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CHRONIC HIGH BLOOD PRESSURE (HYPERTENSION)

Medical science defines hypertension as a chronic (i.e., slowly progressing, persistent) increase in the systolic and diastolic arterial blood pressure which can be caused by a variety of factors, but regardless of the cause follows a typical pattern. Two aspects of the disease represent potentially serious dangers: one, the tendency of the pressure to continue to rise and two, the resultant damage to the arteries, heart, brain, and kidneys. In this respect chronic hypertension differs from the less serious types of elevated pressure previously mentioned. Chronic hypertension usually begins "silently," as a rule after the age of thirty or forty. In certain exceptional cases it can begin quite early in life. In its initial stages, the pressure may go up only intermittently, as for example in situations of ordinary stress, such as long drives, and return to normal more slowly than usual. Or the pressure may go up only at work, not while resting or vacationing. In such cases we speak of a "labile hypertension," or if the readings lie in the upper normal range, of a "borderline hypertension." However, if the readings are consistently above normal, the disease has/ progressed to the "stable" stage.

Chronic hypertension can take a variety of forms, examples of which abound. Every hospital knows of even young people with extremely high blood pressure, from 200/120 to 250/140. They are admitted with chief complaints of a feeling of general malaise, severe headaches, eye problems, and heart troubles. And their pressure does not go down significantly even after protracted bed rest. In cases like this we are probably dealing with a particularly aggressive type of hypertensive disease known as "malignant hypertension." It is called malignant because it progresses rapidly and dramatically and causes serious and early damage to the heart, brain, kidneys and eyes. Until fairly recently the prognosis for people with malignant hypertension was not very promising. Today their chances are considerably better. Because of early detection and treatment many cases of hypertension can be arrested before they become malignant. And even where the disease has progressed to that serious stage the pressure can often be reduced and brought down to less hazardous levels.

In the majority of cases, chronic high blood pressure if treated can be brought down and its complications avoided. At least 95% of all hypertensives have a benign form of hypertension. That is to say, its progress is slower and its effects do not manifest themselves as early. Still, even the so-called "benign" type of hypertension is a danger to health and life.

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