উচ্চ ৰক্তচাপ: বিভিন্ন সংশোধনসমূহৰ মাজৰ পাৰ্থক্য

63 নং শাৰী:
নৱজাতক আৰু কেঁচুৱাৰ উচ্চ ৰক্তচাপ হ'লে ওজন নবঢ়া, খিংখিঙীয়া, সপ্ৰতিভ নোহোৱা, উশাহ লোৱাৰ কষ্ট আদিয়ে দেখা দিয়ে।<ref name="urlHypertension: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine">{{cite web |url=http://emedicine.medscape.com/article/889877-overview |title=Hypertension |author=Rodriguez-Cruz, Edwin |author2=Ettinger, Leigh M |date=April 6, 2010 |work=eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine |publisher=Medscape |pages= |accessdate=16 June 2009}}</ref> শিশু অৱস্থাত উচ্চ ৰক্তচাপে মূৰৰ বিষ, চট্‌ফটনি, বেছি ভাগৰ, চকুৰে ধুঁৱলি-কুঁৱলি দেখা, নাকেৰে তেজ ওলোৱা, [[বেলৰ পক্ষাঘাত|মুখৰ পক্ষাঘাত]] আদি লক্ষণ সৃষ্টি কৰে।<ref name="urlHypertension: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine"/><ref name=Dionne/>
 
==Causesকাৰক==
 
===প্ৰাথমিক উচ্চ ৰক্তচাপ===
===Primary hypertension===
{{Main article|Essentialপ্ৰাথমিক hypertensionউচ্চ ৰক্তচাপ}}
Hypertension[[জিন]] resultsআৰু fromপাৰিবেশিক aকাৰকৰ complexজটিল interactionবিনিময়ৰ ofফলত genesউচ্চ andৰক্তচাপ environmentalহয়। factors.ৰক্তচাপত Numerousঅলপ-অচৰপ commonপ্ৰভাৱ geneticপেলোৱা variants with small effects on blood pressureবহু haveজিনীয় beenকাৰকৰ identifiedলগতে<ref name="pmid21909115">{{cite journal|author=Ehret GB |title=Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk |journal=Nature |volume=478 |issue=7367 |pages=103–09 |date=October 2011|pmid=21909115 |doi=10.1038/nature10405 |name-list-format=vanc|author2=Munroe PB |author3=Rice KM|display-authors=3 |last4=Bochud |first4=Murielle |last5=Johnson |first5=Andrew D. |last6=Chasman|first6=Daniel I. |last7=Smith |first7=Albert V. |last8=Tobin |first8=Martin D. |last9=Verwoert|first9=Germaine C. |pmc=3340926}}</ref> asবেছি wellপ্ৰভাৱ asপেলোৱা someকিছুমান rareদুৰ্লভ geneticজিনীয় variantsকাৰকো withচিনাক্ত largeকৰা effects on blood pressure.হৈছে।<ref>{{cite journal|last=Lifton|first=RP|author2=Gharavi, AG, Geller, DS|title=Molecular mechanisms of human hypertension|journal=Cell|date=2001-02-23|volume=104|issue=4|pages=545–56|pmid=11239411|doi=10.1016/S0092-8674(01)00241-0}}</ref> Also, [[:en:Genome-wide association study|GWAS]] haveঅধ্যয়নে identifiedৰক্তচাপৰ 35লগত geneticসম্পৰ্ক lociথকা related৩৫ toটা bloodজিনীয় pressure;স্থান 12বিচাৰি of these genetic loci influencing blood pressure were newly found.উলিয়াইছে।<ref name=Nor2016>{{Cite journal|last=Kato|first=Norihiro|last2=Loh|first2=Marie|last3=Takeuchi|first3=Fumihiko|last4=Verweij|first4=Niek|last5=Wang|first5=Xu|last6=Zhang|first6=Weihua|last7=Kelly|first7=Tanika N.|last8=Saleheen|first8=Danish|last9=Lehne|first9=Benjamin|date=2015-11-01|title=Trans-ancestry genome-wide association study identifies 12 genetic loci influencing blood pressure and implicates a role for DNA methylation|journal=Nature Genetics|volume=47|issue=11|pages=1282–93|doi=10.1038/ng.3405|issn=1546-1718|pmc=4719169|pmid=26390057}}</ref> Sentinel [[Single-nucleotide polymorphism|SNP]] for each new genetic loci identified has shown an association with [[DNA methylation]] at multiple nearby [[CpG site|Cpg sites]]. These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.<ref name=Nor2016/>
 
