defination,types,mechanism,treatment according to drug clssification,etc.

1. Blood Pressure: Hypertension
BY- ABHISEK PRADHAN M. PHARMACY

2. Definition
 Abnormally high arterial blood pressure that is usually indicated by an
adult systolic blood pressure of 140 mm Hg or greater or a diastolic
blood pressure of 90 mm Hg or greater, is chiefly of unknown cause but
may be attributable to a pre-existing condition (as a renal or endocrine
disorder),

3. Types of Hypertension
1.Primary
Chronic high blood pressure without a source or associated with any other disease.
Most common form of hypertension.
2. Secondary
Elevation of blood pressure associated with another disease
such as kidney disease, OSA, pheochromocytoma, and hyperthyroidism.

4. Causes
 Genetics-some people are prone to hypertension simply based of their genetic
makeup
 Family History- your risk for high blood pressure/hypertension increases if it is in
your family history
 Environment
 Inactivity
 Stress
 Obesity
 Alcohol
 High Sodium Diet
 Tobacco Use

5. Causes of secondary hypertension
 Renal
Parenchymal
Vascular
 Others
Endocrine
chronic kidney disease
pregnancy
birth control pill
thyroid dysfunction

6. Further Complications of High Blood Pressure
 Thickening of the heart muscle
 Increased workload of the heart
 May lead to other conditions such as
Heart attack
Stroke
Renal (Kidney) Failure
Loss of vision

7. Blood pressure classification

8. Symptoms of hypertension

9. Mechanism

10. Mechanism
 Disturbance in the CNS , autonomic nerve fiber's, adrenergic receptors or
baroreceptors.
 Abnormalities in renal or tissue auto regulatory process for sodium excretion ,
plasma volume, and arteriolar constriction.
 Deficiency in synthesis of vasodilating substances in vascular endothelium
(prostacyclin ,bradykinin , and nitric oxide)or excess vasoconstricting substances
(angiotensin-ii, endothelin-i).
 High sodium intake or lack of dietary calcium.

11. Treatments
 Non-Pharmacological treatment
 Lifestyle modifications
Diet and exercise
Limit alcohol and tobacco use
Reduce stress factors
Low sodium intake
reduce dietary food

12. Treatment
 Drug Therapy
Diuretics
Adrenergic inhibitors
β - Adrenergic blockers
ACE Inhibitors
Calcium channel blockers

13. Drug therapy
 Thiazide-type Diuretics
Inhibit NaCl reabsorption
Side effects:
Electrolyte imbalances: ↓ Na, ↓ Cl, ↓ K** (advise K rich foods)
Fluid volume depletion (monitor for orthostatic hypotension)
Impotence,
decreased libido

14. Drug therapy
 Adrenergic Inhibitors
 Reduce sympathetic effects that cause HTN by:
 Reducing sympathetic outflow
 Blocking effects of sympathetic activity on vessels
 Side effects
 Hypotension
 Varied, depending on specific drug

15. Drug therapy
 β – adrenergic blockers (suffix “olol”)
 (metoprolol, propranolol)
 Block β – adrenergic receptors
 ↓ HR, ↓ inotropy, reduces sympathetic vasoconstriction)
 Side effects
 Bradycardia, hypotension, heart failure, impotence

16. Drug therapy
 ACE Inhibitors (suffix “pril)
 Enalapril, captopril
 Prevents conversion of angiotensin I to angiotensin II, thereby preventing the
vasoconstriction associate with A II.
 Side effects
 Hypotension, cough

17. Drug therapy
 Calcium Channel Blockers
 Block movement of calcium into cells, causing vasodilation
 Example-amlodipine,diltiazem,felodipine
 Side effects
 Brdaycardia, heart block

18. Diagnosis
 Measuring blood pressure regularly
 Electrocardiogram
A test that measures the electrical activity, rate, and rhythm of your heartbeat via
electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.
Echocardiogram
This is a test that uses ultrasound waves to provide pictures of the heart's valves and
chambers so the pumping action of the heart can be studied and measurement of the
chambers and wall thickness of the heart can be made.

19. Hypertension management
 Hospitalization
 IV drug therapy
 Monitor cardiac and renal function
 Neurologic checks
 Determine cause
 Education to avoid future crises

20. Prevention
 Lifestyle changes
 Having regular checkups with your physician
 Education
 Being aware of your blood pressure and where it should be
 Understanding your personal risk factors
 Engaging in community health awareness acitivities

21. Living With High Blood Pressure
 Living with High Blood Pressure requires a lot of lifestyle changes
Diet
Exercise
 Taking prescribed medications as required by your doctor.
 Recognize it is an ongoing process which requires regular.
 checkups, taking medication regularly and checking blood pressure regularly
 Recognizing there can be complications with pregnancy while living with high blood
pressure.
Damage to kidneys and other organs in mother and fetus
Low birth weight
Preeclampsia

22. Any questions