Different Types of Hypertension

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Different Types of Hypertension There are two primary hypertension primary hypertension types. For 95 percent of people with high with high blood pressure, the pressure, the cause of their hypertension is unknown  —   this is called essential, or primary, hypertension. When a cause can be found, the condition is called secondary called  secondary hypertension. hypertension.    



Essential hypertension.  This type of hypertension is diagnosed after a doctor notices

that your blood pressure is high on three or more visits and eliminates all other causes of hypertension. Usually people with essential hypertension have no symptoms, but you may experience frequent headaches, tiredness, dizziness, or nose bleeds. Although the cause is unknown, researchers do know that obesity, smoking, alcohol, diet, alcohol, diet, and  and heredity all play a role in essential hypertension.  



Secondary hypertension.  The most common cause of secondary hypertension is an

abnormality in the arteries supplying blood to the kidneys. It results from an identifiable [8]

cause. Renal disease is the most common secondary cause of hypertension. hypertension .   Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome,  syndrome,  hyperthyroidism,   hypothyroidism,  hyperthyroidism, hypothyroidism,  acromegaly,  acromegaly,  Conn's syndrome or hyperaldosteronism,  hyperaldosteronism,  hyperparathyroidism

[8][30]

and  pheochromocytoma.  pheochromocytoma.

  Other

causes

of

secondary

hypertension include obesity, include obesity, sleep  sleep apnea, pregnancy, apnea, pregnancy, coarctation  coarctation of the aorta, excessive aorta,  excessive liquorice consumption and certain prescription medicines, herbal remedies and illegal drugs, diseases and tumors of the adrenal glands, hormone abnormalities, thyroid disease, and too much salt or alcohol in the diet. Drugs can cause secondary hypertension, including over-the-counter medications such as ibuprofen (Motrin, Advil, and others) and  pseudoephedrine (Afrin, Sudafed, and others). The good news is that if the cause is found, hypertension can often be controlled.  



Hypertensive crisis. Severely elevated blood pressure (equal to or greater than a systolic

180 or diastolic of 110 — sometimes sometimes termed malignant or accelerated hypertension) is referred to as a "hypertensive crisis", as blood pressure at this level confers a high risk of complications. People with blood pressures in this range may have no symptoms, but are [9]

more likely to report headaches (22% of cases) cases )   and dizziness than the general [5]

 population..   Other symptoms accompanying a hypertensive crisis may include visual  population deterioration or breathlessness due to heart failure or a general feeling of   malaise malaise due to

 

[8]

renal failure. failure.   Most people with a hypertensive crisis are known to have elevated blood  pressure, but additional triggers may have led to a sudden rise. rise.

[10]

 

A "hypertensive emergency", previously "malignant hypertension", is diagnosed when there is evidence of direct damage to one or more organs as a result of severely elevated  blood pressure greater than 180 systolic or 120 diastolic. diastolic. hypertensive

[11]

  This may include

encephalopathy,  caused by brain swelling and dysfunction, and encephalopathy, 

characterized by headaches and an altered level of consciousness (confusion or drowsiness). Retinal  papilloedema and/or fundal hemorrhages and exudates are another sign of target organ damage. Chest damage. Chest pain may indicate heart indicate heart muscle damage (which may  progress to myocardial to myocardial infarction) or infarction) or sometimes aortic sometimes aortic dissection, the dissection, the tearing of the inner wall of the aorta. the aorta. Breathlessness,  Breathlessness, cough,  cough, and the expectoration of blood-stained sputum are characteristic signs of  pulmonary edema,  edema,  the swelling of lung tissue due to left ventricular failure an inability of the left the left ventricle of the heart to adequately pump blood [10]

from the lungs into the arterial system. system.  Rapid deterioration of kidney function (acute kidney injury) and  and  microangiopathic hemolytic anemia (destruction of blood cells) may [10]

also occur .

  In these situations, rapid reduction of the blood pressure is mandated to

stop ongoing organ damage. damage.

[10]

  In contrast there is no evidence that blood pressure needs

to be lowered rapidly in hypertensive urgencies where there is no evidence of target [8]

organ damage and over aggressive reduction of blood pressure is not without risks. risks .  Use of oral medications to lower the BP gradually over 24 to 48h is advocated in hypertensive urgencies.  



Hypertension.  Hypertension

Gestational

occurs

in

approximately

8 – 10% 10%

of

[8]

 pregnancies..   Two blood pressure measurements six hours apart of greater than  pregnancies 140/90 mm Hg is considered diagnostic of hypertension in pregnancy. pregnancy.

[12]

  Most women

with hypertension in pregnancy have pre-existing primary hypertension, but high blood  pressure in pregnancy may be the first sign of  pre-eclampsia, a   pre-eclampsia, a serious condition of the [8]

second half of pregnancy and puerperium and puerperium..   Pre-eclampsia is characterised by increased [8]

 blood pressure and the presence of  protein in the urine. urine.   It occurs in about 5% of [8]

 pregnancies and is responsible for approximately 16% of all all maternal  maternal deaths globally. globally.   [8]

Pre-eclampsia also doubles the risk of  perinatal mortality. mortality.   Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of

 

 pre-eclampsia occur oc cur the most common are headache, visual disturbance (often "flashing lights"), vomiting, epigastric vomiting, epigastric pain,  pain, and edema. and edema. Pre-eclampsia  Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, called eclampsia, which  which is a hypertensive a hypertensive emergency and has several serious complications including vision loss,  loss,  cerebral edema,  edema,  seizures or convulsions, renal convulsions,  renal failure, pulmonary failure, pulmonary edema, an edema, and d disseminated intravascular coagulation (a blood clotting disorder).  



Whitecoat Hypertension. Whitecoat hypertension is an interesting and fairly common

form of high blood pressure that only occurs during visits to the doctor. People with whitecoat hypertension may have normal blood pressure at home, but consistently have elevated readings at the doctor's office. Sometimes this is a type of stress reaction, but it may signal a more serious underlying problem. Because of this, whitecoat hypertension should always be evaluated by a doctor.  



Resistant hypertension. Resistant hypertension starts out as "regular" hypertension, but

does not respond to treatment. Despite what should be adequate therapy, the blood  pressure remains high. The causes of resistant hypertension are varied. Resistant hypertension may occur in 20 to 30 percent of high blood pressure cases. Resistant hypertension may have a genetic component and is more common in people who are older, obese, female, African American, or have an underlying illness, such as diabetes or kidney disease.  



Isolated systolic hypertension.  Blood pressure is recorded in two numbers: The upper,

or first, number is the systolic pressure, which is the pressure exerted during the heartbeat; the lower, or second, number is the diastolic pressure, which is the pressure as the heart is resting between beats. Normal blood pressure is considered under 120/80. With isolated systolic hypertension, the systolic pressure rises above 140, while the lower number stays near the normal range, below 90. This type of hypertension is most common in people over the age of 65 and is caused by the loss of elasticity in the arteries. The systolic pressure is much more important than the diastolic pressure when it comes to the risk of cardiovascular disease for an older person.  



Pulmonary hypertension. Pulmonary hypertension is a unique condition because, unlike

any other form of high blood pressure, it affects only a specific part of the circulatory system. Despite this, pulmonary hypertension is very dangerous because it affects the part

 

of the circulatory system that connects the heart and lungs - interfering with the lungs' ability to transfer oxygen and the heart's ability to pump blood. Pulmonary hypertension is deadly if left untreated, but those who receive proper treatment have a much better  prognosis.

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