Hypertension is defined as a mean arterial blood pressure greater than 110 mmHg or a systolic BP over 135/90. Untreated hypertension can lead to cardiac failure, cerebral infarcts, and kidney damage by decreasing life expectancy. The causes of hypertension include primary (unknown cause) and secondary causes such as renal artery stenosis, coarctation of the aorta, pre-eclampsia during pregnancy, and hereditary factors. Goldblatt hypertension is caused by constriction of the renal artery and results in long-term high blood pressure.

1. Hypertension

2.  A mean arterial BP of greater than 110 mm of mercury
is hypertension
 This occurs when BP is more than 135/90
 In severe cases mean arterial BP is greater than 150 to
170 mm of mercury

3. Consequences of BP
Life expectancy is decreased due to
 Cardiac failure
 Cerebral infarct (Damage of blood vessel of brain
resulting in death of brain)
 Damage to the kidneys

4. Causes of BP
 Primary HTN
Cause is not known
 Secondary HTN
Renin secreting tumor
One kidney Goldblatt HTN
Two kidney Goldblatt HTN
Coarctation of aorta
Pre-eclampsia
Neurogenic HTH
Hereditary monogenic HTN

5. One kidney-Goldblatt
hypertension
 When one kidney is removed and a constrictor is placed
on the renal artery of the remaining kidney
 immediate effect is greatly reduced pressure in the
renal artery beyond the constrictor
 Then, within seconds or minutes, the systemic arterial
pressure begins to rise and continues to rise for several
days. (e.g transplanted kidney)

6. “Two-Kidney” Goldblatt
Hypertension
 Hypertension which results when the artery to only one
kidney is constricted while the artery to the other
kidney is normal
 Ischemic patch in kidneys in old age

7. Coarctation of aorta

8. Pre-eclampsia
 Approximately 5 to 10 per cent of expectant mothers
develop a syndrome called preeclampsia (also called
toxemia of pregnancy).
 One of the manifestations of preeclampsia is
hypertension that usually subsides after delivery of the
baby.

9. Cause of pre-eclampsia
 Ischemic patchy areas in placenta
 They release toxic substances
 Toxic substances damage kidneys of mother by causing
vasoconstriction of renal vessels
 Thickening of glomerular basement membrane

10. Treatment of hypertension
 Vasodilators
 Diuretics