High blood pressure

Hypertension is a clinical syndrome characterized by high systolic and/or diastolic blood pressure (systolic blood pressure 140 mm hg and diastolic blood pressure 90 mm hg) in the systemic arteries and blood vessels, and can be associated with functional or organic damage to the heart, brain and kidney. Hypertension is the most common chronic disease and the most important risk factor of cardiovascular and cerebrovascular diseases. Normal blood pressure fluctuates within a certain range with the change of internal and external environment. In the general population, blood pressure level gradually increases with age, with systolic blood pressure more obvious, but after 50 years old, diastolic blood pressure presents a downward trend, and pulse pressure also increases. In recent years, the effect of multiple risk factors for cardiovascular disease and the understanding of the heart, brain, kidney target organ protection, the diagnostic criteria for high blood pressure has been adjusted, which is the same level of blood pressure of patients at risk of cardiovascular disease is different, so there is the concept of stratified blood pressure, namely different patients with cardiovascular disease risk, appropriate blood pressure levels should be different. Blood pressure value and risk factor assessment are the main basis for the diagnosis and formulation of hypertension treatment plan. Different patients have different objectives of hypertension management. When facing patients, doctors judge the most appropriate blood pressure range according to their specific conditions on the basis of reference standards and adopt targeted treatment measures. On the basis of improving life style, it is recommended to use 24 hours long acting antihypertensive drugs to control blood pressure. In addition to the assessment room blood pressure, patients should also pay attention to the family early morning blood pressure monitoring and management, in order to control blood pressure, reduce the incidence of cardiovascular and cerebrovascular events.

The cause of
Genetic factors
About 60 percent of people with hypertension have a family history. At present, it is believed that it is caused by polygenic inheritance, and 30% ~ 50% of patients with hypertension have genetic background.
2. Mental and environmental factors
Long-term mental tension, excitement, anxiety, by noise or bad visual stimulation and other factors can also cause hypertension.
age
The incidence of the disease tends to increase with age, and the incidence is higher among people over 40 years old.
Lifestyle factors
Unreasonable dietary structure, such as too much sodium salt, low potassium diet, drinking a lot of alcohol, intake of excessive saturated fatty acids can increase blood pressure. Smoking can accelerate the process of atherosclerosis, a risk factor for hypertension.
5. Drug effects
Contraceptives, hormones, anti-inflammatory painkillers can affect blood pressure.
6. Effects of other diseases
Obesity, diabetes, sleep apnea hypopnea syndrome, thyroid disease, renal artery stenosis, renal parenchymal damage, adrenal space occupying lesions, pheochromocytoma, and other neuroendocrine tumors.

classification
Clinically, hypertension can be divided into two categories:
1. Primary hypertension
It is an independent disease with elevated blood pressure as the main clinical manifestation and the cause of which has not been determined, accounting for more than 90% of all patients with hypertension.
Secondary hypertension
Also known as symptomatic hypertension, in this kind of disease etiology is clear, hypertension is only one of the clinical manifestations of the disease, blood pressure can be temporary or persistent rise.

Clinical manifestations of
The symptoms of high blood pressure vary from person to person. Early may have no symptoms or symptoms are not obvious, the common is dizziness, headache, neck plate tight, fatigue, palpitations. Blood pressure will only increase after fatigue, mental tension, mood swings, and return to normal after rest. As the course of disease prolongs, blood pressure rises apparently continuously, can appear gradually all sorts of symptoms. This is called progressive hypertension. Common clinical symptoms of progressive hypertension include headache, dizziness, inattention, memory loss, limb numbness, increased nocturnal urine, palpitation, chest tightness, and fatigue. The symptoms of hypertension are related to the blood pressure level to some extent. Most of the symptoms can be aggravated after tension or fatigue, and the blood pressure can be rapidly increased after morning activities, resulting in early morning hypertension, which leads to the occurrence of cardiovascular and cerebrovascular events in the early morning.
When sudden high blood pressure to a certain extent even appear the symptom such as severe headache, vomiting, palpitation, dizziness, severe happens dottiness, convulsions, it belongs to the radical type of high blood pressure and high blood pressure in crises, the benefit in the short term a serious heart, brain, kidney and other organ damage and pathological changes, such as stroke, heart attack, kidney failure, etc. There was no consistent association between symptoms and elevated blood pressure.
The clinical manifestations of secondary hypertension are mainly related to the symptoms and signs of primary disease, and hypertension is only one of its symptoms. Hypertension in patients with secondary hypertension may have its own characteristics, such as aortic constriction caused by hypertension can be limited to the upper limbs; The increase in blood pressure due to pheochromocytoma is episodic.