Table 3: High blood pressure phenotypes according to origin or cause .

Phenotype

Primary or essential

Secondary

Pregnancy-related

Definition

Permanent elevation of systolic and/or diastolic BP without defined cause

Permanent elevation of systolic and/or diastolic BP with a defined cause. It is suspected when it begins in childhood or young patients, or patients with refractory or resistant high blood pressure.

Gestational high blood pressure: Elevated blood pressure during pregnancy. It begins after 20 weeks of pregnancy.

Chronic high blood pressure in pregnancy: High blood pressure that begins before the 20th week of pregnancy or before becoming pregnant.

Preeclampsia: Sudden increase in blood pressure after the 20th week of pregnancy. In general, it occurs in the last trimester and can continue in the postpartum period.

Etiology

Multifactorial: genetic, cultural and environmental causes.

Frequent: Primary hyperaldosteronism, renal parenchymal diseases and renal artery stenosis.

Rare: Aortic coarctation, Pheochromocytoma, Cushing's syndrome, Hyperparathyroidism, Brain tumors, Takayasu's disease and other vasculitides, etc.

Unknown

Pathophysiology

Mainly due to increased vascular resistance and cardiac output

Depends on the cause

Generalized inflammation, prothrombosis and proteinuria.

Prognosis

High mortality and morbidity.

Variable

Premature birth, fetal and maternal death.

Treatment

ACEI/ARB combinations, calcium antagonists and thiazide-type diuretics are preferred.

Depends on the cause

Acetyl-salicylic acid, Calcium antagonists, alpha-blockers and beta-blockers.

ESH = European Society high blood pressure;

ACEI = Angiotensin-converting enzyme inhibitors;

ARB = Angiotensin receptor blockers;

BB = Beta-blockers.