Once thought to merely represent an elevation of blood pressure, medical science is starting to recognize that hypertension is a systemic disorder involving many biochemical and physiologic abnormalities, including alterations in blood volume, cardiac output (the amount of blood the heart pumps each minute), kidney function, and cellular resistance to the effects of insulin. Whether there is one yet to be discovered cause of hypertension, or many, is unknown.
It is estimated that nearly 50 million Americans have hypertension, involving almost 20% of all adults and over 60% of all senior citizens. The frequency of hypertension increases with increasing age and body weight, and is higher in african-americans than Caucasians. Half of patients suffering their first heart attack are hypertensive and two thirds of patients suffering their first stroke are significantly hypertensive.
Whether a person's hypertension is graded as mild (140/90-159/99), moderate (160/100-179/109), or severe (180/110-209/109), there is an increased risk of "end-organ" damage (stroke, heart attack, and kidney failure) when compared to people with normal pressures.
Initial treatment must start with life style modification. Weight loss. Decrease in salt intake, cessation of smoking, participating in regular exercise, and decrease in alcohol consumption are all integral to successful blood pressure control. Even if life style modifications must be supplemented by medication, drug dosing can be minimized by successfully managing these aggravating factors.
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