Hypertension Theraphy

Definition: The increase in systolic blood pressure without a concomitant increase in diastolic blood pressure is the systolic hypertension.

Etiology :
1. Decreased elasticity of the aorta due arteriosclerosis aorta (most common cause).
2. Increased cardiac output due to the presence of fever, anemia, thyrotoxicosis, hyperkinetic heart syndrome, arteriovenous fistula, Paget’s disease, beriberi or anxiety.
3. Increased stroke volume due to aortic insufficiency or complete heart block
4. Coarctation.

Symptoms :
The symptoms, if any, are produced by underlying disease and not dependent arterial hypertension per se.

Signs :
The systolic hypertension is characterized by persistently elevated systolic blood pressure.

Diagnostic approach

1. Exclude aortic coarctation checking blood pressure and pulses in both arms and legs. If blood pressure in the legs is 20-30 mmHg lower than in the arms, or if the peak is delayed femoral pulses, or both situations, we need to go deeper in search of aortic coarctation.
2. Exclude been characterized by range and other conditions which result in an increase in stroke volume.
3. If the above conditions are excluded and the patient is middle-aged or elderly is the most likely cause is the presence of atherosclerosis of the aorta.

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