Presentation
We present a case of a young recreational cocaine user with uncontrolled hypertension who presented to hospital with acute chest pain and was diagnosed with an acute aortic dissection. The patient's last use of powdered cocaine was 3 days prior. [ncbi.nlm.nih.gov]
The goal of this review is to present experimental evidence that has led to the conclusion that decreased dopamine receptor function increases ROS activity and vice versa. [doi.org]
Entire Body System
- Congestive Heart Failure
Signs of hypertensive retinopathy are frequently seen in adults 40 years and older, and are predictive of incident stroke, congestive heart failure, and cardiovascular mortality--independently of traditional risk factors. [ncbi.nlm.nih.gov]
High blood pressure is a major risk factor for heart disease, congestive heart failure, stroke, impaired vision, and kidney disease. Generally, the higher the blood pressure, the greater the risk. [healthcommunities.com]
Hypertension is present in 33.5% of adult men and women and a risk factor for myocardial infarction, stroke, renal disease, and congestive heart failure. [doi.org]
During this lecture Ninja Nerd Science will go into detail on how thiazide and thiazide like diuretics are used to lower and control high blood pressure as well as decrease excess fluid in the body in conditions such as congestive heart failure (CHF). [youtube.com]
If left untreated, hypertension can seriously damage the heart and blood vessels by adding to their workload. This can result in congestive heart failure, stroke, heart attack, kidney damage, aneurysms, or even death. [merckmanuals.com]
- Renal Artery Stenosis
The following recommendations were modified: (1) renal artery stenosis should be primarily managed medically; and (2) renal artery angioplasty and stenting could be considered for patients with renal artery stenosis and complicated, uncontrolled hypertension [ncbi.nlm.nih.gov]
1-6 y 7-12 y Thrombosis of renal artery or vein Congenital renal anomalies Coarctation of the aorta Bronchopulmonary dysplasia Renal artery stenosis Renal parenchymal disease Wilms tumor Neuroblastoma Coarctation of the aorta Renal parenchymal disease [web.archive.org]
The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group. N Engl J Med. 2000 ; 342 : 1007–1014. [doi.org]
- Fatigue
Signs and symptoms of PH include shortness of breath, fatigue, chest pain, swelling of legs, and fainting, which could also be seen in many other diseases thus making diagnosis of PH challenging. [medical-center.lomalindahealth.org]
[…] pain, dizziness, and fatigue are related to dose. [merckmanuals.com]
If your blood pressure is extremely high, there may be certain symptoms to look out for,including: Severe headache Fatigue or confusion Vision problems Chest pain Difficulty breathing Irregular heartbeat Blood in the urine Pounding in your chest, neck [webmd.com]
More severe forms may exhibit fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors. [who.int]
- Abdominal Obesity
This rise can be explained, at least in part, by obesity, particularly abdominal obesity. [doi.org]
Obesity and Insulin Resistance Obesity, and especially abdominal obesity, is the main hypertensinogenic factor. [web.archive.org]
- Coronary Atherosclerosis
Coronary, cerebral, and muscle blood flow is maintained unless severe atherosclerosis coexists in these vascular beds. [merckmanuals.com]
Metelskaya, Combined markers of initial stages of coronary atherosclerosis, Biomeditsinskaya Khimiya, 10.18097/pbmc20176303272, 63, 3, (272-277), (2017). [doi.org]
Adiposity, cardiac size and precursors of coronary atherosclerosis in 5- to 15-year-old children: a retrospective study of 210 violent deaths. Int J Obesity. 1997; 21 : 691–697. [dx.doi.org]
Gastrointestinal
- Nausea
Aminosalicylates Sulfasalazine Common: Nausea, headache, dizziness, fatigue, fever, rash, and, in men, reversible infertility Uncommon: Inflammation of the liver (hepatitis), pancreas (pancreatitis), or lung (pneumonitis) and hemolytic anemia Abdominal [merckmanuals.com]
This drug is known to cause adverse effects, such as nausea, appetite loss, headache, insomnia, and hypertension. We herein describe a case of sudden-onset right peripheral facial palsy in a 9-year-old Japanese boy. [ncbi.nlm.nih.gov]
More severe forms may exhibit fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors. [who.int]
[…] values often causes only uncharacteristic ailments: Headaches (especially in the morning in bed) Dizziness Epistaxis (nosebleeds) Abnormal fatigue In case of very high blood pressure the following can appear: Severe dyspnea Angina pectoris Palpitation Nausea [flexikon.doccheck.com]
- Failure to Thrive
