This is force exerted on wall ofthe arteries and their networksby blood while ensuring bloodsupply from the heart gets tovital organs and tissues in thebody.High Blood pressure(Hypertension) accounts for7.1million deaths every year and isfound in about 1 billion peopleworldwide.21. WHAT IS BLOOD PRESSURE?
Two parameters are measured inmillimeters of mercury (mm Hg)using a monitor and stethoscope.They are:SYSTOLIC:- When the heart is contracting.- Evident by sustained tapping sound(Korotkoff I)DIASTOLIC:When the heart is relaxing.Evident on disappearance of sounds(Korotkoff V) or sound muffling(Korotkoff IV) if sound doesn’tdisappear like in pregnant women.32. PARAMETERS OF BLOODPRESSURE
A single reading is not enough to say an individual ishypertensive.The Joint National Committee on Prevention, Detectionand Treatment of High Blood Pressure in their 7th reportin 2003 classified it as:-43. CLASSIFICATION OFHYPERTENSIONClass Systolic(mmHg)Diastolic(mmHg)Action RequiredNormal <120 <80 Lifestyle modifications advisedPrehypertension 120-139 80-89 Lifestyle modifications requiredStage 1hypertension140-159 90-99 Lifestyle modifications and drug treatmentrequired.Stage 2hypertension≥160 ≥100 Lifestyle modifications and drug treatmentrequired.
ESSENTIAL HYPERTENSION:90-95 % of the causes are unknownand probably from increased arterialresistance (via narrowing)SECONDARY HYPERTENSION:5-10% of the causes are known andcomprise of :Kidney diseasesEndocrine diseasesDrugs and Toxins like alcohol,cocaine, herbal remedies withlicorice etcPregnancy induced hypertension.Coarctation of aorta.54. CAUSES OF HIGH BLOODPRESSURE
MODIFIABLE RISK FACTORS:SmokingPhysical inactivity/Lack of ExerciseObesity/Excessive weightPoor DietExcessive Alcohol intakeTREATABLE RISK FACTORS:HypertensionHigh Cholesterol or high LDLDiabetesKidney diseasesNON-MODIFIABLE RISK FACTORS :Family historyAgeGender (males or women at menopause)65. RISK FACTORS OF HEART DISEASE
HEART:- Left Ventricularenlargement/hypertrophy- Heart failureBRAIN:- Stroke ( haemorrhagic type)- Transient ischaemic attackDementiaKIDNEY:- Kidney failureARTERIES:- Atherosclerosis leading to Heart attackor myocardial infarction and AnginaEYE:- Retinopathy.76. COMPLICATIONS OF UNCONTROLLED HYPERTENSION
Usually asymptomatic hence thepseudonym “SILENT KILLER”May only be detected on routinescreening.Some individuals however mayexperience:HeadacheDizzinessBlurred VisionShortness of breath etc. 87. SIGNS AND SYMPTOMS OFHYPERTENSION
Urinalysis (for Blood and Protein)Blood CholesterolBlood GlucoseKidney function Test :- Serum electrolyte, urea andcreatinine.- Glomerulofiltration rate12-lead ElectrocardiogramEchocardiogramOther specific tests to rule outsecondary causes or risk factors andcomplications of hypertension 98. INESTIGATIONS FORHYPERTENSION
Antihypertensive drugs like:- Diuretics,- Angiotensin converting Enzyme (ACE)inhibitors- Angiotensin II receptor blockers- Calcium channel Blockers- Beta-Blockers,Lipid/Cholesterol lowering drugs.Low dose AspirinLife style modifications.Blood Pressure Monitoring at Clinic, Home orduring daily activity(Ambulatory).Are used to attain the goal of Blood pressurecontrol109. TREATMENT OF HYPERTENSION
Weight Loss:Keeping body mass index between 18.5-24.9 kg/m2Dietary Approaches to Stop Hypertension (DASH) eating plan:Lots of fruits and vegetables.Low fat dairy products (low saturated and total fat content).Dietary sodium(salt) intake reduction:At <100 mmol/day (2.4 g sodium or 6 g sodium chloride)Regular dynamic physical exercise:Do regular aerobic physical exercises like brisk walking (at least 30minsdaily for most days in a week)Moderate Alcohol consumption:No more than 2 drinks per day in men (e.g. 24 oz of beer or 10 oz of wineor 3 oz of 80-proof whiskey) andNo more than 1 drink per day in women or lighter weight individuals.1110. LIFESTYLE MODIFICATIONS