2. REVIEW
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Organs and tissues in your body need oxygen to survive.
Oxygen is bound to your blood and is delivered (after an
exchange of carbon dioxide for oxygen in your lungs) to
your body by blood vessels.
When your heart beats, it creates pressure that pushes
blood through your arteries and veins.
Blood pressure is the force of blood pushing against
your blood vessel walls.
Your blood pressure must be within a normal range to
properly deliver this oxygen rich blood to your organs and
tissues in order to survive.
3. REVIEW
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When someone has HIGH BLOOD PRESSURE, this increased force
makes the heart work harder to pump blood to the body.
The increased force puts a strain on both the heart and vessels.
If the force of the blood flow is high for some time, eventually the
tissue that makes up the walls of the arteries gets stretched beyond
its healthy limit.
Overstretching of blood vessels makes them more prone to rupture.
Damages to the vessels results in the development of hardening of
the arteries (atherosclerosis).
• Uncontrolled high blood pressure increases your risk of serious
health problems, including HEART ATTACK AND STROKE.
4. BLOOD PRESSURE
• expressed as two numbers, these represent the
pressure against the walls of your blood vessels
as the blood moves through them
• example: 120/80 mmHg
read as: 120 over 80 millimeters Mercury
• the top number (or first number) represents the
SYSTOLIC PRESSURE, which occurs when the
heart contracts.
• the bottom number (or second number)
represents the DIASTOLIC PRESSURE, which
occurs when the heart relaxes.
5. HYPERTENSION
• High Blood Pressure
• medical condition in which constricted arterial
blood vessels increase the resistance to blood
flow, causing an increase in blood pressure
against vessel walls
• the most common disease in primary care, with
estimated about 1 billion people affected
worldwide
6. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) - J Hypertension 2013;31:1281-1357
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2013 ESH/ESC Guidelines for the management of arterial hypertension
Definitions and classification of office BP levels (mmHg)*
Category Systolic Diastolic
Optimal <120 and <80
Normal 120–129 and/or 80–84
High normal 130–139 and/or 85–89
Grade 1 hypertension 140–159 and/or 90–99
Grade 2 hypertension 160–179 and/or 100–109
Grade 3 hypertension ≥180 and/or ≥110
Isolated systolic hypertension ≥140 and <90
* The blood pressure (BP) category is defined by the highest level of BP, whether systolic or diastolic. Isolated systolic
hypertension should be graded 1, 2, or 3 according to systolic BP values in the ranges indicated.
Hypertension:
SBP >140 mmHg ± DBP >90 mmHg
7. TYPES OF HYPERTENSION
PRIMARY
•also called “essential hypertension”
•most cases the causes of this type is not known
•majority of people with this type feel no different
from those who have normal blood pressure.
SECONDARY
•this is when high blood pressure is as a result of
other medical problems (like kidney or liver
problem) or medication
8.
9. CAUSES AND RISK FACTORS
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Age- Blood pressure rises with increasing age.
Gender- Hypertension is more common in young
adulthood men and middle aged men (<55 years of age).
After the age of 55, it is more common in women.
Family history- Having a close blood relative (parents or
siblings) with hypertension increases your risk of
developing hypertension.
Ethnicity- The incidence of hypertension is twice as high
in African Americans as they are in whites.
10. CAUSES AND RISK FACTORS
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Obesity- Weight gain is highly associated with increased
frequency of hypertension, especially with central
abdominal obesity.
Diabetes Mellitus- Hypertension is more common in
diabetic patients
Elevated Cholesterol and Triglycerides- High levels of
cholesterol and triglycerides are primary risk factors for
atherosclerosis (plaque build up in your blood vessels).
Too much salt in your diet- High sodium intake
contributes to high blood pressure and causes water
retention.
11. CAUSES AND RISK FACTORS
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Alcohol- Excessive alcohol intake is associated with
hypertension
Cigarette smoking- Smoking increases your risk for
cardiovascular disease. If you have hypertension and
smokes, you have a greater risk for cardiovascular disease
and blood clots.
Sedentary lifestyle- Inactivity and weight gain are
associated with high blood pressure and increases the
risk for heart disease.
Stress- People exposed to repeated stress may develop
hypertension more frequently than others.
12. SIGNS AND SYMPTOMS
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Hypertension is often called the “Silent killer” because it is
frequently asymptomatic- meaning “without symptoms” until it has
become severe and damage to organs have occurred.
