Long term complication of uncontrolled hypertension

High blood pressure is called the ‘’Silent killer” because sometimes there is no typical symptoms or complaints so we may discover it late. The main issue in hypertension is atherosclerosis leading to increased risks of heart failure – coronary artery disease – stroke - peripheral artery disease and sudden death. 

• Hypertension cause microscopic tear in arteries and arterioles which can block them or let them bleed. The other thing is left ventricular hypertrophy (LVH) due to mechanical mechanism leading to myocyte hypertrophy, or Neurohormonal mechanism leading to fibroblastic proliferations.
• The heart gets affected by left ventricular hypertrophy causing diastolic dysfunction and heart failure. Good control of blood pressure could reverse LVH and decrease the rate of cardiovascular complication such as:

1. Coronary artery disease (angina and heart attack) the increase of thickness of heart muscle plus the damage of the artery wall cause imbalance between blood supply and demand.
2. Diastolic heart failure .
3. Congestive heart failure and pulmonary edema.
4. Peripheral artery disease (intermittent claudication).

2 – Cerebrovascular accident

• Stroke: brain infarction and hemorrhage when the artery burst or blocked under the effect of hypertension for long time.
• Hypertensive encephalopathy cause severe headache – nausea and vomiting(projectile)- focal neurologic signs and alteration of mental status may progress to stupor,coma ,seizure, and death within hours if not treated properly.

3 – Hypertensive crisis

• If the blood pressure went too high over 180/110 mm hg, it may cause Pulmonary edema – epistaxis (nose bleeding) – cerebral bleeding (CVA) – severe headache. Here it is mandatary to bring the blood pressure down but slowly to protect the vital organs.

4 – Hypertensive retinopathy which has many stages:

5 – Hypertensive Nephropathy

•  Atherosclerosis in renal arterioles can also result in ischemic changes in glomeruli leading to glomerulosclerosis then renal damage and end stage renal failure.

6 - Diabetes and hypertension:

• It is very bad correlation  so when we take about metabolic syndrome ( hypertension – hyperlipemia – insulin resistant diabetes – obesity) it is serious combination which lead to heart failure , strokes – heart attacks , blindness, renal failure, loss of libido and claudication due to leg ischemia. It is necessary to control this bad syndrome as much as we can.

please do not let your hypertension dominates, you need to get it controlled.

• 7 Complaints for patient suffering from high blood pressure
• Primary and Secondary Hypertension

 Do you have any more questions about hypertension ? please visit our cardiology clinic and you will get all the positive answers for your hypertension. best regards

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