What is hypertension?

Written by Tang Li
Cardiology
Updated on September 26, 2024
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Hypertension is characterized by elevated arterial blood pressure in the systemic circulation, and may be accompanied by functional or organic damage to organs such as the heart, brain, and kidneys. Hypertension can be divided into primary hypertension and secondary hypertension. Secondary hypertension is due to certain identified causes or etiologies, leading to increased blood pressure, accounting for about 5% of all hypertension cases. Conditions like primary aldosteronism, pheochromocytoma, renovascular hypertension, and renin-secreting tumors are examples, and cases where the cause of increased blood pressure cannot be found are also referred to as primary hypertension and hypertensive disease. Currently, the classification and standard for blood pressure in China mostly use a systolic pressure of greater than or equal to 140 mmHg and/or a diastolic pressure of greater than or equal to 90 mmHg.

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Written by Pan Wu Shan
Nephrology
1min 11sec home-news-image

What is the difference between hypertensive nephropathy and renal hypertension?

There are fundamental differences between hypertensive nephropathy and nephrogenic hypertension. Firstly, hypertensive nephropathy occurs due to long-term high blood pressure, leading to complications in the kidneys. Generally, the history of hypertension exceeds ten years, and routine urine tests reveal a relatively small amount of protein in the urine. The main damage lies in the renal tubules, whose reabsorption and concentration functions are impaired. The primary treatment is to control the blood pressure well, possibly in conjunction with medication to protect the kidneys. On the other hand, nephrogenic hypertension originates from nephritis causing high blood pressure and is a form of secondary hypertension. In this condition, controlling blood pressure is particularly challenging. Usually, a significant amount of antihypertensive medication is required. Dietary considerations include a low salt and low fat diet, with daily salt intake limited to about three grams, maintaining regular schedules, and avoiding catching colds.

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Written by Tang Li
Cardiology
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Hypertensive crisis blood pressure values

At any stage of hypertension development and other disease emergencies, severe life-threatening blood pressure increases can occur, requiring emergency treatment. Hypertensive crises include hypertensive emergencies and hypertensive urgencies. Hypertensive emergencies refer to severe blood pressure increases within a short time—hours or days—with diastolic pressure greater than 130 mmHg and/or systolic pressure greater than 180 mmHg, accompanied by severe dysfunction or irreversible damage to critical organs and tissues such as the heart, brain, kidneys, retina, and major arteries. Hypertensive urgencies may present as increased blood pressure but without obvious target organ damage.

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Written by Chen Tian Hua
Cardiology
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Can high blood pressure be hereditary?

Hypertension has a certain level of heritability, and research indicates that if parents have hypertension, their children’s risk of developing this condition significantly increases. Of course, genetic factors are only one of the reasons for the development of hypertension. The presence of genetic factors does not necessarily lead to hypertension; postnatal environmental factors are also very important. Maintaining good lifestyle habits over time, including healthy dietary habits, regular physical exercise, reasonable weight control, and a positive mindset can help prevent hypertension. Moreover, even without a family history of hypertension, poor lifestyle habits can still lead to the development of the condition.

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Written by Zhou Qi
Nephrology
1min 27sec home-news-image

The difference between hypertensive nephropathy and renal hypertension

Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.

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Written by Wei Shi Liang
Intensive Care Unit
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How to deal with hypertensive emergencies

Hypertensive emergency is characterized by a significant increase in blood pressure, often with diastolic pressure greater than 130 mmHg. Target organs including the brain, eyes, heart, and kidneys are severely compromised or fail. Hypertensive emergencies require admission to the CCU for cardiac monitoring and the use of intravenous antihypertensives. In the initial one to two hours, the reduction in blood pressure should not exceed 25% of the peak value. Control blood pressure within two to six hours and stabilize it at 160/100 mmHg. Commonly used antihypertensive drugs include sodium nitroprusside and nitroglycerin, while avoiding the use of nifedipine-like drugs for blood pressure reduction.