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Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" refers to the pressure in the large arteries. Blood pressure is usually expressed in terms of the systolic pressure over diastolic pressure in the cardiac cycle. It is measured in millimeters of mercury (mmHg) above the surrounding atmospheric pressure.
Hypertension, also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide.
A hypertensive urgency is a clinical situation in which blood pressure is very high with minimal or no symptoms, and no signs or symptoms indicating acute organ damage. This contrasts with a hypertensive emergency where severe blood pressure is accompanied by evidence of progressive organ or system damage.
Hypertensive retinopathy is damage to the retina and retinal circulation due to high blood pressure.
Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure and the diastolic blood pressure, which are the maximum and minimum blood pressures, respectively. A systolic blood pressure of less than 90 millimeters of mercury (mmHg) or diastolic of less than 60 mmHg is generally considered to be hypotension. Different numbers apply to children. However, in practice, blood pressure is considered too low only if noticeable symptoms are present. Primary symptoms generally include dizziness and lightheadedness. Other symptoms include fatigue, shortness of breath, headaches, shakiness, increased thirst, irregular heartbeat, chest pain, confusion.
Essential hypertension is the form of hypertension that by definition has no identifiable secondary cause. It is the most common type affecting 85% of those with high blood pressure. The remaining 15% is accounted for by various causes of secondary hypertension. Primary hypertension tends to be familial and is likely to be the consequence of an interaction between environmental and genetic factors. Prevalence of essential hypertension increases with age, and individuals with relatively high blood pressure at younger ages are at increased risk for the subsequent development of hypertension. Hypertension can increase the risk of cerebral, cardiac, and renal events.
White coat hypertension (WHT), more commonly known as white coat syndrome, is a form of labile hypertension in which people exhibit a blood pressure level above the normal range, in a clinical setting, although they do not exhibit it in other settings. It is believed that the phenomenon is due to anxiety experienced during a clinic visit.
Mecamylamine is a non-selective, non-competitive antagonist of the nicotinic acetylcholine receptors (nAChRs) that was introduced in the 1950s as an antihypertensive drug. In the United States, it was voluntarily withdrawn from the market in 2009 but was brought to market in 2013 as Vecamyl and eventually was marketed by Turing Pharmaceuticals.
Bretylium (also bretylium tosylate) is an antiarrhythmic agent. It blocks the release of noradrenaline from nerve terminals. In effect, it decreases output from the peripheral sympathetic nervous system. It also acts by blocking K+ channels and is considered a class III antiarrhythmic. The dose is 5–10 mg/kg and side effects are high blood pressure followed by low blood pressure and ventricular ectopy.
Reflux nephropathy is kidney damage (nephropathy) due to urine flowing backward (reflux) from the bladder toward the kidneys; the latter is called vesicoureteral reflux (VUR). Longstanding VUR can result in small and scarred kidneys during the first five years of life in affected children. The end results of reflux nephropathy can include high blood pressure, excessive protein loss in the urine, and eventually kidney failure.
Renal segmental hypoplasia is a kidney with a partially developed or atrophic renal cortex.
Chloride channel protein ClC-Ka is a protein that in humans is encoded by the CLCNKA gene. Multiple transcript variants encoding different isoforms have been found for this gene.
Alpha-blockers, also known as α-blockers or α-adrenoreceptor antagonists, are a class of pharmacological agents that act as antagonists on α-adrenergic receptors (α-adrenoceptors).
ATP-binding cassette, sub-family C member 9 (ABCC9) also known as sulfonylurea receptor 2 (SUR2) is an ATP-binding cassette transporter that in humans is encoded by the ABCC9 gene.
Central aortic blood pressure is the blood pressure at the root of aorta. Studies have shown the importance of central aortic pressure and its implications in assessing the efficacy of antihypertensive treatment with respect to cardiovascular risk factors. The traditional method of measuring blood pressure in the arms has been shown to underestimate the efficacy of medications such as amlodipine and overestimate the efficacy of those like atenolol. A clinical trial demonstrated that different medications for lowering blood pressure have different effects on the central aortic pressure and blood flow characteristics, despite producing similar branchial blood pressure readings. The study also indicated that the CAP is a better independent predictor of cardiovascular and kidney outcomes.
Complications of hypertension are clinical outcomes that result from persistent elevation of blood pressure. Hypertension is a risk factor for all clinical manifestations of atherosclerosis since it is a risk factor for atherosclerosis itself. It is an independent predisposing factor for heart failure, coronary artery disease, stroke, kidney disease, and peripheral arterial disease. It is the most important risk factor for cardiovascular morbidity and mortality, in industrialized countries.
