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High blood pressure (hypertension) has gained considerable significance because it will eventually damage end organs like the heart, brain, kidneys and the eyes. It is estimated that hypertension affects about 10-20 per cent of the population. One can imagine the enormity of the problem in a country like India with one billion population. The biggest advantages in dealing with hypertension are that (1) it is readily identifiable by the primary physician or health worker, (2) the assessment parameters and goals of treatment are very elegantly described by groups like the Joint National Council (JNC), and (3) very satisfactory results can be obtained by proper treatment. However the individual has to be regular about the treatment and needs regular follow up. Since the increasing incidence of hypertension has been attributed to the changing life styles, it would be the task and privilege of the primary physicians to address these factors thereby decreasing the "killing" and the disabling effects of this "silent killer". The aim of this unit is to familiarize the primary physician in the following areas of hypertension:
1) How and when to suspect and how to diagnose hypertension
2) Be able to make a definitive JNC VII classification
3) Look for evidence of any primary causes
4) Examine and make assessment of complications of hypertension
5) Manage acute and chronic phases of hypertension.
The complications that occur in the heart due to hypertension are left ventricular hypertrophy, diastolic dysfunction and cardiac failure. There is also associated coronary artery
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