . Hypertension is more prevalent in men (though menopause tends to decrease this difference ) and in individuals of low socioeconomic status . The prevalence of hypertension in the very young is on the rise : the child is of secondary hypertension due to an underlying disease , while among adolescents is of primary type .
CAUSES
Blood pressure increases with age and the risk of becoming hypertensive in old age is remarkable. The primary hypertension is the result of a complex interaction between genes and environmental factors .
Between environmental factors and inherent to the lifestyle that influence blood pressure : the salt content in the diet , lack of exercise, excess weight , alcohol intake . Insulin resistance , which is common in obesity is a component of the metabolic syndrome that is considered a possible cause hypertension.
Secondary hypertension is due to an identifiable cause . Kidney disease is the most common cause , but also endocrine disorders such as Cushing's syndrome , hyperthyroidism , hypothyroidism , acromegaly , Conn's syndrome or hyperaldosteronism, hyperparathyroidism, and pheochromocytoma. Other secondary causes of hypertension include obesity, sleep apnea , pregnancy, coarctation of the aorta ...
SYMPTOMS AND RISK
Rarely hypertension is accompanied by symptoms and its identification is usually done through screening . Headaches and dizziness may accompany the secondary hypertension .
Disturbances caused by hypertension burden on vital organs : brain, heart, retina , and kidney arteries .
Regarding the heart , in a first time has concentric hypertrophy of the left ventricle , then the left ventricle dilates and the eccentric hypertrophy occurs , with possible hemodynamic decompensation . Furthermore, the increase in cardiac mass exposed to greater risk of ischemic heart disease and sudden cardiac death.
The vascular sclerosis , microaneurysms with possible rupture and intracranial hemorrhage, headache , dizziness , syncope, are all complications that can occur in the central nervous system as a result of hypertension. Although the view may be affected by the condition ipetensiva long -term effects on the retina such as diffuse arteriolar narrowing and sclerosis with ischemic areas , microaneurysms and capillary dilation .
The effects on the kidneys may be different , progressive sclerosis of intrarenal vessels with decreased glomerular filtration rate and a consequent reduction in organ function , to renal failure . While the arterial vessels are prone to atherosclerosis and microaneurysms .
PREVENTION AND TREATMENT
The treatment for hypertension is identical to the changes in lifestyle recommended as a preventive measure and include: changes in diet, in particular the reduction of sodium and alcohol , exercise, and weight loss. These precautions are able to reduce blood pressure in those suffering from hypertension . If hypertension is high changes in lifestyle can be combined antihypertensive drugs , strictly under medical supervision.
The World Health Organization has identified hypertension as the leading cause of cardiovascular mortality : primary hypertension is a major risk factor for cardiovascular disease , which in turn is the main cause of mortality in adult patients . However, hypertension is also the most important risk factor of preventable death in the world . Prevention which, remember , passing in the first place , by a healthy lifestyle .
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