This document discusses hypertension (high blood pressure). It defines hypertension and provides blood pressure categories. It notes that hypertension risk increases with age and is more common in some ethnic groups. The causes of hypertension are largely unknown, though factors like genetics, obesity, stress, smoking, alcohol, salt intake, and personality type can contribute to risk. The document also lists modifiable and non-modifiable risk factors for hypertension.

1. HYPERTENSION
Hawler Medical University
College of Medicine
Community Health
Prepared by:
Hawraz Faris Saadi
BSN, Master Student

2. Hypertension
 Hypertension is a condition in which arterial blood
pressure is chronically elevated.
 Blood pressure occurs within a continuous range,
so cutoff levels are defined according to their
effect on patients’ risk.
 Systemic blood pressure rises with age, and the
incidence of cardiovascular disease

3. Type of Hypertension
1) Essential (primary) hypertension.
2) Secondary hypertension.

4. Etiology
 In more than 95% of cases, a specific underlying
cause of hypertension cannot be found.
 The pathogenesis of this is not clearly understood.
 Many factors may contribute to its development,
including renal dysfunction, peripheral resistance
vessel tone, endothelial dysfunction.

5. Etiology Cont.
 Hypertension is more common in some ethnic
groups, particularly Black Americans and
Japanese, and approximately 40–60% is explained
by genetic factors

6. Definition of hypertension
Definition of hypertension
BP Category
Systolic BP
(mmHg)
Diastolic BP
(mmHg)
Optimal < 120 < 80
Normal < 130 85
High Normal 130–139 85–89
Hypertension Grade 1 (Mild) 140–159 90–99
Hypertension Grade 2 (Moderate) 160–179 100–109
Hypertension Grade 3 (Sever) ≥ 180 ≥ 110
Isolated systolic hypertension Grade 1 140–159 < 90
Isolated systolic hypertension Grade 2 ≥ 160 < 90

7. Risk Factors
Modifiable risk factors Non modifiable risk factors
Obesity Age
Stress Sex/ Gender
Smoking
Family History
Alcohol
Salt
Ethnicity and Race
Personality

8. Non modifiable risk factors
: blood pressure rises with age (More than
66% of people over 65 have hypertension).
:Early adolescence: show higher
Late life: show higher

9. Non modifiable risk factors Cont.
: Polygenic inheritance
(monozygotic twins show strong correlation than
dizygotic twins) Normotensive parents have 3%
and 2 Hypertensive parents have 45% chance of
begetting hypertensive children.
Black Americans and Africans have
higher BP levels than whites.

10. Modifiable risk factors
Epidemiology observed positively
correlated with increased blood pressure.
Anxiety and sympathetic over-activity
increase heart rate and blood pressure.
Cigarette smoking acutely exerts an
hypertensive effect, mainly through the
stimulation of the sympathetic nervous system

11. Modifiable risk factors
Increased intake increases BP and
reversible one.
(> 5 gms per day). Modern Japanese taking
>7gms NaCl per day show more BP than primitive
Japanese consuming <1 gm per day.
Potassium, Calcium, Magnesium, Cadmium
reduce BP.

12. Modifiable risk factors
Type A individuals tend to be very
competitive and self-critical. They strive toward
goals without feeling a sense of joy in their
efforts or accomplishments. This is
characterized by a high work involvement. Type
A individuals are easily ‘wound up’ and tend to
overreact. They also tend to have high blood
pressure (hypertension).

13. References
1. Nicki R., Brian R., Stuart H., (2010) Davidson’s Principles and Practice of
Medicine.
2. Park K. (2015) Park’s textbook of preventive and social medicine.
3. http://www.obesityaction.org/educational-resources/resource-articles-
2/obesity-related-diseases/hypertension-and-obesity-how-weight-loss-affects-
hypertension
4. https://www.simplypsychology.org/personality-a.html