Editing Hypertension (section)

==History==
{{Main|History of hypertension}}
[[File:William Harvey ( 1578-1657) Venenbild.jpg|Image of veins from Harvey's ''Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus''|left|thumb]]

===Measurement===
Modern understanding of the cardiovascular system began with the work of physician [[William Harvey]] (1578–1657), who described the circulation of blood in his book "''De motu cordis''". The English clergyman [[Stephen Hales]] made the first published measurement of blood pressure in 1733.<ref name="pmid1744849"/><ref name=Kotchen2011>{{cite journal | vauthors = Kotchen TA | title = Historical trends and milestones in hypertension research: a model of the process of translational research | journal = Hypertension | volume = 58 | issue = 4 | pages = 522–38 | date = October 2011 | pmid = 21859967 | doi = 10.1161/HYPERTENSIONAHA.111.177766 | doi-access = free }}</ref> However, hypertension as a clinical entity came into its own with the invention of the cuff-based [[sphygmomanometer]] by [[Scipione Riva-Rocci]] in 1896.<ref>{{cite book | title=A century of arterial hypertension 1896–1996 | editor=Postel-Vinay N | pages=213 | location=Chichester | publisher=Wiley | year=1996 | isbn=978-0-471-96788-0}}</ref> This allowed easy measurement of systolic pressure in the clinic. In 1905, [[Nikolai Korotkoff]] improved the technique by describing the [[Korotkoff sounds]] that are heard when the artery is auscultated with a stethoscope while the sphygmomanometer cuff is deflated.<ref name=Kotchen2011/> This permitted systolic and diastolic pressure to be measured.

===Identification===
Symptoms similar to those of patients with a hypertensive crisis are discussed in medieval Persian medical texts in the chapter of "fullness disease".<ref name="The medieval origins of the concept of hypertension">{{cite journal | vauthors = Heydari M, Dalfardi B, Golzari SE, Habibi H, Zarshenas MM | title = The medieval origins of the concept of hypertension | journal = Heart Views | volume = 15 | issue = 3 | pages = 96–98 | date = July 2014 | pmid = 25538828 | pmc = 4268622 | doi = 10.4103/1995-705X.144807 | doi-access = free }}</ref> The symptoms include headache, heaviness in the head, sluggish movements, general redness and warm to touch feel of the body, prominent, distended and tense vessels, a fullness of the pulse, distension of the skin, coloured and dense urine, loss of appetite, weak eyesight, impairment of thinking, yawning, drowsiness, vascular rupture, and hemorrhagic stroke.<ref name="pmid25310615">{{cite journal | vauthors = Emtiazy M, Choopani R, Khodadoost M, Tansaz M, Dehghan S, Ghahremani Z | title = Avicenna's doctrine about arterial hypertension | journal = Acta medico-historica Adriatica | volume = 12 | issue = 1 | pages = 157–162 | year = 2014 | pmid = 25310615 }}</ref> Fullness disease was presumed to be due to an excessive amount of blood within the blood vessels.

Descriptions of hypertension as a disease came among others from [[Thomas Young (scientist)|Thomas Young]] in 1808 and especially [[Richard Bright (physician)|Richard Bright]] in 1836.<ref name="pmid1744849"/> The first report of elevated blood pressure in a person without evidence of kidney disease was made by [[Frederick Akbar Mahomed]] (1849–1884).<ref>{{cite book |editor=Swales JD|title=Manual of hypertension |publisher=Blackwell Science |location=Oxford |year=1995 |page=xiii |isbn=978-0-86542-861-4}}</ref>

Until the 1990s, systolic hypertension was defined as systolic blood pressure of 160 mm Hg or greater.<ref>{{Cite journal |last=Wilking |first=Spencer Van B. |date=1988-12-16 |title=Determinants of Isolated Systolic Hypertension |url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1988.03410230069030 |journal=JAMA: The Journal of the American Medical Association |language=en |volume=260 |issue=23 |pages=3451–3455 |doi=10.1001/jama.1988.03410230069030 |pmid=3210285 |issn=0098-7484}}</ref> In 1993, the WHO/ISH guidelines defined 140 mmHg as the threshold for hypertension.<ref>{{Cite journal |date=1993 |title=1993 guidelines for the management of mild hypertension: memorandum from a WHO/ISH meeting. |journal=Bulletin of the World Health Organization |volume=71 |issue=5 |pages=503–517 |issn=0042-9686 |pmc=2393474 |pmid=8261554}}</ref>

