Hypertension, or high blood pressure, is defined as a systolic blood pressure over 140 mm Hg or a diastolic pressure over 90 mm Hg. It can be classified based on these levels into normal, prehypertension, stage 1, and stage 2. Primary hypertension, which accounts for 95% of cases, has no identifiable cause and results from an interaction of genetic and lifestyle factors, while secondary hypertension has an identifiable underlying cause. Hypertension often has no symptoms but can sometimes cause headaches, vision problems, chest pain, or other issues. Uncontrolled high blood pressure can damage organs over time and lead to heart attacks, strokes, kidney failure, and other complications. Diagnosis involves blood and urine tests and blood pressure monitoring

1. Internal Medicine
Hypertension
‫الصحة‬ ‫معهد‬‫العالي‬
‫المادة‬ ‫مدرس‬
‫م‬.‫إختصاص‬ ‫جامعي‬
‫الوهاب‬ ‫عبد‬ ‫نزار‬ ‫صـالح‬
‫تمـريض‬ ‫علــوم‬ ‫ماجـستير‬
Salah Nazar Abdulwahhab M.Sc. Nursing
www.slideshare.net
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2. Definition of Hypertension
Blood Pressure: Is the force of blood flow on the walls of blood vessels especially arteries
Diastolic pressure: occur at ventricles rest
Systolic pressure: occur when the ventricles contract
Hypertension (HTN or HT): is defined as a systolic blood pressure greater than 140 mm Hg
and a diastolic pressure greater than 90 mm Hg, based on two or more measurements.
Increase in blood pressure [ Hypertension]
Decrease in blood pressure [ Hypotension]
Hypertension can be classified as follows
• Normal: systolic less than 120 mm Hg; diastolic less than 80 mm Hg
• Prehypertension: systolic 120 to 139 mm Hg; diastolic 80 to 89 mm Hg
• Stage 1: systolic 140 to 159 mm Hg; diastolic 90 to 99 mm Hg
• Stage 2: systolic 160 mm Hg; diastolic 100 mm Hg
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3. Types of Hypertension
Primary Hypertension
Also known as essential hypertension
About (95%) of hypertension cases
- Idiopathic
- predisposing factors
interaction of genes and environmental factors such as:
High salt intake, lack of exercise , obesity, aging, stress, Smoking, .. etc.
Secondary Hypertension
About (5%) of hypertension cases
results from an identifiable causes such as:
Kidney disease, Hypothyroidism, Hyperthyroidism, Heart disease, .. etc.
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4. Classification of Hypertension
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5. Clinical Manifestations of Hypertension (Common)
Some persons with hypertension maybe
asymptomatic
so hypertension called the [silent killer]
If blood pressure is high there are many
symptoms such as:
- Severe headache
- Fatigue or confusion
- Vision problems
- Chest pain
- Difficulty breathing
- Epistaxis
- Irregular heartbeat
- Blood in the urine
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6. Hypertensive Crises
Severe elevation in blood pressure
(equal to or greater than a systolic 180 mmHg or diastolic of 110 mmHg)
Hypertensive crisis categorized as:
1- Hypertensive Urgency [absence of organ damage]
2- Hypertensive Emergency [presence of organ damage]
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HTN URGENCY HTN EMERGENCY
- No progressive end organ dysfunction.
- Severe elevated bp in range of stage 2 htn
<159/99 mmHg.
- Examples : Highly elevated bp without severe
headache, shortness of breathe or chest pain.
- Progressive end-organ dysfunction.
- Severely elevated bp >180/120mmHg
- Require emergent lowering of bp.
- Examples include: Acute Myocardial infarction or
unstable Angina.

7. Hypertension Complications
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ORGANS DISEASES
Heart Heart attack, Heart failure
Eyes Retinopathy, vision loss
The Kidneys Kidney Failure
Brain Stroke

8. Diagnostic Tests
1. CBC [Complete Blood Count]
2. Blood Glucose
- Glycated Hemoglobin (HbA1c) test
- Random blood sugar test [RBS]
- Fasting blood sugar test [FBS]
- Oral glucose tolerance test
3. LFT [Liver Function Tests]
4. RFT [Renal Function Tests]
- Serum creatinine test
- Blood urea (BU)
- Serum Uric Acid
- Estimated GFR
- Urinalysis
5. Serum Electrolytes
6. ECG SCAN
B.P Measurement Tools
Sphygmomanometer and Stethoscope8

9. The Treatment
A - Non-pharmacological therapy of hypertension
- Maintaining a normal weight
- Healthy diet low in fats and Sodium restriction
- Drinking water
- Prevent tobacco products
- Reduce stress
- Regular Exercises
- Prevent Smoking and alcohol intake
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10. The Treatment (Con.)
B- pharmacological therapy of hypertension (Common)
- Diuretics: Drugs that increase urine flow are called diuretics
(Furosemide, hydrochlorothiazide, spironolactone, ..etc.)
- Angiotensin-converting Enzyme (ACE inhibitors): (captopril, enalapril, lisinopril, ..etc.)
- Angiotensin II receptor antagonists (candesartan, losartan, valsartan, ..etc.)
- Calcium channel blockers (amlodipine, nifedipine, diltiazem, verapamil, ..etc.)
- Adrenergic receptor antagonists
 Beta blockers (atenolol, carvedilol, metoprolol, propranolol, ..etc.)
 Alpha blockers: (prazosin, terazosin, .. etc.)
 Mixed Alpha + Beta blockers: (carvedilol, labetalol. …etc.)
- Vasodilators (hypertensive emergencies = Hydralazine )
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11. Thank You
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