Abstract

Background: Hypertension remains the most common readily identifiable and reversible risk factor for myocardial infarction, stroke, heart failure, atrial fibrillation, aortic dissection and peripheral arterial disease. Because of the escalating obesity and population aging, the global burden of hypertension is rising and it is estimated to affect 1.5 billion persons – ie, one third of the world’s population-by the year 2025. Currently, high blood pressure (BP) causes about 54% of stroke and 47% of ischemic heart disease worldwide.

Half of this disease burden is in people with hypertension; the other half is in people with lesser degrees of high BP (prehypertension). Thus, high BP remains the leading cause of death worldwide and one of the world’s great public health problems.

In 90% to 95% of hypertensive patients, a single reversible cause of the elevated BP cannot be identified, hence the term essential hypertension. In the remaining 5% to10%- cases denoted secondary or identifiable hypertension- a more discrete mechanism can be identified.

Materials And Methods: The study was conducted in medicine OPD and wards of Kanyakumari Government Medical College, Kanyakumari. It is an Analytical type of study. The study period was from January2016-December 2016. A total of 100cases (50 cases and 50 controls) were studied. The present project was submitted in Institutional Ethical Committee and its approval was obtained. The participants were taken up after getting a written informed consent from them.

Inclusion Criteria:

            1. Patients with essential hypertension.

            2. Age above 30 yrs.

            3. Both sexes were included.

Exclusion Criteria:

1.      Patients below 30 years.

2.      Patients with diabetes mellitus.

3.      Patients with renal failure / active urinary sediment / significant proteinuria.

4.      Pregnancy

5.      Patients whose BP shows significant disparity between right and left arm or between upper limbs and lower limbs

6.      Patients with bruit in renal arteries

7.      Patients with peripheral vascular diseases

8.      Patients admitted with features of malignant hypertension, hypertensive encephalopathy, flash pulmonary edema and other hypertensive emergencies.

9.      Patients with acute diarrhoeal disease.

10.  Patients on NSAIDS, anti-hypertensives, diuretics, oral contraceptives, beta blockers or agonists.

All the patients were subjected to detailed history taking, careful physical examination and biochemical analysis to exclude secondary hypertension.  Patient’s height and weight were measured.  The body mass index was calculated using the formula weight / height. Patient’s hip and waist circumferences were measured.  All the peripheral pulses were checked with special attention to carotid and the femoral to detect evidence for early atherosclerosis. An ocular fundus examination was done to detect hypertensive retinopathy.

Patients were informed to refrain from smoking or drinking tea or coffee for at least thirty minutes before measuring blood pressure.

Observation: The total number of subjects included in this study was 100. Among these 100 subjects, 50 were cases (hypertensive) and 50 were controls (normotensive).

Results: Serum sodium was significantly more among hypertensives and it was independent of associated risk factors and gender& also correlated positively with the level of blood pressure. Serum potassium was significantly less among hypertensives and it correlated negatively with blood pressure.