Hypertension.pptx

blood pressure
types of blood pressure
hypertension
types
causes
diagnose
treatment

1. Hypertension: Dr.Sami

2. Hypertension : High Blood Pressure:

3. Normal Blood Pressure: The force of circulating blood on the walls of the arteries . There are two types of blood pressure: Systolic blood pressure refers to the pressure inside your arteries when heart is pumping ; Diastolic blood pressure is the pressure inside your arteries when heart is resting between beats

4. Stage Approximate age Systolic BP, mmHg Diastolic BP, mmHg Infants 0 to 12 months 75–100 50–70 Toddlers and preschoolers 1 to 5 years 80–110 50–80 School age 6 to 12 years 85–120 50–80 Adolescents 13 to 18 years 95–140 60–90

5. Hypertension: Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated . High blood pressure typically does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia

6. Classifications: Primary (essential) hypertension S econdary hypertension

7. Primary Hypertension: Idiopathic hypertension is the form of hypertension that by definition has no identifiable secondary cause . It is the most common type affecting 85% of those with high blood pressure. The remaining 15% is accounted for by various causes of secondary hypertension. Hypertension can increase the risk of cerebral, cardiac, and renal Disorders .

8. Risk factors of Primary Hypertension: Essential hypertension has no identifiable cause . However, several risk factors have been identified. Genetic variation Aging Obesity Salt ( Sodium Intake ) Smoking, Alcohol Diabetes Vitamin deficiency Lack of exercise

9. Signs & Symptoms: Hypertension is generally a silent condition . Many people won’t experience any symptoms . It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious . Symptoms of severe hypertension can include : headaches shortness of breath nosebleeds flushing dizziness chest pain visual changes blood in the urine

10. Secondary Hypertension Secondary hypertension (or, less commonly, inessential hypertension ) is a type of hypertension that is caused by an identifiable primary cause or by a known disease or condition. It is much less common than the other type , called essential hypertension , affecting only 15% of hypertensive patients.

11. Causes of Secondary Hypertension Kidney disease: An injury to the kidney or arteries that are too narrow can lead to poor blood supply to the organ. This can trigger higher production of a hormone called renin . Renin leads to production of substances in the body (like the protein molecule angiotensin II ) that can raise blood pressure.

12. Renin converts angiotensinogen , (which is produced in the liver) , to the hormone angiotensin I . An enzyme known as ACE or angiotensin-converting enzyme found in the lungs metabolizes angiotensin I into angiotensin II. Angiotensin II causes blood vessels to constrict and blood pressure to increase.

13. Adrenal disease: Located on top of the kidneys , the adrenal glands produce and regulate hormones. (Produce hormones that help regulate your metabolism, immune system, blood pressure, response to stress and other essential functions ). When there is a problem with these glands, hormones in the body can become unbalanced and cause several conditions.

14. Hyperparathyroidism: In this condition, the parathyroid glands (located in the neck), which plays a key role in the regulation of calcium levels in the blood . Overproduction of this hormones and this condition may lead to high blood pressure .

15. Thyroid problems: The thyroid gland produces hormones that regulate the body's metabolic rate controlling heart, muscle and digestive function, A bnormal thyroid function may also lead to high blood pressure .

16. Coarctation (constriction or tightening) of the aorta: Coarctation of the aorta is a birth defect in which a part of the aorta is narrower than usual (the main artery on the left side of the heart). Coarctation restricts normal blood flow

17. Obstructive sleep apnea: In this condition, a person is awakened frequently from sleep and has pauses in breathing during sleep due to collapsed passages in the upper airways . Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat, such as your tongue and soft palate , temporarily relax . When these muscles relax, your airway is narrowed or closed , and breathing is momentarily cut off . Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure

18. Side effects from certain medications can also contribute to secondary hypertension. Medications like : Hormonal contraceptives (birth control pills) Non-steroidal anti-inflammatory agents (NSAIDs) Diet pills Stimulants (a substance that raises levels of physiological or nervous activity in the body .) Antidepressants Immune system suppressants

19. Signs & Symptoms: Symptoms of secondary hypertension can vary depending on the type of condition or disease that is acting in combination with high blood pressure . Pheochromocytoma : Sweating, increased frequency or force of heartbeats, headache, anxiety Cushing’s syndrome : Weight gain, weakness, abnormal growth of body hair or loss of menstrual periods (in women), purple striations (lines) on the skin of the abdomen

20. Thyroid problems : Fatigue (tiredness), weight gain or weight loss, intolerance to heat or cold Conn’s syndrome or primary aldosteronism : Weakness due to low levels of potassium in the body Obstructive sleep apnea : excessive fatigue or sleepiness during daytime, snoring, pauses in breathing during sleep

21. Complications of Hypertension: The excessive pressure on artery walls caused by high blood pressure can damage blood vessels as well as organs . The higher blood pressure and the longer it goes uncontrolled, the greater the damage . Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries ( atherosclerosis ), which can lead to a heart attack, stroke or other complications. Aneurysm . Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm . If an aneurysm ruptures, it can be life-threatening.

