What Is Hypertension (HT)?
Hypertension (high blood pressure, elevated blood pressure) is a condition in which the pressure that blood chronically exerts on the walls of the blood vessels stays above levels considered normal. According to current medical guidelines, hypertension is generally defined as a blood pressure of 130/80 mm Hg or higher.
Why Is Hypertension (HT) Important for Our Health?
Correctly diagnosing and controlling hypertension is vitally important, because if left untreated it significantly increases the risk of heart attack, stroke (paralysis), heart failure, and kidney disease. With appropriate and successful treatment, a large proportion of cardiovascular diseases can be prevented.
What Are the Types of Hypertension (HT)?
Hypertension is divided into two main groups:
- Essential (Primary) Hypertension: Accounts for about 90% of patients. No clear organic cause can be identified; it usually develops due to genetic factors, age, and lifestyle.
- Secondary Hypertension: Seen in about 10% of cases. It is high blood pressure that develops as a result of another disease.
What Are the Most Common Causes of Secondary Hypertension?
Renal parenchymal diseases: The most common secondary cause. It develops as a result of diseases affecting the kidney tissue.
Primary aldosteronism: Responsible for about 11% of cases of resistant hypertension. It is related to a hormone secreted by the adrenal glands that plays a critical role in regulating the body's fluid-electrolyte balance. This hormone increases sodium (Na/salt) retention in the body while decreasing potassium (K) retention.
Renovascular diseases: Diseases of the kidney blood vessels.
Endocrine diseases: These develop due to abnormal hormone release by the endocrine glands.
What Are the Special Situations in Hypertension?
What is white coat hypertension?
White coat hypertension is a condition in which blood pressure readings are high in settings such as a doctor's office or hospital, while blood pressure stays at normal levels in the person's natural, everyday environment.
What Causes White Coat Hypertension (HT)?
People may become stressed without realizing it when they see a doctor. This causes a temporary rise in blood pressure.
Why Does White Coat Hypertension (HT) Matter?
If this condition goes unnoticed, the patient may be started on blood pressure medication that they do not need.
How Is White Coat Hypertension (HT) Diagnosed?
In people whose blood pressure is high when measured in the office, automatic devices that can record for 24 hours are generally used to diagnose white coat hypertension. Another method is for patients to measure their own blood pressure at home at regular intervals.
What Is Resistant Hypertension (HT)?
Resistant hypertension is a condition in which blood pressure remains above target levels (130/80 mm Hg) even though the patient is taking at least three different blood pressure medications, one of which is a diuretic (water pill), at the highest tolerated doses. It is associated with a marked increase in both cardiovascular deaths and deaths from all causes.
It accounts for about 20% of patients with hypertension. If resistant hypertension is still present after white coat hypertension, poor medication adherence, and secondary causes of hypertension (endocrine diseases, kidney diseases, etc.) have been ruled out, the condition is called "true resistant hypertension," and it accounts for about 10% of all hypertension cases.
What Are the Causes and Risk Factors of Resistant Hypertension?
Resistant hypertension arises from hormonal imbalances, excessive sympathetic nervous system activity, and mechanisms that cause excess fluid and sodium (salt) to accumulate in the body. Diabetes, kidney failure, obesity, and sleep apnea are among the most important risk factors. Lifestyle-related risk factors include excessive alcohol consumption and high salt intake.
How Is Resistant Hypertension Treated? Are There Special Considerations?
1. Lifestyle Changes (The Foundation of Treatment)
2. Treatment of Sleep Apnea
3. Adjusting Blood Pressure Medication
4. Additional Medication Support
5. Device-Based Treatment
What is resistant hypertension?
It is a condition in which blood pressure cannot be lowered below 130/80 mm Hg despite at least three different blood pressure medications, one of which is a diuretic (water pill).
What is pseudohypertension (false hypertension)?
It occurs when, especially in older people, stiffening of the arteries causes the cuff of the measuring device to show values higher than the actual blood pressure.
What is masked hypertension?
It is a condition in which blood pressure is normal when measured in a clinical setting but high in daily life and at home.