High blood pressure, also called hypertension, is when blood pressure is consistently higher than normal levels. There are two main types of hypertension - primary/essential hypertension which has no identifiable cause and occurs in 95% of hypertensive patients, and secondary hypertension which is caused by an underlying condition and occurs in 5% of patients. Risk factors for developing hypertension include increasing age, family history, being overweight, lack of exercise, smoking, excessive alcohol consumption, and certain chronic conditions. Symptoms of severe hypertension can include headaches, confusion, vision issues, chest pain, and difficulty breathing. Treatment involves lifestyle modifications like diet changes and exercise as well as medications to lower blood pressure. Uncontrolled hypertension can increase the risk of heart attack, stroke

6. • According to Brunner & Suddarth's
High blood pressure, also called hypertension, is
blood pressure that is higher than normal. blood
pressure changes throughout the day based on
activities. Having blood pressure measures
consistently above normal may result in a diagnosis
of high blood pressure (or hypertension).

7. • Hypertension (HTN ), also known
as high blood pressure (HBP), is a
long- term medical condition in
which the blood pressure in the
arteries is persistently elevated.
According to lippin cott

9. A) Primary or
Essential HTN :-
Essential hypertension (also
called primary hypertension, or
idiopathic hypertension
1. Occurs in approx. 95 %.
2.The diastolic pressure is 90
mmHg & the systolic pressure is
140mmHg or higher & the
other causes of HTN are
absent.
B) Secondary HTN :-
1. Occurs in approx. 5 % of
patients with hypertension
secondary to other pathology.
2. Renal pathology are :-
congenital anomalies,
Pyelonephritis,Renal artery
obstruction,Acute & Chronic
glomerulonephritis.
3. Endocrine disturbances :-
Pheochromocytoma
4. Adrenal cortex tumor.
5. Cushing’s syndrome .
6. Medications such as
Estrogens,anti-depressants,
steroids,NSAIDs.

10. • Risk factors and etiology
• High blood pressure has many risk
factors, including:
• Age. The risk of high blood pressure increases as
you age. Until about age 64, high blood pressure
is more common in men. Women are more likely
to develop high blood pressure after age 65.
• Race. High blood pressure is particularly common
among people of African heritage, Serious
complications, such as stroke, heart attack and
kidney failure, also are more common in people of
African heritage.

11. • Family history. High blood pressure tends to run
in families.
• overweight or obese. The more weight the more
blood need to supply oxygen and nutrients to
tissues. As the volume of blood circulated
through blood vessels increases, so does the
pressure on artery walls.
• Not being physically active.
• People who are inactive tend to have higher
heart rates. The higher heart rate, the harder
heart must work with each contraction and the
stronger the force on arteries. Lack of physical
activity also increases the risk of being
overweight.

12. • Using tobacco. Not only does smoking or chewing
tobacco immediately raise your blood pressure
temporarily, but the chemicals in tobacco can damage
the lining of your artery walls. This can cause arteries to
narrow and increase your risk of heart disease.
Secondhand smoke also can increase your heart
disease risk.
• Too much salt(sodium) in diet. Too much sodium in diet
can cause body to retain fluid, which increases blood
pressure.
• Too little potassiumin your diet. Potassium helps
balance the amount of sodium in cells. If you don't
get enough potassium diet or retain enough
potassium, you may accumulate too much sodium
in blood.

13. • Drinking too much alcohol. Over time, heavy drinking can
damage heart. Having more than one drink a day for women
and more than two drinks a day for men may affect your blood
pressure.
• . Anxiety causes the release of stress hormones in the
body. These hormones trigger an increase in the heart rate
and a narrowing of the blood vessels. Both of these
changes cause blood pressure to rise,
• Certain chronic conditions. Certain chronic conditions also
may increase risk of high blood pressure, such as kidney
disease, diabetes and sleep apnea.

