A report on Hypertension

Automated arm blood pressure meter showing arterial hypertension (shown by a systolic blood pressure 158 mmHg, diastolic blood pressure 99 mmHg and heart rate of 80 beats per minute)
Determinants of mean arterial pressure
Illustration depicting the effects of high blood pressure
Rates of hypertension in adult men in 2014.
Diagram illustrating the main complications of persistent high blood pressure
Image of veins from Harvey's Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus
Graph showing, prevalence of awareness, treatment and control of hypertension compared between the four studies of NHANES

Long-term medical condition in which the blood pressure in the arteries is persistently elevated.

- Hypertension
Automated arm blood pressure meter showing arterial hypertension (shown by a systolic blood pressure 158 mmHg, diastolic blood pressure 99 mmHg and heart rate of 80 beats per minute)

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Overall
CT scan of the brain showing a prior right-sided ischemic stroke from blockage of an artery. Changes on a CT may not be visible early on.

Stroke

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Medical condition in which poor blood flow to the brain causes cell death.

Medical condition in which poor blood flow to the brain causes cell death.

CT scan of the brain showing a prior right-sided ischemic stroke from blockage of an artery. Changes on a CT may not be visible early on.
There are two main categories of strokes. Ischemic (top), typically caused by a blood clot in an artery (1a) resulting in brain death to the affected area (2a). Hemorrhagic (bottom), caused by blood leaking into or around the brain from a ruptured blood vessel (1b) allowing blood to pool in the affected area (2b) thus increasing the pressure on the brain.
A slice of brain from the autopsy of a person who had an acute middle cerebral artery (MCA) stroke
CT scan of an intraparenchymal bleed (bottom arrow) with surrounding edema (top arrow)
Illustration of an embolic stroke, showing a blockage lodged in a blood vessel.
Histopathology at high magnification of a normal neuron, and an ischemic stroke at approximately 24 hours on H&E stain: The neurons become hypereosinophilic and there is an infiltrate of neutrophils. There is slight edema and loss of normal architecture in the surrounding neuropil.
A CT showing early signs of a middle cerebral artery stroke with loss of definition of the gyri and grey white boundary
Dens media sign in a patient with middle cerebral artery infarction shown on the left. Right image after 7 hours.
12-lead ECG of a patient with a stroke, showing large deeply inverted T-waves. Various ECG changes may occur in people with strokes and other brain disorders.
Walking with an orthosis after a stroke
Stroke deaths per million persons in 2012
Hippocrates first described the sudden paralysis that is often associated with stroke.

The main risk factor for stroke is high blood pressure.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.

Heart failure

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Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body.

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.
Signs and symptoms of severe heart failure
Severe peripheral pitting edema
Kerley B lines in acute cardiac decompensation. The short, horizontal lines can be found everywhere in the right lung.
Model of a normal heart (left); and a weakened heart, with over-stretched muscle and dilation of left ventricle (right); both during diastole
Chest radiograph of a lung with distinct Kerley B lines, as well as an enlarged heart (as shown by an increased cardiothoracic ratio, cephalization of pulmonary veins, and minor pleural effusion as seen for example in the right horizontal fissure. Yet, no obvious lung edema is seen. Overall, this indicates intermediate severity (stage II) heart failure.
Siderophages (one indicated by white arrow) and pulmonary congestion, indicating left congestive heart failure
Ultrasound showing severe systolic heart failure
Congestive heart failure with small bilateral effusions
Kerley B lines

Common causes of heart failure include coronary artery disease, including a previous myocardial infarction (heart attack), high blood pressure, atrial fibrillation, valvular heart disease, excess alcohol use, infection, and cardiomyopathy of an unknown cause.

A healthcare worker measuring blood pressure using a sphygmomanometer.

Blood pressure

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Pressure of circulating blood against the walls of blood vessels.

Pressure of circulating blood against the walls of blood vessels.

A healthcare worker measuring blood pressure using a sphygmomanometer.
A healthcare worker measuring blood pressure using a sphygmomanometer.
A digital sphygmomanometer used for measuring blood pressure
Overview of main complications of persistent high blood pressure
Cardiac systole and diastole
Blood flow velocity waveforms in the central retinal artery (red) and vein (blue), measured by laser Doppler imaging in the eye fundus of a healthy volunteer.
Schematic of pressures in the circulation
A schematic representation of the arterial pressure waveform over one cardiac cycle. The notch in the curve is associated with closing of the aortic valve.
Taking blood pressure with a sphygmomanometer

Blood pressure that is too low is called hypotension, pressure that is consistently too high is called hypertension, and normal pressure is called normotension.

