Complications of arterial hypertension

Prof. Dr. Ahmed A .Rozza Md , Dacc ,Fesc , Fasc
Prof. of Cardiovascular Medicine
Alazhar Medical School
Complications of arterial hypertension
Arterial hypertension (HTN) is called the silent killer, it has no symptoms and the patient has no complain. The pt. may present with his complications mainly related to cardiovascular system.
The prevalence of HTN:
About 30% of population is suffering from (HTN) the treated group is less than 50% of them and the controlled are less than 70% of the treated pts.
In England 7% only of hypertensive patients are controlled in Scandinavian countries about 12% controlled the highest % of controlled hypertensive pts. In Western countries is less than 26% of pts.
Cardiac complications
the most popular complication is CV stroke either high stroke or embolic which usually affect about 25% of pts.
Myocardial infraction (mi) and acute coronary syndrome occurs in about 30% of pts. and increased if the pt. has LVH. Lowering BP by 5mm Hg either systolic end or diastolic protect pts. From stroke and MI. by about 25-35%.
Renal complications
The incidence of expected complication of chronic untreated HTN. CKD . can be identified by micro albuminuria in the early stages and Macro albuminuria with manifest impaired EGF and keratinize levels (renal function) in the late stages which usually ended by renal failure and dialysis or renal replacement.
How to detect the early signs of HTN complications
the heart complications start with unexplained dyspnea and chest discomfort which could be diagnosed with ECG. Echocardiography and chest x-ray that show LVH and impaired either systolic or diastolic functions of the heart, this will end to either congestive heart failure.
Cerebrovascular complications
Stroke is the most serious complications of uncontrolled HTN and usually occurs suddenly, but in routine Examination and follow up it could be detected and expected by examining the carotid arteries by Duplex B. mode which shows an internal medial thickness which is a good indicator of advanced atherosclerotic dangers.
Also the last complication is the peripheral arterial disease and it happened in the lower extremities mainly leading to ischemic limb which is serious disease.
we advise every adult to check his BP regularly and if it is high he has to consult his physician for advice and to choose the proper drug for him.