Hypertension Overview: From Etiology to Clinical Features

Hypertension, commonly known as high blood pressure, is a chronic medical condition where the force of blood against the arterial walls is consistently elevated. It often progresses silently, posing a significant risk for cardiovascular diseases, stroke, and kidney failure if left unmanaged. This presentation offers a detailed overview of hypertension, including its classification, underlying causes, global prevalence, pathophysiology, contributing risk factors, and clinical features that aid in early diagnosis and intervention.

1. Hypertension
Presented by
Prasan Das
M.Pharm, 1st Year
Department of Pharmacology
Parul Institute of Pharmacy & Research

2. Hypertension
According to WHO hypertension is persistent increase in
blood pressure i.e, 140 mmHg systolic & 90 mmHg diastolic.
120/80 mmHg Normal
1
Hypertension also known as high blood pressure, is a long
term medical condition in which the blood pressure in the
arteries is persistantly elevated.

3. Lumen
(internal radius)
2
Blood Vessel
(i)
(ii)
These blood particles apply some force on
particular area of blood vessel
Plaque

4. Normal Normal
High 120/80Below
JNC 7; 2003
3
120/80
140/90 90/60
Stages of hypertension
(From the Joint National Committee on prevention, detection,
evaluation & treatment of high blood pressure. JAMA
2003;289:2560)

5. 4
Etiology
Primary Hypertension
Elevation in BP without an identified cause.
Secondary Hypertension
Elevation in BP with an exact cause. This type is account for 5-10% of total cause.
The causes of secondary hypertension includes :
Congenital narrowing of aorta
Renal Disease
Neurological disorders like brain tumors & head injury
Medication like Oral contraceptive pills, NSAIDS & Coccaine
Sleep apnea & Cirrhosis of liver

6. 5
Etiology
Hypertension may transfer due to Hereditary Tendency. It have passed down through
3 generations by statistically significant application of Mendel’s Law.
Faulty Diet frequently associated with over-weight. The person predisposed towards
hypertension on a hereditary basis must frequently acquire faulty dietary habits. The
effect of salty food or overuse of salt is also well demonstrated in patients in whom
hypertension has developed.
The connection between blood pressure & the emotion, especially Anger & Fear has
long been established.

7. 6
Etiology
Long-continued increased Tension eventually produces degenerative changes in the
intima & thickening of the walls of arteriols.
Stress Response
System

8. 7
Epidemiology
Overall approximately 20% of the world’s adults are estimated to have hypertension.
Worldwide approx. 1 billion people have hypertension, contributing to more than 7.1
million deaths per year.
The age-specific prevalence was
3.3% in group aged 18-29 Yrs.
13.2% in group aged 30-39 Yrs.
22% in group aged 40-49 Yrs.
37.5% in group aged 50-59 Yrs.
51% in group aged 60-74 Yrs.

9. 8
Pathophysiology
The pathophysiology behind this disease related to regulation of blood presssure.

Blood pressure is regulated by following theories :
Sympathetic Nervous System Activities (Short-term Regulatory
Mechanism/Nervous Mechanism
1.
When the BP is decreases the activation of SNS will occur. The increased SNS
activity increases the heart rate & cardiac contraction.
The increased heart rate & cardiac contraction produce vasoconstriction in the
peripheral arterioles & promotes the release of renin from the kidney.
The net effect of SNS activation is to increase the arterial blood pressure by
increasing cardiac output & systemic vascular resistance.
BP=CO X SVR

10. Aldosterone
Blood Volume
BP
Liver
from kidney
9
Angiotensinogen
Angiotensin - I
Angiotensin - II
Bind with receptor
Vesoconstriction
Na+ Reabsorption
Sympathetic changes
Adrenal Cortex
Release
Na+ Reabsorption
Renin
ACE
ACE inhibitor
BP
Normal
Work by ACE inhibitor
BP
BP
2. RAAS System

11. When the angiotensin-II is stimulated in the adrenal cortex, it will secrete aldosterone.
The aldosterone will stimulate the kidneys to retain sodium & water. Thus the BP &
cardiac output will get increased.
10
3. Activities of Endocrine System
Angiotensinogen
Angiotensin - I
Angiotensin - II
Liver
Renin
from kidney
Aldosterone
Adrenal Cortex
Release
Na+ Reabsorption
Blood Volume
BP
ACE

12. 11
Risk Factors
Age: Chance of Coronary Artery Disease after 50 Yrs. of age
Alcohol, Smoking & DM
Excessive dietary intake of sodium
Gender, Family history
Sedentary life style, Obesity, Stress

13. 12
Clinical Features
Sometimes the high blood pressure does not causes any symptoms, so that it is
known as Silent Killer Disease.
In some patients the symptoms will develop like
Severe headache, Blurred vision
Nausea, Vomiting, Dizziness
Chest pain
Shortness of breath
Irregular heart beat

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