22. Heart failure. To pump blood against the higher pressure in your vessels , the heart has to work harder. This causes the walls of the heart's pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure. Weakened and narrowed blood vessels in your kidneys . This can prevent these organs from functioning normally.

23. Thickened , narrowed or torn blood vessels in the eyes. This can result in vision loss. Metabolic syndrome. This syndrome is a group of disorders of body's metabolism , including increased waist size, high triglycerides, decreased high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) and high insulin levels. These conditions make you more likely to develop diabetes, heart disease and stroke

24. Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure. Dementia . Narrowed or blocked arteries can limit blood flow to the brain , leading to a certain type of dementia. A stroke that interrupts blood flow to the brain also can cause vascular dementia.

25. Diagnose: D octor will ask questions about Medical history and do a physical examination. Blood Pressure Measurement: Blood pressure measurements fall into several categories:

26. Ranges of BP in Adults: Five categories define blood pressure readings for adults : Healthy: A healthy blood pressure reading is 120/80 millimeters of mercury (mm Hg). Elevated : The systolic number is between 120 and 129 mm Hg , and the diastolic number is less than 80 mm Hg. Doctors usually don’t treat elevated blood pressure with medication. Instead , doctor may encourage lifestyle changes to help lower your numbers.

27. Stage 1 hypertension : The systolic number is between 130 and 139 mm Hg , or the diastolic number is between 80 and 89 mm Hg . Stage 2 hypertension : The systolic number is 140 mm Hg or higher, or the diastolic number is 90 mm Hg or higher.

28. Hypertensive crisis : The systolic number is over 180 mm Hg , or the diastolic number is over 120 mm Hg . Blood pressure in this range requires urgent medical attention . If any symptoms such as chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in the emergency room is needed .

29. Tests: If pt. have high blood pressure, doctor may recommend tests to confirm the diagnosis and check for underlying conditions that can cause hypertension . Ambulatory monitoring. This 24-hour blood pressure monitoring test is used to confirm if pt. have high blood pressure. The device used for this test measures blood pressure at regular intervals over a 24-hour period and provides a more accurate picture of blood pressure changes over an average day and night. However, these devices aren't available in all medical centers, and they may not be reimbursed.

30. Lab tests. D octor may recommend a urine test (urinalysis) and blood tests, including a cholesterol test. Electrocardiogram (ECG or EKG). This quick and painless test measures your heart's electrical activity. Echocardiogram. Depending on your signs and symptoms and test results, doctor may order an echocardiogram to check for more signs of heart disease. An echocardiogram uses sound waves to produce images of the heart . Ultra Sound of Kidney.

31. Treatment: Life Style Modification: Changing lifestyle can help control and manage high blood pressure . doctor may recommend that you make lifestyle changes including : Getting at least 150 minutes of physical activity each week (about 30 minutes a day, 5 days a week) Not smoking Eating a healthy diet, including limiting sodium (salt) and alcohol Managing stress Maintaining a healthy weight or losing weight if you're overweight or obese Limiting the amount of alcohol you drink

32. Medications Medications used to treat high blood pressure include : Diuretics . Diuretics , sometimes called water pills , are medications that help kidneys eliminate sodium and water from the body . These drugs are often the first medications tried to treat high blood pressure . Angiotensin-converting enzyme (ACE) inhibitors . These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. Angiotensin II

33. Angiotensin II receptor blockers (ARBs ). These medications relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels . Calcium channel blockers : These medications block some of the calcium from entering the cardiac muscles of heart. This leads to less forceful heartbeats and a lower blood pressure.

34. Alpha blockers. These medications reduce nerve signals to blood vessels, lowering the effects of natural chemicals (Angiotensin II) that narrow blood vessels . Beta blockers. These medications that relax the heart muscles and widen your blood vessels, causing heart to beat slower and with less force . Renin inhibitors . slows the production of renin enzyme that produced by kidneys that starts a chain of chemical steps that increases blood pressure.

35. Vasodilators. They work directly on the muscles in the walls of your arteries , preventing the muscles from tightening and your arteries from narrowing . Central-acting agents. These medications prevent brain from telling nervous system to increase your heart rate and narrow your blood vessels.