This document discusses hypertension (high blood pressure). It defines hypertension and provides classifications based on systolic and diastolic blood pressure readings. The main causes of hypertension are described as essential (90-95% of cases) where the cause is unknown, or secondary which has known medical causes. Risk factors for hypertension and heart disease are identified as both modifiable (lifestyle) and non-modifiable factors. The complications of uncontrolled hypertension are outlined affecting the heart, brain, kidneys, arteries and eyes. Tests used in evaluation and treatment options emphasizing lifestyle modifications and medication are summarized.

1. HYPERTENSION
By
Dr. ANUGOM Emeka.

2. This is force exerted on wall of
the arteries and their networks
by blood while ensuring blood
supply from the heart gets to
vital organs and tissues in the
body.
High Blood pressure
(Hypertension) accounts for
7.1million deaths every year and is
found in about 1 billion people
worldwide.
2
1. WHAT IS BLOOD PRESSURE?

3. Two parameters are measured in
millimeters 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’t
disappear like in pregnant women.3
2. PARAMETERS OF BLOOD
PRESSURE

4. A single reading is not enough to say an individual is
hypertensive.
The Joint National Committee on Prevention, Detection
and Treatment of High Blood Pressure in their 7th report
in 2003 classified it as:
-
4
3. CLASSIFICATION OF
HYPERTENSION
Class Systolic
(mmHg)
Diastolic
(mmHg)
Action Required
Normal <120 <80 Lifestyle modifications advised
Prehypertension 120-139 80-89 Lifestyle modifications required
Stage 1
hypertension
140-159 90-99 Lifestyle modifications and drug treatment
required.
Stage 2
hypertension
≥160 ≥100 Lifestyle modifications and drug treatment
required.

5. ESSENTIAL HYPERTENSION:
90-95 % of the causes are unknown
and probably from increased arterial
resistance (via narrowing)
SECONDARY HYPERTENSION:
5-10% of the causes are known and
comprise of :
Kidney diseases
Endocrine diseases
Drugs and Toxins like alcohol,
cocaine, herbal remedies with
licorice etc
Pregnancy induced hypertension.
Coarctation of aorta.
5
4. CAUSES OF HIGH BLOOD
PRESSURE

6. MODIFIABLE RISK FACTORS:
Smoking
Physical inactivity/Lack of Exercise
Obesity/Excessive weight
Poor Diet
Excessive Alcohol intake
TREATABLE RISK FACTORS:
Hypertension
High Cholesterol or high LDL
Diabetes
Kidney diseases
NON-MODIFIABLE RISK FACTORS :
Family history
Age
Gender (males or women at menopause)6
5. RISK FACTORS OF HEART DISEASE

7. HEART:
- Left Ventricular
enlargement/hypertrophy
- Heart failure
BRAIN:
- Stroke ( haemorrhagic type)
- Transient ischaemic attack
Dementia
KIDNEY:
- Kidney failure
ARTERIES:
- Atherosclerosis leading to Heart attack
or myocardial infarction and Angina
EYE:
- Retinopathy.
7
6. COMPLICATIONS OF UNCONTROLLED HYPERTENSION

8. Usually asymptomatic hence the
pseudonym “SILENT KILLER”
May only be detected on routine
screening.
Some individuals however may
experience:
Headache
Dizziness
Blurred Vision
Shortness of breath etc. 8
7. SIGNS AND SYMPTOMS OF
HYPERTENSION

9. Urinalysis (for Blood and Protein)
Blood Cholesterol
Blood Glucose
Kidney function Test :
- Serum electrolyte, urea and
creatinine.
- Glomerulofiltration rate
12-lead Electrocardiogram
Echocardiogram
Other specific tests to rule out
secondary causes or risk factors and
complications of hypertension 9
8. INESTIGATIONS FOR
HYPERTENSION

10. Antihypertensive drugs like:
- Diuretics,
- Angiotensin converting Enzyme (ACE)
inhibitors
- Angiotensin II receptor blockers
- Calcium channel Blockers
- Beta-Blockers,
Lipid/Cholesterol lowering drugs.
Low dose Aspirin
Life style modifications.
Blood Pressure Monitoring at Clinic, Home or
during daily activity(Ambulatory).
Are used to attain the goal of Blood pressure
control
10
9. TREATMENT OF HYPERTENSION

11. Weight Loss:
Keeping body mass index between 18.5-24.9 kg/m2
Dietary 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 30mins
daily 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 wine
or 3 oz of 80-proof whiskey) and
No more than 1 drink per day in women or lighter weight individuals.
11
10. LIFESTYLE MODIFICATIONS

12. Questions
12