TD Chawana
Epidemiology
1/3 of the global adult population affected
Females > males
Common finding in African ancestry
Occurs at a younger age in blacks vs whites
Blacks 3-5X more likely to develop renal
complications
Blacks more vulnerable to strokes than whites
Definition
Raised blood pressure (BP)
BP= Cardiac output (CO)x total peripheral
resistance (TPR)
Factors that can increase BP:
-increased CO
-reduced lumen diameter of arteries
CO-
TPR-
Definition
18-60 years:
Systolic 140mmHg
Diastolic 90mmHg
Or both
>60 years:
Systolic >150mmHg
NB-systolic BP more important, and is basis of
diagnosis in most patients
Risk factors
Age (>45)- men develop HTN earlier than women
Race-blacks>whites
Excess sodium (salt) intake
Potassium deficiency
Excess alcohol intake
Lipid abnormalities
Glucose intolerance
Diabetes mellitus
Positive family history
Obesity
Cigarette smoking or chewing tobacco
Stress
Pregnancy
Risk factors
3 phenomena driving HTN:
2. Obesity
Primary
Secondary
Primary HTN
Aka essential HTN
95% of adults
Aetiology not known
Genetic and environmental factors are thought to
contribute
Environmental- salt, obesity, sedentary lifestyle
Stiffening of aorta with increasing age (high
systolic often with normal diastolic)
Secondary HTN
5% of adults
Cause can be identified and sometimes
treated
Causes- chronic kidney dzz
-renal artery stenosis
-excess aldosterone secretion
-phaeochromocytoma
-sleep apnea
Classification
Normal- systolic <120mmHg; diastolic <80mmHg