Study on Essential Hypertension

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Essential hypertension, otherwise known as primary or idiopathic hypertension, is a condition of raised blood pressure with no identifiable cause. Secondary hypertension occurs when blood pressure elevation results from a specific and potentially treatable cause. These include renal diseases, endocrine causes, congenital cardiovascular causes and pregnancy.

This study however, will focus on essential hypertension so as to avoid unnecessary confusion. Blood pressure is relative to each individual and tends to vary markedly depending on height and weight. Levels of blood pressure
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In the arteries, there is thickening of each of the layers in the vessel wall, thus narrowing the lumen and reducing its effectiveness. A similar development occurs in the arterioles causing increased rigidity of the walls thus reducing their ability to contract and expand. Hence the lumen size is reduced. As a result, there is slowing down of the blood flow resulting in ‘ischaemia’ of cell tissue.

This then increases the pressure through the vessels and the left ventricular myocardium or heart muscle undergoes hypertrophy. Ischaemic heart disease and left ventricular failure are common results of hypertension in this case.

Due to occurrence of the above, the blood vessel in the brain become more fragile and paves the way for haemorrhage. Damage to small blood vessels within the cerebral hemispheres produce microscopic infarctions (localised necrotic areas) appearing as small areas of brain destruction that fill with fluid, otherwise known as hypertensive lacunae.

In malignant hypertension the vessels undergo similar changes but more acutely. Therefore the damage is more severe, leading to actual cessation of blood flow through the vessels. This results in multiple areas of tissue necrosis as in the glomeruli of the kidney.

As the glomeruli are part of the filtration system in the nephron of the kidney, damage can hinder removal of waste products, salt and water from the blood stream. Progressive destruction of
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