2. Objectives:
By the end of this session participants should be able to:
1. To identify the risks for hypertension
2. To identify causes and factors associated with secondary
hypertension
3. To identify signs and symptoms of hypertension
2
3. Pathogenesis of Hypertension
Cause of hypertension is unknown in more than 90% of
cases.
- But several factors can increase the risk of developing
hypertension
Where there is no specific cause, it is referred to
as primary or essential hypertension.
Essential hypertension tends to develop gradually over
many years.
3
4. Pathogenesis of HTN….
A specific cause can be found in about 5% of adults. This is called
secondary hypertension
Secondary hypertension tends to appear suddenly and causes higher
blood pressure than does primary hypertension.
Causes of secondary hypertension:
- Renal diseases
• Renal vascular; renal parenchymal; polycystic kidneys
- Adrenal disease
• Pheochromocytoma, Cushing’s and Conn’s syndromes, 11-alpha-
hydroxylase, 17 hydroxylase deficiency
4
5. Pathogenesis of HTN…
Other Causes of secondary hypertension also includes
- Thyroid (Hyper-and hypothyroidism)
- Coarctation of the aorta.
- Obstructive sleep apnoea
- Drugs: steroids; birth control pills; sympathomimetic drugs
(eg. Some cough remedies), cocaine, methamphetamine
5
6. Etiologic Types of hypertension Summary
Primary Secondary
Over 90% of cases Less than 10%
No known causes Hypertension with a specific
cause
Develops gradually over
time
Sudden onset; often severe
and refractory
Commonly occurs between
30-55 years of age
Appears at age <30 or >55
6
7. Risk factors for Hypertension
Risk Factors are those conditions which increase the likelihood of
developing hypertension but are not underlying causes.
The following are commonly identified risk factors for hypertension:
Age: risk of hypertension increases with age
- More common in male through early middle age, or about age 45 years
- Women are more likely to have hypertension after age 55
Race. Common among blacks, often developing at earlier age
- Serious complications, such as stroke, heart attack, and kidney failure, also
more common in blacks
7
8. Risk factors for Hypertension….
Family history: Hypertension tends to run in families.
Overweight or obesity: increased risk of hypertension
Physical inactivity.
- Lack of physical activity increases risk of hypertension and
also overweight.
8
9. Risk factors for Hypertension….
Tobacco use
- Both active and passive smoking increase risk of hypertension
- Chemicals in tobacco can also damage lining of artery walls
High dietary salt (sodium) consumption
9
10. Risk factors for Hypertension…..
High/chronic alcohol consumption
Stress
- High levels of stress can lead to a temporary increase in blood
pressure
- Stress related factors like eating more,
using tobacco or drinking alcohol
may increase risk
Chronic medical conditions: examples are kidney disease
and sleep apnea
10
11. Signs and symptoms of Hypertension
One may not know that they have it: the most
dangerous aspects of hypertension
- Nearly 1/3rd of people with hypertension are
unaware
- Only way to know is through regular blood pressure
checkups
11
12. Signs and symptoms of Hypertension…
Some symptoms with very high blood pressure and/or
possible hypertensive crisis:
Severe headache or occipital headache
Fatigue or confusion
Visual problems
Chest pain
Difficulty breathing or shortness of breath
Irregular heartbeat
Epistaxis, Blood in the urine
Palpitations (pounding in the chest, neck, or ears)
12
