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Ha cause for the blood pressure
elevation can be defined, it is
`° called secondary hypertension.
Some of the recognized causes of
secondary hypertension include
diseases of the kidney or adren-
al glands, narrowing of the artery
that supplies the kidney (renal
artery), a birth defect that nar-
rows the aorta (coarctation) and
the use of birth control pills (es-
pecially in women over 40 years
of age).
When the specific cause for sec-
ondary hypertension is effective-
ly treated or surgically removed,
the hypertension is cured. Often
no further treatment is needed.
Unfortunately, probably no
more than 3 percent to 5 percent
of hypertensive patients fall into
this category. For all the others,
medications are needed for a life-
time to keep blood pressure un-
;=-3 der control.
When the kidney's blood sup-
ply is restricted, it produced an
enzyme called renin. Renin reacts
with a blood protein to produce
angiotensin, a powerful arterial
constrictor that increases resis-
tance to the flow of blood, thereby
raising blood pressure. Increased
renin in the blood stream is prob-
ably responsible for hypertension
associated with some types of kid-
ney disorders; however, it is not
the cause in most cases of essen-
tial hypertension because more
than 80 percent of these patients
have normal or low renin blood
levels.
An overactive sympathetic ner-
vous system, which controls the
pulse rate, force of the heartbeat
and constriction of arteries, has
been defined in many hyperten-
sive people, sometimes before
blood pressure is persistently el-
evated.
Modern medicines used to treat
essential hypertension work in re-
lation to these known factors. Beta
blockers blunt the effects of the
sympathetic nervous system,
while angiotensin inhibitors fight
the arterial constriction caused by
this powerful substance. Because
constriction of small arteries,
called arterioles, is a common de-
nominator in almost all cases of
hypertension, direct vasodilators
(medicines that dilute arterioles)
are also effective.
Salt restriction, weight control,
proper exercise and emotional
stress reduction are also impor-
tant.
Hypertension hastens the
process of arteriosclerosis, or hard-
ening of the arteries, which is a
factor contributing to stroke and
heart attack. Damage to arteri-
oles leads to brain hemorrhage or
kidney failure. The arterioles can
be visualized in the retina, af-
fording the physician a window to
assess the severity of the disease
and follow its progress.
Have your blood pressure
checked, and start treatment if it
is needed. You owe it to your loved
ones. ❑
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