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Submitted to: Mr. Ehtesham Sarwar
ZSM Novartis Pharma Pakistan ltd
Submitted by: Mohammad Bilal Rashid


• Hypertension or High blood pressure(HBP) is a
common condition in which the force of the
blood against your artery walls is high enough
that it may eventually cause health problems,
such as heart disease.
• Blood pressure is summarized by two
measurements, systolic and diastolic, which
depend on whether the heart muscle is
contracting (systole) or relaxed between beats
(diastole). This equals the maximum and
minimum pressure, respectively.

TYPES OF HYPERTENSION • The two major types are: • Primary or essential hypertension • Secondary hypertension The other types include: • Malignant Hypertension. • Isolated Systolic Hypertension • Renal Hypertension .

... and it is by far the most common type of hypertension.. Essential hypertension has no obvious or yet identifiable cause. approximately 54 % • more than 70 years old . 11-21 % • 50-59 years old . and is diagnosed in about 95% of cases.PRIMARY HYPERTENSION • This type is also called essential hypertension.... ≥ 64 % . prevalence: • children.. approximately 44 % • 60-69 years old ...about 4 % • middle age .

it is called secondary hypertension. blood pressure usually returns to normal or is significantly lowered. . If that is the case. when the root cause is treated. In such cases. high blood pressure is caused by another disease.SECONDARY HYPERTENSION • In about 5-10% of people.

 Unless properly treated. is severe and progressive. is consistently above 160 mm Hg.  Renal Hypertension • also called renovascular hypertension. and the diastolic below 90 mm Hg. . (the top number). It rapidly leads to organ damage. it is fatal within five years for the majority of patients.Malignant Hypertension • The most severe form of hypertension.  Isolated Systolic Hypertension • In this case the systolic blood pressure. is elevated blood pressure caused by kidney disease.

MEASURMENT Blood pressure measurements fall into four general categories: • Normal blood pressure. Your blood pressure is normal if it's below 120/80 mm Hg. • Prehypertension. More severe hypertension. • Stage 2 hypertension. • Stage 1 hypertension. . Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg. Prehypertension tends to get worse over time. stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

dizzy spells or a few more nosebleeds than normal. • Although a few people with early-stage high blood pressure may have dull headaches.SIGNS & SYMPTOMS of HBP • Most people with high blood pressure have no signs or symptoms. . these signs and symptoms usually don't occur until high blood pressure has reached a severe or life-threatening stage. even if blood pressure readings reach dangerously high levels.

CAUSES OF HBP • • • • • • • • • • Chronic kidney disease Sleep apnea Tumors or other diseases of the adrenal gland Pregnancy Obesity Sodium (salt) sensitivity Alcohol use Birth control pills (oral contraceptive use) Lack of exercise (physical inactivity) Drugs .

Pharmacologic treatment of HBP DRUG CLASS DIURETICS DRUG NAME MECHANISIM OF ACTION Furosemide increase the Antihypertensives Hydroclorothizi ed kidney's excretion of sodium BETA BLOCKER Propranolol Alenolol. Bisoprolol Labitalol reduce the workload on your heart and open your blood vessels CALCIUM CHANNEL BLOCKERS amlodipine.laci dipine lercanidipine help relax the muscles of your blood vessels ANGIOTENSIN CONVERTING ENZYME(ACE) INHABITORS Captropril Lisinopril enalapril perindopril help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels ALPHA BLOCKING Prazosin block alpha .

.Nonpharmacological Treatment HBP Change of life-style: • intake of salt . ≤ 5 – 6 g per day • prevention of obesity – dietetic modification • smoking – stop • physical activity • psychical relaxation ..

DIABETES DEFINITION • Diabetes is the condition in which the body does not properly process food for use as energy. or sugar. This is why many people refer to diabetes as “sugar. The pancreas.” . makes a hormone called insulin to help glucose get into the cells of our bodies. for our bodies to use for energy. This causes sugars to build up in your blood. When you have diabetes. an organ that lies near the stomach. Most of the food we eat is turned into glucose. your body either doesn't make enough insulin or can't use its own insulin as well as it should.

• This form of diabetes usually strikes children and young adults. • Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. the only cells in the body that make the hormone insulin that regulates blood glucose. • Was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. although disease onset can occur at any age. .TYPES OF DIABETES TYPE 1 DIABETES • Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells.

• Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. the pancreas gradually loses its ability to produce insulin. a disorder in which the cells do not use insulin properly. • Type 2 diabetes is increasingly being diagnosed in children and adolescents.TYPE 2 DIABETES • Was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. . • It usually begins as insulin resistance. As the need for insulin rises.

blood sugar level targets are as follows: • Before meals: 4 to 7 mmol/L for people with type 1 or type 2 • After meals: under 9 mmol/L for people with type 1 and 8.8 mmol/L (140 mg/dL) For people with diabetes.4 to 6.1 mmol/L (82 to 110 mg/dL) • Shortly after a meal the blood glucose level may rise temporarily up to 7.MEASURMENT OF DIABETES Normal blood glucose level in humans is about 4 mM (4 mmol/L or 72 mg/dL) • When operating normally the body restores blood sugar levels to a range of 4.5mmol/L for people with type 2 .

SIGNS & SYMPTOMS OF DIABETES • • • • • • • • • • Frequent urination Excessive thirst Unexplained weight loss Extreme hunger Sudden vision changes Tingling or numbness in hands or feet Feeling very tired much of the time Very dry skin Sores that are slow to heal More infections than usual .

CAUSES OF DIABETES • • • • • • • • Genetic Susceptibility Autoimmune Destruction of Beta Cells Environmental Factors Viruses and infections Infant feeding practices.  Obesity and Physical Inactivity Abnormal Glucose Production by the Liver Medications and Chemical Toxins .

Biguanides ii.PHARMACOLOGICAL TREAMENT OF DIABETES There are currently four classes of oral anti-diabetic agents: i. Insulin Secretagogues – Sulphonylureas iii. Insulin Secretagogues – Nonsulphonylureas iv. Thiazolidinediones (TZDs) . α-glucosidase inhibitors v.

PHARMACOLOGICAL TREAMENT OF DIABETES DRUG CLASS DRUG NAME MECHANISIM OF ACTION Biguanides Metformin Inhibit glucose production by the liver Sulfonylureas (second generation) Glimepiride Glipizide Glyburide Increase insulin secretion by pancreatic beta cells Meglitinides Repaglinide Nateglinide Increase insulin secretion by pancreatic beta cells Thiazolidinedione Pioglitazone s (TZD’s) Rosiglitazone Increase glucose uptake by .

. a programme of regular physical activity and exercise should be considered for each person.NON PHARMACOLOGICAL TREATMENT • • • • • • Eat starchy foods regularly Eat more fruit and vegetables Reduce animal or saturated fat Cut down on sugar Reduce salt Together with dietary treatment.

THANK YOU .SUMMARY • Both hypertension and diabetes are the conditions on the human body that causes many diseases. To overcome and escape from these conditions we have to change our life style by taking mandatory measures on our diet which are not good for health. by adopting regular physical activities. by overcome on obesity etc.