Hypertension
Also known as: high blood pressure, HTN
Hypertension is chronically elevated arterial blood pressure. Usually symptomless, it is a major risk factor for heart attack, stroke, heart failure, and kidney disease, which is why it is called the "silent killer."
Hypertension is a sustained elevation of the pressure that circulating blood exerts on artery walls, measured as systolic pressure (during heart contraction) over diastolic pressure (during relaxation). A diagnosis rests on repeated elevated readings taken with proper technique — correct cuff size, seated patient, arm supported at heart level — not on a single measurement.
About nine in ten cases are primary (essential) hypertension, which has no single identifiable cause but is linked to age, genetics, obesity, high sodium intake, inactivity, and alcohol use. The remainder is secondary hypertension, driven by an underlying condition such as renal artery stenosis, chronic kidney disease, primary hyperaldosteronism, pheochromocytoma, or certain medications — suspected when hypertension appears young, suddenly, or resists treatment.
Untreated hypertension quietly damages end organs. Sustained pressure accelerates atherosclerosis and left ventricular hypertrophy, raising the risk of myocardial infarction, stroke, heart failure, chronic kidney disease, and retinopathy. Management combines lifestyle change with drug classes including thiazide diuretics, ACE inhibitors, angiotensin receptor blockers, and calcium channel blockers. A related but distinct entity, portal hypertension, is elevated pressure in the portal venous system — usually from cirrhosis — and produces varices and ascites rather than arterial disease.
Hypertension spans many licensing exams. The CCMA tests blood pressure measurement technique and classification, USMLE Step 1 tests the pathophysiology, secondary causes, and antihypertensive pharmacology, and the NPTE-PTA expects recognition of hypertension as a cardiovascular pathology and its implications during therapy.
Key takeaways
- Hypertension is chronically elevated arterial blood pressure, diagnosed from repeated proper measurements.
- Roughly 90% of cases are primary (essential); secondary causes include renal and endocrine disease.
- It is usually asymptomatic but drives heart attack, stroke, heart failure, and kidney damage.
- Treatment pairs lifestyle modification with diuretics, ACE inhibitors, ARBs, and calcium channel blockers.
- The CCMA, USMLE Step 1, and NPTE-PTA all test hypertension from measurement to pharmacology.