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Hypertension is defined as high arterial blood pressure. Causes are either unknown (essential or idiopathic hypertension) or associated with other primary diseases (secondary hypertension). Various criteria for its threshold range from 140 mm Hg systolic and 90 mm Hg diastolic to 200 mm Hg systolic and 110 mm Hg diastolic. Per 2003 ESH/ESC Hypertension Guidelines and NHLBI, optimal blood pressure is less than 120/80 mm Hg. Prehypertension is defined as blood pressure120-139/80-89 mm Hg. Newer definitions characterize hypertension as a complex progressive cardiovascular syndrome. The majority of patients are asymptomatic; hypertension is only identified by measuring blood pressure. Signs and symptoms include headache (only in severe hypertension); and other possibly related complaints: dizziness, flushed face, early fatigability, palpitation, and nervousness. Complaints referable to vascular effects include epistaxis, hematuria and blurring of vision. Common presentations of hypertensive emergencies are chest pain, dyspnoea, and neurologic deficit. Neurologic presentations include occipital headache, cerebral infarction or hemorrhage, visual disturbance, or hypertensive encephalopathy. No early pathological changes occur in primary hypertension. Ultimately, generalized arteriolar sclerosis develops, particularly in the kidneys. Hypertension is an important risk factor for cardiovascular events, such as myocardial infarction and stroke. Early diagnosis and treatment is essential.
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