High blood pressure, also called hypertension (HTN) occurs when the body's smaller blood vessels (arterioles) narrow, causing the blood to exert excessive pressure against the vessel walls. The heart must therefore work harder to maintain the higher pressure. Over time, damage to the brain, eye and kidney can result ("target organ damage").
Cardiovascular disease is the leading cause of mortality in the United States. The most significant risk factor for cardiovascular disease is hypertension. High blood pressure is the key risk factor for stroke, heart attack, heart failure, kidney disease, and mortality.
Essential or primary hypertension means that there is no underlying condition that is causing the blood pressure to increase. Up to 95% of hypertension is the essential type. When an underlying cause is detected, the elevated blood pressure is considered to be secondary hypertension.
Unless blood pressure readings are very high, initial efforts at controlling blood pressure in essential hypertension are usually based on lifestyle changes. These include weight loss (if appropriate), exercise, dietary changes, and stress reduction. The goal of hypertensive treatment is to reduce overall cardiovascular disease risk and thus its morbidity and mortality.
More aggressive control of blood pressure is recommended for persons with comorbid conditions such as diabetes or renal (kidney) insufficiency.
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Hypertensive emergencies. Lancet. 2000
Angiotensin converting enzyme inhibition: from viper to patient. Heart. 2000
Elevated systolic blood pressure as a cardiovascular risk factor. American Journal of Cardiology. 2000
Choosing a first-line drug in the management of elevated blood pressure: what is the evidence? 3: Angiotensin-converting-enzyme inhibitors. CMAJ. 2000
Choosing a first-line drug in the management of elevated blood pressure: what is the evidence? 2: Beta-blockers. CMAJ. 2000
Choosing a first-line drug in the management of elevated blood pressure: what is the evidence? 1: Thiazide diuretics. CMAJ. 2000
The diagnosis and management of hypertensive crises. Chest. 2000
Angiotensin II receptor blockers: equal or preferred substitutes for ACE inhibitors?. Archives of Internal Medicine. 2000
When antihypertensive monotherapy fails: fixed-dose combination therapy. Southern Medical Journal. 2000
Insulin resistance and hypertension. Patients in double jeopardy for cardiovascular disease. Geriatrics. 2000
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