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have hypertension. In the United States, the prevalence of hypertension tends to be higher in Blacks and Hispanics as compared to Caucasians. Women under the age of 50 tend to have a lower risk of hypertension than men. However, women over the age of 50 have higher risk of hypertension than men.
     

Causes and risk factors
    Primary hypertension can be attributed to a variety of causes including emotional stress, licorice toxicity, salt sensitivity, high renin levels, insulin resistance, sleep apnea, genetic factors, natural aging, and other factors. Individuals with a family member with primary hypertension are at an increased risk of developing the condition. Also, being of African American descent increases risk of hypertension compared to Caucasians.
     
    Secondary hypertension can be attributed to renal disease, adrenal disease, Cushing syndrome, spinal misalignment, adrenal gland tumor, alcohol poisoning, anxiety, stress, pain, arteriosclerosis, obesity, pregnancy, hyperthyroidism, hypothyroidism, retroperitoneal fibrosis, oral contraceptives, antihypertensive medication withdrawal, and drugs such as NSAIDs.
     
    The 2003 National Heart, Lung, and Blood Institute (NHLBI) guidelines divide blood pressure into 4 general categories for adults that include:
The first category is “normal blood pressure,” which includes individuals with a blood pressure below 120/80 mmHg.
The secondary category is called “prehypertension” and includes individuals with a systolic blood pressure ranging from 120 to 139 and diastolic blood pressure ranging from 80 to 89. Without lifestyle modifications, prehypertension may worsen over time and should be monitored by a practicing clinician.
The third category is referred to as “stage 1 hypertension” and includes individuals with systolic pressure ranging from 140 to 159 and/or a diastolic pressure ranging from 90 to 99.
The fourth category is “stage 2 hypertension,” which includes individuals with severe hypertension. Individuals who present with a systolic pressure above 160 and/or diastolic pressure above 100.
     
    Diagnosis, screening and symptoms
    Hypertension is typically diagnosed during routine physical examinations or when addressing other conditions or concerns. The only test used for diagnosis of hypertension is blood pressure measurement. However, blood pressure measurements need to be taken on a regular basis when persistent high blood pressure is a concern. Also, proper measurement is necessary for accurate diagnosis. If other cardiovascular complications are suspected, other testing including echocardiogram, urinalysis, CBC, serum electrolytes, serum creatine, serum glucose, and x-rays may be performed.
     
    Most patients present with no symptoms, but some patients experience headaches, fatigue, dizziness, confusion, chest pain, irregular heartbeat, nosebleed, blurred vision, facial flushing, or tinnitus. Hypertension is sometimes misdiagnosed as stress and/or anxiety. Although stress and anxiety can contribute to elevated blood pressure, they cannot cause persistent hypertension.
     

Dyslipidemia
     
    Dyslipidemia is a disorder of lipoprotein metabolism, including hyperlipidemia and hypolipidemia. Dyslipidemia can be classified as primary dyslipidemia or as result of a comorbid condition and referred to as secondary dyslipidemia. The condition is typically characterized by elevations in total cholesterol, low-density lipoprotein cholesterol, triglyceride levels, and a decrease in high-density cholesterol levels.
     
    Primary dyslipidemia is more prevalent among adolescents and children than in adults. Secondary dyslipidemia is the main cause dyslipidemia in adults. African Americans and Hispanic Americans are at greater risk for the development of dyslipidemia and cardiovascular complications as compared to Caucasian Americans.
     

Causes and risk factors
    The causes of dyslipidemia include genetic as well as environmental contributions.
     
    In secondary