Hypertension, or increased blood pressure, is one of the leading health problems facing the world today. It is a condition that is difficult to cure, and is instead managed with lifestyle changes and pharmacologic therapy. Due to either inadequate therapy or inadequate compliance, hypertension persists and results in a variety of effects on the body. Usually it is asymptomatic for the majority of the disease course, until the damage done to organs over time manifests through various means.
Cardiovascular System
The heart and blood vessels are strongly affected by an increased blood pressure. The heart pumps blood against a higher pressure constantly, which can cause it to increase in size (hypertrophy). This increase in size is associated with many problems, such as chest pain, heart failure, rhythm disturbances and even heart attack. The blood vessels are also affected, increasing the formation of plaques that can dislodge later and block downstream vessels; this results in end organ damage such as a heart attack. In addition, vessels can suffer actual tears, such as the case in aortic dissection. This complication of hypertension results in massive bleeding from tears in the aorta, a major artery. Finally, aneurysms can also form in areas of high blood pressure (such as the aorta).
Kidneys
Increased blood pressure has very damaging effects on the kidneys as well. Nephrosclerosis is a renal complication of hypertension; it is the narrowing of arteries leading to the kidney, which results in impaired kidney blood flow. In addition, hypertension can cause the smooth muscle cells in arteries to grow and thicken, causing damage and obliteration of the artery. This is very common in kidneys as a result of hypertension, and usually causes damage to the organs. This is why hypertension is one of the main reasons behind end stage kidney disease.
Brain
Hypertension is a major risk factor for hemorrhagic stroke, which is the rupture of a blood vessel in the brain. This can result in a variety of symptoms, such as altered mental state, sensory disturbances, motor difficulties, problems with speech and communication, altered judgment and death. Chronic ruptures of small vessels can result in a disease known as vascular dementia. This results in the symptoms of dementia occurring in a "step-by-step" fashion; every successive vessel that is damaged causes a subsequent quantifiable decrease in function.
Malignant Hypertension
Malignant hypertension occurs when existing chronic hypertension rises very quickly to very high levels (over 220/120, with organ damage symptoms). Symptoms include confusion, headache, drowsiness, nausea and vision disturbances. This is an emergency, and rapid treatment must be undertaken to prevent serious organ damage.
Eyes
High blood pressure can damage the vessels leading to and inside the eye and the retina. This is known as retinopathy, and hypertensive patients are screened regularly for this condition as it is usually asymptomatic until the late stages of the disease, at which point visual disturbances start occurring.
Sexual Dysfunction
Hypertension also causes sexual dysfunction, and it seems more common and severe in men. The damage to the blood vessels of the penis from the increased blood pressure is hypothesized to be the main reason behind erectile dysfunction, or ED.
References
- "Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th Edition;" Libby; 2007
- "Medical Clinics of North America"; Target organ involvement in hypertension: a realistic promise of prevention and reversal; Frohlich, E.; January 2004
- "Medical Clinics of North America"; Hypertension and Cardiac Failure in its Various Forms; Gaddam, K., Verma, A., Thompson, M., Amin, R., Ventura, H.; May 2009
