Conditions InDepth: Hypertension

Overview

Hypertension is the medical term for high blood pressure. Blood pressure is the measure of force that blood flow creates against the artery walls. High blood pressure is when this pressure is higher than expected.

Normal blood pressure is in the range of 120/80 mmHg. The higher number, called the systolic, represents the pressure in the artery when the heart beats. The lower number, called the diastolic, represents the pressure when the heart is at rest. Hypertension is defined as regular systolic pressure greater than 140 mmHg and/or diastolic pressure greater than 90 mmHg.

There are 2 main types of hypertension:

  • Primary—hypertension without any known cause, most common cause
  • Secondary—hypertension with a known or underlying cause

The Cardiovascular System

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The blood vessels throughout the body are designed to help blood flow smoothly, direct blood flow where necessary, and help to manage blood pressure. High blood pressure may occur because of one or more of the following:

  • Damage to the walls of the blood vessels that make it difficult for blood to flow through
  • Build up of plaque (atherosclerosis) or blood clots on blood vessel walls that reduce the area the blood can pass through
  • Structural problems with blood vessels—from congenital conditions
  • Conditions or medication that make blood vessels tighten when they should not
  • Decreased elasticity of blood vessels—common effect of aging

These conditions make it harder for the heart to push blood throughout the body. The heart has to push harder for each heart beat and the blood flow can become more turbulent, which both increase pressure on the blood vessel walls.

Primary blood pressure often develops over time because of a combination of these factors.

Secondary hypertension on the other hand, usually develops more quickly and is caused by other health conditions, such as kidney or endocrine disorders, or sleep apnea. Over-the-counter and prescription medications can also cause secondary hypertension.

Causes

The blood vessels throughout the body are designed to help blood flow smoothly, direct blood flow where necessary, and help to manage blood pressure. High blood pressure may occur because of one or more of the following:

  • Damage to the walls of the blood vessels that make it difficult for blood to flow through
  • Build up of plaque (atherosclerosis) or blood clots on blood vessel walls that reduce the area the blood can pass through
  • Structural problems with blood vessels—from congenital conditions
  • Conditions or medication that make blood vessels tighten when they should not
  • Decreased elasticity of blood vessels—common effect of aging

These conditions make it harder for the heart to push blood throughout the body. The heart has to push harder for each heart beat and the blood flow can become more turbulent, which both increase pressure on the blood vessel walls.

Primary blood pressure often develops over time because of a combination of these factors.

Secondary hypertension on the other hand, usually develops more quickly and is caused by other health conditions, such as kidney or endocrine disorders, or sleep apnea. Over-the-counter and prescription medications can also cause secondary hypertension.

References:

About high blood pressure. American Heart Association website. Available at:
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/About-High-Blood-Pressure_UCM_002050_Article.jsp
Updated January 22, 2013. Accessed February 26, 2014.

Hypertension. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated February 12, 2014. Accessed February 26, 2014.

What is high blood pressure? National Heart, Lung, and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/hbp
Updated August 2, 2012. Accessed February 26, 2014.

Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol. 2005;25(5):932-943.

12/11/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
He J, Gu D, Chen J, et al. Premature deaths attributable to blood pressure in China: a prospective cohort study. Lancet. 2009;374(9703):1765-1772.

Last reviewed September 2015 by Michael J. Fucci, DO
Last Updated: 9/17/2014

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