Hypertensive retinopathy is damage to the retina and retinal circulation due to high blood pressure (i.e. hypertension ).
103-440: Hypertension , also known as high blood pressure , is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms itself. It is, however, a major risk factor for stroke , coronary artery disease , heart failure , atrial fibrillation , peripheral arterial disease , vision loss , chronic kidney disease , and dementia . Hypertension
206-428: A healthy diet . If lifestyle changes are not sufficient, blood pressure medications are used. Up to three medications taken concurrently can control blood pressure in 90% of people. The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy . The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg
309-404: A western diet and lifestyle, and the risk of becoming hypertensive in later life is substantial in most such societies. Several environmental or lifestyle factors influence blood pressure. Reducing dietary salt intake lowers blood pressure; as does weight loss, exercise training, vegetarian diets, increased dietary potassium intake and high dietary calcium supplementation. Increasing alcohol intake
412-576: A 10-year risk of cardiovascular disease of greater than 10%, it recommends medications if the systolic blood pressure is >130 mmHg or if the diastolic BP is >80 mmHg. The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical activity, and weight loss. Though these have all been recommended in scientific advisories, a Cochrane systematic review found no evidence (due to lack of data) for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension. The review did find
515-492: A 24-hour period). Hypertension occurs in around 0.2 to 3% of newborns; however, blood pressure is not measured routinely in healthy newborns. Hypertension is more common in high risk newborns. A variety of factors, such as gestational age , postconceptional age and birth weight needs to be taken into account when deciding if a blood pressure is normal in a newborn. Hypertension defined as elevated blood pressure over several visits affects 1% to 5% of children and adolescents and
618-417: A baseline measurement of kidney function that can be used to monitor for side effects of certain anti-hypertensive drugs on kidney function. Testing of urine samples for protein is used as a secondary indicator of kidney disease. Lipid panel and glucose tests are done to identify comorbidities such as diabetes and hyperlipidemia and for cardiovascular risk stratification. Electrocardiogram (EKG/ECG) testing
721-465: A clearly identifiable cause, such as chronic kidney disease , narrowing of the kidney arteries , an endocrine disorder , or the use of birth control pills . Blood pressure is classified by two measurements, the systolic (first number) and diastolic (second number) pressures. For most adults, normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic. For most adults, high blood pressure
824-415: A complete history and physical examination . The World Health Organization suggests the following initial tests: serum electrolytes , serum creatinine , lipid panel , HbA1c or fasting glucose , urine dipstick and electrocardiogram (ECG/EKG). Serum creatinine is measured to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. eGFR can also provide
927-508: A complex interaction of genes and environmental factors. More than 2000 common genetic variants with small effects on blood pressure have been identified in association with high blood pressure, as well as some rare genetic variants with large effects on blood pressure. There is also evidence that DNA methylation at multiple nearby CpG sites may link some sequence variation to blood pressure, possibly via effects on vascular or renal function. Blood pressure rises with aging in societies with
1030-920: A decrease in SBP by 5-15mmHg, versus resistance training showing a decrease of only 3-5mmHg. Aerobic exercises such as jogging, rowing, dancing, or hiking can decrease SBP the greatest. The decrease in SBP can regulate the effect of hypertension ensuring the baby will not be harmed. Resistance training takes a toll on the cardiovascular system in untrained individuals, leading to a reluctance in prescription of resistance training for hypertensive reduction purposes. Failure to thrive , seizures , irritability , lack of energy , and difficulty in breathing can be associated with hypertension in newborns and young infants. In older infants and children, hypertension can cause headache, unexplained irritability, fatigue , failure to thrive, blurred vision , nosebleeds , and facial paralysis . Primary (also termed essential) hypertension results from
1133-466: A decrease in body weight and blood pressure. Their potential effectiveness is similar to and at times exceeds a single medication. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication. Dietary changes shown to reduce blood pressure include diets with low sodium, the DASH diet (Dietary Approaches to Stop Hypertension), which
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#17328733936321236-436: A decreased blood pressure in the lower extremities relative to the arms, or delayed or absent femoral arterial pulses . Pheochromocytoma may cause abrupt episodes of hypertension accompanied by headache, palpitations , pale appearance , and excessive sweating . Severely elevated blood pressure (equal to or greater than a systolic 180 mmHg or diastolic of 120 mmHg) is referred to as a hypertensive crisis. Hypertensive crisis
1339-442: A disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes , functional gastrointestinal disorder , eczema , arthritis , asthma , chronic obstructive pulmonary disease , autoimmune diseases , genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome . An illness which
1442-415: A hump of fat behind the neck and shoulders (referred to as a buffalo hump), and purple abdominal stretch marks . Hyperthyroidism frequently causes weight loss with increased appetite, fast heart rate , bulging eyes , and tremor. Renal artery stenosis may be associated with a localized abdominal bruit to the left or right of the midline, or in both locations. Coarctation of the aorta frequently causes
