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Hypertension
The document discusses hypertension, highlighting its definition, classification, and various risk factors including genetics, age, lifestyle, and comorbidities. It explains the pathophysiology of primary and secondary hypertension, emphasizing the multifactorial nature of this condition and the importance of blood pressure monitoring. The treatment goals focus on managing blood pressure to prevent complications, with an overview of dietary recommendations and pharmacologic management options.
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Hypertension
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- 4. Classification of bloodpressure for adults
- 5. RISK FACTORS FORHYPERTENSION
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- 7. •Diabetes mellitus •Stress •Obesity •Sedentary lifestyle •Socio economic status •Elevated serum lipids levels •Nutrients (increase sodium consumption.) •Substance abuse
- 8. PATHOPHYSIOLOGY •Although the precisecause for most cases of hypertension cannot be identified, it is understood that hypertension is a multifactorial condition. •Although the exact cause of HTN is unknown in most cases of HTN. •It is understood that HTN is a multifactorial condition. •Increased sympathetic nervous system activity related to dysfunction of the autonomic nervous system.
- 9. PATHOPHYSIOLOGY •Increased renal reabsorptionof sodium. Chloride, and water related to a genetic variation in the pathways by which the kidneys handle sodium. •Resistance to insulin action, which may be a common factors linking HTN, type 2 DM, hypettriglycerdemia, obesity and glucose intolerance.
- 10. PATHOPHYSIOLOGY • The predominantmechanisms of blood pressure control are the central nervous system (CNS),the renin-angiotension-aldosterone system, and extracellular fluid volume. Why these mechanisms fail is not known.
- 12. •Primary Hypertension oralso known as essential or idiopathic Hypertension. • The cause of essential hypertension is unknown; however, there are several areas investigation. •It is more common type of hypertension it accounts for 90 to 95 % of all cause of HTN. •In this condition the BP is elevated from an unidentified cause.
- 13. •Although the exactcause of primary HTN is unknown. Several contributing factors including… . •Increased SNS activity. •Over production of sodium retaing hormones and vasoconstrictors •Increased sodium intake. •Greater than body weight and and excessive alcohol consumption.
- 14. •In this typeof hypertension the BP is elevated with a specific cause that often can be identified and corrected. Or high blood pressure from an identified cause. •It accounts for 5 to 10% of hypertension.
- 15. •Endocrine disorder (Cushingsyndrome) • Renal disease ( CRF) •Neurological disorder (brain tumor and HI) •Sleep apnea, cirrhosis and pregnancy induced hypertension (PIH). • Prescription medications such as estrogen and steroids ( cause fluid retention), sympathomimetic ( cause vasoconstriction and tachycardia)
- 16. 1. Hypertension cancause intimal wall injury in the arteries, which can lead to arteriosclerosis in which smooth muscle cell proliferation, lipid infiltration, and calcium accumulation occur in the vascular endothelium.
- 17. • Prolonged hypertensiondamages small blood vessels in the brain, eyes, heart, and kidneys.
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- 19. •History collection (family history of HTN, DM, CAD or renal disease, medications and dietary history) •Smoking history, dietary history and stress and coping. Etc. •Previous documentation of HBP including age, at one St, level of elevation and currently prescribed medication. •History of all prescribed and OTC medications.
- 20. •History of anydisease or trauma and target organs. •Results /side effects of previous anti hypertensive therapy. •History of recent weight gain, sodium intake, fat intake, alcohol use and smoking.
- 21. •Vital signs andweight •Blood work measurement : use appropriate cuff size will ensure an accurate measurement. •BP measurement should be taken with a mercury sphygmomanometer. •Both SBP and DBP should be record.
- 22. 1. ECG (to determine effects of HTN on the heart) 2. Chest x-ray
- 23. … •Routine urinalysis •Serum potasiumand Sr, sodium levels. •BUT and Sr, creatine •FBGL and Sr, cholesterol (HDL and LDL) •ECG and CXR •LFT •Sr.TSH
- 24. The goal ofhypertension treatments is to prevent complications and target organs damage by achieving and maintain the blood pressure at 140/90 mm Hg or lower. And reduce risk factors.
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- 29. ) Food groups Numberof servings per day Grains and grain products 7 or 8 Vegetables 4 or 5 Fruits 4 or 5 Low fat or fat free dairy foods 2 or 3 Meat, fish ,and poultry 2 or fewer Nuts ,seeds. And dry beans 4 0r 5 weekly
- 31. •Many therapeutic agentscan be used for the pharmacologic management of hypertension.
- 32. 1. Diuretics andrelated drugs (e.g. Thiazide diuretics ( Lower BP by promoting urinary exerction of water and sodium to lower blood volume.) 2. Loop diuretics ( e.g. Furosimide (Lasix), for semi detached (Demadex) 3. Potassium sparing diuretics (e.g. amiloride)
- 34. 4. Beta blockers( e.g. stenosis, metrolrolol)
- 35. •Vasodilators •Calicum channel blockers •ACEinhibitors (angiotension- converting enzyme)
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- 39. •Explain in simpleterms what is the HTN. •Causes and prevention measures. •Explain hypertension means HBP and not related to hyper personality. •Describe the normal range of blood pressure, hypotension and hypertension. •Educate regarding medications and it’s side effects
- 40. • Develop aplan of instruction for medication self – management. • Determine recommended dietary plans and provide dietary education, as appropriate. • Importance of life style changes. • Complications and its prevention. • Ambulatory BP monitoring.
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