hypertension or high blood pressure, elevated blood pressure resulting from an increase in the amount of blood pumped by the heart or from increased resistance to the flow of blood through the small arterial blood vessels (arterioles). Hypertension is generally defined as a blood pressure reading greater than 140 over 90; presssures of 120-139 over 80-89 are now considered prehypertension. When the cause is unknown, the hypertension is called primary, or essential, hypertension. When a cause can be identified (e.g., a disorder of the adrenal glands, kidneys, or arteries), the condition is known as secondary hypertension. Factors such as heredity, obesity, smoking, and emotional stress are thought to play a role; the usual immediate cause is an imbalance in the body's vasoconstriction/fluid retention systems, often involving a decrease in the kidney's secretion of the regulatory hormone, renin.

Known as the "silent killer," hypertension often produces few overt symptoms; it may, however, result in damage to the heart, eyes, kidneys, or brain and ultimately lead to congestive heart failure, heart attack (see infarction), kidney failure, or stroke. African Americans and women are the most affected. Treatment of hypertension includes diets to reduce weight and salt and alcohol intake, increased exercise, quitting smoking, and various drugs, such as diuretics, ACE inhibitors, beta-blockers, calcium-channel blockers or angiotensin-receptor blockers, as well as biofeedback. Many patients require a combination of drugs to control their blood pressure. Treatment for persons with prehypertension includes dietary and other lifestyle changes. Recent research has questioned the importance of dietary salt as a major contributor to hypertension; some studies point to low calcium intake as a cause.

See also eclampsia.

or high blood pressure

Condition in which blood pressure is abnormally high. Over time, it damages the kidneys, brain, eyes, and heart. Hypertension accelerates atherosclerosis, increasing the risk of heart attack, stroke, and kidney failure. More common in the elderly and blacks, it usually has no symptoms but can be detected by a routine blood-pressure test. Secondary hypertension, caused by another disorder (most often kidney disease or hormone imbalance), accounts for 10percnt of cases. The other 90percnt have no specific cause (essential hypertension). A low-salt diet, weight loss, smoking cessation, limited alcohol intake, and exercise can prevent or treat hypertension or reduce medication if drug therapy proves necessary. Malignant hypertension, a severe, rapidly progressing form, requires emergency treatment with drugs to dilate the blood vessels.

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