1545-738: A major cause for the disparities observed in the care of chronic disease. Lack of access and delay in receiving care result in worse outcomes for patients from minorities and underserved populations. Those barriers to medical care complicate patients monitoring and continuity in treatment. In the US, minorities and low-income populations are less likely to seek, access and receive preventive services necessary to detect conditions at an early stage. The majority of US health care and economic costs associated with medical conditions are incurred by chronic diseases and conditions and associated health risk behaviors. Eighty-four percent of all health care spending in 2006
1648-451: A means of improving the number of people with chronic conditions that miss medical appointments, however there is no strong evidence that these approaches make a difference. Nursing can play an important role in assisting patients with chronic diseases achieve longevity and experience wellness. Scholars point out that the current neoliberal era emphasizes self-care, in both affluent and low-income communities. This self-care focus extends to
1751-710: A much larger scale in these areas. In Europe, the European Chronic Disease Alliance was formed in 2011, which represents over 100,000 healthcare workers. In the United States, there are a number of nonprofits focused on chronic conditions, including entities focused on specific diseases such as the American Diabetes Association , Alzheimer's Association , or Crohn's and Colitis Foundation . There are also broader groups focused on advocacy or research into chronic illness in general, such as
1854-440: A nursing-heavy approach to the management of chronic disease. Foregrounding the problem of distance from healthcare facility, the study recommends patients increase their request for care. It uses nurses and health officers to fill, in a cost-efficient way, the large unmet need for chronic disease treatment. They led their health centers staffed by nurses and health officers; so, there are specific training required for involvement in
1957-431: A psychosocial approach to chronic illness to aid the increasing number of individuals diagnosed with these conditions. Despite this movement, there is still criticism that chronic conditions are not being treated appropriately, and there is not enough emphasis on the behavioral aspects of chronic conditions or psychological types of support for patients. The mental health intersectionality on those with chronic conditions
2060-727: A quiet room so the medical professional checking the blood pressure can hear the Korotkoff sounds while listening to the brachial artery with a stethoscope for accurate blood pressure measurements. The blood pressure cuff should be deflated slowly (2–3 mmHg per second) while listening for the Korotkoff sounds. The bladder should be emptied before a person's blood pressure is measured since this can increase blood pressure by up to 15/10 mmHg. Multiple blood pressure readings (at least two) spaced 1–2 minutes apart should be obtained to ensure accuracy. Ambulatory blood pressure monitoring over 12 to 24 hours
2163-631: A report that estimated investing $ 10 per person annually in community-based programs of proven effectiveness and promoting healthy lifestyle (increase in physical activity, healthier diet and preventing tobacco use) could save more than $ 16 billion annually within a period of just five years. A 2017 review (updated in 2022) found that it is uncertain whether school-based policies on targeting risk factors on chronic diseases such as healthy eating policies, physical activity policies, and tobacco policies can improve student health behaviours or knowledge of staffs and students. The updated review in 2022 did determine
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#17328733936322266-481: A role in AIDS prevalence, only exposure is truly needed to contract this chronic disease. Communicable chronic diseases are also typically only treatable with medication intervention, rather than lifestyle change as some non-communicable chronic diseases can be treated. As of 2003, there are a few programs which aim to gain more knowledge on the epidemiology of chronic disease using data collection. The hope of these programs
2369-592: A slight improvement in measures of obesity and physical activity as the use of improved strategies lead to increased implementation interventions but continued to call for additional research to address questions related to alcohol use and risk. Encouraging those with chronic conditions to continue with their outpatient ( ambulatory ) medical care and attend scheduled medical appointments may help improve outcomes and reduce medical costs due to missed appointments. Finding patient-centered alternatives to doctors or consultants scheduling medical appointments has been suggested as
2472-436: A straightforward cause and effect relationship with chronic disease diagnosis. While typically higher socioeconomic status is correlated with lower occurrence of chronic disease, it is not known is there is a direct cause and effect relationship between these two variables. The epidemiology of communicable chronic diseases such as AIDS is also different from that of noncommunicable chronic disease. While Social factors do play
2575-532: A twofold increase in psychiatric disorders. Higher parental depression and other family stressors predicted more problems among patients. In addition, sibling problems along with the burden of illness on the family as a whole led to more psychological strain on the patients and their families. A growing body of evidence supports that prevention is effective in reducing the effect of chronic conditions; in particular, early detection results in less severe outcomes. Clinical preventive services include screening for
2678-452: A year to non-communicable diseases. In the United States approximately 40% of adults have at least two chronic conditions. Living with two or more chronic conditions is referred to as multimorbidity . Chronic conditions have often been used to describe the various health related states of the human body such as syndromes, physical impairments, disabilities as well as diseases. Epidemiologists have found interest in chronic conditions due to
