Hypertension, essential

In the United States, African-Americans are twice as likely as Caucasians to experience hypertension. After age 65 years, African-American women have the highest incidence of hypertension. Essential hypertension cannot be cured but can be controlled. Many individuals experience hypertension as they grow older, but hypertension is not a part of healthy aging. For many older individuals, the systolic pressure gives the most accurate diagnosis of hypertension. Display 42-2 discusses the importance of the systolic pressure ... 

In most individuals the etiology of hypertension is unknown and is simply referred to as essential hypertension. Essential hypertension is probably due to a combination of several abnormalities, including genetic predisposition, stress, environmental and dietary factors. Specific potential mechanisms are listed in Table 12.1. 

Q2 The cause of 90% of hypertension (essential hypertension) is unknown. Risk factors for essential hypertension include ... 

Indications Liver/kidney yin deficiency, liver yang ascendancy, qi and blood counterflow and chaos. Wind stroke, convulsions, epilepsy, cerebrovascular accident, aphasia, apraxia, renal hypertension, essential hypertension, hypertensive encephalopathy, cerebral arteriosclerosis, arteriosclerotic heart disease, hyperthyroidism, premenstrual tension, postpartum fever with spasms and convulsions, and glaucoma... 

Essential hypertension. Essential hypertension affects 90% of patients who are hypertensive and is caused by conditions other than those related to renal and endocrine disorders. 

Hypertension is one of the two principal risk factors of many cardiovascular diseases, such as coronary heart disease (CHD), stroke, and CHF. Individuals are considered hypertensive if their systoHc arterial blood pressure is over 140 mm Hg (18.7 Pa) or their diastoHc arterial blood pressure is over 90 mm Hg (12 Pa). Over 60 million people, or one-third of the adult population in the United States are estimated to be hypertensive (163). About 90% of these patients are classified as primary or essential hypertensive because the etiology of their hypertension is unknown. It is generally agreed that there is a very strong genetic or hereditary component to this disease. 

Treatment of essential or primary hypertension emphasizes not only the lowering of the elevated blood pressure, but also individualized therapy for each patient, providing each patient with minimized unnecessary side effects. The patient s cardiovascular morbidity and mortaUty should be decreased and end organ damage reversed or reduced (184,185). 

Carretero OA, Oparil S (2000) Essential Hypertension. Part II Treatment. Circulation 101 329-335... 

Tarif N, Bakris GL (2000) Pharmacologic treatment of essential hypertension. In Johnson RJ, Feehally J (eds) Comprehensive clinical nephrology. Mosby, London, pp 37.1-37.11... 

If 50% of Europeans with essential hypertension are affected by this disease because of an elevated secretion of endogenous ouabain, then there might be a chance to block its interaction at the cardiac glycoside binding site of Na+/K+-ATPase and thus lower blood pressure. This therapeutic approach seems to be successfiil. Recent studies provide evidence that the cardenolide analogue Rostafuroxin (PST 2238 Fig. 4) at very low concentrations can overcome the ouabain-induced tise of hypertension in experimental animals [6]. This compound has recently entered the phase I of clinical trials and is certainly a prototype of a new class of antihypertensive drugs. 

As pharmacogenetics and pharmacogenomics are not mutually exclusive, but even sometimes display overlapping features, both disciplines are aimed at better tailoring medical therapy for a given complex disease such as essential hypertension or other CVD. In the wake of new technologies to identify candidate region for whatever phenotype, more robust and complex bioinformatic analyses are necessary to... 

Phenotype is the actual appearance of an organism or, more specifically in the research context, of a trait of interest. It may be a binary trait, i.e., the presence/ absence of a disease, for example essential hypertension, or a quantitative trait, such as blood pressure level. 

Analysis of ESRB 7 mice showed fewer and smaller litters than wild type mice as well as abnormal vascular function and hypertension. The reduction in fertility was attributed to reduced ovarian efficiency. Mutant females had normal breast development and lactated normally. Older mutant males displayed signs of prostate and bladder hyperplasia. s -2-deficient mice furthermore display diverse regulatory defects in the function of brain, lung, and white blood cells. The results indicated that ESRB is essential for normal ovulation efficiency but is not essential for lactation, female or male sexual differentiation, or fertility. 

Labetalol is used in the treatment of hypertension, either alone or in combination with another drag such as a diuretic. Carvedilol is used to treat essential hypertension and in congestive heart failure to reduce progression of the disease. 

Most cases of hypertension have no known cause. When there is no known cause of hypertension, the term essential hypertension is used. Essential hypertension has been linked to certain risk factors, such as... 

Once essential hypertension develops, management of this disorder becomes a lifetime task. When a direct cause of the hypertension can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks first, with tumors or other abnormalities of the adrenal glands following. In malignant hypertension the diastolic pressure usually exceeds 130 mm Hg. In secondary hypertension,... 

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