A Silent killer

1. HYPERTENSION: A SILENT KILLER
Dr. Meenakshi Vachher
Department of Biochemistry
Institute of Home Economics
University of Delhi

2. Blood pressure can be defined as the pressure exerted by circulating blood
upon the walls of the blood vessels.
Most of this pressure is due to work done by the heart by pumping blood
through the circulatory system.

4.  Hypertension (HTN or HT) is a
long-term medical condition in which
the blood pressure in the arteries is
persistently elevated.
 A condition in which the force of the
blood against the artery walls is too
high.
 Identified by WHO as one of the
most significant risk factors for
cardiovascular morbidity and
mortality worldwide.
 Globally it is responsible for the
deaths of approximately nine million
people annually.
 Global Burden of Diseases study
reported that hypertension led to
1.63 million deaths in India in 2016
as compared to 0.78 million in 1990
(+108%).
Gupta et al., 2019 J Hum Hypertens

7. TYPES OF
HYPERTENSION
Primary
(Essential)
Hypertension
Secondary
Hypertension
Accounts for 95% cases
No universally established
cause known
Majority of people with this
type feel no different from
those who have normal BP
Less common cause (5%
cases
Due to other medical
problems (like kidney or
liver disorder) or
medication

10. Pathophysiology of Hypertension
• Increased sympathetic activation
• Increased vascular volume
• Activation of Renin-Angiotensin aldosterone system
• Peripheral resistance
• Inflammation

11. Complications of Prolonged
Uncontrolled HTN
• Changes in the vessel wall leading to vessel
trauma and arteriosclerosis throughout the
vasculature
• Complications arise due to the “target organ”
dysfunction and ultimately failure.
• Target Organs
CVS (Heart and Blood Vessels)
The kidneys
Nervous system
The Eyes

13. Signs and Symptoms
• No symptoms – many people unaware they
have hypertension until accidentally found
• Non–specific symptoms – mild symptoms
Headache, Morning headache, Tinnitus,
Dizziness, Confusion, Fatigue, Shortness of
breath, Changes in vision – blindness, Nausea

15. Millimeters Matter……
“ A 2-mm Hg reduction in DBP would result in…
a 6% reduction in the risk of CVD and a 15%
reduction in the risk of stroke ”
Cook, et al. Arch Int med. 2015; 155:711-109

16. Treatment of HTN
• Aim of treatment - <140/ 90
• Reduction of blood pressure by 5-6 mm/Hg
decreases the risk of stroke by 40%, coronary
heart disease by 15- 20%, heart failure and
mortality from vascular disease by 50%
• Prevention
• Antihypertensive drugs – act by lowering
blood pressure

17. LifeStyle Modifications
• Socioeconomic condition in the world suggest that prevention
through Lifestyle Modifications is the “universal vaccine”
against Hypertension
• Weight Reduction – Maintain normal body weight
– BMI: 18.5 – 24.9
– BP reduction: 2 mmHg/1 kg loss
• DASH Eating Plan – Dietary Approaches to Stop Hypertension
Fruits, Vegetables, Low-fat dairy
Reduce saturated and total fat
8-14 mmHg BP reduction

20. THANK YOU
Have a healthy blood pressure