pathology: hypertension, arterial

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hypertension, arterial

Hypertension, arterial

Definition of

according to WHO: systolic resting RR without medication or other influencing factors > 140 or diastolic > 90 mmHg. 10-50% of the population in Germany; 20% of Central Europeans have RRsys > 160. Only 35% of 44-year-old working people have normal blood pressure. Only 7.5% of hypertensive patients have normal blood pressure under medication. 75% of those over 60. Increasing with age. Currently 51% of Germans and Austrians die from cardiovascular disease. Germany is the European leader in hypertension and apoplexy mortality!
Hypertension is one of the most important factors in the reduction of vascular elasticity, the associated increase in pulse wave velocity, the development of arteriosclerosis and its re-intensifying effects on hypertension.

ICD I10, I11

Cause

primary or essential:

  1. idiopathic (95%)
  2. multifactorial
  3. familial disposition
  4. Metabolic syndrome with hyperinsulinemia
  5. psychogenic

secondary (partially reversible):

  1. Medication, e.g. corticosteroids, non-steroidal anti-inflammatory drugs
  2. central nervous
  3. Luxury food (licorice)
  4. Drugs (cocaine, amphetamines)
  5. Gravidity
  6. renal (GN, interstitial nephritis, diabetic kidney damage, cystic kidneys, mechanical compression)
  7. hormonal contraceptives
  8. otherwise endocrine
  9. Licorice

Predisposing

  1. Smoking
  2. Alcohol
  3. Overweight
  4. Excessive consumption of table salt or unsaturated fatty acids
  5. Lack of exercise
  6. Potassium deficiency

Diagnosis

  1. RR, 24h-RR
  2. Falsely too high by:

Symptoms

  1. mostly asymptomatic
  2. Possible morning headache
  3. Dizziness
  4. Nausea
  5. Epistaxis
  6. Fatigue
  7. Insomnia
  8. Increased thirst
  9. Increased urination
  10. Hyperhydrosis
  11. Reduced resilience
  12. Consequential damage is often the first symptom
  13. Exercise-induced dyspnea in severe cases
  14. in severe cases angina pectoris
  15. visual disturbances in severe cases
  16. in case of maglignic hypertension (sys above 180 or diastolic above 110):
  17. in hypertensive crisis (sys above 230 or diastolic above 130):
    1. Organ damage
    2. Hypertensive encephalopathy

Complications

  1. Hypertensive crisis
  2. Hypertrophy of the heart with formation of insufficiency
  3. Arteriosclerosis
  4. Heart attack
  5. Stroke
  6. Pulmonary edema
  7. Aortic dissection

Therapy

  1. Primary: lifelong medication
  2. For morning headaches: raise the pillow