Hypertension & Associated Complications

  • Hypertension is known as the silent killer, because there are no symptoms. Current U.S. Preventive Services Task Force guidelines recommend that all adults 18 years and older be screened for high BP. If a patient has elevated BP clinicians should check their pulse, examine the neck for distended veins or enlarged thyroid, listen for heart murmurs, examine the abdomen and check the patient’s vision. Patients with hypertension should also be evaluated for diabetes.

  • If left unchecked, hypertension can place stress on multiple organ system. This colored angiogram shows an anterior oblique view of the left coronary artery in a 59-year-old smoker with arterial hypertension showing severe stenosis (narrowing greater than 75%) of the proximal region of the artery (top center).

  • Hypertension can cause renal atrophy and scarring (left), and left ventricular hypertrophy in the sectioned heart (right). In chronic hypertension the arteriole walls thicken, resulting in reduced renal blood flow, chronic ischemia and atrophy of the kidney tubules. The loss of functioning nephrons can eventually lead to chronic renal failure.

  • Ventricular hypertrophy, as illustrated in this angiogram, has been associated with heart failure. The pulmonary artery and aorta appear as pale white tubes at the top of the enlarged heart.

  • Hypertension can damage blood vessels in the retina, shown here through the view of an ophthalmoscope. The higher the BP and the longer BP has been elevated, the more severe the damage is likely to be. Many patients with hypertensive retinopathy do not have symptoms until late in the disease. These can include double or dim vision, headaches, visual disturbances and loss of vision.

  • Another potential outcome of untreated hypertension is intracerebral hemorrhage, which accounts for 8% to 13% of all strokes and is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage. This MRI shows a hypertensive subacute hematoma.

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One in three U.S. adults has hypertension, the CDC estimates, which increases the risk for heart disease and stroke, the first and third leading causes of U.S. deaths. Learn more about hypertension and associated complications with this slideshow.

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