The document discusses hypertension on World Hypertension Day. It defines hypertension as blood pressure above 140/90 mmHg. It discusses blood pressure measurement, risk factors and causes of hypertension like age, weight, family history. It outlines diagnostic tests like medical history, physical exam, blood tests. Treatment involves lifestyle changes like diet, exercise, smoking cessation and medication based on JNC 8 guidelines starting with ACE inhibitors, ARBs, thiazide diuretics or calcium channel blockers.

1. MANAGEMENT OF HYPERTENSION
DR. MUHAMMAD ABDUL WASEE
MBBS (DU), INTERN DOCTOR (SMC&H)

2. AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 2
WORLD HYPERTENSION DAY
17TH MAY 2023
বিশ্ব উচ্চ রক্তচাপ বিিস
১৭ই মে, ২০২৩

3. CONTENT
 Definition, Blood Pressure
 Blood pressure measurement
 Etiology
 Diagnostic and clinical tests
 Treatment and advices to be
given
 JNC 8 HTN guideline algorithm
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 3

4. DEFINITION
REF: Davidson’s Principles and Practice of Medicine (24th Edition)
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY
Hypertension is when
the pressure in blood
vessels is too high
(140/90 mmHg or
higher). -World Health Organization
(WHO)

5. BLOOD PRESSURE
REF: Guyton and Hall, pp
174.
The pressure / force exerted by the blood against
any unit area of the vessel wall is called Blood
Pressure.
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023

6. ARTERIAL BP
REF: Davidson’s Medicine (24th Edition)
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY

7. BLOOD PRESSURE MEASUREMENT
 Two methods:
1. Direct (Arterial catheter)
2. Indirect (Sphygmomanometer, Stethoscope and
blood pressure cuff)
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 7

8. BLOOD PRESSURE MEASUREMENT (CONT…)
2023 8
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY

9. ETIOLOGY
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 9
Age Sex
Physical
activity
Smoking
Weight
Family
history
Serum
cholesterol
Diabetes
mellitus
Pre-existing
vascular
disease
Risk Factors
 REF: Davidson’s Principles and Practice of Medicine (24th
Edition)

10. ETIOLOGY
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 10
Causes of
Secondary Hypertension
 REF: Davidson’s Principles and Practice of Medicine (24th
Edition)

11. DIAGNOSTIC AND CLINICAL TESTS
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 11
Medical History
• BP, Risk factors, Co-morbidities, Sign/symptoms of secondary HTN…
Physical Examination
• Circulation, Heart, Other systems…
Lab investigations
• Na+, K+, Creatinine, eGFR, dipstick lipids, Fasting glucose where available
• 12 lead ECG (AF, V. hypertrophy, IHD…
Additional tests to consider
• Extended biochemistry, cardiac/brain/vascular imagine, fundoscopy…

12. TREATMENT AND ADVICES TO BE GIVEN
Adult aged ≥18 yrs with HTN
Lifestyle changes:
 Smoking Cessation
 Control blood glucose and lipids
 Diet
o Eat healthy (i.e., DASH diet)
o Moderate alcohol consumption
o Reduce sodium intake to no more than 2,400 mg/day
 Physical activity
o Moderate-to-vigorous activity 3-4 days a week averaging 40 min per session.
 Initiate BP-lowering medication based on algorithm.
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 12

13. TREATMENT AND ADVICES TO BE GIVEN (CONT…)
Initial Drugs of Choice for Hypertension
 ACE inhibitor (ACEI)
 Angiotensin receptor blocker (ARB)
 Thiazide diuretic
 Calcium channel blocker (CCB)
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 13

14. TREATMENT AND ADVICES TO BE GIVEN (CONT…)
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 14
Reference: James PA, Ortiz E, et al. 2014 evidence-based guideline for the management of high
blood pressure in adults: (JNC8). JAMA. 2014 Feb 5;311(5):507-20 Card developed by Cole Glenn,
Pharm.D. & James L Taylor, Pharm.D.

15. AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 15
JNC 8 HYPERTENSION GUIDELINE ALGORITHM

16. AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 16
JNC 8 HYPERTENSION GUIDELINE ALGORITHM (CONT…)
Reference: James PA, Ortiz E, et al. 2014 evidence-based guideline for the management of high
blood pressure in adults: (JNC8). JAMA. 2014 Feb 5;311(5):507-20 Card developed by Cole Glenn,
Pharm.D. & James L Taylor, Pharm.D.

17. AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 17
JNC 8 HYPERTENSION GUIDELINE ALGORITHM (CONT…)
Reference: James PA, Ortiz E, et al. 2014 evidence-based guideline for the management of high
blood pressure in adults: (JNC8). JAMA. 2014 Feb 5;311(5):507-20 Card developed by Cole Glenn,
Pharm.D. & James L Taylor, Pharm.D.

18. THANKS TO
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 18
Prof. Dr. M Mujibul Haque Mollah
sir
For the guidance.

19. THANK YOU
DR. MUHAMMAD ABDUL WASEE
muhdawasee@gmail.com
SAMPLE FOOTER TEXT

20. DOWNLOAD THIS CONTENT IN PDF FORMAT-
SCAN ME
AN APPROACH TO HYPERTENSION ON WORLD HYPERTENSION DAY 2023 20