2781-504: Is 77% higher among non-Hispanic blacks, and American Indians and Alaska Natives are 60% more likely to be obese than non-Hispanic whites. Some of this prevalence has been suggested to be in part from environmental racism . Flint, Michigan, for example, had high levels of lead poisoning in their drinkable water after waste was dumped into low-value housing areas. There are also higher rates of asthma in children who live in lower income areas due to an abundance of pollutants being released on
2884-432: Is a hypertensive emergency and has several serious complications including vision loss , brain swelling , seizures , kidney failure , pulmonary edema , and disseminated intravascular coagulation (a blood clotting disorder). In contrast, gestational hypertension is defined as new-onset hypertension during pregnancy without protein in the urine. There have been significant findings on how exercising can help reduce
2987-504: Is a component of syndrome X (or metabolic syndrome ), can cause hyperuricemia and gout and is also associated with elevated blood pressure. Events in early life, such as low birth weight , maternal smoking , and lack of breastfeeding may be risk factors for adult essential hypertension, although strength of the relationships is weak and the mechanisms linking these exposures to adult hypertension remain unclear. Secondary hypertension results from an identifiable cause. Kidney disease
3090-511: Is a form of salt -sensitive hypertension, where sodium intake does not modulate either adrenal or renal vascular responses to angiotensin II . They make up 25% of the hypertensive population. Hypertension is diagnosed on the basis of a persistently high resting blood pressure. Elevated blood pressure measurements on at least two separate occasions is required for a diagnosis of hypertension. For an accurate diagnosis of hypertension to be made, it
3193-437: Is a large aspect often overlooked by doctors. And chronic illness therapists are available for support to help with the mental toll of chronic illness a it is often underestimated in society. Adults with chronic illness that restrict their daily life present with more depression and lower self-esteem than healthy adults and adults with non-restricting chronic illness. The emotional influence of chronic illness also has an effect on
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3296-527: Is a major cause of premature death worldwide. High blood pressure is classified as primary (essential) hypertension or secondary hypertension . About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight , smoking , physical inactivity and alcohol use. The remaining 5–10% of cases are categorized as secondary hypertension, defined as high blood pressure due to
3399-491: Is abnormally high, but diastolic pressure may be normal or low, a condition termed isolated systolic hypertension . The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness , which typically accompanies aging and may be exacerbated by high blood pressure. Many mechanisms have been proposed to account for the rise in peripheral resistance in hypertension. Most evidence implicates either disturbances in
3502-470: Is also associated with decreased peripheral venous compliance , which may increase venous return , increase cardiac preload and, ultimately, cause diastolic dysfunction . For patients having hypertension, higher heart rate variability (HRV) is a risk factor for atrial fibrillation . Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure
3605-399: Is associated with elevated blood pressure. Air pollution is associated with hypertension. Whether these associations are causal is unknown. Gout and elevated blood uric acid are associated with hypertension and evidence from genetic ( Mendelian Randomization) studies and clinical trials indicate this relationship is likely to be causal. Insulin resistance , which is common in obesity and
3708-417: Is associated with higher blood pressure, but the possible roles of other factors such as caffeine consumption, and vitamin D deficiency are less clear. Average blood pressure is higher in the winter than in the summer. Depression is associated with hypertension and loneliness is also a risk factor. Periodontal disease is also associated with high blood pressure. Arsenic exposure through drinking water
3811-481: Is associated with long-term risks of ill-health. Blood pressure rises with age in childhood and, in children, hypertension is defined as an average systolic or diastolic blood pressure on three or more occasions equal or higher than the 95th percentile appropriate for the sex, age and height of the child. High blood pressure must be confirmed on repeated visits however before characterizing a child as having hypertension. In adolescents, it has been proposed that hypertension
3914-531: Is believed to be due to calcification of the arteries resulting in abnormally high blood pressure readings with a blood pressure cuff while intra arterial measurements of blood pressure are normal. Orthostatic hypertension is when blood pressure increases upon standing. Once the diagnosis of hypertension has been made, further testing may be performed to find secondary hypertension , identify comorbidities such as diabetes , identify hypertension-caused organ damage such as chronic kidney disease or thickening of
4017-514: Is categorized as either hypertensive urgency or hypertensive emergency , according to the absence or presence of end organ damage, respectively. In hypertensive urgency, there is no evidence of end organ damage resulting from the elevated blood pressure. In these cases, oral medications are used to lower the BP gradually over 24 to 48 hours. In hypertensive emergency, there is evidence of direct damage to one or more organs. The most affected organs include
4120-453: Is debated, but it has been proposed that individuals with signs of hypertensive retinopathy signs, especially retinal hemorrhages, microaneurysms and cotton-wool spots, should be assessed carefully. A major aim of treatment is to prevent, limit, or reverse target organ damage by lowering the person's high blood pressure to reduce the risk of cardiovascular disease and death. Treatment with antihypertensive medications may be required to control
