Introduction of disease
High blood pressure, also known as hypertension, is a condition characterized by the high long-term force of the blood against the artery walls that negatively affect the heart’s function. The blood pressure depends on the two main conditions: the amount of blood in heart pumps and blood flow resistance in arteries. The pressure is measured in millimeters of mercury (mm Hg) and displays top and bottom numbers (Bakris, 2021). The top number or systolic pressure shows the upper measure of the pressure in arteries, while the bottom number or diastolic pressure represents the lower measure of blood pressure.
High blood pressure could be dangerous, increasing the risk of heart problems, including heart attacks and stroke. People with high blood pressure usually have no symptoms; even the blood pressure is extremely high (Bakris, 2021). The diseases could develop gradually over the years or result from various medical conditions such as obstructive sleep apnea, kidney disease, adrenal gland tumors, thyroid problems, or consumption of illegal drugs. The danger of high blood pressure is emphasized by its complications, including heart attack, aneurysm, heart failure, weakened and narrowed blood vessels in the kidney, metabolic syndrome, and dementia. Systolic blood pressure in this condition is higher than 130 mm Hg, and diastolic blood pressure is higher than 80 mm Hg.
Etiology and risk factors
Hypertension has two conditions that could cause these conditions: primary and secondary hypertension. Primary hypertension is a result of multiple medical conditions that covers hemodynamics and physiologic components. In the situation when one factor results in high blood pressure, the usual malfunction of ion pumps on sarcolemma membranes of smooth muscle cells is observed (Bakris, 2021). Heredity could be a significant factor in increased vascular tone and hypertension. Moreover, it is important to consider environmental factors such as stressful lifestyle, lack of sleep, and age. On the other hand, secondary hypertension is determined by various health conditions, including diabetes mellitus, obesity, obstructive sleep apnea, primary aldosteronism, and renovascular disease (Bakris, 2021). Alcohol, oral contraceptives, sympathomimetics, nonsteroidal anti-inflammatory drugs also could result in increased blood pressure. Considering the age and sex distribution of the diseases, it can be noticed that men under the age of 65 are more commonly affected by this condition. At the same time, among women, this state is observed after the age of 65. Moreover, the race also has a considerable impact, as naturally high blood pressure is more common among people with African heritage.
Pathophysiological processes
High blood pressure occurs when either cardiac output (CO) or total peripheral vascular resistance (TPR) or both are increased. Various situations involve a combination of conditions that cause the distribution of the heart cycle. Mostly, abnormal sodium transport could result in the sodium-potassium pump that causes decreased permeability of sodium ions (Bakris, 2021). As Na+, K- and ATPase could transform norepinephrine back into sympathetic neurons; inhibition mechanism could enhance the influence of norepinephrine, causing high blood pressure. The deficiency of vasodilators such as bradykinin, nitric oxide could also cause hypertension (Bakris, 2021). When the kidney does not produce an adequate amount of vasodilators and vasoconstrictors such as angiotensin or norepinephrine are in excess, blood pressure starts to increase.
Clinical manifestations and complications
Although hypertension has no symptoms that could emphasize the disease, complications develop in the target organs. The patient could have dizziness, facial flushing, headache, fatigue, and nervousness, highlighting difficulties of high blood tension. In hypertension emergency cases, severe cardiovascular, neurologic, renal, and retinal symptoms appear. Retinal changes are classified according to the main four grades (Bakris, 2021). Grade 1 refers to constriction of arterioles, while Grade 2 has constriction and sclerosis of arterioles. In Grade 3, hemorrhages and exudates along with vascular changes are observed. The last and the most complicated, Grade 4, is characterized by papilledema, also known as hypertensive retinopathy.
Diagnostics
Hypertension could be diagnosed by various methods that include physical and laboratory examinations. The main ways are to conduct multiple measurements of blood pressure to identify pathology. Moreover, urinalysis and urinary albumin tests, including creatinine ratio and ultrasonography, are required. It is necessary to conduct blood tests identifying fasting lipids, creatinine, and potassium (Bakris, 2021). Additionally, the doctor should do ECG to test the presence of left ventricular hypertrophy. Some investigations could include thyroid-stimulating hormone measurement. Sphygmomanometry is one of the main ways to diagnose and classify hypertension. Therefore, all factors, including the history of illnesses and the patient’s physical state, should be considered.
Interview
The person who has been interviewed is my 45-years, old father. He has been diagnosed with hypertension for the last ten years. In the first stages, he tried to ignore his condition. However, last year he experienced a heart attack and had a colonoscopy. I could assume it is secondary hypertension due to his lifestyle (excessive drinking and smoking, stressful lifestyle). Moreover, high blood pressure could result from obesity, as my father is overweight. The main issue associated with his condition is the risk of repeated heart attacks and limitations related to physical activity. Also, he is required to keep his diet and stop smoking and drinking alcohol. Despite the complicated situation, his conditions are satisfactory, and our family is optimistic about the future.
References
Bakris, G. L. (2021). Hypertension – cardiovascular disorders. MSD Manual Professional Edition. Web.
