Hypertension, Part One: A Patient Guide

Primary and secondary hypertension

Primary or essential hypertension has no known cause, however genetic and lifestyle factors such as body weight and salt consumption can contribute to high blood pressure. Eighty to ninety percent of persons diagnosed with hypertension fit in this category. The diagnosis is made when no other cause for the high blood pressure is found.

Secondary hypertension is caused by another medical condition such as a blockage of an artery to the kidney, adrenal and neurendocrine tumors, kidney disease, or pregnancy. Several medications including oral contraceptives prednisone, cyclosporine, and the intake of certain foodstuffs (licorice) may also cause hypertension as a drug-related side effect.

Risk factors

There are several factors that put people at risk for hypertension. Increasing age, gender, heredity and race are factors that cannot be controlled. Elderly individuals are especially encouraged to undergo regular screening for the presence of hypertension because the condition is so prevalent in this population and is treatable once identified. African Americans are at greater risk for developing hypertension than Caucasians.Controllable risk factors are lifestyle related: obesity, diet, lack of exercise, certain medications, smoking and excessive alcohol consumption.

Symptoms

Hypertension is called the silent killer because most of the time there are no symptoms and it therefore goes undiagnosed. The patient who has less access to medical care is therefore less likely to be diagnosed. When patients state that they “can tell” if their blood pressure is elevated they are wrong as often as they are right. If you are feeling any of the following however, you should seek medical attention and have your blood pressure checked: Headache, dizziness, irregular or rapid heartbeat, chest pains, shortness of breath, nosebleeds, fatigue and blurred vision.

Sources

National Heart, Lung, and Blood Institute. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Journal of the American Medical Association . May 2003; 289:2573-2574.