4223-637: Is debated. In 2004, the National High Blood Pressure Education Program recommended that children aged 3 years and older have blood pressure measurement at least once at every health care visit and the National Heart, Lung, and Blood Institute and American Academy of Pediatrics made a similar recommendation. However, the American Academy of Family Physicians supports the view of the U.S. Preventive Services Task Force that
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4326-429: Is diagnosed and classified using the same criteria as in adults. Much of the disease burden of high blood pressure is experienced by people who are not labeled as hypertensive. Consequently, population strategies are required to reduce the consequences of high blood pressure and reduce the need for antihypertensive medications. Lifestyle changes are recommended to lower blood pressure. Recommended lifestyle changes for
4429-622: Is diverse and the epidemiology of some chronic diseases can change in response to new treatments. In the treatment of HIV, the success of anti-retroviral therapies means that many patients will experience this infection as a chronic disease that for many will span several decades of their chronic life. Some epidemiology of chronic disease can apply to multiple diagnosis. Obesity and body fat distribution for example contribute and are risk factors for many chronic diseases such as diabetes, heart, and kidney disease. Other epidemiological factors, such as social, socioeconomic, and environment do not have
4532-504: Is done to check for evidence that the heart is under strain from high blood pressure, such as thickening of the heart muscle or whether the heart has experienced a prior minor disturbance such as a silent heart attack. Blood pressure measurements can be influenced by circumstances of measurement. Guidelines use different thresholds for office (also known as clinic), home (when the patient measures their own blood pressure at home), and ambulatory blood pressure (using an automated device over
4635-462: Is essential for proper blood pressure measurement technique to be used. Improper measurement of blood pressure is common and can change the blood pressure reading by up to 10 mmHg, which can lead to misdiagnosis and misclassification of hypertension. Correct blood pressure measurement technique involves several steps. Proper blood pressure measurement requires the person whose blood pressure is being measured to sit quietly for at least five minutes which
4738-468: Is less clear, with some reviews finding benefit and others finding unclear benefit. High blood pressure affects 33% of the population globally. About half of all people with high blood pressure do not know that they have it. In 2019, high blood pressure was believed to have been a factor in 19% of all deaths (10.4 million globally). Hypertension is rarely accompanied by symptoms . Half of all people with hypertension are unaware that they have it. Hypertension
4841-542: Is lifelong because it ends in death is a terminal illness . It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms. In medicine , chronic conditions are distinguished from those that are acute . An acute condition typically affects one portion of
4944-485: Is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. Different numbers apply to children. Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement . Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. Lifestyle changes include weight loss , physical exercise , decreased salt intake , reducing alcohol intake , and
5047-434: Is the development of combined antiviral therapies that led to remarkable improvement in survival rates and quality of life of HIV -infected patients. In addition to direct costs in health care, chronic diseases are a significant burden to the economy, through limitations in daily activities, loss in productivity and loss of days of work. A particular concern is the rising rates of overweight and obesity in all segments of
5150-496: Is the most accurate method to confirm the diagnosis. An exception to this is those with very high blood pressure readings especially when there is poor organ function. With the availability of 24-hour ambulatory blood pressure monitors and home blood pressure machines, the importance of not wrongly diagnosing those who have white coat hypertension has led to a change in protocols. In the United Kingdom, current best practice
5253-460: Is the most common secondary cause of hypertension. Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome , hyperthyroidism , hypothyroidism , acromegaly , Conn's syndrome or hyperaldosteronism , renal artery stenosis (from atherosclerosis or fibromuscular dysplasia ), hyperparathyroidism , and pheochromocytoma . Other causes of secondary hypertension include obesity , sleep apnea , pregnancy , coarctation of
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#17328733936325356-438: Is then followed by application of a properly fitted blood pressure cuff to a bare upper arm. The person should be seated with their back supported, feet flat on the floor, and with their legs uncrossed. The person whose blood pressure is being measured should avoid talking or moving during this process. The arm being measured should be supported on a flat surface at the level of the heart. Blood pressure measurement should be done in
5459-402: Is to follow up a single raised clinic reading with ambulatory measurement, or less ideally with home blood pressure monitoring over the course of 7 days. The United States Preventive Services Task Force also recommends getting measurements outside of the healthcare environment. Pseudohypertension in the elderly or noncompressibility artery syndrome may also require consideration. This condition