Signs and symptoms that should alert the physician to the possibility of hypertension include the following: Neonates Failure to thrive Seizure Irritability or lethargy Respiratory distress Congestive heart failure Children (Findings in addition to those [web.archive.org]
In older infants and children, hypertension can cause headache, unexplained irritability, fatigue, failure to thrive, blurred vision, nosebleeds, and facial paralysis.[32][33] Causes[edit] Primary hypertension[edit] Hypertension results from a complex [en.wikipedia.org]
Cardiovascular
- Chest Pain
If the second reading is just as high and you are not experiencing any other associated symptoms of target organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, or difficulty speaking, this would be considered [heart.org]
We present a case of a young recreational cocaine user with uncontrolled hypertension who presented to hospital with acute chest pain and was diagnosed with an acute aortic dissection. The patient's last use of powdered cocaine was 3 days prior. [ncbi.nlm.nih.gov]
[…] edema (fluid backup in the lungs) Eclampsia If you get a blood pressure reading of 180 or higher on top or 110 or higher on the bottom, and are having any symptoms of possible organ damage (chest pain, shortness of breath, back pain, numbness/weakness [web.archive.org]
More severe forms may exhibit fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors. [who.int]
Hypertensive urgencies frequently present with headache (22%), epistaxis (17%), faintness, and psychomotor agitation (10%) and hypertensive emergencies frequently present with chest pain (27%), dyspnea (22%) and neurological deficit (21%). [oadoi.org]
- Diastolic Hypertension
Elevated blood pressure (known as hypertension) increases with age, and most rapidly over age 60. Systolic hypertension is more strongly associated with cardiovascular disease than diastolic hypertension, and occurs more commonly in older people. [ncbi.nlm.nih.gov]
Artifactual/Benign Isolated Diastolic Hypertension in Young Adults The concept of artifactual or benign isolated diastolic hypertension arose from previous observations that individuals presenting with raised diastolic pressure and a narrow pulse pressure [doi.org]
[…] classifications Form of blood pressure increase Isolated systolic hypertension Isolated diastolic hypertension Combined systolic-diastolic hypertension Time-dependent hypertensiono Labile hypertension ( borderline hypertension ) Stable hypertension [flexikon.doccheck.com]
- Cardiomegaly
Steinmetz JC (1989) Neonatal hypertension and cardiomegaly associated with a congenital neuroblastoma. Pediatr Pathol 9:577–582 PubMed CrossRef Google Scholar 101. [oadoi.org]
- Gallop Rhythm
Daily examination should include a funduscopic examination for retinal spasm or edema, lung examination for signs of volume overload, cardiac examination for gallop rhythms, abdominal examination for hepatic tenderness, extremities/sacrum examination [emedicine.medscape.com]
Eyes
- Blurred Vision
Without treatment, hypertension can lead to bleeding in the eye, blurred vision, damage to the optic nerve, glaucoma, and vision loss. [vsp.com]
Symptoms of high blood pressure that has gone untreated for a long time include: Headache Fatigue Nausea Vomiting Shortness of breath Restlessness Blurred vision Causes and Risk Factors In most cases, the causes of high blood pressure are not known. [cedars-sinai.edu]
These symptoms include: Headache Dizziness Shortness of breath Blurred vision Feeling of pulsations in the neck or head Nausea SLIDESHOW High Blood Pressure (Hypertension): Symptoms, Causes, Treatments See Slideshow Source: iStock What causes high blood [medicinenet.com]
Ears
- Tinnitus
Some people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.[20] These symptoms, however [en.wikipedia.org]
Face, Head & Neck
- Epistaxis
Hypertensive urgencies frequently present with headache (22%), epistaxis (17%), faintness, and psychomotor agitation (10%) and hypertensive emergencies frequently present with chest pain (27%), dyspnea (22%) and neurological deficit (21%). [oadoi.org]
[…] neuronal stimulation of the blood vessel tonus. 5 Symptoms Hypertension appears mostly asymptomatic and in case of moderately high blood pressure values often causes only uncharacteristic ailments: Headaches (especially in the morning in bed) Dizziness Epistaxis [flexikon.doccheck.com]
Urogenital
- Kidney Failure
Essential hypertension is a major risk factor for stroke, myocardial infarction, and heart and kidney failure. [doi.org]
It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called high blood pressure. [cancer.gov]
Stealthy as a cat, it can cause blood vessel changes in the back of the eye (retina), abnormal thickening of the heart muscle, kidney failure, and brain damage. For diagnosis, there is no substitute for measurement of blood pressure. [medicinenet.com]
