This document discusses hypertension, including its definition, classification, prevalence, risk factors, clinical manifestations, diagnosis, complications, and prevention. Hypertension, defined as a blood pressure over 140/90 mmHg, is a major global health problem. It is estimated that over 1 billion people will have hypertension by 2025. Risk factors include age, family history, obesity, diet, physical inactivity, and stress. Symptoms may include fatigue, dizziness, and headaches. Diagnosis involves blood pressure measurement. Complications can include heart disease, stroke, and kidney damage if left untreated. Prevention focuses on lifestyle changes like reducing salt intake, maintaining a healthy weight, exercising regularly, and managing stress.

1. Dr.Anjalatchi Muthukumaran
Vice principal
Era college of nursing
Lucknow
PREVALENCE ABOUT
HYPERTENSION
AND ITS SINIFICANCES

2. Learning objectives
 Introduce the topic
 Define the term hypertension
 Explain the classification of hypertension
 Describe the prevalence of hypertension
 Enlist the risk factors
 List out the clinical manifestation
 Explain the diagnostic test of
hypertension
 Elaborate the prevention

3. Introduction
 Hypertension (HTN) is a silent, invisible
killer that rarely causes symptoms.
Increasing public awareness is key, as is
access to early detection. Raised blood
pressure is a serious warning sign that
significant lifestyle changes are urgently
needed. People need to know why
raised blood pressure is dangerous, and
how to take steps to control it.

5. Blood pressure (BP)
 It is the amount of force on the walls of
the arteries as the blood circulates
around the body.
 Hypertension is defined as a systolic
blood pressure equal to or above
140mmHg and/ or diast0olic blood
pressure equal to or above 90mmHg.

6. History of hypertension
 Historical of hypertension records as far
back as 2600 BC. Hold mention of “hard
pulse disease”.
 First treatments: Leeching/ phlebotomy,
acupuncture
 Hippocrates recommended phlebotomy
 120 AD – cupping of the spine to draw
animal spirits down and out was
recommended.

7. Continued
 1733- Reverend Stephen Hales
measured the intra arterial BP of a
horse.
 1905- N.C. Korotkoff reported on the
method of auscultation of brachial artery,
the method which is widely used today.
 Allowed auscultation of Diastolic BP as
well.

8. Classification of
hypertension
 Hypertension is divided into primary and
secondary
1. Hypertension is classified as essential
when the causes are generally
unknown. It is the most prevalent form
of HTN accounting for 90- 95 % of all
cases of HTN.
2. HTN is classified as secondary when
some other disease process or
abnormality is involved its causation.

9. WHO classification of BP
CATEGORY SYSTOLIC(mmHg) DIASTOLIC(mmHg)
Optimal <120 <80
Normal <130 <85
Grade 1 140-159 >90-99
Grade 2 160-179 >100-109
Grade 3 “severe” >180 >110

10. Prevalence of hypertension
 Globally ,the overall prevalence of
raised BP in adult aged 25years and
over was around 40% in 2008. the
proportion of the world’s population with
high BP, or uncontrolled HTN, fell
modestly between 1980 and 2008.
 Worldwide, raise BP is estimated to
cause 7.5 million deaths.

11. Global Burden Of Hypertension
2025 Projection
YEAR 2020
 26.4% of world adult
population had
hypertension.
 Total of 972 million
adults
 Highest prevalence is in
established marked
economics e.g. North
America, Europe
YEAR 2025
 29.2% of world adult
population will have
hypertension.
 Total of 1.56 billion
adults 20% in developed
nations, 80% in
developing nations.
 Highest prevalence will
be in developing
continents (e.g. Asia,
Africa) will account for
75% of world’s
hypertensive patients

12.  According to the survey report, the
prevalence of HTN was varying from 17
to 21% in all the states of India. An
overall pattern of prevalence was found
increasing with age group and all state.
 HTN was prevalent in all educational
level, it was high in higher education
level of Uttarakhand, Mizoram and
Madhya Pradesh.