5562-1006: Is to gather epidemiological data on various chronic diseases across the United States and demonstrate how this knowledge can be valuable in addressing chronic disease. In the United States, as of 2004 nearly one in two Americans (133 million) has at least one chronic medical condition, with most subjects (58%) between the ages of 18 and 64. The number is projected to increase by more than one percent per year by 2030, resulting in an estimated chronically ill population of 171 million. The most common chronic conditions are high blood pressure , arthritis , respiratory diseases like emphysema , and high cholesterol . Based on data from 2014 Medical Expenditure Panel Survey (MEPS), about 60% of adult Americans were estimated to have one chronic illness, with about 40% having more than one; this rate appears to be mostly unchanged from 2008. MEPS data from 1998 showed 45% of adult Americans had at least one chronic illness, and 21% had more than one. According to research by
5665-425: Is typical of all people who ultimately develop hypertension is disputed. The increased peripheral resistance in established hypertension is mainly attributable to structural narrowing of small arteries and arterioles , although a reduction in the number or density of capillaries may also contribute. It is not clear whether or not vasoconstriction of arteriolar blood vessels plays a role in hypertension. Hypertension
5768-481: Is unresolved, although some experts propose more intensive blood pressure lowering than advocated in some guidelines. For people who have never experienced cardiovascular disease who are at a 10-year risk of cardiovascular disease of less than 10%, the 2017 American Heart Association guidelines recommend medications if the systolic blood pressure is >140 mmHg or if the diastolic BP is >90 mmHg. For people who have experienced cardiovascular disease or those who are at
5871-490: Is usually identified as part of health screening or when seeking healthcare for an unrelated problem. Some people with high blood pressure report headaches , as well as lightheadedness , vertigo , tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes . These symptoms, however, might be related to associated anxiety rather than the high blood pressure itself. Long-standing untreated hypertension can cause organ damage with signs such as changes in
5974-402: Is viewed and treated in society. Women's chronic health issues are often considered to be most worthy of treatment or most severe when the chronic condition interferes with a woman's fertility. Historically, there is less of a focus on a woman's chronic conditions when it interferes with other aspects of her life or well-being. Many women report feeling less than or even "half of a woman" due to
6077-621: The CDC , chronic disease is also especially a concern in the elderly population in America. Chronic diseases like stroke, heart disease, and cancer were among the leading causes of death among Americans aged 65 or older in 2002, accounting for 61% of all deaths among this subset of the population. It is estimated that at least 80% of older Americans are currently living with some form of a chronic condition, with 50% of this population having two or more chronic conditions. The two most common chronic conditions in
6180-555: The optic fundus seen by ophthalmoscopy . The severity of hypertensive retinopathy correlates roughly with the duration or the severity of the hypertension. Other hypertension-caused organ damage include chronic kidney disease and thickening of the heart muscle . Secondary hypertension is hypertension due to an identifiable cause, and may result in certain specific additional signs and symptoms. For example, as well as causing high blood pressure, Cushing's syndrome frequently causes truncal obesity , glucose intolerance , moon face ,
6283-847: The National Association of Chronic Disease Directors, Partnership to Fight Chronic Disease, the Chronic Disease Coalition which arose in Oregon in 2015, and the Chronic Policy Care Alliance. Signs and symptoms Syndrome Disease Medical diagnosis Differential diagnosis Prognosis Acute Chronic Cure Eponymous disease Acronym or abbreviation Remission Hypertensive retinopathy Most patients with hypertensive retinopathy have no symptoms. However, some may report decreased or blurred vision , and headaches . Signs of damage to
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#17328733936326386-1082: The U.S. population. Obesity itself is a medical condition and not a disease, but it constitutes a major risk factor for developing chronic illnesses, such as diabetes, stroke, cardiovascular disease and cancers. Obesity results in significant health care spending and indirect costs, as illustrated by a recent study from the Texas comptroller reporting that obesity alone cost Texas businesses an extra $ 9.5 billion in 2009, including more than $ 4 billion for health care, $ 5 billion for lost productivity and absenteeism, and $ 321 million for disability. There have been recent links between social factors and prevalence as well as outcome of chronic conditions. The connection between loneliness, overall health, and chronic conditions has recently been highlighted. Some studies have shown that loneliness has detrimental health effects similar to that of smoking and obesity. One study found that feelings of isolation are associated with higher self reporting of health as poor, and feelings of loneliness increased
6489-456: The aorta , excessive eating of liquorice , excessive drinking of alcohol, certain prescription medicines, herbal remedies, and stimulants such as cocaine and methamphetamine . A 2018 review found that any alcohol increased blood pressure in males while over one or two drinks increased the risk in females. In most people with established essential hypertension , increased resistance to blood flow ( total peripheral resistance ) accounts for
6592-405: The arterial and arteriolar circulation in response to the high blood pressure. Fundoscopy and patients history. Several other diseases can result in retinopathy that can be confused with hypertensive retinopathy. These include diabetic retinopathy , retinopathy due to autoimmune disease , anemia , radiation retinopathy , and central retinal vein occlusion . There is an association between
