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Hypertension

Prepared by Dr.Mustafa AlShehabat

What is Blood Pressure?

Pressure created by the heart as it pumps blood through the arteries and the circulatory system Top number (Systolic)= Pressure while heart is beating Bottom number (Diastolic)= Pressure while heart is resting between beats

What do Blood Pressure Numbers Mean?

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

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

Blood Pressure Measurement

Sphygmomanometer Systolic pressure= pressure when 1st sound is heard Diastolic pressure= pressure when last sound is heard Small children and small adults Average Large overweight and large adults

Blood Pressure Cuff Size

BP Category Optimal Normal

Systolic (mmHg) < 120 < 130 and and or

Diastolic (mmHg) < 80 < 85 85-89

Follow-up Recheck 2 years Recheck 2 years Recheck 1 year

High Normal 130-139

BP Category Stage 1
(mild HTN)

Systolic (mmHg) 140-159 or

Diastolic (mmHg) 90-99

Follow-up

Confirm within months Evaluate within 1 month Evaluate immediately

Stage 2
(moderate HTN)

160-179 or

100-109

Stage 3
(severe HTN)

180 or >

or

110 or >

What

Causes High Blood Pressure?


Kidney Abnormalities Narrowing of certain arteries Rare tumors Adrenal gland abnormalities Pregnancy

Cause unknown in 90 to 95% of cases = Primary Hypertension Secondary Hypertension = 5 to 10%

What

Causes High Blood Pressure?


Controllable Risk Factors
Increased salt intake Obesity Alcohol Stress Lack of exercise

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

Women

and High Blood Pressure

Birth Control Pill Pregnancy Overweight After Menopause African Americans

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

What does High Blood Pressure do to my Body?


Stroke Congestive heart failure Kidney failure Heart attack Heart rhythm problems Aneurysm

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

What

Can I Do?

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

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

Ten

Commandments for Blood Pressure Control


1 Know your blood pressure
Have it checked regularly

Know what your weight should be 2


Keep it at that level or below

Dont use excessive salt in cooking or at meals 3 Avoid salty foods

Ten

Commandments for Blood Pressure Control


According to AHA regulations Or use tobacco products

4 Eat a low-fat diet

Dont smoke cigarettes 5

Take your medicine exactly as prescribed 6 Dont run out of pills even for a single day

Ten

Commandments for Blood Pressure Control


7 Keep your appointments with the doctor Follow your doctors advice about exercise 8 Make certain family members have their blood pressure checked regularly 9 Live a normal life in every other way!

10

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

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)

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

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

Home

Blood Pressure Monitoring

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

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