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Back to Cardiovascular Diseases
Hypertension
Updated: September 19, 2006
Causes
Over 90% of all hypertension has no known cause and is therefore
called "essential/primary hypertension". Approximately 30 % of cases
of essential hypertension are attributable to genetic factors.
Often, it is part of the Syndrome X in patients with insulin
resistance as it occurs in combination with diabetes mellitus (type
2), combined hyperlipidemia and central obesity.
Important causes of secondary hypertension are:
- Renal artery stenosis (due to fibromuscular hyperplasia in
younger individuals and atherosclerosis in older people)
- Pheochromocytoma
- Hyperaldosteronism (Conn's syndrome)
- Cushing's disease
- Steroid use
- Coarctation of the aorta
- Chronic renal failure
- Scleroderma crisis
Risk factors
- African American descendants
- Obesity and physical inactivity
- Alcohol
- High salt intake
- Psychosocial stress
- Hereditary (genetic)
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Pathogenesis
High blood pressure or hypertension means high pressure (tension)
in the arteries. The arteries are the vessels that carry blood from
the pumping heart to all of the tissues and organs of the body. The
systolic blood pressure represents the pressure in the arteries as
the heart contracts and pumps blood into the arteries. The diastolic
pressure represents the pressure in the arteries as the heart
relaxes after the contraction. The diastolic pressure, therefore,
reflects the minimum pressure to which the arteries are exposed. An
elevation of the systolic and/or diastolic blood pressure increases
the risk of developing heart disease, kidney disease,
atherosclerosis or arteriosclerosis, eye damage, and stroke.
The vast majority of patients with essential hypertension have in
common a particular abnormality of the arteries. They have an
increased resistance (stiffness or lack of elasticity) in the
peripheral arteries or arterioles. Just what makes the peripheral
arteries become stiff is not known. Yet, this increased peripheral
arteriolar stiffness is present in those individuals whose essential
hypertension is associated with genetic factors, obesity, lack of
exercise, overuse of salt, and aging. Inflammation also may play a
role in hypertension since a predictor of the development of
hypertension is the presence of an elevated C reactive protein level
in some individuals.
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