Essential hypertension as a contributing factor to heart disease

¶ … hypertension is a condition that concerns blood pressure and causes other serious conditions, including heart disease and possible arterial aneurysm. It is the most common form of hypertension, affecting an approximate 72 million Americans (MedicineNet, 2010). Although the precise causes of hypertension are now always known, there are factors that increase the likelihood of the condition, or exacerbates it in patients who already suffer from essential hypertension. Carretero and Oparil (2000) for example list many factors that can contribute to the condition, including obesity, insulin resistance, high salt intake, low potassium and calcium intake, and lifestyle issues such as a sedentary lifestyle along with high alcohol intake. According to Vikrant and Tiwari (2001, p. 140), essential hypertension is a somewhat dangerous condition, which could lead to a higher risk for problems such as heart disease, stroke, and kidney failure. A high level of salt intake therefore affects the ability of blood to retain water, and may therefore lead to high blood pressure.

In terms of heart disease, Reaven (2003) suggests that, although coronary heart disease is one of the major causes of morbidity in those with essential hypertension, not all such patients are at equal risk of such problems. Indeed, those who are also insulin resistant for example present a higher risk of heart disease than those who do not present such a resistance.

Narkiewicz (2006) focuses on the links of obesity with hypertension and the increased risk of cardiovascular disease and mortality. Although the author acknowledges that these links are not yet fully understood, there are some specific factors that link obesity with hypertension. Obesity might for example activate the renin -- angiotensin -- aldosterone system, and promotes insulin and leptin resistance. Other mechanisms that play a role include the increased reabsorption of sodium, which causes a shift of pressure to result in hypertension. Insulin resistance and glucose intolerance.

In addition to cardiovascular disease, other conditions resulting from essential hypertension include atherosclerosis, arterial aneurysm, and myocardial infarction.

According to Alexander (1995), atherosclerosis and hypertension in the same patient can both conspire to cause oxidative stress in the arterial wall. Indeed, hypertension alone, without the addition of other existing conditions, has been associated with Leukocyte adhesion and smooth muscle cell migration. In other words, it causes oxidative stress or injury to the endothelium, which results in mechanisms for recruiting mononuclear leukocytes to the arterial wall.

In terms of treatment, Alexander suggests a growing interest in the use of antioxidants. Further investigation is however required to determine the viability of this treatment. The author notes that it can also be used in the mitigation of hypertensive vascular injury that can lead to atherosclerosis.

Hypertension is also one of the most common conditions in the occurrence of renal arterial aneurysm, which makes it a likely cause or at least an associated indicator, for the condition. According to Lew (2008), up to 90 per cent of cases presenting renal arterial aneurysm also present essential hypertension.

Myocardial infarction is one of the most common forms of heart attach associated with essential hypertension. According to Fenton (2010), the condition is caused by the rapid development of myocardial necrosis, which in turn is caused by a critical imbalance between oxygen supply and demand in the myocardium.

This is closely related to atherosclerosis, as mentioned above. A plaque or rupture in a coronary vessel results in a significant reduction of blood supply to a critical portion of the myocardium.

Although not causing the condition directly, essential hypertension could be a significant contributing factor to the condition. Hypertension in such patients is also associated with elevated catecholamine levels, which in turn are caused by anxiety, pain, or other medical factors.

In addition to treatments for essential hypertension, Garas (2010) suggests that the condition can be treated by means of restoring the myocardial perfusion either by medical means or by surgery. Surgery might be administered either by percutaneous coronary intervention or coronary artery bypass grafting. Other suggested treatments include the restoration of balance between oxygen supply and demand to the myocardium; pain relief, or prevention and treatment measures for complications. Survival rates are reported to increase with Thrombolytic therapy, or with aspirin/antiplatelet treatment.