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Causes of Hypertension
from: Kyle BesserHypertension, or high blood pressure, is one of the most common complex disorders. Hypertension is a dangerous condition because it can lead to strokes, heart attacks, heart failure or kidney disease, especially is left untreated.
The causes of hypertension vary widely among the individuals within a large population. Essential hypertension is the form of hypertension that, by definition, has no identifiable cause. Essential hypertension is the more common type and affects 90-95% of hypertensive patients.
Even though there are no direct causes of essential hypertension, there are many risk factors, such as sedentary lifestyle, obesity, salt sensitivity, alcohol intake, and smoking. Hypertension is also related to aging and genetics. Family history increases the risk of developing hypertension.
Secondary hypertension is, by definition, a result from an identifiable cause. This type is important to recognize since its treated differently than essential hypertension by treating the underlying cause.
Some of the causes are common, while others are not. A variety of adrenal cortical abnormalities can cause hypertension. Another adrenal related cause is Cushing's syndrome; more than 80% of patients with Cushing's syndrome develop hypertension. A common and under-recognized cause is sleep apnea. Another cause is an exceptionally rare neurological disease called binswanger's disease, which is a rare form of multi-infarct dementia, and is one of the neurological syndromes associated with hypertension.
Other well known causes include diseases of the kidney. This includes diseases such as polycystic kidney disease, which is a cystic genetic disorder of the kidneys, characterized by the presence of multiple cysts in both kidneys. Hypertension can also be caused by diseases of the renal arteries supplying the kidney.
Few women of childbearing age have high blood pressure, but up to 11% develop hypertension of pregnancy and possibly resulting in three complications of pregnancy: pre-eclampsia, HELLP syndrome and eclampsia. Follow-up and control with medication is often necessary.
Initial assessment of the hypertensive patient should include a complete medical history and physical examination to confirm a diagnosis of hypertension. Most patients with hypertension have no specific symptoms referable to their blood pressure elevation. Although headache is popularly considered a symptom of high arterial pressure, headache generally occurs only in patients with severe hypertension. Characteristically, a "hypertensive headache" occurs in the morning and is localized to the occipital region. Other nonspecific symptoms that may be related to high blood pressure include dizziness, palpitations, easy fatigability, and impotence.
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