6695-417: The association between high sodium intake and adverse outcomes is only observed in people with hypertension. Consequently, in the absence of results from randomized controlled trials, the wisdom of reducing levels of dietary sodium intake below 3 g/day has been questioned. ESC guidelines mention periodontitis is associated with poor cardiovascular health status. The value of routine screening for hypertension
6798-412: The available evidence is insufficient to determine the balance of benefits and harms of screening for hypertension in children and adolescents who do not have symptoms. The US Preventive Services Task Force recommends screening adults 18 years or older for hypertension with office blood pressure measurement. According to one review published in 2003, reduction of the blood pressure by 5 mmHg can decrease
6901-408: The benefits of trying to achieve a lower than standard blood pressure target (at or below 140/90 mmHg) are outweighed by the risk associated with the intervention. These findings may not be applicable to other populations. Many expert groups recommend a slightly higher target of 150/90 mmHg for those over somewhere between 60 and 80 years of age. The JNC 8 and American College of Physicians recommend
7004-471: The body and responds to treatment. A chronic condition, on the other hand, usually affects multiple areas of the body, is not fully responsive to treatment, and persists for an extended period of time. Chronic conditions may have periods of remission or relapse where the disease temporarily goes away, or subsequently reappears. Periods of remission and relapse are commonly discussed when referring to substance abuse disorders which some consider to fall under
7107-463: The body. Through regular bouts of physical activity, blood pressure can reduce the incidence of hypertension. Aerobic exercise has been shown to regulate blood pressure more effectively than resistance training. It is recommended to see the effects of exercising, that a person should aim for 5-7 days/ week of aerobic exercise. This type of exercise should have an intensity of light to moderate, utilizing ~85% of max heart rate (220-age). Aerobic has shown
7210-883: The brain, kidney, heart and lungs, producing symptoms which may include confusion , drowsiness, chest pain and breathlessness. In hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage; however, there is a lack of randomized controlled trial evidence for this approach. Hypertension occurs in approximately 8–10% of pregnancies. Two blood pressure measurements six hours apart of greater than 140/90 mmHg are diagnostic of hypertension in pregnancy. High blood pressure in pregnancy can be classified as pre-existing hypertension, gestational hypertension , or pre-eclampsia . Women who have chronic hypertension before their pregnancy are at increased risk of complications such as premature birth , low birthweight or stillbirth . Women who have high blood pressure and had complications in their pregnancy have three times
7313-516: The category of chronic condition. Chronic conditions are often associated with non-communicable diseases which are distinguished by their non-infectious causes. Some chronic conditions though, are caused by transmissible infections such as HIV/AIDS. 63% of all deaths worldwide are from chronic conditions. Chronic diseases constitute a major cause of mortality , and the World Health Organization (WHO) attributes 38 million deaths
7416-604: The chronic illness being a source of stress for the individual. A study of loneliness in adults over age 65 found that low levels of loneliness as well as high levels of familial support were associated with better outcomes of multiple chronic conditions such as hypertension and diabetes. There are some recent movements in the medical sphere to address these connections when treating patients with chronic illness. The biopsychosocial approach for example, developed in 2006 focuses on patients "patient's personality, family, culture, and health dynamics." Physicians are leaning more towards
7519-565: The effects of hypertension just after one bout of exercise. Exercising can help reduce hypertension as well as pre-eclampsia and eclampsia. The acute physiological responses include an increase in cardiac output (CO) of the individual (increased heart rate and stroke volume). This increase in CO can inadvertently maintain the amount of blood going into the muscles, improving functionality of the muscle later. Exercising can also improve systolic and diastolic blood pressure making it easier for blood to pump to
7622-566: The elderly are high blood pressure and arthritis, with diabetes, coronary heart disease, and cancer also being reported among the elder population. In examining the statistics of chronic disease among the living elderly, it is also important to make note of the statistics pertaining to fatalities as a result of chronic disease. Heart disease is the leading cause of death from chronic disease for adults older than 65, followed by cancer, stroke, diabetes, chronic lower respiratory diseases, influenza and pneumonia, and, finally, Alzheimer's disease. Though
7725-404: The existence of the disease or predisposition to its development, counseling and immunizations against infectious agents. Despite their effectiveness, the utilization of preventive services is typically lower than for regular medical services. In contrast to their apparent cost in time and money, the benefits of preventive services are not directly perceived by patient because their effects are on
7828-449: The fact they contribute to disease, disability, and diminished physical and/or mental capacity. For example, high blood pressure or hypertension is considered to be not only a chronic condition itself but also correlated with diseases such as heart attack or stroke . Additionally, some socioeconomic factors may be considered as a chronic condition as they lead to disability in daily life. An important one that public health officials in
7931-564: The four major types as: Other examples of chronic diseases and health conditions include: While risk factors vary with age and gender, many of the common chronic diseases in the US are caused by dietary, lifestyle and metabolic risk factors. Therefore, these conditions might be prevented by behavioral changes , such as quitting smoking, adopting a healthy diet, and increasing physical activity. Social determinants are important risk factors for chronic diseases. Social factors , e.g., socioeconomic status, education level, and race/ethnicity, are
