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William H. McMicken, M.D.
Suite 323
2600 Philmont Avenue
Huntingdon Valley, Pennsylvania 19006
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Hypertension, The Silent Disease

Introduction to High Blood Pressure
High blood pressure is a major health problem in the United Sates. It is estimated that up to half of all Americans will have high blood pressure at some time during their life. Millions of people who have high blood pressure do not even know they have it, because they have no symptoms. Because of this it has been called by some "the silent killer". Even among people who are being treated for high blood pressure are significant numbers whose blood pressure is not adequately controlled. High blood pressure is important because it is associated with leading causes of deathÖ heart attack and stroke. High blood pressure usually causes no symptoms for many years. It can only be detected in its earlier stages by looking for it. The first symptom experienced by a person with high blood pressure who has not been diagnosed and treated is often a sudden heart attack or stroke. A person with high blood pressure which is not controlled is five times more likely to have a heart attack than a person with normal pressure. About 90 percent of stroke patients have high blood pressure.

Hypertension is the medical term which means high blood pressure. As is much medical terminology, it is derived from Greek and Latin words, since the early academic literature of Western medical knowledge was written in Greek or Latin. Hyper is from a Greek word meaning "over" or "above". It has come to be a prefix in English meaning "over, above, more than normal", or "excessive". Tension is from the Latin tensus, which means "stretched tight, taut, tense, under pressure". "Tension" is often used by both the general public and medical authorities to refer to mental or emotional strain and anxiety. Many people mistakenly understand the word "hypertension" to be a mental state, rather than a physical state of having elevated blood pressure.

While anxiety and "nervous tension" may sometimes be associated with high blood pressure, the association is not always present. The first impression is that someone "hypertensive" would be excitable, nervous, overactive, anxious, and worried. This type of person is often thought of as the only kind susceptible to high blood pressure. The fact is that most people with high blood pressure have no symptoms related directly to their blood pressure. It is possible to have a calm, relaxed personality and still have high blood pressure requiring treatment.

In about 90 percent of persons with high blood pressure, it is not possible to assign a single cause for the disorder. It is this majority that this article discusses in detail. Doctors call this most common type "essential" or "primary" hypertension. "Essential" in this instance does not mean something very necessary, or something you must have. Rather "essential" is used as a synonym for "intrinsic", or existing of itself, without known cause. The small percentage of cases of high blood pressure which have a specific cause are referred to as "secondary" hypertension.

It is important to make a proper diagnosis of secondary hypertension, however, since the secondary type may actually be curable by correcting the cause. Diagnosis of secondary hypertension can usually be made without much difficulty by history, physical examination, x-rays, and laboratory studies. The causes of secondary hypertension are not discussed in detail in this article.

Many persons believe they "can tell" when their blood pressure is high. It has been shown on scientific testing that such people are quite inaccurate and inconsistent in predicting their blood pressure by how they feel. How one feels can not reliably predict blood pressure elevation. The only way to detect this disease is to measure the blood pressure. Today, it is simple to have one's blood pressure checked. This was not always so, as the review of medical history earlier in this article described.

Causes of Essential Hypertension

With advancements in medical knowledge in the late 19th and early 20th century it soon became apparent that the systems used by the body to regulate blood pressure were extremely complex. To this day, the exact mechanisms of blood pressure control are not fully known. While we know the tendency to high blood pressure may be genetic, or inherited, we do not know all the precise chemical or physical changes in the body that cause high blood pressure, or control it.

The kidneys, brain, nervous system, adrenal glands, and other organs all play a part in blood pressure regulation. The normal system keeps blood pressure within a present range. The system senses when the blood pressure is tending too high or too low and then corrects it. Some of the factors involved are chemical substances called hormones. These include epinephrine (also called adrenaline) and related chemicals known as catecholamines.

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