A person with severe hypertension may have symptoms caused by
the effects on the blood vessels which my be:
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Fatigue
Reduced activity tolerance
Dizziness
Blurred visions
Nape pain
Palpitations
Angina (chest pain)
Difficulty breathing
13. SIGNS AND SYMPTOMS
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According to the American Heart Association, there is a
common misconception that people with high blood
pressure will experience symptoms such as nervousness,
sweating, difficulty sleeping, or facial flushing.
The truth is that HBP (high blood pressure) is largely a
symptomless condition.
If you ignore your blood pressure because you think
symptoms will alert you to the problem, you are taking a
dangerous chance with your life.
Everybody needs to know their blood pressure numbers,
and everyone needs to prevent high blood pressure from
developing.
14. TREATMENT
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Step 1: lifestyle modifications
• Diet and exercise
• Limit alcohol and tobacco use
• Reduce stress factors
Step 2: seek medical advise
–If lifestyle changes are not enough, drug therapy will be introduced
Step 3:
– If previous steps did not work, drug dose or type will be changed
or another drug is added
Step 4:
– More medications are added until blood pressure is controlled
15. COMPLICATIONS
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Cardiovascular Disease
Atherosclerosis – “Hardening of the arteries”
Coronary Artery Disease- damage to the heart and coronary arteries
Cerebrovascular Disease
Peripheral Vascular Disease
Stroke or Heart Attack
Angina- Chest pain
Kidney damage
Vision loss
• HEART FAILURE- Over time as the heart works harder to push the
blood throughout the body, the heart (which is a muscle) enlarges.
16. 2013 ESH/ESC Guidelines for the management of arterial hypertension
* Unless contraindicated. BMI, body mass index.
The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) - J Hypertension 2013;31:1281-1357
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LIFESTYLE CHANGES FOR HYPERTENSIVE PATIENTS
RECOMMENDATIONS TO REDUCE BP AND/OR CV RISK FACTORS
Salt intake Restrict 5-6 g/day
Moderate alcohol intake
Limit to 20-30 g/day men,
10-20 g/day women
Increase vegetable, fruit, low-fat dairy intake
BMI goal 25 kg/m2
Waist circumference goal
Men: <102 cm (40 in.)*
Women: <88 cm (34 in.)*
Exercise goals
≥30 min/day, 5-7 days/week
(moderate, dynamic exercise)
Quit smoking
17. PREVENTION
MAINTAIN A HEALTHY WEIGHT
•a weight loss of even 10 pounds can decrease your systolic
by 5-20mmHg
INCREASE LEVEL OF PHYSICAL ACTIVITY
MONITOR BLOOD PRESSURE
•know if it is high, low, normal, or borderline
REGULAR CHECK UPS WITH YOUR PRIMARY CARE
PHYSICIAN.
18.
19. Frequently Asked Questions
• How dangerous is hypertension?
– It is called the silent killer for good reason
• contributes to more than 200,000 deaths each yea,
• afflicts more than 1 billion worldwide
• is on the rise, increasing 35 percent in just ten years from the
late 1980s to the late 1990s
• costs more than $37 billion per year in health care
• What is the DASH diet?
– The Dietary Approaches to Stop Hypertension (DASH) diet is an
eating plan designed to prevent and treat hypertension.
• Does potassium help lower blood pressure?
– Yes, potassium has a favorable effect on blood pressure.
Potassium is richly present in the DASH diet, which is
recommended for persons with hypertension
20.
21. BP Monitoring
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Your blood pressure should be taken during your regular health
check ups.
Your doctor may recommend checking your blood pressure at home
if you have risk factors of hypertension or if you have been
diagnosed with pre-hypertension (systolic: between 120 and
139mmHg OR diastolic: between 80 and 89mmHg).
A record of readings taken over time can provide you and your
healthcare provider a clearer picture of your blood pressure.
AHA Recommendation:
• The American Heart Association recommends an automatic, cuff-
style, bicep (upper-arm) monitor. Wrist and finger monitors are not
recommended because they yield less reliable readings.
22. BP Monitoring
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Use a bicep (upper-arm) monitor for more accurate readings as
recommended by the AHA.
Electronic or automatic versions at work or in your local
pharmacy/shopping center may be used but can give inaccurate
readings.
A manual blood pressure cuff can also be used if you have someone
that knows how to accurately use it.
Make sure the cuff fits
Be still
Sit correctly with your back straight and supported (using a dining
chair instead of a sofa is recommended), feet flat (do not cross your
legs), and upper arm supported at heart level.
Make sure the middle of the cuff is directly over the brachial artery.
23. BP Monitoring
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Record all your readings and understand the readings
(optimal BP is <120/80mmHg).
The average of three readings, at least one minute apart,
should be used as the BP reading.
Consult your health care provider if you get several high
recordings.
