What are the causes and effects of hypertension (high blood pressure) and hypotension (low blood pressure)?

From the Guidelines

Hypertension is defined as a blood pressure consistently above 130/80 mmHg, and hypotension is generally considered below 90/60 mmHg, with both conditions requiring careful management to prevent complications and improve quality of life. The causes of hypertension include lifestyle factors such as high sodium intake, physical inactivity, and excessive alcohol consumption, as well as genetic predisposition and underlying medical conditions like kidney disease or sleep apnea 1. Hypotension, on the other hand, can be caused by dehydration, blood loss, or certain medications, and may also be a symptom of underlying conditions like heart failure or thyroid disorders.

Effects of Hypertension and Hypotension

The effects of hypertension can be severe and long-lasting, including damage to blood vessels, increased risk of heart disease and stroke, and kidney damage 1. Hypotension, if left untreated, can lead to dizziness, fainting, and inadequate organ perfusion, which can be life-threatening in severe cases. Lifestyle modifications, such as reducing sodium intake, regular exercise, and stress management, are the first line of treatment for hypertension, and medications like ACE inhibitors, ARBs, and calcium channel blockers may be prescribed if necessary 1. For hypotension, treatment typically involves addressing the underlying cause, and may include measures like adequate hydration, increasing salt intake, and wearing compression stockings.

Management and Treatment

The goal of treatment for both hypertension and hypotension is to manage symptoms, prevent complications, and improve quality of life. This can be achieved through a combination of lifestyle modifications, medications, and regular monitoring of blood pressure. It is essential to work with a healthcare provider to develop a personalized treatment plan, as the most effective approach will vary depending on the individual's specific needs and medical history. By prioritizing blood pressure management and making informed lifestyle choices, individuals can reduce their risk of complications and improve their overall health and well-being 1.

From the FDA Drug Label

Lisinopril tablets USP are indicated for the treatment of hypertension in adult patients and pediatric patients 6 years of age and older to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit Lisinopril can cause symptomatic hypotension, sometimes complicated by oliguria, progressive azotemia, acute renal failure or death Patients at risk of excessive hypotension include those with the following conditions or characteristics: heart failure with systolic blood pressure below 100 mmHg, ischemic heart disease, cerebrovascular disease, hyponatremia, high dose diuretic therapy, renal dialysis, or severe volume and/or salt depletion of any etiology

The causes of hypertension (high blood pressure) are not explicitly stated in the provided drug labels. The effects of hypertension include increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures. The causes of hypotension (low blood pressure) include:

• Heart failure with systolic blood pressure below 100 mmHg
• Ischemic heart disease
• Cerebrovascular disease
• Hyponatremia
• High dose diuretic therapy
• Renal dialysis
• Severe volume and/or salt depletion of any etiology The effects of hypotension include:
• Oliguria
• Progressive azotemia
• Acute renal failure
• Death 2 2

From the Research

Causes of Hypertension

• Hypertension is associated with increased risk of cardiovascular disease (CVD) events and death 3
• Factors that contribute to hypertension include:
  • High sodium intake
  • Low potassium intake
  • Physical inactivity
  • Excessive alcohol consumption
  • Stress
  • Unhealthy dietary patterns
  • Obesity 4, 5, 6

Effects of Hypertension

• Hypertension increases the risk of:
  • Cardiovascular disease (CVD) events (coronary heart disease, heart failure, and stroke)
  • Death 3
• Uncontrolled hypertension can lead to:
  • Cardiovascular morbidity and mortality
  • Kidney disease
  • Vision loss 3, 7

Causes of Hypotension

• No direct evidence is provided in the given studies to discuss the causes of hypotension

Effects of Hypotension

• No direct evidence is provided in the given studies to discuss the effects of hypotension

Lifestyle Modifications for Hypertension

• Recommended lifestyle modifications for hypertension include:
  • Weight loss
  • Healthy dietary pattern (e.g. Dietary Approaches to Stop Hypertension (DASH) diet)
  • Physical activity
  • Moderation or elimination of alcohol consumption
  • Sodium restriction
  • Potassium supplementation
  • Stress management 3, 4, 5, 6
• These lifestyle modifications can help lower blood pressure and reduce the risk of CVD events 3, 4, 5, 6

Treatment of Hypertension

• First-line therapy for hypertension is lifestyle modification 3
• When drug therapy is required, first-line therapies include:
  • Thiazide or thiazide-like diuretics
  • Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers
  • Calcium channel blockers 3, 7