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Hypertension Slides

The document defines hypertension as a systolic blood pressure over 140 mm Hg or a diastolic pressure over 90 mm Hg. It classifies blood pressure into several categories and types of hypertension, including primary (essential) and secondary. The pathophysiology of hypertension involves factors that increase peripheral resistance and cardiac output. Treatment involves lifestyle modifications like weight loss, reduced sodium, and increased potassium, as well as medications.

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Moffat Mose
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Download as PPTX, PDF, TXT or read online on Scribd
42 views

Hypertension Slides

The document defines hypertension as a systolic blood pressure over 140 mm Hg or a diastolic pressure over 90 mm Hg. It classifies blood pressure into several categories and types of hypertension, including primary (essential) and secondary. The pathophysiology of hypertension involves factors that increase peripheral resistance and cardiac output. Treatment involves lifestyle modifications like weight loss, reduced sodium, and increased potassium, as well as medications.

Uploaded by

Moffat Mose
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Hypertension

Introduction
 Hypertension is a systolic blood pressure greater than 140 mm Hg and a
diastolic pressure greater than 90 mm Hg over a sustained period

 This is based on the average of two or more blood pressure measurements


taken in two or more contacts
Classification of Blood Pressure

SYSTOLIC (mmHg) DIASTOLIC (mm Hg)


CATEGORY
Optimal <120 and <80
Normal† <130 and <85
High-normal 130–139 or 85–89

Hypertension‡
Stage 1 140–159 or 90–99
Stage 2 160–179 or 100–109
Stage 3 ≥180 or ≥110
Types of Hypertension
 Primary hypertension
 Majority of pts reason for the elevation in blood pressure cannot be
identified

 A few of the pts the high BP is associated wit:


 narrowing of the renal arteries
 renal parenchymal disease
 hyperaldosteronism (mineralocorticoid hypertension)
 certain medications
 Pregnancy
 coarctation of the aorta
Types of Hypertension
 Secondary hypertension
 The high blood pressure from an identified cause
Pathophysiology
 Most cases of hypertension cannot be identified

 Its understood that hypertension is a multifactorial condition

 Because hypertension is a sign


 It is most likely to have many causes

 For hypertension to occur, there must be a change in one or more factors


affecting;
 peripheral resistance
or
 cardiac output
Pathophysiology
 In addition, there must also be a problem with the control systems that
monitor or regulate pressure

 Genetics
 Single gene mutations have been identified for a few rare types of
hypertension

 most types of high blood pressure are thought to be polygenic


(mutations in more than)
Pathophysiology
 Hypertension may be caused by:
 Increased sympathetic nervous system activity related to dysfunction of the autonomic
nervous system

 Increased renal reabsorption of sodium, chloride, and water related to a genetic variation in
the pathways by which the kidneys handle sodium

 Increased activity of the renin-angiotensin-aldosterone system, resulting in expansion of


extracellular fluid volume and increased systemic vascular resistance

 Decreased vasodilation of the arterioles related to dysfunction of the vascular endothelium

 Resistance to insulin action, which may be a common factor linking hypertension, type 2
diabetes mellitus, hypertriglyceridemia, obesity, and glucose intolerance
Pathophysiology

 Gerontologic Considerations
 Structural and functional changes in the heart and blood vessels
contribute to increases in blood pressure that occur with age

 The changes include:


 accumulation of atherosclerotic plaque
 fragmentation of arterial elastins
 increased collagen deposits
 impaired vasodilation
Pathophysiology
 Gerontologic Considerations
 The result of these changes is a decrease in the elasticity of the major
blood vessels

 Consequently, the aorta and large arteries are less able to accommodate
the volume of blood pumped out by the heart (stroke volume)
and
 the energy that would have stretched the vessels instead elevates the
systolic blood pressure

 Isolated systolic hypertension is more common in older adults


Clinical Manifestations

 Initial stages: Asymptomatic

 high blood pressure

 In late stages: Symptoms depend on the organ affected and the degree of effects
 retinal changes such as;
 Hemorrhages
 exudates (fluid accumulation)
 arteriolar narrowing
 cotton wool spots (small infarctions)
 papilledema (swelling of the optic disc)

 Coronary artery disease with angina or myocardial infarction is a common consequence of


hypertension
Clinical Manifestations
 Left ventricular hypertrophy occurs in response to the increased workload
placed on the ventricle

 Pathologic changes in the kidneys


 increased blood urea nitrogen [BUN] and creatinine levels)
Clinical Manifestations
 Cerebrovascular involvement:
 stroke or transient ischemic attack (TIA)
 alterations in vision
 speech,
 Dizziness
 Weakness
 sudden fall
 temporary paralysis on one side (hemiplegia)

NB: Cerebral infarctions account for most of the strokes and TIAs in
patients with hypertension
Lifestyle Modifications for Hypertension Prevention and
Management

 Lose weight if overweight

 Limit alcohol intake

 Increase aerobic physical activity

 Reduce sodium intake


Lifestyle Modifications for Hypertension Prevention
and Management

 Maintain adequate intake of dietary potassium (approximately 90


mmol per day)

 Maintain adequate intake of dietary calcium and magnesium

 Stop smoking

 reduce intake of dietary saturated fat and cholesterol


Medical Management
 Antihypertensive

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