8034-607: The general public. Within the medical-industrial complex , chronic illnesses can impact the relationship between pharmaceutical companies and people with chronic conditions. Life-saving drugs, or life-extending drugs, can be inflated for a profit . There is little regulation on the cost of chronic illness drugs, which suggests that abusing the lack of a drug cap can create a large market for drug revenue. Likewise, certain chronic conditions can last throughout one's lifetime and create pathways for pharmaceutical companies to take advantage of this. Gender influences how chronic disease
8137-409: The grade of retinopathy and mortality. In a classic study in 1939 Keith and colleagues described the prognosis of people with differing severity of retinopathy. They showed 70% of those with grade 1 retinopathy were alive after 3 years whereas only 6% of those with grade 4 survived. The most widely used modern classification system bears their name. The role of retinopathy grading in risk stratification
8240-414: The heart muscle , and for cardiovascular disease risk stratification. Secondary hypertension is more common in preadolescent children, with most cases caused by kidney disease . Primary or essential hypertension is more common in adolescents and adults and has multiple risk factors, including obesity and a family history of hypertension. Initial assessment upon diagnosis of hypertension should include
8343-475: The high pressure while cardiac output remains normal. There is evidence that some younger people with prehypertension or 'borderline hypertension' have high cardiac output, an elevated heart rate and normal peripheral resistance, termed hyperkinetic borderline hypertension. These individuals may develop the typical features of established essential hypertension in later life as their cardiac output falls and peripheral resistance rises with age. Whether this pattern
8446-510: The impact of risk factors on the individual's development and functioning. People with chronic conditions pay more out-of-pocket; a study found that Americans spent $ 2,243 more on average. The financial burden can increase medication non-adherence. In some countries, laws protect patients with chronic conditions from excessive financial responsibility; for example, as of 2008 France limited copayments for those with chronic conditions, and Germany limits cost sharing to 1% of income versus 2% for
8549-535: The intellectual and educational development of the individual. For example, people living with type 1 diabetes endure a lifetime of monotonous and rigorous health care management usually involving daily blood glucose monitoring, insulin injections, and constant self-care. This type of constant attention that is required by type 1 diabetes and other chronic illness can result in psychological maladjustment. There have been several theories, namely one called diabetes resilience theory, that posit that protective processes buffer
8652-546: The kidneys' salt and water handling (particularly abnormalities in the intrarenal renin–angiotensin system ) or abnormalities of the sympathetic nervous system . These mechanisms are not mutually exclusive and it is likely that both contribute to some extent in most cases of essential hypertension. It has also been suggested that endothelial dysfunction and vascular inflammation may also contribute to increased peripheral resistance and vascular damage in hypertension. Interleukin 17 has garnered interest for its role in increasing
8755-399: The likelihood of mental health disorders in individuals. The connection between chronic illness and loneliness is established, yet oftentimes ignored in treatment. One study for example found that a greater number of chronic illnesses per individual were associated with feelings of loneliness. Some of the possible reasons for this listed are an inability to maintain independence as well as
8858-580: The long term or might be greater for society as a whole than at the individual level. Therefore, public health programs are important in educating the public, and promoting healthy lifestyles and awareness about chronic diseases. While those programs can benefit from funding at different levels (state, federal, private) their implementation is mostly in charge of local agencies and community-based organizations. Studies have shown that public health programs are effective in reducing mortality rates associated to cardiovascular disease, diabetes and cancer, but
8961-454: The nursing of patients with chronic diseases, replacing a more holistic role for nursing with an emphasis on patients managing their own health conditions. Critics note that this is challenging if not impossible for patients with chronic disease in low-income communities where health care systems, and economic and social structures do not fully support this practice. A study in Ethiopia showcases
9064-580: The pressures that society puts on the importance of fertility and health when it comes to typically feminine ideals. These kinds of social barriers interfere with women's ability to perform various other activities in life and fully work toward their aspirations. Race is also implicated in chronic illness, although there may be many other factors involved. Racial minorities are 1.5-2 times more likely to have most chronic diseases than white individuals. Non-Hispanic blacks are 40% more likely to have high blood pressure that non-Hispanic whites, diagnosed diabetes
9167-562: The prevention of hypertension include: Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results. There is considerable evidence that reducing dietary salt intake lowers blood pressure , but whether this translates into a reduction in mortality and cardiovascular disease remains uncertain. Estimated sodium intake ≥6 g/day and <3 g/day are both associated with high risk of death or major cardiovascular disease, but
