This document provides an overview of arterial hypertension, including its definition, classification, epidemiology, etiology, pathogenesis, diagnosis, and complications. Arterial hypertension, or high blood pressure, is defined as having a systolic blood pressure over 140 mm Hg or a diastolic blood pressure over 90 mm Hg. Both genetic and environmental factors, such as diet and lifestyle, contribute to its development. It is a very common condition worldwide whose prevalence increases with age. Diagnosis involves measuring blood pressure in clinical settings as well as through ambulatory monitoring. Complications can include cardiac, neurological, kidney, and retinal issues if not properly treated.

1. UNIVERSIDAD TECNICA DE MACHALA
ACADEMIC UNIT OF CHEMICAL
SCIENCES AND HEALTH
MEDICINE SCHOOL
ENGLISH
ARTERIAL
HYPERTENSION
STUDENTS
William Cruz
Kevin Herrera
TEACHER:
Mgs. Barreto Huilcapi Lina Maribel
CLASS:
EIGHTH SEMESTER ‘’A’’
Machala, El Oro
2018

2. ARTERIAL HYPERTENSION
DEFINITION AND CLASSIFICATION
Arterial Hypertension or High Blood Pressure (HBP) is defined by the presence of
systolic blood pressure (SBP) levels equal to or greater than 140 mm Hg or diastolic BP
(DBP) equal to or greater than 90 mm Hg or both. Its importance lies in the fact that
that, the higher the systolic and diastolic pressure figures are, the higher the morbidity
and mortality of the individuals.
Systolic and Diastolic Blood Pressure
All vascular complications associated
with HBP, which includes coronary heart
disease, stroke, peripheral arterial disease,
heart failure and chronic kidney disease,
are related to both SBP and DBP.
However, starting at age 55, the
relationship is much closer with the SBP.
Epidemiology
HBP is a very common condition and the main factor related to mortality worldwide.
The pressure figures increase progressively with age.
Of very low prevalence in individuals below 30 years, this prevalence can reach up to
80% in those over 80 years. All ethnic groups suffer HBP except those communities
that have remained culturally isolated.
Etiopathogenesis of Essential Arterial Hypertension
 Etiological Factors:
Genetic: the influence of genetics on HBP is determined by a family aggregation, so
that prevalence increases among first-degree relatives.
 Environmental factors:
The main factors related to the development of HTA are linked to progress and changes
in lifestyle and dietary habits.
A.De la Sierre Iserte ¨ Hipertensión arterial¨En Farreras-
Rozman ¨ Medicina Interna¨18 vaedición, 513p

3. Sedentary lifestyle, imbalance between caloric intake and energy expenditure, along
with specific dietary elements such as high intake of saturated fats and high salt intake.
 Pathogenetic factors:
Sympathetic nervous system: Hypertensive patients have sympathetic hyperactivity,
with imbalance between it and parasympathetic activity.
Renina-Angiotensin System: (SRA) is undoubtedly the main responsible for the
development of vascular disease and one of the main focuses of therapeutic care.
Dysfunction and endothelial injury: The alterations observed in HT and its
cardiovascular complications include both dysfunction and damage to the endothelial
cell layer.
Structural Changes in the
Arteries: The three types of
changes described are the
presence of capillary
rarefaction, hypertrophy of the
middle layer of the arteries of
resistance and rigidity of the
great arteries.
Etiopathogenesis of
Secondary Arterial
Hypertension
Arterial Hypertension of Renal
Origin
 Arterial Hypertension
Vasculorrenal.
 Renin Secretory
Tumors
 Tubulopathies
 Primary
hyperaldosteronism
 Pheochromocytoma
 Apnea-Hypopnea Syndrome

4. Diagnostic Evaluation:
One of the pillars of the evaluation of the
hypertensive patient is the assessment of
the absolute individual risk, which
depends on the pressure figures, but also
on the concomitance of other risk factors,
target organ injury or established disease.
In general, they quantify this risk
according to the presence and severity of the main individual factors.
Measurement of arterial pressure
The diagnosis of hypertension and the therapeutic decisions that derive from said
diagnosis require the highest possible reliability in the determination of BP figures.
 Measurement of blood pressure in the clinical setting: The reference technique
for measuring BP is taking it in consultation using the auscultatory technique
with a mercury sphygmomanometer. The measurement of BP in the clinical
setting must be made with the subject at physical and mental rest.
Its strict compliance, especially in the number of measurements made and at the
time of measurement, avoiding the hours following the taking of
antihypertensive medication, allows the results to be brought closer to the values
obtained by measures outside of consultation and, therefore, to increase the
validity of the results.
 Ambulatory Blood Pressure Monitoring: provides information of great
importance. The mean estimators (average 24 h PA, daytime PA or nocturnal
BP) correlate better with the cardiovascular prognosis than the one measured in
the clinic and, in addition, they allow to diagnose and quantify the phenomenon
of the white coat and the masked HTN. The limit of normality for the average
values during the waking period is accepted as less than 135/85 mm Hg and for
the rest period less than 120/70 mm Hg. The normality in the 24 h estimator is
considered to be below 130/80 mm Hg.
 Clinical History of the Hypertensive Patient: The initial evaluation of all
hypertensive patients must pursue five objectives: to establish if the AHT is
sustained and if the patient is going to benefit from the treatment, to identify the
existence of especially silent organic disease, to detect the coexistence of other

5. factors of vascular risk and rule out the existence of curable causes of
hypertension
 Self-measurement of blood pressure
Complicaciones de La Hipertensión Arterial
 Cardiac Complications: HBP doubles the risk of ischemic heart disease and
triples the risk of congestive heart failure, left ventricular hypertrophy.
 Complications of the Central Nervous System: ischemic and hemorrhagic
CVA, Hypertensive Encephalopathy.
 Kidney Complications: Nocturia, microalbuminuria, nephroangiosclerosis,
decrease in kidney size,
 Accelerated hypertension: rapidly progressive hypertension, characterized by
fibrinoid degeneration and necrotizing arteritis and the Existence of an elevated
Blood Pressure, hemorrhages and retinal exudates.
Bibliography
 de la Sierre Iserte; arterial hypertension; in Farreras-Rozman "Internal
Medicine" 18th edition, Elsevier, Spain, 512-520 p