===Treatment===
Historically the treatment for what was called the "hard pulse disease" consisted of reducing the quantity of blood by [[bloodletting]] or the application of [[leech]]es.<ref name="pmid1744849">{{cite journal | vauthors = Esunge PM | title = From blood pressure to hypertension: the history of research | journal = Journal of the Royal Society of Medicine | volume = 84 | issue = 10 | pages = 621 | date = October 1991 | doi = 10.1177/014107689108401019 | pmid = 1744849 | pmc = 1295564 }}</ref> This was advocated by The [[Yellow Emperor]] of China, [[Aulus Cornelius Celsus|Cornelius Celsus]], [[Galen]], and [[Hippocrates]].<ref name="pmid1744849"/> The therapeutic approach for the treatment of hard pulse disease included lifestyle changes (staying away from anger and [[sexual intercourse]]) and dietary program for patients (avoiding the consumption of [[wine]], meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of [[spinach]] and [[vinegar]]).

In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side effects: strict sodium restriction (for example the [[rice diet]]<ref name="pmid1744849"/>), [[sympathectomy]] (surgical ablation of parts of the [[sympathetic nervous system]]), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).<ref name="pmid1744849"/><ref name=Dustan>{{cite journal | vauthors = Dustan HP, Roccella EJ, Garrison HH | title = Controlling hypertension. A research success story | journal = Archives of Internal Medicine | volume = 156 | issue = 17 | pages = 1926–1935 | date = September 1996 | pmid = 8823146 | doi = 10.1001/archinte.156.17.1926 }}</ref>

The first chemical for hypertension, [[sodium thiocyanate]], was used in 1900 but had many side effects and was unpopular.<ref name="pmid1744849"/> Several other agents were developed after the [[World War II|Second World War]], the most popular and reasonably effective of which were [[tetramethylammonium chloride]], [[hexamethonium]], [[hydralazine]], and [[reserpine]] (derived from the medicinal plant ''[[Rauvolfia serpentina]]''). None of these were well tolerated.<ref>{{cite journal | vauthors = Lyons HH, Hoobler SW | title = Experiences with tetraethylammonium chloride in hypertension | journal = Journal of the American Medical Association | volume = 136 | issue = 9 | pages = 608–613 | date = February 1948 | pmid = 18899127 | doi = 10.1001/jama.1948.02890260016005 }}</ref><ref>{{cite journal | vauthors = Bakris GL, Frohlich ED | title = The evolution of antihypertensive therapy: an overview of four decades of experience | journal = Journal of the American College of Cardiology | volume = 14 | issue = 7 | pages = 1595–1608 | date = December 1989 | pmid = 2685075 | doi = 10.1016/0735-1097(89)90002-8 | doi-access = free }}</ref> A major breakthrough was achieved with the discovery of the first well-tolerated orally available agents. The first was [[chlorothiazide]], the first [[thiazide]] [[diuretic]] and developed from the antibiotic [[sulfanilamide]], which became available in 1958.<ref name="pmid1744849"/><ref>{{cite journal|vauthors=Novello FC, Sprague JM | title=Benzothiadiazine dioxides as novel diuretics | journal=J. Am. Chem. Soc. | year=1957 | volume=79 | pages=2028–2029 | doi=10.1021/ja01565a079|issue=8  }}</ref> Subsequently, [[beta blocker]]s, [[calcium channel blockers]], [[angiotensin converting enzyme]] (ACE) inhibitors, [[angiotensin receptor blockers]], and [[renin inhibitors]] were developed as antihypertensive agents.<ref name=Dustan />