From the Guidelines
Hypertension is primarily caused by a combination of genetic factors, lifestyle choices, and certain medical conditions, and a CT scan of the brain is crucial in detecting complications such as stroke, bleeding, or brain swelling, especially in cases of severe or sudden hypertension, as recommended by the 2020 international society of hypertension global hypertension practice guidelines 1.
Causes of High Hypertension
The causes of high hypertension include:
- Genetic factors
- Lifestyle choices, such as obesity, high sodium intake, physical inactivity, excessive alcohol consumption, stress, and smoking
- Certain medical conditions, such as kidney disease, thyroid disorders, and sleep apnea
Importance of CT Scan for Brain
A CT scan of the brain is essential in detecting complications related to high hypertension, including:
- Stroke
- Bleeding
- Brain swelling This imaging is particularly important if a patient experiences neurological symptoms like severe headaches, confusion, vision changes, or weakness, which might indicate hypertensive emergency affecting the brain, as stated in the esc council on hypertension position document on the management of hypertensive emergencies 1.
Guidelines for Hypertension Management
The current recommendations for hypertension management are to treat to <140/90 mmHg or <130/80 mmHg in patients with diabetes mellitus or chronic kidney disease, as indicated in the 2015 american heart association scientific statement on congenital heart disease in the older adult 1.
Diagnostic Workup
The standard diagnostic workup of hypertension includes assessment of target organ damage and exclusion of identifiable causes of hypertension, such as sleep apnea, nonsteroidal anti-inflammatory drug use, chronic kidney disease, endocrine causes, renovascular disease, and coarctation, as recommended in the 2020 international society of hypertension global hypertension practice guidelines 1.
From the Research
Causes of High Hypertension
- High hypertension can be caused by various factors, including lifestyle habits and underlying medical conditions 2, 3.
- Some of the lifestyle factors that contribute to high hypertension include a high-sodium diet, low potassium intake, physical inactivity, and excessive alcohol consumption 2, 3.
- Certain medical conditions, such as kidney disease, can also increase the risk of developing high hypertension 4.
Importance of Controlling Hypertension
- Controlling hypertension is crucial to reduce the risk of cardiovascular disease, stroke, and kidney disease 2, 3, 5.
- Studies have shown that reducing blood pressure can decrease the risk of cardiovascular events by approximately 20-30% 2.
- The American Heart Association recommends lifestyle modifications, such as weight loss, healthy dietary patterns, and regular exercise, as the first line of treatment for hypertension 2, 3.
Use of CT Scan for Brain
- A CT scan may be ordered to evaluate the brain in patients with high hypertension, especially if there are concerns about hemorrhagic stroke or other cerebrovascular complications 5.
- The scan can help identify any abnormalities in the brain, such as bleeding or damage to blood vessels, which may be related to high hypertension 5.
- In some cases, a CT scan may be used to monitor the effects of treatment on the brain and to adjust the treatment plan as needed 5.
Treatment of Hypertension
- The treatment of hypertension typically involves a combination of lifestyle modifications and medication 2, 3, 6, 4.
- First-line medications for hypertension include thiazide diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers 2, 3, 6, 4.
- The choice of medication depends on various factors, including the patient's medical history, kidney function, and other health conditions 6, 4.