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Central Nervous System
Hypertension is one of the leading causes of cerebrovascular disease. It has been associated with accelerated age related cognitive decline. The most dreaded complication is the occurrence of strokes. The risk of a stroke increases almost 4 fold in a person with a diastolic pressure of 91 to one with 105 mmHg. Transient ischemic attacks (TIA) do occur due to extracranial atherosclerosis.
Renal
Hypertension induces microalbuminuria in the early stages. Later on nephrosclerosis sets in leading to renal failure with rise in blood urea and creatinine.
Aorta
The commonest abnormality of the aorta, associated with hypertension is abdominal aneurysms. This can eventually lead on to rupture with fatal results.
Eye
The changes in the eye can be identified and assessed by fundus examination. Keith Wagner classification is the usual method of grading.
Grade I: Narrowing of arteries giving rise to copper wire or silver wire appearance.
Grade II: In addition to copper wire appearance, arterio-venous nipping where the arteries cross the veins.
Grade III : In addition to above, superficial flame shaped and deep dot like haemorrhages and cotton wool exudates.
Grade IV : In addition to all the above, papilloedema.
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