Bloodবয়সৰ pressureলগে risesলগে withৰক্তচাপ [[aging]]বৃদ্ধি andপায় theআৰু riskপাছলৈ ofউচ্চ becomingৰক্তচাও hypertensiveহোৱা inসম্ভাৱনা later life is considerable.বাঢ়ে।<ref>{{cite journal|last=Vasan|first=RS|author2=Beiser, A |author3=Seshadri, S |author4=Larson, MG |author5=Kannel, WB |author6=D'Agostino, RB |author7=Levy, D |title=Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study|journal=JAMA: The Journal of the American Medical Association|date=2002-02-27|volume=287|issue=8|pages=1003–10|pmid=11866648|doi=10.1001/jama.287.8.1003}}</ref> Severalপাৰিবেশিক environmentalকাৰকৰ factorsভিতৰত influenceনিমখ bloodসংবেদী pressure.লোকৰ Highঅধিক saltনিমখ intakeগ্ৰহণ, raisesব্যায়াম the blood pressure in salt sensitive individuals; lack of exerciseনকৰা, obesity,[[মেদবহুলতা]] andআৰু [[depression (mood)|depressionহতাশা]] আদি চিনাক্ত কৰা হৈছে।<ref>{{cite journal|last1=Meng|first1=L|last2=Chen|first2=D|last3=Yang|first3=Y|last4=Zheng|first4=Y|last5=Hui|first5=R|title=Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies.|journal=Journal of Hypertension|date=May 2012|volume=30|issue=5|pages=842–51|pmid=22343537|doi=10.1097/hjh.0b013e32835080b7}}</ref> canঅধিক playকেফেইন a role in individual cases. The possible role of other factors such as caffeine consumption,গ্ৰহণ<ref>{{cite journal|last=Mesas|first=AE|author2=Leon-Muñoz, LM |author3=Rodriguez-Artalejo, F |author4= Lopez-Garcia, E |title=The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis|journal=The American Journal of Clinical Nutrition|date=October 2011|volume=94|issue=4|pages=1113–26|pmid=21880846|doi=10.3945/ajcn.111.016667}}</ref> andআৰু vitaminভিটামিন Dডিৰ deficiencyঅভাৱৰ<ref>{{cite journal |author=Vaidya A, Forman JP |title=Vitamin D and hypertension: current evidence and future directions |journal=Hypertension |volume=56 |issue=5 |pages=774–79 |date=November 2010 |pmid=20937970 |doi=10.1161/HYPERTENSIONAHA.109.140160 |url=|last2=Forman }}</ref> areভূমিকা lessস্পষ্ট clear.নহয়। [[Insulinমেদবহুলতা resistance]],আৰু whichমেটাব'মিল isছীন্‌ড্ৰমত common in obesity and is a component ofপোৱা [[metabolicইন্‌চুলিন syndromeঅৱৰোধ|syndromeইন্‌চুলিন Xঅৱৰোধেও]] (orউচ্চ theৰক্তচাপলৈ [[metabolicঅৱদান syndrome]]),আগবঢ়াব is also thought to contribute to hypertension.পাৰে।<ref name="pmid12364344">{{cite journal |author=Sorof J, Daniels S |title=Obesity hypertension in children: a problem of epidemic proportions |journal=Hypertension |volume=40 |issue=4|pages=441–47 |date=October 2002 |pmid=12364344 |doi= 10.1161/01.HYP.0000032940.33466.12|url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=12364344 |accessdate=3 June 2009|last2=Daniels }}</ref> Eventsপ্ৰাৰম্ভিক inঘটনা earlyযেনে life,জন্মাৱস্থাৰ suchকম as [[low birth weight]]ওজন, [[Smokingগৰ্ভাৱস্থাত andধূমপান pregnancy|maternalআৰু smoking]],স্তনপান andনকৰোৱা lackআদিও ofসম্ভাব্য [[breastকাৰক feeding]]হ'ব mayপাৰে beকিন্তু riskএইবোৰৰ factorsপদ্ধতি forস্পষ্ট adult essential hypertension, although the mechanisms linking these exposures to adult hypertension remain unclear.নহয়।<ref name = "Lawlor 2005">{{cite journal|last=Lawlor|first=DA|author2=Smith, GD|title=Early life determinants of adult blood pressure|journal=Current Opinion in Nephrology and Hypertension|date=May 2005|volume=14|issue=3|pages=259–64|pmid=15821420|doi=10.1097/01.mnh.0000165893.13620.2b}}</ref> Anজহকালিতকৈ increasedজাৰকালি rateসাধাৰণতে ofৰক্তচাপে [[hyperuricemia|highবেছি blood urea]] has been found in untreated people with hypertensive in comparison with people with normal blood pressure, although it is uncertain whether the former plays a causal role or is subsidiary to poor kidney function.<ref>{{cite journal|last1=Gois|first1=PH|last2=Souza|first2=ER|title=Pharmacotherapy for hyperuricemia in hypertensive patients.|journal=The Cochrane database of systematic reviews|date=31 January 2013|volume=1|page=CD008652|doi=10.1002/14651858.CD008652.pub2|pmid=23440832}}</ref> Blood pressure on average may be higher in the winter than in the summer.হয়।<ref>{{cite journal|last1=Fares|first1=A|title=Winter Hypertension: Potential mechanisms.|journal=International journal of health sciences|date=June 2013|volume=7|issue=2|pages=210–9|pmid=24421749|pmc=3883610|doi=10.12816/0006044}}</ref>
 
