Hypertension

And
Blood Pressure
 Hypertension
• What is Blood Pressure?
– Pressure created by the heart as it pumps blood
through the arteries and the circulatory system
• What do Blood Pressure Numbers
Mean?
– Top number (Systolic)= Pressure while heart is
beating
– Bottom number (Diastolic)= Pressure while heart
is resting between beats
 Hypertension

• Normal Blood Pressure

– Blood Pressure of < 140/ 90
– Blood Pressure of 130 to 139/ 85 to 89 should
be closely watched
• High Blood Pressure
– Blood Pressure > 140/ 90
 Hypertension

• How can I tell if I have High

Blood Pressure?
– Usually NO SYMPTOMS!
– “The Silent Killer”
– May have:
• Headache
• Blurry vision
• Chest Pain
• Frequent urination at night
 Hypertension

• Blood Pressure Measurement

– Sphygmomanometer
– Systolic pressure= pressure when 1st sound is
heard
– “Diastolic pressure= pressure when last sound
is heard
• Blood Pressure Cuff Size
– Small – children and small adults
– Average
– Large – overweight and large adults
 Recommended Blood Pressure Levels

BP Systolic Diastolic Follow-up

Category (mmHg) (mmHg)
Optimal < 120 and < 80 Recheck
2 years
Normal < 130 and < 85 Recheck 2
years

High 130-139 or 85-89 Recheck 1

Normal year
 Recommended Blood Pressure Levels

Systolic
BP Diastolic
Follow-up
Category (mmHg)
(mmHg)
Stage 1
Confirm within
(mild HTN) 140-159 or 90-99
months

Stage 2
Evaluate within
(moderate 160-179 or 100-109
1 month
HTN)
Stage 3 Evaluate
180 or > or 110 or >
(severe HTN) immediately
 Hypertension

• What Causes High Blood

Pressure?
– Cause unknown in 90 to 95% of cases =
Primary Hypertension
– Secondary Hypertension = 5 to 10%
• Kidney Abnormalities
• Narrowing of certain arteries
• Rare tumors
• Adrenal gland abnormalities
• Pregnancy
 Hypertension

• What Causes High Blood

Pressure?
– Controllable Risk Factors
• Increased salt intake
• Obesity
• Alcohol
• Stress
• Lack of exercise
 Hypertension

• What Causes High Blood

Pressure?
– Uncontrollable Risk Factors
• Heredity
• Age
– Men between age 35 and 50
– Women after menopause
• Race
– 1 out of every 3 African Americans
– Higher incidence in non-Hispanic blacks and
Mexican Americans
 Hypertension

• Women and High Blood Pressure

– Birth Control Pill
– Pregnancy
– Overweight
– After Menopause
– African Americans
 Hypertension

• How does High Blood Pressure

develop?
– Certain nerve impulses cause arteries to
become larger (dilate) or smaller (contract)
– If vessels wide open blood flows easily
– If vessel narrows pressure inside
increases causing hypertension
 Hypertension

• What does High Blood Pressure do

to my Body?
– Stroke
– Congestive heart failure
– Kidney failure
– Heart attack
– Heart rhythm problems
– Aneurysm
 Hypertension

• What Can I Do?

– High blood pressure is a lifelong
disease
– Blood pressure can be controlled not
cured
– Controlling blood pressure will reduce
the risk of stroke, heart attack, heart
failure and kidney disease
 Hypertension

• What Can I Do?

– Loose weight if your overweight
– Get regular physical activity
– Avoid excessive alcohol
– Stop smoking
– Manage your stress
 Hypertension

• What Can I Do?

– Decrease salt intake
– Eat for heart health
– Discuss the use of oral contraceptives
with your doctor
– Discuss the use of some medications
with your doctor
 Hypertension

• Ten Commandments for Blood

Pressure Control
1– Know your blood pressure
• Have it checked regularly
2– Know what your weight should be
• Keep it at that level or below
3– Don’t use excessive salt in cooking or
at meals
• Avoid salty foods
 Hypertension

• Ten Commandments for Blood

Pressure Control
4– Eat a low-fat diet

5
– Don’t smoke cigarettes
• Or use tobacco products
6–
Take your medicine exactly as
prescribed
• Don’t run out of pills even for a single day
 Hypertension

• Ten Commandments for Blood

Pressure Control
7– Keep your appointments with the doctor

8– Follow your doctors advice about

exercise
9– Make certain family members have their
blood pressure checked regularly
10
– Live a normal life in every other way!
 Hypertension

• Medication for High Blood

Pressure
– Diuretics
• Rid the body of excess fluids and salt
– Beta-blockers
• Reduce the heart rate and the work of the
heart
– Calcium antagonists
• Reduce heart rate and relax blood vessels
 Hypertension

• Medication for High Blood

Pressure
– Angiotensin II receptor blockers(ACE)
• Interfere with the bodies production of
angiotensin, a chemical that causes the
arteries to constrict (narrow)
– Vasodialators
• Cause the muscle in the wall of the blood
vessels to relax, allowing the vessel to
dialate (widen)
 Hypertension

• Medication for High Blood

Pressure
– Sympathetic nerve inhibitors
• Sympathetic nerves go from the brain to all
parts of the body, including the arteries
• Cause arteries to constrict raising blood
pressure
• These drugs reduce blood pressure by
inhibiting these nerves from constricting
blood vessels
 Hypertension

• Home Blood Pressure

Monitoring
– Mercury sphygmomanometer
• Standard for BP monitoring
• No calibration
• May be bulky
• Need a second person to use machine
• May be difficult for hearing impaired or
patients with arthritis
 Hypertension

• Home Blood Pressure

Monitoring
– Aneroid equipment
• Inexpensive, lightweight and portable
• Two person operation/need stethoscope
• Delicate mechanism, easily damaged
• Needs calibration with mercury
sphygmomanometer
 Hypertension

• Home Blood Pressure

Monitoring
– Automatic equipment
• Contained in one unit
• Portable with easy-to-read digital display
• Expensive, fragile
• Must be calibrated
• Requires careful cuff placement