Persistently raised blood pressure exceeding about 140 mmHg (systolic) and 90 mmHg (diastolic) at rest. Hypertension is very common, particularly in men, and its incidence is highest in middle-aged and elderly people. Hypertension is usually symptomless but may cause headaches and visual disturbances when severe. It increases the risk of stroke, coronary artery disease, and heart failure, and may eventually lead to kidney damage and retinopathy. In many cases, there is no obvious cause. Factors associated with hypertension include high alcohol intake, a high-salt diet, obesity, a family history of the condition, a sedentary lifestyle, a high degree of stress, and smoking. Specific causes include various kidney disorders, certain disordes of the adrenal glands, pre-eclampsia, coarctation of the aorta, and use of certain drugs. Taking the combined contraceptive pill can increase the risk. With mild to moderate hypertension, if no underlying cause is found, lifestyle changes are recommended, for example, introducing regular exercise and stopping smoking. Biofeedback training and relaxation techniques can help reduce blood pressure. If self-help measures have no effect, or hypertension is severe, 1 or a combination of antihypertensive drugs may be given.


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