Arteriosclerosis and Hypertension: With Chapters on Blood Pressure

Arteriosclerosis and Hypertension
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Eventually, deposits called plaques may form. The deposits may narrow — or block — your arteries. These plaques can also burst, causing a blood clot. Atherosclerosis is a slow, progressive disease that may begin as early as childhood. Although the exact cause is unknown, atherosclerosis may start with damage or injury to the inner layer of an artery. The damage may be caused by:. Once the inner wall of an artery is damaged, blood cells and other substances often clump at the injury site and build up in the inner lining of the artery. Over time, fatty deposits plaque made of cholesterol and other cellular products also build up at the injury site and harden, narrowing your arteries.

The organs and tissues connected to the blocked arteries then don't receive enough blood to function properly. In addition, the smooth lining of the plaque may rupture, spilling cholesterol and other substances into your bloodstream. This may cause a blood clot, which can block the blood flow to a specific part of your body, such as occurs when blocked blood flow to your heart causes a heart attack. A blood clot can also travel to other parts of your body, blocking flow to another organ.

Effects of High Blood Pressure

Hardening of the arteries occurs over time. Besides aging, factors that increase the risk of atherosclerosis include:. Atherosclerosis can also cause aneurysms, a serious complication that can occur anywhere in your body. An aneurysm is a bulge in the wall of your artery. Most people with aneurysms have no symptoms. Pain and throbbing in the area of an aneurysm may occur and is a medical emergency. If an aneurysm bursts, you may face life-threatening internal bleeding.

Although this is usually a sudden, catastrophic event, a slow leak is possible. If a blood clot within an aneurysm dislodges, it may block an artery at some distant point.


The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These include:. Just remember to make changes one step at a time, and keep in mind what lifestyle changes are manageable for you in the long run. Mayo Clinic does not endorse companies or products.

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Home > August - Volume 20 - Issue 11 > ARTERIOSCLEROSIS AND HYPERTENSION, WITH CHAPTERS ON BLOOD PR < Previous Abstract. Email to. Arteriosclerosis and Hypertension, with Chapters on Blood Pressure by Warfield. No cover available. Download; Bibrec.

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Obesity and habitual high-alcohol intake appear to be associated with an increased risk of hypertension. Advertising revenue supports our not-for-profit mission. Read on the Scribd mobile app Download the free Scribd mobile app to read anytime, anywhere. Gleibermann, L. Clinically, it is useful for the screening of hypertensive patients with dyspnea for heart failure. Related Stress and your health Doppler ultrasound: What is it used for? Sign up now.

Toggle navigation. Subscribe Register Login. Your Name: optional. Hypertension is also sub-classified: JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly.

Hypertension is classified as "resistant" if medications do not reduce blood pressure to normal levels. Hypertension occurs in around 0.

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A variety of factors, such as gestational age , postconceptional age and birth weight needs to be taken into account when deciding if a blood pressure is normal in a newborn. High blood pressure must be confirmed on repeated visits however before characterizing a child as having hypertension. The value of routine screening for hypertension in children over the age of 3 years is debated.

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Preventive Services Task Force that the available evidence is insufficient to determine the balance of benefits and harms of screening for hypertension in children and adolescents who do not have symptoms. Much of the disease burden of high blood pressure is experienced by people who are not labeled as hypertensive. Lifestyle changes are recommended to lower blood pressure, before starting medications.

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The British Hypertension Society guidelines [86] proposed lifestyle changes consistent with those outlined by the US National High BP Education Program in [94] for the primary prevention of hypertension:. Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results. Various expert groups have produced guidelines regarding how low the blood pressure target should be when a person is treated for hypertension. The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss.

Though these have all been recommended in scientific advisories, [] a Cochrane systematic review found no evidence for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension. Dietary changes shown to reduce blood pressure include diets with low sodium, [] [] [] the DASH diet , [] vegetarian diets , [] and green tea consumption. Increasing dietary potassium has a potential benefit for lowering the risk of hypertension.

Physical exercise regimens which are shown to reduce blood pressure include isometric resistance exercise , aerobic exercise , resistance exercise , and device-guided breathing.

Chapter 2. Measurement and clinical evaluation of blood pressure

Stress reduction techniques such as biofeedback or transcendental meditation may be considered as an add-on to other treatments to reduce hypertension, but do not have evidence for preventing cardiovascular disease on their own. Several classes of medications, collectively referred to as antihypertensive medications , are available for treating hypertension.

First-line medications for hypertension include thiazide-diuretics , calcium channel blockers , angiotensin converting enzyme inhibitors ACE inhibitors , and angiotensin receptor blockers ARBs. Previously beta-blockers such as atenolol were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, a Cochrane review that included 13 trials found that the effects of beta-blockers are inferior to that of other antihypertensive medications in preventing cardiovascular disease. Resistant hypertension is defined as high blood pressure that remains above a target level, in spite of being prescribed three or more antihypertensive drugs simultaneously with different mechanisms of action.

Rates also vary markedly within regions with rates as low as 3. Rates of high blood pressure in children and adolescents have increased in the last 20 years in the United States. Kidney disease is the most common secondary cause of hypertension in children and adolescents. Nevertheless, primary or essential hypertension accounts for most cases.

Hypertension is the most important preventable risk factor for premature death worldwide. Modern understanding of the cardiovascular system began with the work of physician William Harvey — , who described the circulation of blood in his book " De motu cordis ". The English clergyman Stephen Hales made the first published measurement of blood pressure in In , Nikolai Korotkoff improved the technique by describing the Korotkoff sounds that are heard when the artery is ausculted with a stethoscope while the sphygmomanometer cuff is deflated.

The symptoms similar to symptoms of patients with hypertensive crisis are discussed in medieval Persian medical texts in the chapter of "fullness disease".

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Descriptions of hypertension as a disease came among others from Thomas Young in and especially Richard Bright in Historically the treatment for what was called the "hard pulse disease" consisted in reducing the quantity of blood by bloodletting or the application of leeches. In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction for example the rice diet [] , sympathectomy surgical ablation of parts of the sympathetic nervous system , and pyrogen therapy injection of substances that caused a fever, indirectly reducing blood pressure.

The first chemical for hypertension, sodium thiocyanate , was used in but had many side effects and was unpopular. None of these were well tolerated. The first was chlorothiazide , the first thiazide diuretic and developed from the antibiotic sulfanilamide , which became available in The World Health Organization has identified hypertension, or high blood pressure, as the leading cause of cardiovascular mortality. Over the past three years, more national societies have been engaging in WHD and have been innovative in their activities to get the message to the public.

In , there was record participation from 47 member countries of the WHL. During the week of WHD, all these countries — in partnership with their local governments, professional societies, nongovernmental organizations and private industries — promoted hypertension awareness among the public through several media and public rallies.

Using mass media such as Internet and television, the message reached more than million people. As the momentum picks up year after year, the WHL is confident that almost all the estimated 1. High blood pressure is the most common chronic medical problem prompting visits to primary health care providers in USA. People also face the challenges of adhering to medicine schedules and making lifestyle changes.

Nonetheless, the achievement of blood pressure goals is possible, and most importantly, lowering blood pressure significantly reduces the risk of death due to heart disease and stroke, the development of other debilitating conditions, and the cost associated with advanced medical care.