hypertension or high blood pressure, elevated blood pressure resulting from an increase in the amount of blood pumped by the heart or from increased resistance to the flow of blood through the small arterial blood vessels (arterioles). Hypertension was generally defined as a blood pressure reading of 140 over 90 or higher, but new guidelines issued in 2017 define hypertension as 130 over 80 or higher. Presssures of 120–129 over less than 80 are considered elevated. When the cause is unknown, the hypertension is called primary, or essential, hypertension. When a cause can be identified (e.g., a disorder of the adrenal glands, kidneys, or arteries), the condition is known as secondary hypertension. Factors such as heredity, obesity, smoking, and emotional stress are thought to play a role; the usual immediate cause is an imbalance in the body's vasoconstriction/fluid retention systems, often involving a decrease in the kidney's secretion of the regulatory hormone, renin.

Known as the "silent killer," hypertension often produces few overt symptoms; it may, however, result in damage to the heart, eyes, kidneys, or brain and ultimately lead to congestive heart failure, heart attack (see infarction), kidney failure, or stroke. African Americans and women are the most affected. Treatment of hypertension includes diets to reduce weight and salt and alcohol intake, increased exercise, quitting smoking, and various drugs, such as diuretics, ACE inhibitors, beta-blockers, calcium-channel blockers or angiotensin-receptor blockers, as well as biofeedback. Many patients require a combination of drugs to control their blood pressure. Treatment for persons with prehypertension includes dietary and other lifestyle changes. Recent research has questioned the importance of dietary salt as a major contributor to hypertension; some studies point to low calcium intake as a cause.

See also eclampsia.

The Columbia Encyclopedia, 6th ed. Copyright© 2018, The Columbia University Press.

Hypertension: Selected full-text books and articles

Hypertension and Stress: A Unified Concept By Alvin P. Shapiro Lawrence Erlbaum Associates, 1996
Lifestyle Modification for the Prevention and Treatment of Hypertension By Paul K. Whelton; Jiang He; Gail T. Louis Marcel Dekker, 2003
Stress, Coping, and Cardiovascular Disease By Philip M. McCabe; Neil Schneiderman; Tiffany Field; A. Rodney Wellens Lawrence Erlbaum Associates, 2000
Librarian's tip: Chap. 7 "Cardiovascular Reactivity as an Indicator of Risk for Future Hypertension"
Neuropsychology of Cardiovascular Disease By Shari R. Waldstein; Merrill E. Elias Lawrence Erlbaum Associates, 2001
Librarian's tip: Chap. Two "Hypertension and Cognitive Function"
Cardiovascular Reactivity to Psychological Stress & Disease By Jim Blascovich; Edward S. Katkin American Psychological Association, 1993
Librarian's tip: Chap. 3 "Biobehavioral Stressors, Laboratory Investigation, and the Risk of Hypertension"
Hypertension in Diabetes By Bryan Williams Martin Dunitz, 2003
The Management of Obesity and Related Disorders By Peter G. Kopelman Martin Dunitz, 2001
Librarian's tip: Chap. 4 "Obesity and Cardiovascular Disease and Hypertension"
The Deadly Emotions: The Role of Anger, Hostility, and Aggression in Health and Emotional Well-Being By Ernest H. Johnson Praeger, 1990
Librarian's tip: Chap. 3 "Cardiovascular Disease and the AHA! Syndrome"
Handbook of Psychology and Health By Andrew F. Baum; Jerome E. Singer Lawrence Erlbaum Associates, vol.2, 1982
Librarian's tip: Chap. 3 "Hypertension in Adolescents"
Heart Disease in Women By Susan Wilansky; James T. Willerson Churchill Livingstone, 2002
Librarian's tip: Section VI "Hypertension"
Handbook of Black American Health: The Mosaic of Conditions, Issues, Policies, and Prospects By Ivor Lensworth Livingston Greenwood Press, 1994
Librarian's tip: Chap. 4 "Hypertension: A Community Perspective"
African-American Women's Health and Social Issues By Catherine Fisher Collins Auburn House, 1996
Librarian's tip: Chap. 4 "Hypertension and African-American Women"
Handbook of Religion and Health By Harold G. Koenig; Michael E. McCullough; David B. Larson Oxford University Press, 2001
Librarian's tip: Chap. 17 "Hypertension"
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