Hypertension
KEY POINTS
Normal Regulation of Blood Pressure
¥ Blood pressure (BP) is the force exerted by the blood against the walls of the blood
vessel. It must be adequate to maintain tissue perfusion during activity and rest.
¥ Regulation of BP involves nervous, cardiovascular, endothelial, renal, and endocrine
functions.
HYPERTENSION
ClassiÞcation of Hypertension
¥ Hypertension, or high BP, is deÞned as a persistent systolic BP (SBP) greater than o
equal to 140 mm Hg, diastolic BP (DBP) greater than or equal to 90 mm Hg, or curr
use of antihypertensive medication.
¥ Hypertension is classiÞed as follows:
Prehypertension is BP 120 to 139/80 to 89 mm Hg.
greater than or equal to 100 mm Hg.
mm Hg coupled with an average DBP less than 90 mm Hg.
¥ ISH is more common in older adults.
¥ Control of ISH decreases the incidence of stroke, heart failure,
cardiovascular mortality, and kidney failure.
Etiology
¥ Primary (essential or idiopathic) hypertension is elevated BP without an identiÞed c
It accounts for 90% to 95% of all cases of hypertension.
¥ Secondary hypertension is elevated BP with a speciÞc cause. It accounts for 5% to
of hypertension in adults.
Pathophysiology of Primary Hypertension.
¥ The hemodynamic hallmark of hypertension is persistently increased systemic vas
resistance (SVR).
¥ This persistent elevation in SVR may occur in various ways. Defects in any of the
mechanisms involved in the maintenance of normal BP, including sodium intake, th
renin-angiotensin-aldosterone mechanism, and sympathetic nervous system (SNS)
stimulation, can result in the development of hypertension.
¥ Defects in glucose, insulin, and lipoprotein metabolism are common in primary
hypertension.
¥ Contributing factors to the development of hypertension include cardiovascular ris
KEY POINTS
Normal Regulation of Blood Pressure
¥ Blood pressure (BP) is the force exerted by the blood against the walls of the blood
vessel. It must be adequate to maintain tissue perfusion during activity and rest.
¥ Regulation of BP involves nervous, cardiovascular, endothelial, renal, and endocrine
functions.
HYPERTENSION
ClassiÞcation of Hypertension
¥ Hypertension, or high BP, is deÞned as a persistent systolic BP (SBP) greater than o
equal to 140 mm Hg, diastolic BP (DBP) greater than or equal to 90 mm Hg, or curr
use of antihypertensive medication.
¥ Hypertension is classiÞed as follows:
Prehypertension is BP 120 to 139/80 to 89 mm Hg.
greater than or equal to 100 mm Hg.
mm Hg coupled with an average DBP less than 90 mm Hg.
¥ ISH is more common in older adults.
¥ Control of ISH decreases the incidence of stroke, heart failure,
cardiovascular mortality, and kidney failure.
Etiology
¥ Primary (essential or idiopathic) hypertension is elevated BP without an identiÞed c
It accounts for 90% to 95% of all cases of hypertension.
¥ Secondary hypertension is elevated BP with a speciÞc cause. It accounts for 5% to
of hypertension in adults.
Pathophysiology of Primary Hypertension.
¥ The hemodynamic hallmark of hypertension is persistently increased systemic vas
resistance (SVR).
¥ This persistent elevation in SVR may occur in various ways. Defects in any of the
mechanisms involved in the maintenance of normal BP, including sodium intake, th
renin-angiotensin-aldosterone mechanism, and sympathetic nervous system (SNS)
stimulation, can result in the development of hypertension.
¥ Defects in glucose, insulin, and lipoprotein metabolism are common in primary
hypertension.
¥ Contributing factors to the development of hypertension include cardiovascular ris