It kills so many people because it may contribute to deaths from a variety of causes, including aneurysms, heart attacks, heart failure, kidney failure, and stroke. [nutritionfacts.org]
News High blood pressure, or hypertension, usually has no symptoms, but can seriously damage the body—raising the risk of heart attack, stroke, kidney failure, and other problems. A healthy blood pressure is below 120/80 mm Hg. [health.com]
- Nocturia
Another factor in the presence of OSA is nocturia, which is present in about one third of patients. Apneic episodes cause an increase in secretion of atrial natriuretic factor, which causes diuresis throughout the night. [aafp.org]
Diagnostic Screening Tests Prevalence Clinical Indications Physical Examination Screening Tests Additional/Confirmatory Tests Common causes Renal parenchymal disease S5.1-1,S5.1-2 1%–2% Urinary tract infections; obstruction, hematuria; urinary frequency and nocturia [dx.doi.org]
Diagnostic Screening Tests Prevalence Clinical Indications Physical Examination Screening Tests Additional/Confirmatory Tests Common causes Renal parenchymal disease S5.4-1,S5.4-3 1%–2% Urinary tract infections; obstruction, hematuria; urinary frequency and nocturia [doi.org]
Neurologic
- Stroke
[…] increase in risk and people with high-end prehypertensive BP were 95 percent more likely to have a stroke.) [healthcommunities.com]
we observed that the frequency of the Pl A2 allele was higher among stroke versus nonstroke patients (stroke, 46.4%; nonstroke, 22.6%; P = 0.01). [oadoi.org]
This can cause an ischemic stroke and hypertension is the most important cause of this type of stroke and also transient ischemic attacks. [world-heart-federation.org]
[…] findings suggest that higher adherence to the DASH diet is associated with a decreased risk of stroke. [ncbi.nlm.nih.gov]
- Headache
Feverfew may increase heart rate and blood pressure when it is taken with drugs used to manage migraine headaches. NSAIDs reduce the effectiveness of feverfew in preventing and managing migraine headaches. [merckmanuals.com]
He described in detail the symptoms of hypertension such as headache, heaviness in the head, sluggish movements, general redness and warm to touch feel of the body, prominent, distended and tense veins, fullness of the pulse, distension of the skin, coloured [ncbi.nlm.nih.gov]
- Dizziness
Side effects can include fast pulse, palpitations, dizziness, diarrhea, or headaches. Home Remedies and Treatment It has been shown that meditation and other relaxation techniques can help lower blood pressure. [onhealth.com]
A large proportion of participants thought hypertension was principally caused by stress and produced symptoms, particularly headache, dizziness, and sweating. [ncbi.nlm.nih.gov]
[…] pain, dizziness, and fatigue are related to dose. [merckmanuals.com]
Extremely high blood pressure may cause symptoms like dizziness, visual disturbance, headache, fatigue and facial flushing. Risk factors In over 90% of cases, no specific cause can be identified. These cases are called primary hypertension. [chp.gov.hk]
- Insomnia
BACKGROUND: Hypertension and insomnia are common diseases in the elderly. [ncbi.nlm.nih.gov]
Are you an adult who has insomnia and high blood pressure? This study is evaluating three different behavioral interventions for treatment of insomnia and the effects of insomnia on blood pressure. [nhlbi.nih.gov]
[…] hoarseness; weight gain Delayed ankle reflex; periorbital puffiness; coarse skin; cold skin; slow movement; goiter Thyroid-stimulating hormone; free thyroxine None Hyperthyroidism S5.1-9 Warm, moist skin; heat intolerance; nervousness; tremulousness; insomnia [dx.doi.org]
- Papilledema
Retinal changes may include arteriolar narrowing, hemorrhages, exudates, and, in patients with encephalopathy, papilledema ( hypertensive retinopathy ). [merckmanuals.com]
Retinal changes may include arteriolar narrowing, hemorrhages, exudates, and, in patients with encephalopathy, papilledema (hypertensive retinopathy). [msdmanuals.com]
Workup
A workup for secondary hypertension was negative and no other risk factors for aortic dissection were determined. [ncbi.nlm.nih.gov]
Makris A, Seferou M, Papadopoulos DP: Resistant hypertension workup and approach to treatment. Int J Hypertens 2010; 2011: 598694. MEDLINE 9. [doi.org]
What is the proper workup of a patient with hypertension?. Cleve Clin J Med. 2008 Sep. 75(9):663-72. [Medline]. Institute for Clinical Systems Improvement (ICSI). Hypertension diagnosis and treatment. [emedicine.medscape.com]
The common physical findings in OSA are listed in Table 3. 43, 44 Because many patients with OSA have an upper airway abnormality, an ear, nose and throat evaluation is essential in the diagnostic workup. [aafp.org]
Urine
- Albuminuria