===অপ্ৰধান উচ্চ ৰক্তচাপ===
===Secondary hypertension===
{{Main article|Secondaryঅপ্ৰধান hypertensionউচ্চ ৰক্তচাপ}}
Secondaryঅপ্ৰধান hypertensionউচ্চ resultsৰক্তচাপৰ fromনিৰ্দিষ্ট anকাৰণ identifiableথাকে। cause.ইয়াৰ Kidneyভিতৰত diseaseপ্ৰধান isহৈছে theবৃক্কৰ most common secondary cause of hypertension.ৰোগ।<ref name="ABC" /> Hypertensionআন্তঃশ্ৰাৱী canৰোগ alsoযেনে beকুশ্বিং caused by endocrine conditions, such as [[Cushingছীন্দ্ৰ's syndrome]], [[hyperthyroidismহাইপাৰথাইৰইডিজম]], [[hypothyroidismহাইপ'থাইৰইডিজম]], [[acromegaly]]এক্ৰ'মেগেলী, [[Conn's syndrome]]ছীন্‌ড্ৰ'ম, orহাইপাৰপাৰাথাইৰ‌ইডিজম [[hyperaldosteronism]],আৰু [[hyperparathyroidism]]ফিঅ'ক্ৰম'চাইট'মাৰ andফলতো [[pheochromocytoma]].উচ্চ ৰক্তচাপ হয়।<ref name="ABC" /><ref>{{cite book|author=Dluhy RG, Williams GH eds|title=Williams textbook of endocrinology|year=1998|publisher=W.B. Saunders|location=Philadelphia ; Montreal|isbn=0721661521|edition=9th|chapter=Endocrine hypertension|veditors=Wilson JD, Foster DW, Kronenberg HM|pages=729–49}}</ref> Otherআন causesকাৰকৰ ofভিতৰত secondary hypertension include [[obesity]]মেদবহুলতা, [[sleepস্লীপ apnea]]এপ্‌নিয়া, [[pregnancy]]গৰ্ভধাৰণ, [[coarctationঅত্যাধিক of the aorta]]মদ্যপান, excessiveকিছুমান eatingদৰব ofআদিলৈ [[liquorice]],আঙুলিয়াব excessive drinking of alcohol, and certain prescription medicines, herbal remedies and [[illegal drugs]].পাৰি।<ref name="ABC" /><ref>{{cite journal |author=Grossman E, Messerli FH |title=Drug-induced Hypertension: An Unappreciated Cause of Secondary Hypertension |journal=Am. J. Med. |volume=125 |issue=1 |pages=14–22 |date=January 2012 |pmid=22195528 |doi=10.1016/j.amjmed.2011.05.024 |url=|last2=Messerli }}</ref> [[Arsenic]]খোৱা exposureপানীত throughবেছি drinkingআৰ্ছেনিক waterথাকিলে hasৰক্তচাপ beenবাঢ়ে shownবুলি toপ্ৰমাণ correlateপোৱা with elevated blood pressure.গৈছে।<ref name=ehp>{{cite journal|author1=Jieying Jiang |author2=Mengling Liu |author3=Faruque Parvez |title=Association between Arsenic Exposure from Drinking Water and Longitudinal Change in Blood Pressure among HEALS Cohort Participants|journal=Environmental Health Perspectives|date=August 2015|volume=123|issue=8|doi=10.1289/ehp.1409004|display-authors=etal |pmid=25816368 |pmc=4529016}}</ref><ref>{{cite journal|last1=Abhyankar|first1=LN|last2=Jones|first2=MR|last3=Guallar|first3=E|last4=Navas-Acien|first4=A|title=Arsenic exposure and hypertension: a systematic review.|journal=Environmental Health Perspectives|date=April 2012|volume=120|issue=4|pages=494–500|pmid=22138666|doi=10.1289/ehp.1103988|pmc=3339454}}</ref>
 
==Pathophysiology==