Hypertension (HTN), also known as high blood pressure, is a common condition where the long-term force of blood pushing against artery walls is too high. It often has no symptoms, even at dangerously high levels, but can eventually cause health issues like heart disease if left untreated. Treatment involves lifestyle modifications like diet, exercise, and stress management as well as medication prescribed based on an individual's blood pressure levels, health history, and risk factors such as age, family history, weight, and race. Care managers help monitor patients' blood pressure, medication adherence, and lifestyle changes through interventions like education, risk assessment, and evaluation tools to improve outcomes.

1. Hypertension(HTN)
Meirong Wen
Asian Community Care Management
11/30/2015

2. Definition
• High blood pressure is also called hypertension.
• It is a common condition in which the long-term force of the
blood pushing against the artery wall is high enough that it
may eventually cause health problems, such as heart disease.

3. Symptoms
• Asymptomatic, usually no warning signs and symptoms, even
if blood pressure readings reach dangerously high levels.
• May have nonspecific S + Sx, such as headaches, shortness of
breath or nosebleeds.

4. What BP Number Means
Blood Pressure Levels
Normal systolic: less than 120 mmHg
diastolic: less than 80mmHg
At risk (prehypertension) systolic: 120–139 mmHg
diastolic: 80–89 mmHg
High systolic: 140 mmHg or higher
diastolic: 90 mmHg or higher

5. Causes
Primary(essential) hypertension
No identifiable cause of high blood pressure, tends to develop
gradually over many years.
Secondary hypertension
Caused by an underlying condition, including:
• Obstructive sleep apnea
• Kidney problems
• Thyroid problems
• Illegal drugs, such as cocaine and amphetamines
• Certain medications, such as birth control pills, cold remedies,
decongestants, OTC pain relievers
• Alcohol abuse or chronic alcohol use

6. Risk Factor
• Race: If you're African American, there's a good chance that
you or a relative has HBP.
• Gender: Starting at age 65, women are more likely to have
high blood pressure than men.
• Family History
• Advanced age
• Lack of physical activity
• Too much sodium in your diet
• Being overweight and obesity
• Too much alcohol intake
• Using tobacco
• stress

7. Treatment/Intervention
Lifestyle modifications:
• Eat healthy food, try the Dietary Approaches to Stop
HTN(DASH) diet
• Reduce salt intake, avoid table salt.
• Increase physical activity
• Maintain a healthy weight
• Manage stress
• Avoid tobacco smoke
• Limit alcohol intake
• Monitor your blood pressure at home
Medication Regimen:
• Take medication as prescribed

8. Medication
Thiazide diuretics
Hydrochlorothiazide (Microzide), chlorthalidone……
Beta blockers
Acebutolol (sectral), atenolol (Tenormin)……
Angiotensin-converting enzyme(ACE)inhibitors
Lisinopril (Zestril), benazepril (Lotensin), captopril (Capoten)……
Angiotensin II receptor blockers(ARBs)
Candesartan (Atacand), losartan (Cozaar)……
Calcium channel blockers
Amlodipine (Norvasc), diltiazem (Cardizem)

9. Medication Continued…
Alpha blockers
Doxazosin(cardura), Prazosin (Minipress)…
Alpha-beta blockers
Carvedilol (Coreg), labetalol (Trandate)…
Central-acting agents
Clonidine (Catapres, Kapvay), Guanfacine (Intunivm Tenex)
Vasodilators
Hydralazine and minoxidil
Aldosterone antagonists
Spironolactone (Aldactone), Eplerenone (Inspra)

10. Side Effect of antihypertensive
medications
• Cough
• Diarrhea or constipation
• Dizziness or light-headedness
• Erection problems
• Feeling nervous
• Feeling tired, weak, drowsy, or a lack of energy
• Headache
• Nausea or vomitting
• Skin rash
• Weight loss or gain without trying

11. Blood Pressure Treatment Goal
Less than150/90 mm
Hg
If you're a healthy
adult age 60 or older
Less than140/90 mm
Hg
If you're a healthy
adult younger than
age 60
Less than140/90 mm
Hg
If you have chronic
kidney disease,
diabetes or coronary
artery disease or are
at high risk of
coronary artery
disease

12. Care Manager's Intervention
Evidence-based Guidelines
• Telephonic care management
• Lifestyle modification education
• Risk assessment
• Hypertension assessment

13. Outcome Measures
• Medication adherence
• Lifestyle changes
• BP within normal range
• Response to treatment
• Effective of evaluation assessments & screening tools

14. References
• 1)
http://www.heart.org/HEARTORG/Conditions/HighBloodPress
ure/High-Blood-Pressure-or-
Hypertension_UCM_002020_SubHomePage.jsp#
• 2) http://www.mayoclinic.org/diseases-conditions/high-
blood-pressure/basics/definition/con-20019580
• 3)
http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_blo
odpressure.htm
• 4)
https://www.nlm.nih.gov/medlineplus/ency/article/007484.ht
m