Hypertension

seminar topic hypertension/ raised blood pressure
for PG & UG

1. H ypertension Presented by Dr. Chetan Sharma

2. It is a chronic condition It is of concern due to its role in CHD, Stroke & other vascular complications. It is one of the major risk factor for cardiovascular mortality, which accounts for 20-50% of all death. It is measured by sphyngomanometer .

3. Classification of BP measurement category Systolic blood pressure Diastolic blood pressure normal <130 <85 High normal 130-139 85-90 Hypertension Stage 1 (mild) 140-159 90-99 Stage 2(moderate) 160-179 100-109 Stage 3 (severe) >180 >110

4. Error in BP measurement 3 source of error- A. Observer errors- hearing acuity, interpretation of Korotkow sounds. B. Instrumental errors- leaking valve, cuffs not encircling the arm C. Subject errors- circumstances of examination. It includes physical environment, position of subject, external stimuli eg -fear, anxiety.

5. Hypertension is of 2 types- A. P rimary/essential- when the cause is unknown B. S econdary- when it is due to other disease process or abnormality.eg-adrenal glands tumour, congenital narrowed aorta, toxaemia of pregnancy.

6. Rule of halves It is an iceberg disease. In developed countries only half of the affected persons were aware of hypertension. Only half of aware population were taking medication. Only half of those treated were considered adequately treated.

7. prevalence Globally it was estimated to be 1.13 billion cases. It is about 30-40%in adults. 24% in men & 20% in women The high prevalence is irrespective of income status.

8. In india - according to national health survey 4, hypertension among age group 15-49, 11% women were having hypertension. 30% women were in pre hypertensive stage 1% were on medication. 15% of men were hypertensive,30% were pre hypertensive 1% were on medication.

9. Tracking of BP For this individuals were followed up over a period of years from childhood to adult. Low blood pressure were tend to remain low in later stage of life & higher blood pressure tent to become higher This phenomenon is called tacking of blood pressure. It is used to estimate children & adolescence at risk.

10. Risk factors A. Non modifiable B. Modifiable A. Non modifiable- age, sex, genetic factor, ethinicity (high bp in black) B. Modifiable- 1.obesity- greater weight gain = greater risk 2. salt intake- high salt intake(7-8g/day)= high bp 3. saturated fat- raises bp

11. 4.dietary fibre- risk of chd & hypertension is inversely related to consumption of dietary fibre. 5. alcohol- increased intake = increased risk factor 6. heart rate- invariably higher in hypertensive patient. 7. physical activity- reducing bodyweight have indirect effect on blood pressure.

12. 8. environmental stress- stress increases blood pressure 9.socio economic status- high bp in low socio economic category 10.other factors- oc pills, noise, vibration.

13. prevention 1. primary- reduced the incidence by reducing risk factors. Population strategy- slight reduction in mean bp of group leads to higher reduction in incidence of chd . This reduction is done by- Reduced salt intake, moderate fat intake, avoid high alcohol, weight management, health education.

14. High risk strategy 2. secondary prevention- Early case detection Treatment Patient compliance

15. Thank you