Blood-pressure categories and causes of secondary hypertension
THE CONTEXT
The target material lists blood-pressure categories and secondary causes of hypertension. It also describes a Doppler finding in chronic aortic dissection.
Blood-pressure categories
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Optimal blood pressure has systolic pressure below 120 mmHg and diastolic pressure below 80 mmHg.
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High-normal blood pressure is listed as systolic pressure 130–139 mmHg and diastolic pressure 85–89 mmHg.
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Grade 1, or mild hypertension, is listed with systolic pressure 140–159 mmHg and diastolic pressure 90–99 mmHg.
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Grade 2, or moderate hypertension, is listed with systolic pressure 160–179 mmHg and diastolic pressure 100–109 mmHg.
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Grade 3, or severe hypertension, is listed with systolic pressure at least 180 mmHg and diastolic pressure above 110 mmHg.
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For isolated systolic hypertension, grade 1 has systolic pressure 140–159 mmHg and grade 2 has systolic pressure at least 160 mmHg; both have diastolic pressure below 90 mmHg.
Renal and other secondary causes
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Listed causes include alcohol, obesity, pregnancy, drugs and coarctation of the aorta.
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Renal causes include glomerular or tubulointerstitial parenchymal disease and polycystic kidney disease.
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Macrovascular renal causes include atherosclerosis, fibromuscular dysplasia and vasculitis. Microvascular causes include small vessel vasculitis and thrombotic microangiopathies.
Endocrine causes
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Listed endocrine causes include phaeochromocytoma, Cushing syndrome, primary hyperaldosteronism (Conn syndrome), glucocorticoid-suppressible hyperaldosteronism, hyperparathyroidism and acromegaly.
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Other listed causes are primary hypothyroidism, thyrotoxicosis, congenital adrenal hyperplasia due to 11β-hydroxylase or 17α-hydroxylase deficiency, Liddle syndrome and 11β-hydroxysteroid dehydrogenase deficiency.
Chronic aortic dissection
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The illustrated colour-flow Doppler study shows flow from the larger false lumen into the true lumen, described as characteristic of chronic disease.