Overview
Definition
Sustained elevation of systemic arterial blood pressure without a known, curable secondary cause.
Epidemiology
Affects over 1 billion adults worldwide. A major risk factor for stroke, MI, and CKD.
Etiology & Risk Factors
- Multifactorial (Genetics, Diet high in sodium, Obesity, Sedentary lifestyle, Stress)
- Increased sympathetic nervous system activity
- Overactive Renin-Angiotensin-Aldosterone System (RAAS)
Clinical Symptoms
- Often asymptomatic ('The Silent Killer')
- Headaches (in severe cases)
- Dizziness
- Vision changes
Clinical Approach
Diagnosis
- Resting BP ≥ 130/80 mmHg (ACC/AHA guidelines)
- Ambulatory Blood Pressure Monitoring (ABPM) to rule out 'white coat' hypertension
- Basic Metabolic Panel, Lipid Panel, Urinalysis (to check for end-organ damage)
Management
- Lifestyle changes (DASH diet, weight loss, exercise)
- Thiazide diuretics (Chlorthalidone, Hydrochlorothiazide)
- ACE Inhibitors / ARBs (Lisinopril, Losartan)
- Calcium Channel Blockers (Amlodipine)
Complications
- Coronary Artery Disease
- Ischemic and Hemorrhagic Stroke
- Heart Failure (LVH)
- Hypertensive Nephrosclerosis
- Retinopathy