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High Blood Pressure

Hypertension And Related Disease Risk

While increases in blood pressure from the resting rate are expected under certain conditions such as excitement, stress or physical exertion, a prolonged elevation in blood pressure can be detrimental. Sustained high pressure within the cardiovascular system compromises the integrity of vessels, leading to vascular damage and failure of the organs that the vessels supply (Schmieder 2010). Short of this, even modest, sustained increases in blood pressure elevate the risk of several diseases, including arteriosclerosis, stroke, chronic kidney disease/failure, peripheral arterial disease (PAD), aneurysm, and vision loss. Hypertension is a more important risk factor for coronary artery disease than high non-HDL cholesterol, elevated C-reactive protein, high serum triglycerides, or obesity (Kones 2010; Emerging Risk Factors Collaboration 2010; Schnohr 2002). Even so, one cannot completely reduce cardiovascular risk without controlling all of their risk factors.

The current definition of hypertension is based upon the risk of serious complications and the methods of their management (Chobanian 2003). While the threshold used to define hypertension has been >139/89 mmHg for decades, several published studies reveal that blood pressure should be kept around 115/75 mmHg in order to truly protect against cardiovascular disease (Basile 2008; Bakris 2007; Russell 2006).

Hypertension is classified as Primary and Secondary based on underlying cause. Primary hypertension, the most frequent and preventable type, arises from a number of underlying contributing factors (Chiong 2008; Carretero 2000). Inadequate intake of nutrients including potassium, magnesium, vitamin D and vitamin K may also play a role. Secondary hypertension represents only about 5-10% of hypertension cases, and results from an underlying condition, usually associated with diseases of the kidneys, endocrine, vascular, or central nervous system. Although antihypertensive drugs are sometimes used to manage secondary hypertension, correcting the underlying cause can often lead to a cure (Chiong 2008).

Prehypertension is a “predisease” state, which carries an increased risk of progression to hypertension. Those in the 130/80 to 139/89 mmHg blood pressure range (which is already dangerously high) are twice as likely to develop clinical hypertension (which means much higher blood pressure readings) as those with lower values (Viera 2011; Vasan 2001). Despite the availability of studies which indicate that individuals within this blood pressure range are at increased risk of developing clinical hypertension as well as heart disease, mainstream medicine usually opts not to treat blood pressure with pharmaceutical drugs at this level.

Stage 1 and Stage 2 Hypertension, defined as 140-159/90-99 and greater than 160/100 mmHg, respectively, carry the greatest risk of cardiovascular disease. The two stages of hypertension differ in their conventional medical treatments, with stage 2 hypertensive patients usually requiring the most aggressive intervention using combinations of anti-hypertensive drugs.

Some Causes Of Secondary Hypertension (Chiong 2008; Chobanian 2003)

Renal:

Chronic kidney disease
Renal vascular disease
Renin-producing tumors

Endocrine:

Primary aldosteronism (secretion of excess aldosterone, a hormone that increases salt retention)
Hypo- or Hyperthyroidism
Adrenocortical hyperfunction (oversecretion of adrenal hormones)
Acromegaly (secretion of excessive growth hormone)

Neurogenic:

Acute stress-related hypertension
Spinal cord damage/Quadriplegia

Vascular:

Rigidity or narrowing of the aorta

Hypertension induced by drugs:

Oral-contraceptives
Steroid therapy
Sympathomimetic drugs (decongestants, appetite suppressants)
Non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors
Immunosuppressants
Erythropoietin
Amphetamines

Miscellaneous:

Obstructive sleep apnea
Nutrient deficiency
Pregnancy-induced hypertension