14. PATHOPHYSIOLOGY
Angiotensin-converting
enzyme

15. CLINICALMANIFESTATION
1. Headache
2. Dizziness
3. Blurred vision
4. Nausea & vomiting
5. Chest pain
6. Shortness of breath
7. Palpitation

16. • blood pressure is extremely high, there may be
certain symptoms to look out for,including:
• Severe headache
• Fatigue or confusion
• Vision problems
• Chest pain
• Difficulty breathing
• Irregular heartbeat
• Blood in the urine

17. DIAGNOSTICEVALUATION
1)History taking & physical exam.
2) Chest X-ray
3) ECG
4) Proteinuria,↑ed BUN & creatinine
5) Serum potassium
6) 24 hrs. urine output
7) Renal scan
8) Renal duplex imaging

22. • Blood Tests
• Blood tests may be needed to determine if you have
secondary hypertension due to a serious or treatable
health condition.5 Blood tests that may be ordered to
assist in the diagnosis of hypertension include:
• Electrolyte levels
• Blood glucose
• Thyroid function tests
• Kidney function tests: blood urea nitrogen
(BUN) and creatinine levels
• Urine Tests
• Urine tests can help determine if diabetes, kidney failure,
or illegal drugs are causing or contributing to high blood
pressure

23. ELECTROCARDIOGRAM (ECG )
records the electrical signal from heart to
check for different heart conditions.
Electrodes are placed on chest to record
heart's electrical signals,
A RENAL SCAN
involves the use of nuclear radioactive material to
examine your kidneys and assess their function.
A renal scan is also known as a renal scintigraphy,
nuclear renal imaging, or a renogram. Other forms
of renal imaging include CT scans, X-rays, ultrasounds,
and MRI

24. MANAGEMENT

25. 1)Loose weight if body mass index is
greater than or equal to 25.
2)Limit alcohol.
3)Get regular aerobic exercise equivalent
to 30-45 min of walking most days.
4)Cut sodium intake to 2.4 gm or less per
day.
5)Include recommended daily allowances
of potassium,calcium & magnesium in diet.
6)Smoking cessation.
7)Reduced dietary saturated fat &
cholesterol.
8)Consider reducing coffee intake.

27. 1) Diuretics (lower BP by promoting urinary excretion)
2) Beta-adrenergic blockers (reducing cardiac output as well as
release of renin from the kidneys) (atenolol)
3) Central alpha agonist (diminishing sympathetic outflow
from the brain,thereby lowering peripheral resistance)
(methyldopa)
4) Peripheral adrenergic agents
5) Combined alpha & beta adrenergic blockers
6) ACE inhibitors (blocking the enzyme that converts
Angiotensin-I to
Angiotensin-II) (Captopril,remipril)
7)Calcium channel blocker (stop the movement of calcium
into the cells causes vasodilation & inhibit reabsorbtion of
sodium in the renal tubules) (verapamil)
8)Direct vasodilators (direct smooth muscles relaxants
that primarily dilate arteries & arterioles) (hydralazine)

37. +-+

38. Diet
People can prevent high blood pressure by
following a heart-healthy diet.
Reducing salt intake
People’s average salt intake is between 9 grams
(g) and 12 g per day in most countries around
the world.
The World Health Organization (WHO)
recommend reducing intake to under 5 g a day
to help decrease the risk of hypertension and
related health problems.
Lowering salt intake can benefit people both with
and without hypertension.

39. NURSING
M
ANAGEMENT

40. COMPLICATION

41. • Heart attack or stroke. High blood pressure can cause
hardening and thickening of the arteries (atherosclerosis),
which can lead to a heart attack, stroke or other complications.
• Aneurysm. Increased blood pressure can cause your blood
vessels to weaken and bulge, forming an aneurysm. If an
aneurysm ruptures, it can be life-threatening.
• Heart failure. To pump blood against the higher pressure in
your vessels, the heart has to work harder. This causes the
walls of the heart's pumping chamber to thicken (left ventricular
hypertrophy). the thickened muscle may have a hard time
pumping enough blood to meet your body's needs, which can
lead to heart failure.
• .

42. • Metabolic syndrome. This syndrome is a cluster of disorders
of body's metabolism, including increased waist circumference;
high triglycerides; low high-density lipoprotein (HDL)
cholesterol, the "good" cholesterol; high blood pressure and
high insulin levels. These conditions make you more likely to
develop diabetes, heart disease and stroke.
• Trouble with memory or understanding. Uncontrolled high
blood pressure may also affect your ability to think, remember
and learn. Trouble with memory or understanding concepts is
more common in people with high blood pressure.
• Dementia. Narrowed or blocked arteries can limit blood flow to
the brain, leading to a certain type of dementia (vascular
dementia). A stroke that interrupts blood flow to the brain also
can cause vascular dementia. a chronic or persistent disorder of
the mental processes caused by brain disease or injury and marked
by memory disorders, personality changes, and impaired reasoning.