Hypertension is defined as elevated blood pressure above 140/90 mm Hg. It can be primary, caused by unknown factors like family history or stress, or secondary, caused by underlying conditions like kidney disease or hormonal issues. Symptoms include headaches, dizziness, and vision issues. Diagnosis involves measuring blood pressure repeatedly and potential tests like chest x-rays. Treatment uses medications to lower blood pressure such as diuretics, beta blockers, ACE inhibitors, calcium channel blockers, and vasodilators. Complications of untreated hypertension include heart disease, renal failure, and stroke.

1. HYPERTENSION
By Abhishek

2. Definition
Hypertension is a disease of vascular regulation in which elevation of arterial pressure
above the normal range.
Normal blood pressure: 120/80mm of Hg.
In Hypertension: 140/90 or above

3. Causes
1. Primary Hypertension:
It is due to unknown causes or without systemic cause.
Example:
● Family history
● Prolonged mental tension
● Arterial degeneration
● Hormonal or metabolic disturbance.

4. 2. Secondary Hypertension:
It is due to pathological conditions.
Example:
● Due to kidney disease, e.g., Pyelonephritis.
● Due to endocrine disorders, e.g., cushing Syndrome, diabetes mellitus.
● Congenital deformities, e.g., Renal artery obstruction.

5. Others:
● Enlarged Prostate
● Toxaemia in pregnancy
● Excessive body weight
● Excessive sodium intake
● Obesity
● Smoking.

6. 3. Borderline Hypertension:
It is defined as intermittent elevation of B.P. with normal readings.
4. Malignant Hypertension:
It is a Syndrome of markedly elevated blood pressure (above 140 mm of hg).
5. Benign Hypertension:
Also known as uncomplicated hypertension, usually of long duration and mild to moderate severity,
may be Primary or Secondary.
6. White Coat Hypertension:
It is due to anxiety only at a time of measuring blood pressure by doctor or nurse in hospital or clinic.

7. Pathophysiology

8. Sign and symptoms
● Morning occipital headache
● Fatigue
● Dizziness
● Bluring vision
● proteinuria
● Haematuria (blood in urine)
● Cardiac asthma
● Anginal Pain
● Epistaxis (Nose bleeding)
● Palpitation
● Tinnitus (Ringing in ears)
● Breathlessness

9. Diagnostic evaluation
● By measuring B.P.
● Chest X-ray
● Urine test
● Blood test
● History collection
● Physical examination

10. Complications
● Heart disease
● Renal failure
● Cerebral haemorrhage
● Angina pectoris

11. Medical management
Diuretic: They increase frequency of urine.
Example:
● Thiazide - 40mg
● Furosemide - 20mg.
Beta blocker: Prevents stimulation of beta-adrengeic receptors of sympathetic nervous
system. Because beta adrenergic receptors are responsible for vasoconstriction in blood
vessels.
Example:
● Atenolol
● betaxolol
● Timolol
● propranolol.

12. Vasodilators: These drugs acts as blood vessel dilator and open vessels by relaxing
their muscular walls and decreased blood pressure.
Example: Nitrates.
● Short acting: Nitroglycerine - 15-12 mg (sublingual)
● Long Acting: Isosorbide dinitrate - 5-10 mg.
Calcium channel blockers (calcium Antagonist):
They are used to decrease oxygen demand in Heart and improve coronary blood flow.
Example:
● Verapamil (Antiarrhythmic) (Administer empty stomach before meal).
● Nifedipine.

13. Angiotensin Converting Enzyme inhibitor:
They inhibit Angiotensin I and II Conversion.
Example:
● Captopril
● ramapril
● Benazepril