Clinicians should also consider an ACE inhibitor or ARB in patients with hypertension at any level of albuminuria (urinary albumin excretion ≥30 mg/g creatinine) ( 66 ). [care.diabetesjournals.org]
Reductions in albuminuria and in electrocardiographic left ventricular hypertrophy independently improve prognosis in hypertension: The LIFE study. J Hypertens. 2006; 24 :775–81. [ PubMed ] [ Google Scholar ] 32. [ncbi.nlm.nih.gov]
[…] readings to confirm diagnosis of hypertension, look for target organ damage - look for hypertensive retinopathy, left ventricular hypertrophy on ECG; perform blood tests (serum electrolytes, creatinine, eGFR, fasting glucose and lipids) and urinalysis for albuminuria [patient.info]
and a formal assessment of cardiovascular risk using a cardiovascular risk assessment tool (see recommendation 1.3.2). [2011] 1.2.7 If hypertension is not diagnosed but there is evidence of target organ damage such as left ventricular hypertrophy, albuminuria [nice.org.uk]
Hypertrophy
- Left Ventricular Hypertrophy
Sixteen months later, his average HBP was 147/106 mm Hg with no side effects and the left ventricular hypertrophy had completely regressed. [ncbi.nlm.nih.gov]
Daniels SR, Loggie JMH, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97:1907–1911 PubMed Google Scholar 29. [doi.org]
Treatment
Treatment of hypertension to blood pressure 28 ). [care.diabetesjournals.org]
occurred in the amlodipine-based treatment group than in the atenolol-based treatment group. [ncbi.nlm.nih.gov]
1.6.16 Before considering step 3 treatment, review medication to ensure step 2 treatment is at optimal or best tolerated doses. [2011] 1.6.17 If treatment with three drugs is required, the combination of ACE inhibitor or angiotensin II receptor blocker [nice.org.uk]
Treatment versus No Treatment [doi.org]
Prognosis
Abstract The scientific studies that have been conducted so far highlight that renal resistive index (RI) and aortic knob width (AKW) indicate poor prognosis regarding renal and cardiovascular mortality. [ncbi.nlm.nih.gov]
Primary Hypertension May Not Affect Prognosis of Postmenopausal Osteoporosis The presence of primary hypertension does not appear to have an effect on the prognosis of postmenopausal osteoporosis. [endocrinologyadvisor.com]
[…] inhibitors gene expression profiles in leukocytes of primary hypertension (PH), non-alcoholic fatty liver disease (NAFLD), and obese children PPT Version | PDF Version Paloma Manea COMPARISON BETWEEN HS-C REACTIVE PROTEIN AND MICROALBUMINURIA LEVELS FOR THE PROGNOSIS [omicsonline.org]
These terms when used specifically to hypertension refer to something that does not correspond with reality—a false perception; implicit in this definition is normalcy or a benign prognosis. [doi.org]
Etiology
View/Print Table TABLE 4 History Suggesting Possible Etiologies or Associations with Hypertension Possible etiology and/or associations Family history Cardiovascular disease (e.g., myocardial infarction, stroke) Primary hypertension Deafness Congenital [aafp.org]
Most cases are idiopathic; however, some have specific etiologies, such as herpesvirus infection, immunological disorders, and hypertension. [ncbi.nlm.nih.gov]
AT1R PPT Version | PDF Version Yuanlin Song ARDS, lung infectious disease PPT Version Denis Hadjiliadis Susceptibility of CF patients to Pseudomonas acquisition PPT Version Speaker PPTs Ekambaram Umapathy An association between vasoactive agents and etiology [omicsonline.org]
Epidemiology
[…] and Health Services, University of Washington, Seattle, WA, USA 22 Laboratory of Epidemiology, Demography, Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA 23 MRC Epidemiology Unit, Institute of Metabolic [ncbi.nlm.nih.gov]
Ioanna Tzoulaki Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110 Ioannina, Greece. [dx.doi.org]
Pathophysiology
[…] those clinical pathophysiological alterations was hemodynamic evidence of impaired cardiovascular and renal structure and function. [doi.org]
This evolution has taken place because of a greater understanding of the pathophysiology of hypertensive diseases, the development of new classes of antihypertensive agents that attack specific pressor mechanisms, and the ability to wed these concepts [ncbi.nlm.nih.gov]
The aim of this handbook is to provide state-of-the-art information concerning the pathophysiology, diagnosis, investigation and management of hypertension in the 21st century. [libreriacortinamilano.it]
Prevention
The National High Blood Pressure Education Program Coordinating Committee published its first statement on the primary prevention of hypertension in 1993. [ncbi.nlm.nih.gov]
Current recommendations for primary prevention of hypertension involve a population-based approach and an intensive targeted strategy focused on individuals at high risk for hypertension. [oadoi.org]