Arterial hypertension, or high blood pressure is a medical
condition where the blood pressure is chronically elevated. Normal
blood pressure is below 120/80; blood pressure between 120/80 and
139/89 is called ??pre-hypertension??, and a blood pressure of
140/90 or above measured on both arms at two instances (several
weeks apart) is considered high blood pressure. The complications of
hypertension are often referred to as end-organ damage because
damage to these organs is the end result of chronic high blood
pressure. Uncontrolled hypertension can cause strokes, which can
lead to brain or neurological damage. The strokes are usually due to
a hemorrhage or a thrombosis of the blood vessels that supply blood
to the brain. The patient's symptoms and signs are evaluated to
assess the neurological damage. A stroke can cause weakness,
tingling, or paralysis of the arms or legs and difficulties with
speech or vision. Multiple small strokes can lead to dementia. The
best prevention for this complication of hypertension or, for that
matter, for any of the complications, is control of the blood
The level of blood pressure regarded as deleterious has been
revised down during years of epidemiological studies. A widely
quoted and important series of such studies is the Framingham Heart
Study carried out in an American town: Framingham, Massachusetts.
The results from Framingham and of similar work in Busselton,
Western Australia have been widely applied. To the extent that
people are similar this seems reasonable, but there are known to be
genetic variations in the most effective drugs for particular
High blood pressure does not mean excessive emotional tension,
although emotional tension and stress can temporarily increase the
blood pressure. While chronic anxiety is associated with poor
outcomes in people with hypertension, it alone does not cause it.
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Cardiovascular diseases (CVD), most of which are due to
atherosclerosis (mainly heart attack and stroke) and often related
to arterial hypertension (AH), are responsible for nearly 20% of all
deaths world-wide (nearly 10 million). They are the principal cause
of death in all developed countries accounting for 50% of all deaths
and are also emerging as a prominent public health problem in
developing countries, ranking third with nearly 16% of all deaths.
It is known that more than 95 % of hypertensive patients in the
community are of essential or idiopathic/unknown aetiology, and only
a small percentage have an identifiable cause (secondary
Essential hypertension affects approximately 75 million
Americans, almost 1 in 4 adults in the United States. It is thus a
major public health problem. African American patients with poorly
controlled hypertension are at a higher risk than Caucasians for
most end-organ damage and particularly kidney damage. These
differentials are more pronounced in young adult women. Among the
very old, race differentials in hypertension prevalence rates are
less pronounced. The reasons for the epidemic hypertension rates in
the United States are largely environmental: Obesity and physical
inactivity probably account for a significant proportion of the
premature excess hypertension in African Americans relative to white
According to a recent survey, 1.0% of the adult American
population use complementary and alternative medicine to treat
Mean systolic and diastolic blood pressure and prevalence of AH
increase with age throughout childhood, adolescence and adulthood in
most populations of developed and developing countries. However, in
some isolated populations, this age-related rise of blood pressure
(BP) is not evident.
Men tend to display higher blood pressure than women, more
evident in youth and middle-age. Later in life (over 50 years old),
the difference narrows and the pattern may be reversed.
Although the precise mode of heredity/inheritance has not yet
been demonstrated, a high occurrence of hypertension is observed
among subjects with a family history of hypertension and it is
higher and more severe when both parents are concerned.
Studies have also revealed higher blood pressure levels in the
black community than in other ethnic groups, mainly in black
Afro-Americans with early onset, severity and appearance of