Uremic frost on the head in someone with chronic kidney disease

Chronic kidney disease

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Type of kidney disease in which there is gradual loss of kidney function over a period of months to years.

Type of kidney disease in which there is gradual loss of kidney function over a period of months to years.

Uremic frost on the head in someone with chronic kidney disease
A 12-lead ECG of a person with CKD and a severe electrolyte imbalance: hyperkalemia (7.4 mmol/l) with hypocalcemia (1.6 mmol/l). The T-waves are peaked and the QT interval is prolonged.
Chronic renal disease caused by glomerulonephritis with increased echogenicity and reduced cortical thickness. Measurement of kidney length on the US image is illustrated by '+' and a dashed line.
Nephrotic syndrome. Hyperechoic kidney without demarcation of cortex and medulla.
Chronic pyelonephritis with reduced kidney size and focal cortical thinning. Measurement of kidney length on the US image is illustrated by '+' and a dashed line.
End-stage chronic kidney disease with increased echogenicity, homogenous architecture without visible differentiation between parenchyma and renal sinus and reduced kidney size. Measurement of kidney length on the US image is illustrated by '+' and a dashed line.

Complications can relate to hormonal dysfunction of the kidneys and include (in chronological order) high blood pressure (often related to activation of the Renin-Angiotensin-Aldosterone system), bone disease, and anemia.

Hydrochlorothiazide, a popular thiazide diuretic

Antihypertensive drug

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Hydrochlorothiazide, a popular thiazide diuretic
Captopril, the prototypical ACE inhibitor
Valsartan, an angiotensin II receptor antagonist
Propranolol, the first beta-blocker to be successfully developed

Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure).

Leads aVL and aVF of an electrocardiogram showing atrial fibrillation. There are irregular intervals between heart beats. No P waves are seen and there is an erratic baseline between QRS complexes. The heart rate is about 125 beats per minute.

Atrial fibrillation

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Abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart.

Abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart.

Leads aVL and aVF of an electrocardiogram showing atrial fibrillation. There are irregular intervals between heart beats. No P waves are seen and there is an erratic baseline between QRS complexes. The heart rate is about 125 beats per minute.
Normal rhythm tracing (top) Atrial fibrillation (bottom)
How a stroke can occur during atrial fibrillation
Non-modifiable risk factors (top left box) and modifiable risk factors (bottom left box) for atrial fibrillation. The main outcomes of atrial fibrillation are in the right box. BMI=Body Mass Index.
A 12-lead ECG showing atrial fibrillation at approximately 132 beats per minute
Diagram of normal sinus rhythm as seen on ECG. In atrial fibrillation the P waves, which represent depolarization of the top of the heart, are absent.
ECG of atrial fibrillation (top) and normal sinus rhythm (bottom). The purple arrow indicates a P wave, which is lost in atrial fibrillation.
3D Medical Animation still shot of Left Atrial Appendage Occlusion

High blood pressure and valvular heart disease are the most common modifiable risk factors for AF.

The progression of atherosclerosis (narrowing exaggerated)

Atherosclerosis

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Pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions.

Pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions.

The progression of atherosclerosis (narrowing exaggerated)
Atherosclerosis and lipoproteins
Micrograph of an artery that supplies the heart showing significant atherosclerosis and marked luminal narrowing. Tissue has been stained using Masson's trichrome.
Severe atherosclerosis of the aorta. Autopsy specimen.
Progression of atherosclerosis to late complications.
CT image of atherosclerosis of the abdominal aorta. Woman of 70 years old with hypertension and dyslipidemia.
Microphotography of arterial wall with calcified (violet color) atherosclerotic plaque (hematoxylin and eosin stain)
Doppler ultrasound of right internal carotid artery with calcified and non-calcified plaques showing less than 70% stenosis

Risk factors include abnormal cholesterol levels, elevated levels of inflammatory markers, high blood pressure, diabetes, smoking, obesity, family history, genetic, and an unhealthy diet.

Heart

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Muscular organ in most animals.

Muscular organ in most animals.

