Most hypertensive patients do not present with specific symptoms related to increased blood pressure. Although headaches are commonly thought of as a symptom of elevated blood pressure, they generally only occur in patients with severe hypertension. Other non-specific symptoms that can be traced back to high blood pressure include dizziness, palpitations, easy fatigability and impotence. When symptoms are present they are usually associated with hypertensive cardiovascular disease or manifestations of secondary hypertension.
Hypertension
Hypertension is one of the major causes of cardiovascular disease worldwide.
The prevalence of hypertension varies from country to country and between different populations within the same country.
In approximately 80-95% of hypertensive patients, primary or ‘essential’ hypertension is diagnosed. In the remaining 5-20% of individuals, a specific underlying disease causing the elevation of blood pressure can be identified.
Primary hypertension tends to run in families and is likely to be the result of an interaction between environmental and genetic factors. The prevalence of primary hypertension increases with age.
Diagnosis of hypertension
In today's clinical practice, the diagnosis of hypertension is generally based on measurements taken on a patient sitting in the doctor's office. A recent classification recommends blood pressure limits to define hypertension as systolic pressure ≥140 mmHg and/or diastolic pressure ≥90 mmHg. Current clinical criteria for defining hypertension are generally based on the average of two or more blood pressure measurements during two or more outpatient visits.
The initial assessment of a hypertensive patient should include a complete history and objective examination to confirm the diagnosis of hypertension, evaluation of other risk factors for cardiovascular disease and possible secondary causes of hypertension.
Symptoms of hypertension
Complications of hypertension
Heart, brain, kidney and peripheral arteries are target organs of hypertension.
Heart disease is the most common cause of death in hypertensive patients, as a consequence of the structural and functional adaptations generated by hypertension in the heart.
High blood pressure is the most important risk factor for stroke. The incidence of stroke increases progressively with increasing blood pressure levels, particularly systolic blood pressure in individuals over 65 years of age.
The kidney is both cause and target organ of hypertension. Conversely, hypertension is a risk factor for kidney damage and end-stage nephropathy.
Blood vessels, in addition to contributing to the pathogenesis of hypertension, may be a target organ of atherosclerotic disease secondary to persistent elevation of blood pressure.