13. Rules of halves
 HTN is an “iceberg” disease. Rule of
halves’ states that half of hypertensive
patients remain undiagnosed, half of
known do not receive treatment and half
of treated, do not receive adequate
control.

14. Risk factors
 Non modifiable risk factors-
1. Age- BP rises with age in both sexes
2. Sex
3. Genetic factor
4. Ethinicity

15. Continued
 Modifiable risk factors-
1. Obesity
2. Dietary fibers
3. Salt intake
4. Saturated fat
5. Alcohol

16. Continued
6. Physical activity
7. Heart rate
8. Environmental stress
9. Socio- economic status
10. Other factors- such as noise, vibration,
temperature and humidity require

17. Clinical manifestations
 Fatigue
 Dizziness/ headache
 Palpitations
 Dyspnoea
 Angina

18. Diagnostic test-
 A device called sphygnomanometer will
be used to measure blood pressure(BP).

19. BP measurement
 Seated quietly for 5 minutes.
 Appropriate size cuff.
 Inflate 20-30 mmHg above loss of radial
pulse. Deflate at 2mmHg per second.
 1st sound SBP; disappearance of
Korotkoff sound (phase 5) is DBP.
 Confirm elevated BP within 2 months
(stage 1)- shorter for stage 2 if new
onset.

20. Complications
 Coronary artery disease
 Heart failure
 Stroke
 Peripheral vascular disease
 Retinal damage

21. Prevention of HTN
 The WHO has recommended the
following approaches for the prevention
of hypertension
 Primary prevention
 Secondary prevention

22. Primary prevention
 Population strategy- the concept of
population approach is based on the fact
that even small reduction in the average
BP of population would produce a large
reduction in the incidence of cardiovascular
complications.
 NUTRITION – Dietary changes are
paramount importance.
 Reduction of salt intake to average of not
more than 5gm per day

23.  Moderate fat intake
 The avoidance of high alcohol intake
 Restriction of energy intake appropriate
to body needs.
 WEIGHT REDUCTION- the prevention
and correction of overweight /obesity
(BMI>25) is a prudent way of reducing
the risk of hypertension and indirectly
CHD.

24.  EXERCISE PROMOTION- regular
physical activity should be encouraged
as part of strategy for risk factor control.
 BEHAVIORAL CHANGES
 HEALTH EDUCATION
 SELF CARE

25.  High risk strategy
 The aim is to prevent the attainment of
levels of blood pressure. Hypertension
tends to cluster in families, the family
history of hypertension and tracking of
blood pressure from child blood may be
used to identify individuals at risk.

26. Secondary prevention
 The goal of secondary prevention is to
detect and control high BP in affected
individuals.
 EARLY DETECTION –the only effective
method of diagnosis of hypertension is to
screen population.
 TREATMENT- to obtain BP below 140/90,
and ideally a BP 120/80. Control of
hypertension has been shown to reduce
the incidence of stroke and other
complications.

27.  PATIENT COMPLIANCE- the treatment
of high BP must normally be life- long
and this presents problems of patient
compliance, defined as “the extent to
which patient behaviour ( in terms of
taking medicines, following diets or
executing other life style changes)
coincides with clinical prescription.

28. Summary
 Under the topic “application of
epidemiology in hypertension ”, we have
covered: the introduction, definition,
history, classification of hypertension,
prevalence of hypertension, risk factors,
clinical manifestation, diagnostic test,
complications, prevention of
hypertension.

29. Conclusion
 Hypertension is the commonest
cardiovascular disorders. The causes
are modifiable and non- modifiable. This
can be diagnosed by monitoring BP. The
hypertension can be prevented by
following measures like modifying the
diet and changes in lifestyle.

30. Bibliography
 Book reference-
• Lewis’s .L. Medical Surgical Nursing:
Assessment and management of clinical
problems. Elsevier publishers, India Pvt
Ltd. 2014. page no- 769,772,769,770,776
 Online reference-
• https://www.slideshare.net/harshrastogi1/h
ypertyension-in-community-health-nursing
• https://www.slideshare.net/HemantKumar9
8/epidemiology-of-hypertension-51274983

31. Thank you