Human heart during an autopsy
Computer-generated animation of a beating human heart
The human heart is in the middle of the thorax, with its apex pointing to the left.
Heart being dissected showing right and left ventricles, from above
Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via chordae tendineae.
Layers of the heart wall, including visceral and parietal pericardium
The swirling pattern of myocardium helps the heart pump effectively
Arterial supply to the heart (red), with other areas labelled (blue).
Autonomic innervation of the heart
Development of the human heart during the first eight weeks (top) and the formation of the heart chambers (bottom). In this figure, the blue and red colors represent blood inflow and outflow (not venous and arterial blood). Initially, all venous blood flows from the tail/atria to the ventricles/head, a very different pattern from that of an adult.
Blood flow through the valves
The cardiac cycle as correlated to the ECG
The x-axis reflects time with a recording of the heart sounds. The y-axis represents pressure.
Transmission of a cardiac action potential through the heart's conduction system
Conduction system of the heart
The prepotential is due to a slow influx of sodium ions until the threshold is reached followed by a rapid depolarization and repolarization. The prepotential accounts for the membrane reaching threshold and initiates the spontaneous depolarization and contraction of the cell; there is no resting potential.
3D echocardiogram showing the mitral valve (right), tricuspid and mitral valves (top left) and aortic valve (top right). The closure of the heart valves causes the heart sounds.
Cardiac cycle shown against ECG
Heart and its blood vessels, by Leonardo da Vinci, 15th century
Animated heart
Elize Ryd making a heart sign at a concert in 2018
The tube-like heart (green) of the mosquito Anopheles gambiae extends horizontally across the body, interlinked with the diamond-shaped wing muscles (also green) and surrounded by pericardial cells (red). Blue depicts cell nuclei.
Basic arthropod body structure – heart shown in red
The human heart viewed from the front
The human heart viewed from behind
The coronary circulation
The human heart viewed from the front and from behind
Frontal section of the human heart
An anatomical specimen of the heart
Heart illustration with circulatory system
Animated Heart 3d Model Rendered in Computer

Risk factors include: smoking, being overweight, little exercise, high cholesterol, high blood pressure, and poorly controlled diabetes, among others.

Micrograph of a heart with fibrosis (yellow) and amyloidosis (brown). Movat's stain.

Cardiovascular disease

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Class of diseases that involve the heart or blood vessels.

Class of diseases that involve the heart or blood vessels.

Micrograph of a heart with fibrosis (yellow) and amyloidosis (brown). Movat's stain.
Calcified heart of an older woman with cardiomegaly
Density-Dependent Colour Scanning Electron Micrograph SEM (DDC-SEM) of cardiovascular calcification, showing in orange calcium phosphate spherical particles (denser material) and, in green, the extracellular matrix (less dense material)
Cardiovascular diseases deaths per million persons in 2012
Disability-adjusted life year for inflammatory heart diseases per 100,000 inhabitants in 2004 No data Less than 70 70–140 140–210 210–280 280–350 350–420 420–490 490–560 560–630 630–700 700–770 More than 770
Disability-adjusted life year for cardiovascular diseases per 100,000 inhabitants in 2004 no data <900 900–1650 1650–2300 2300–3000 3000–3700 3700–4400 4400–5100 5100–5800 5800–6500 6500–7200 7200–7900 >7900

This may be caused by high blood pressure, smoking, diabetes mellitus, lack of exercise, obesity, high blood cholesterol, poor diet, excessive alcohol consumption, and poor sleep, among other things.

Silhouettes and waist circumferences representing optimal, overweight, and obese

Obesity

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Condition in which excess body fat has accumulated to such an extent that it may have a negative effect on health.

Condition in which excess body fat has accumulated to such an extent that it may have a negative effect on health.

Silhouettes and waist circumferences representing optimal, overweight, and obese
A "super obese" male with a BMI of 53 kg/m2: weight 182 kg, height 185 cm. He presents with stretch marks and enlarged breasts.
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Average per capita energy consumption of the world from 1961 to 2002
A 1680 painting by Juan Carreno de Miranda of a girl presumed to have Prader–Willi syndrome
The disease scroll (Yamai no soshi, late 12th century) depicts a woman moneylender with obesity, considered a disease of the rich.
Obesity in developed countries is correlated with economic inequality.
A comparison of a mouse unable to produce leptin thus resulting in obesity (left) and a normal mouse (right)
During the Middle Ages and the Renaissance obesity was often seen as a sign of wealth, and was relatively common among the elite: The Tuscan General Alessandro del Borro, attributed to Charles Mellin, 1645
Venus of Willendorf created 24,000–22,000 BC
Services accommodate obese people with specialized equipment such as much wider chairs.
United States President William Howard Taft was often ridiculed for being overweight.
Share of adults that are obese (2016)

These comorbidities are most commonly shown in metabolic syndrome, a combination of medical disorders which includes: diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.