This document discusses hypertension (high blood pressure). It defines hypertension and describes its classification into primary and secondary types. Risk factors for hypertension include age, genetics, diet, obesity, and physical inactivity. Hypertension often has no symptoms but can lead to serious complications affecting the heart, brain, kidneys and eyes if left untreated. The prognosis is good if hypertension is detected early and blood pressure is well-controlled through lifestyle changes and medication.

1. HYPERTENSION
BREAKTHROUGH
Dimas Fujiansyah

2. PHYSIOLOGY OF
BLOOD PRESSURE
01

3. INTRODUCTION

4. Peripheral resistance
Humoral factors
● Constrictors
○ Angiotensin II
○ Catecholamine
○ Thromboxane
○ Leukotrienes
○ Endothelin
● Dilators
○ Prostaglandins
○ Kinins
○ nitric oxide
Neuronal factors
● Constrictors
○ α-Adrenergics
● Dilators
○ β-Adrenergics

5. Cardiac output
Blood volume
● Sodium
● Mineralocorticoid
● Atrial natriuretic
peptide
Cardiac factors
● Heart rate
● Contractility

6. Blood Pressure Regulation: Hormones

7. Blood Pressure Regulation: Hormones

8. WHAT IS
HYPERTENSION ?
From the 2017 American College of Cardiology/American Heart Association, but there is some
controversy over this definition (Bell KJL, et al, JAMA Intern Med. 2018;178(6):755-757). Other
professional associations define hypertension as a systolic pressure diastolic pressure iety of
Hypertension (ISH), as well as the National Institute for Health and Care Excellence (NICE)

9. WHAT IS
HYPERTENSION ?
From the 2017 American College of Cardiology/American Heart Association, but there is some
controversy over this definition (Bell KJL, et al, JAMA Intern Med. 2018;178(6):755-757). Other
professional associations define hypertension as a systolic pressure diastolic pressure iety of
Hypertension (ISH), as well as the National Institute for Health and Care Excellence (NICE)

10. CLASSIFICATION
02

11. CLASSIFICATION
PRIMARY (IDIOPATHIC)
HYPERTENSION
SECONDARY
HYPERTENSION
Cumulative effects of several genetic
polymorphisms, environmental factors,
hypersensitive symphatic NS.
Renal artery stenosis,
Hyperaldosteronism,
Pheochromocytoma,

12. White Coat Hypertension
Diagnostics
● Blood pressure measurements several minutes
apart (after rest)
● Blood pressure measurements on several visits (at
least 2)
● Use 24-hour ambulatory Blood pressure monitoring

13. ETIOLOGY
03

14. ETIOLOGY
PRIMARY (IDIOPATHIC)
HYPERTENSION
● 25- 55 years old
● Hypersensitive
symphatetic nervous
system
● Cumulative effects of
several genetic
polymorphisms
● Interacting
environmental factors
SECONDARY HYPERTENSION
● Renal disorder
○ Renal Parencymal diseases
■ Damage on the stuctur of renal include collecting duct, t.
proximal, t. distal, etc.
○ Glomerulonephritis
○ DM nephropathy
○ polycystic kidney disease
● Renal vascular diseases
○ Stenosis > arterosclerosis renal artery
○ Inflamation > vasculitis
● Endocrine system
○ Adrenal gland
■ Khan syndrome
■ Cushing syndrome
■ pheocromocytoma

15. ETIOLOGY
SECONDARY HYPERTENSION
● Thyroid
○ Hyperthyroid
○ Hypothyroid
○ Hyperparathyroid
● Coarctation aorta

16. RISK FACTORS
05

17. RISK FACTORS

18. CLINICAL
MANIFESTATIONS
06

19. Signs and Symptoms

20. Asymptomatic until:
● Complications of
end-organ
damage arise
● An acute increase
in blood pressure
occurs
(hypertensive
crisis)

21. Signs and Symptoms
Nonspecific symptoms of hypertension
● Headaches (especially in the early morning or waking
headache)
● Flushed appearance
● Dizziness
● Tinnitus
● Blurred vision

22. PATHOPHYSIOLOGY
07

23. PATHOPHYSIOLOGY

24. PATHOPHYSIOLOGY

25. DIAGNOSIS
08

26. Diagnostic Criteria
The diagnosis of hypertension is made when at least three of the
following diagnostic criteria are met:
● Accurate measurement of BP
● Assessment of cardiovascular risk
● Assessment about secondary hypertension

29. TREATMENT
09

31. COMPLICATIONS
10

32. Cardiovascular System Complications
● Atherosclerosis
● Hypertensive heart disease
● Aortic aneurysm
● Aortic dissection

33. Brain Complications
● Stroke, transient ischemic attack (TIA)

34. Renal Complications
● Hypertensive nephrosclerosis

35. Ophthalmic Complications
● Hypertensive Retinopathy

36. PROGNOSIS
11

37. PROGNOSIS
● The prognosis depends on blood pressure control and is favorable
only if the blood pressures attain adequate control;
however, complications may develop in some patients as
hypertension is a progressive disease.
● Adequate control and lifestyle measures only serve to delay the
development and progression of sequelae such as chronic kidney
disease and renal failure.

38. EDUCATION
12

39. PROGNOSIS
● Detailed education regarding lifestyle modification and
pharmacological therapy is the key to success for better control of
blood pressure and to prevent complications.
● Weight management, physical activity, limiting
alcohol/tobacco/smoking is a critical strategy to decrease
cardiovascular risk

40. THANK
YOU

41. References
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