9270-433: The production of several other immune system chemical signals thought to be involved in hypertension such as tumor necrosis factor alpha , interleukin 1 , interleukin 6 , and interleukin 8 . Excessive sodium or insufficient potassium in the diet leads to excessive intracellular sodium, which contracts vascular smooth muscle, restricting blood flow and so increases blood pressure. Non-modulating essential hypertension
9373-477: The programmed must be carried out regularly, to ensure that new staff is educated in administering chronic disease care. The program shows that community-based care and education, primarily driven by nurses and health officers, works. It highlights the importance of nurses following up with individuals in the community, and allowing nurses flexibility in meeting their patients' needs and educating them for self-care in their homes. The epidemiology of chronic disease
9476-419: The rates of chronic disease differ by race for those living with chronic illness, the statistics for leading causes of death among elderly are nearly identical across racial/ethnic groups. Chronic illnesses cause about 70% of deaths in the US and in 2002 chronic conditions (heart disease, cancers, stroke, chronic respiratory diseases, diabetes, Alzheimer's disease, mental illness and kidney diseases) were six of
9579-469: The results are somewhat heterogeneous depending on the type of condition and the type of programs involved. For example, results from different approaches in cancer prevention and screening depended highly on the type of cancer. The rising number of patient with chronic diseases has renewed the interest in prevention and its potential role in helping control costs. In 2008, the Trust for America's Health produced
9682-429: The retina caused by hypertension include: Mild signs of hypertensive retinopathy can be seen quite frequently in normal people (3–14% of adult individuals aged ≥40 years), even without hypertension. Hypertensive retinopathy is commonly considered a diagnostic feature of a hypertensive emergency although it is not invariably present. The changes in hypertensive retinopathy result from damage and adaptive changes in
9785-405: The risk of death of the baby around the time of birth . Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of pre-eclampsia occur the most common are headache, visual disturbance (often "flashing lights"), vomiting, pain over the stomach, and swelling . Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia , which
9888-453: The risk of developing cardiovascular disease compared to women with normal blood pressure who had no complications in pregnancy. Pre-eclampsia is a serious condition of the second half of pregnancy and following delivery characterised by increased blood pressure and the presence of protein in the urine . It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally. Pre-eclampsia also doubles
9991-657: The risk of stroke by 34%, of ischemic heart disease by 21%, and reduce the likelihood of dementia , heart failure , and mortality from cardiovascular disease . Various expert groups have produced guidelines regarding how low the blood pressure target should be when a person is treated for hypertension. These groups recommend a target below the range 140–160 / 90–100 mmHg for the general population. Cochrane reviews recommend similar targets for subgroups such as people with diabetes and people with prior cardiovascular disease. Additionally, Cochrane reviews have found that for older individuals with moderate to high cardiovascular risk,
10094-537: The social science setting have begun highlighting is chronic poverty . Researchers, particularly those studying the United States, utilize the Chronic Condition Indicator (CCI) which maps ICD codes as "chronic" or "non-chronic". The list below includes these chronic conditions and diseases: In 2015 the World Health Organization produced a report on non-communicable diseases, citing
10197-412: The target of 150/90 mmHg for those over 60 years of age, but some experts within these groups disagree with this recommendation. Some expert groups have also recommended slightly lower targets in those with diabetes or chronic kidney disease , but others recommend the same target as for the general population. The issue of what is the best target and whether targets should differ for high risk individuals
10300-564: The top ten causes of mortality in the general US population. Chronic diseases are a major factor in the continuous growth of medical care spending. In 2002, the U.S. Department of Health and Human Services stated that the health care for chronic diseases cost the most among all health problems in the U.S. Healthy People 2010 reported that more than 75% of the $ 2 trillion spent annually in U.S. medical care are due to chronic conditions; spending are even higher in proportion for Medicare beneficiaries (aged 65 years and older). Furthermore, in 2017 it
10403-461: Was estimated that 90% of the $ 3.3 billion spent on healthcare in the United States was due to the treatment of chronic diseases and conditions. Spending growth is driven in part by the greater prevalence of chronic illnesses and the longer life expectancy of the population. Also, improvement in treatments has significantly extended the lifespans of patients with chronic diseases but results in additional costs over long period of time. A striking success
10506-425: Was for the 50% of the population who have one or more common chronic medical conditions (CDC, 2014). There are several psychosocial risk and resistance factors among children with chronic illness and their family members. Adults with chronic illness were significantly more likely to report life dissatisfaction than those without chronic illness. Compared to their healthy peers, children with chronic illness have about
10609-446: Was the best against 11 other diet in an umbrella review, and plant-based diets. A 2024 clinical guideline recommended an increase dietary fiber intake, with a minimum of 28g/day for women and 38g/day for men diagnosed with hypertension. Chronic condition A chronic condition (also known as chronic disease or chronic illness ) is a health condition or disease that is persistent or otherwise long-lasting in its effects or
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