Clinical manifestations of hypertension -- a must-read article

by 60888888 on 2010-01-29 10:59:46

As the Spring Festival approaches, it is important for some hypertensive patients to know how to control their blood pressure. Due to the recent high attention on hypertensive patients, I would like to introduce the clinical manifestations of hypertension today. Hypertension can be divided into two types according to the onset and progression of the disease: slowly progressive hypertension and rapidly progressive malignant hypertension.

Slowly progressive hypertension is more common, accounting for about 95%. The onset is insidious, the disease develops slowly, and the course of the disease lasts more than 10-20 years. There are often no symptoms in the early stage, and occasionally blood pressure is found to be elevated during a physical examination. Some patients may suddenly suffer from cerebral hemorrhage, at which point hypertension is discovered. Hypertension often shows both systolic and diastolic blood pressure being high. Initially, blood pressure fluctuates greatly, and tends to increase after mental tension, emotional fluctuations, or fatigue. After removing the cause or resting, blood pressure can return to normal. As the disease progresses, hypertension cannot return to normal even after rest, and antihypertensive drugs are needed for treatment. A significant increase in systolic blood pressure often indicates arteriosclerosis.

Rapidly progressive malignant hypertension includes rapidly progressive hypertension and malignant hypertension. Rapidly progressive hypertension refers to a rapid progression from the start or after a few years of slow progression. It is commonly seen in young people under 40 and the elderly. Clinically, there is a marked elevation in blood pressure, often persisting above 26.6/17.3 kPa (200/130 mmHg). Fundus examination may reveal retinal bleeding or exudation. Malignant hypertension is more common in young people, with diastolic blood pressure often exceeding 18.6 kPa (140 mmHg) and papilledema (Grade II). Currently, it is believed that the pathological changes and clinical manifestations of the two are similar. If rapidly progressive hypertension is not treated in time, it can quickly turn into malignant hypertension. In other words, malignant hypertension is the most severe stage of rapidly progressive hypertension. Therefore, they are now collectively referred to as rapidly progressive malignant hypertension.

In the early stages of hypertension, patients may experience symptoms such as headache, dizziness, tinnitus, palpitations, blurred vision, lack of concentration, memory loss, numbness in hands and feet, fatigue, and irritability. These symptoms are mostly caused by dysfunction of the higher nervous system, and their severity may not be consistent with the degree of blood pressure increase.

In the later stages, blood pressure often remains at a high level, accompanied by damage to target organs such as the brain, heart, and kidneys. This organ damage can be directly caused by hypertension or indirectly caused by accelerated atherosclerotic diseases. In the early stages of target organ damage, there may be no symptoms, eventually leading to functional disorders, and even failure. For example, after hypertension causes brain damage, transient cerebral vasospasm may occur, worsening headaches and dizziness, transient blindness, and paralysis of one side of the body, which can last for several minutes or hours and then recover. Cerebral hemorrhage may also occur. Heart damage first manifests as cardiac enlargement, followed by left heart failure, with symptoms such as chest tightness, shortness of breath, and coughing. When the kidneys are damaged, there may be an increase in nighttime urine volume or frequency of urination. In severe cases, renal failure occurs, with symptoms such as reduced urine output, anuria, loss of appetite, and nausea. If these symptoms appear, prompt treatment should be sought to avoid worsening of the condition.

During the Spring Festival, I have compiled a comprehensive list of dietary therapies for hypertension patients to help control blood pressure through diet.