Hypertension, or high blood pressure, is defined as a systolic blood pressure over 140 mm Hg or a diastolic blood pressure over 90 mm Hg. It has many risk factors including family history, age, gender, obesity, and substance abuse. If left untreated, it can lead to complications like heart attack, stroke, and kidney damage. The document discusses the types of hypertension, diagnostic tests, and medical and nursing management including lifestyle modifications and medications to control blood pressure.

1. HYPERTENSION
Nehal N. Sharma
S.Y M.Sc. Nursing

2. INTRODUCTION
Arterial hypertension, simply started is high blood
pressure. It is defined as a persistent evaluation of the
systolic blood pressure at a level of 140 mm Hg or higher
and diastolic blood pressure at a level of 90 mm Hg or
higher.

3. The American Heart Association has
recommended guidelines to define
normal and high blood pressure.

4. Classification Systolic BP
(mm Hg)
Diastolic BP
(mm Hg)
Normal
blood pressure
Pre hypertension
High BP (stage 1)
High BP (stage 2)
<120
120-139
140-159
Higher than 160
<80
80-89
90-99
Higher than 100

5. RISK FACTORS

6. 1.Family history 2. Age

7. Cont…
3. Gender 4. Ethnicity

8. 5. 6.

9. 7. Obesity 8. Nutrients

10. 9. Substance abuse

11. PATHOPHYSIOLOGY

12. Renin released
By kidneys
Stress
Sympathetic nervous
System stimulation
Angiotensinogen acts
To form angiotensin I,
Which is then converted
To angiotensin II.
↑Peripherral
Vascular resistance
↑Cardiac output
Arteriole
constriction
↑Peripheral
resistance
↑Aldosterone
secretion
Retention
Of sodium
And water
↑Blood volume
↑Blood
pressure
↑ Heart rate
↑Cardic contractility
↑Vasoconstriction

13. CLINICAL
MANIFESTATIONS

14. Headache Nausea and
vomiting

15. Fatigue and
confusion
Chest pain

16. Dizziness

17. Angina

18. COMPLICATIONS

19. Coronary artery
disease
Left ventricular
hypertrophy

20. Heart attack or stroke

21. Retinal damage

23. TYPES

25. PRIMARY HYPERTENSION

26. Primary hypertension is the most common
form of hypertension. The cause of primary
hypertension is unknown.
Some factors also cause the hypertension.

27. Examples
Age

28. Increased of salt
intake
Tension

29. Insufficient rest

30. lack of exercise Smoking

32. SECONDARY HYPERTENSION

33. Some people have high blood pressure caused by
an underling condition. This type of high blood
pressure called secondary hypertension. Various
condition and medications can lead to secondary
hypertension.
Including…

35. Oral contraceptive
pills
Illegal drugs

36. OTHER TYPES OF
HYPERTENSION

37. 1. White coat hypertension
White coat syndrome have normal
reading at home and only have high
readings when their BP is taken by a
doctor.

38. 2. Isolated systolic hypertension
It’s not uncommon to have either a systolic
number that’s elevate while the diastolic
number remains normal.
It’s less common for patients to have
elevated diastolic number. This condition
known as isolated systolic hypertension.

39. 3. Persistent Hypertension
Characterized by a diastolic blood
pressure above 110 to 120 mm Hg.
It results when hypertension is
unresponsive to treatment and become a
truly severe emergency condition as the
pressure continues to rise unchecked.

40. • Family history
• Physical examination
• Vital sign (BP)
• Full blood count
• Urine albumin
• Serum creatinine
• Serum lipid profile
• ECG
• Fasting blood sugar
DIAGNOSTIC STUDIES

41. MANAGEMENT

42. MEDICAL MANAGEMENT

43. ANTIHYPERTENSIVE DRUGS

44. 1. ACE inhibitors

45.  Angiotensin is a hormone in the body that
causes blood vessels to narrow. The
angiotensin converting enzyme inhibitors
decreases the production of angiotensin and
in turn that helps lower blood pressure.
• Captopril (25-150 mg/day)
• Ramipril (1.25-20 mg/day)

46. 2. Alpha blockers
These medicines reduces nerve
impulses to blood vessels, reducing
the effects of natural chemicals that
narrow blood vessels.
• Prazocin (2-30 mg/day)
• Terazocin (1-20 mg/day)

47. 3. Alpha- beta blockers
 In addition to reducing nerve impulses to
blood vessels, alpha beta blockers slow
the heartbeat to reduce the amount of
blood that must be pumped through the
vessels.
• Labetalol (2-30 mg/day)
• Carvedilol (12.5-20 mg/day)

48. 4. Angiotensin II receptor blockers
 These medications help relax blood
vessels by blocking the action, not
the formation of a natural chemical
that narrows blood vessels.
• Valsartan
• losartan

49. 5.Beta blockers
These medications reduce the
workload on heart and open blood
vessels, causing heart to beat slower
and with less force.
• Propranolol (40-480 mg/day)
• Atenolol (25-100 mg/day)

50. 6. Calcium channel blockers
These medications relax the muscles
of blood vessels. Some slow the
heart rate.
• Diltizem (120-36- mg/day)
• Verapamil (90-480 mg/day)

51. 7. Diuretics
 Diuretics help the kidneys get rid of
sodium and water from body. This
decreases the volume of blood in the
body and lowers blood pressure.
• Furosemide (40-240mg/day)
• Spironolactone (25-100 mg/day)

52. 8. Vasodilators
 These medications work directly on the
muscles in the walls of arteries.
• Minoxidil (5-100 mg/day)
• Hydralazine (50-300 mg/day)

53. DASH Diet :
Dietary Approaches to Stop
Hypertension

54. NURSING MANAGEMENT

55. NURSING DIAGNOSIS

56. 1. Risk for ineffective therapeutic regimen
management related to no previous learning
about the disease process.
Use written materials with clear instruction for
teaching the client with newly diagnosed
hypertension.
Teach the client to measure blood pressure at
home at least once a week.
Record the findings in a diary.

57. 2. Imbalanced nutrition more than body
requirements related to high sodium,
fat and calorie intake.
Give advice for reduce the weight.
Mild to moderate sodium restriction.
Done the exercises.

58. 3.Risk for noncompliance related to a lack
of understanding about the seriousness of
high blood pressure.
Done the communication with client.
Teaching to the client and his/her family.
Ensuring adequate follow up.

59. Patient/ Family teaching

60. Lifestyle modifications
Sodium restriction
Nutritional therapy
Physical activity
Alcohol restriction
Relaxation technique
Weight reduction

61. Summary

62. Introduction
Risk factors
Pathophysiology
Clinical manifestations
Complications
Types

63. Cont…
Other types of hypertension
1. White coat hypertension
2. Isolated systolic hypertension
3. Persistent Hypertension
Diagnostic studies

64. Cont…
Management
1) Medical management
2) Nursing management

65. ASSIGNMENT
A 52 year old client has Hypertension how
will you manage the condition of client at
home?
Submission date :

66. THANK YOU