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]
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]
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]
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]
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
[…] 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]
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]
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]
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]
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]
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]
Updated September 2018: According to the Centers for Disease Control and Prevention, one in three adults has hypertension (or high blood pressure), which is a leading cause of stroke, heart attack and kidney failure. [stateofobesity.org]
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]
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
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]
[…] less than 140 mm Hg to reduce the risk for recurrent stroke. [doi.org]
Raised blood pressure is a major risk factor for coronary heart disease and ischemic as well as hemorrhagic stroke. Blood pressure levels have been shown to be positively and continuously related to the risk for stroke and coronary heart disease. [who.int]
- 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
A large proportion of participants thought hypertension was principally caused by stress and produced symptoms, particularly headache, dizziness, and sweating. [ncbi.nlm.nih.gov]
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]
[…] 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
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]
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]
[…] 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]
[…] hoarseness; weight gain Delayed ankle reflex; periorbital puffiness; coarse skin; cold skin; slow movement; goiter Thyroid-stimulating hormone; free thyroxine None Hyperthyroidism S5.4-10 Warm, moist skin; heat intolerance; nervousness; tremulousness; insomnia [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]
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]
Fetal well-being must also be considered with the workup of the mother. [emedicine.medscape.com]
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.com]
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
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]
Our study aimed to evaluate the association between apolipoprotein E (ApoE) genetic polymorphism and hypertension, and to provide evidence for the etiology of 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
Ioanna Tzoulaki Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110 Ioannina, Greece. [dx.doi.org]
[…] 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]
The specifications of several epidemiological studies however partly clearly vary from one another. [flexikon.doccheck.com]
Pathophysiology
[…] those clinical pathophysiological alterations was hemodynamic evidence of impaired cardiovascular and renal structure and function. [doi.org]
The pathophysiology of this complication of hypertension is unclear. Preserving the RV and preventing the development of pulmonary vascular disease may be considered among the targets of optimized therapy for systemic hypertension. [ncbi.nlm.nih.gov]
In addition, adrenaline ensures the reduction of triglyceride within the fat tissue. 4 Pathophysiology You can find an overproduction of adrenaline at the so-called pheochromocytoma. [flexikon.doccheck.com]
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]