Lactotripeptides are two naturally occurring milk peptides: Isoleucine-Proline-Proline (IPP) and Valine-Proline-Proline (VPP). These lactotripeptides are derived from casein, which is a milk protein also found in dairy products. Although most normal dairy products contain lactotripeptides, they are inactive within the original milk proteins. Dairy peptides can be effectively released through enzymatic predigestion – a process by which milk protein is enzymatically broken down into smaller pieces. Some clinical studies have suggested that these lactotripeptides help promote healthy blood pressure levels as part of a healthy diet and lifestyle. However, other clinical trials have seen no effects from these compounds.
The modern history of hypertension begins with the understanding of the cardiovascular system based on the work of physician William Harvey (1578–1657), 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 1733. Descriptions of what would come to be called hypertension came from, among others, Thomas Young in 1808 and especially Richard Bright in 1836. Bright noted a link between cardiac hypertrophy and kidney disease, and subsequently kidney disease was often termed Bright's disease in this period. In 1850 George Johnson suggested that the thickened blood vessels seen in the kidney in Bright's disease might be an adaptation to elevated blood pressure. William Senhouse Kirkes in 1855 and Ludwig Traube in 1856 also proposed, based on pathological observations, that elevated pressure could account for the association between left ventricular hypertrophy to kidney damage in Bright's disease. Samuel Wilks observed that left ventricular hypertrophy and diseased arteries were not necessarily associated with diseased kidneys, implying that high blood pressure might occur in people with healthy kidneys; however, the first report of elevated blood pressure in a person without evidence of kidney disease was made by Frederick Akbar Mahomed in 1874 using a sphygmograph. The concept of hypertensive disease as a generalized circulatory disease was taken up by Sir Clifford Allbutt, who termed the condition "hyperpiesia". However, hypertension as a medical entity really came into being in 1896 with the invention of the cuff-based sphygmomanometer by Scipione Riva-Rocci in 1896, which allowed blood pressure to be measured in the clinic. In 1905, 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. Tracking serial blood pressure measurements was further enhanced when Donal Nunn invented an accurate fully automated oscillometric sphygmomanometer device in 1981.
Carbonaceous sulfur hydride is a purported room-temperature superconductor that was announced in October 2020. The material is claimed to have a maximal superconducting transition temperature of 15 °C (59 °F) at a pressure of 267 gigapascals (GPa), though the validity of the claim has faced criticism. In September 2022 the article was retracted by Nature journal editorial board due to a non standard, user-defined data analysis calling into question the scientific validity of the claim.
References
- ↑ Thavarajah (1 December 2003). "Terminal digit bias in a specialty hypertension faculty practice". Nature . 17 (12): 819–822. doi: 10.1038/sj.jhh.1001625 . PMID 14704725.
- ↑ Nietert, Paul J.; Wessell, Andrea; Feifer, Chris; Ornstein, Steven (2006). "Effect of Terminal Digit Preference on Blood Pressure Measurement and Treatment in Primary Care". American Journal of Hypertension. 19 (2): 147–152. doi:10.1016/j.amjhyper.2005.08.016. PMID 16448884. S2CID 25597886 . Retrieved 2 October 2021.
- ↑ Thavarajah (1 December 2003). "Terminal digit bias in a specialty hypertension faculty practice". Nature . 17 (12): 819–822. doi: 10.1038/sj.jhh.1001625 . PMID 14704725.
- ↑ Hla, Khin (1986). "Observer Error in Systolic Blood Pressure Measurement in the Elderly". Arch Intern Med. 146 (12): 2373. doi:10.1001/archinte.1986.00360240099017 . Retrieved 29 September 2021.
- ↑ Hayes (2008). "Terminal digit preference occurs in pathology reporting irrespective of patient management implication". Journal of Clinical Pathology . 61 (9): 1071–1072. doi:10.1136/jcp.2008.059543. PMID 18755731. S2CID 10737432 . Retrieved 29 September 2021.
- ↑ Lusignan (23 March 2004). "End-digit preference in blood pressure recordings of patients with ischaemic heart disease in primary care". Nature. 18 (4): 261–265. doi:10.1038/sj.jhh.1001663. PMID 15037875. S2CID 430764 . Retrieved 29 September 2021.
- ↑ Lawrence, Jack (22 September 2021). "The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable". Nature. 27 (11): 1853–1854. doi: 10.1038/s41591-021-01535-y . PMID 34552263.
- ↑ Brown, Nick. "Dr". More problematic articles from the Food and Brand Lab. Nick Brown. Retrieved 30 November 2021.
- ↑ Retraction Watch (19 September 2018). "JAMA journals retract six papers by food marketing researcher Brian Wansink". Retraction Watch. Retrieved 30 November 2021.
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