Hypertension is a chronic disease that requires lifelong treatment. The document outlines guidelines for diagnosing and treating hypertension including measuring blood pressure in the office and out of office, aiming for specific systolic and diastolic blood pressure targets that vary depending on patient age and conditions like diabetes, chronic kidney disease, or pregnancy. Treatment involves lifestyle modifications and medications and differs based on any special conditions in individual patients.

1. Physiology & Guidelines of
Hypertension
By
Fatma Abdelnasser Ghoneim
Eman Mohammed Ghanem
Cairo University
Faculty of medicine
General Medicine Department
Dr. Hazem Bebawy’s Unit
December 2018
Under supervision of
Dr. Yumn Ahmed

2. Pathophysiology

4. Hormonal

6. Secondary Hypertension
Age
Family history
Response to treatment
Severity
Presence of HMOD
Other clinical manifestations
suggesting the cause
Renovascular disease
Endocrinal
Coarctation of the aorta
Obstructive sleep apnea
Drugs
When to suspect Causes

8. • Diagnosis of HTN depends on:
▫ Repeated office measurements of BP
▫ Out of office ABPM – HBPM
• Aim of treatment:
• Systolic BP target
▫ In all patients < 140/90 or even < 130/80 mmHg
▫ Patients < 65 years 120 – 129 mmHg
▫ Patients > 65 years 130 – 139 mmHg
• Diastolic BP target < 80 mmHg

9. Plan of Treatment

10. Uncomplicated HTN

12. Hypertension & CAD

13. Hypertension & CKD

14. Hypertension & DM
• Treatment is recommended for diabetic patients
with BP >140/90 mmHg.
• Target BP < 130/80 mmHg.
• Initiate treatment with combination of RAS
blocker with CCB or thiazide.

15. Hypertension & Pregnancy
• Initiate treatment when BP > 150/95 mmHg.
• Drug of choice methyl dopa, labetalol, CCB.
• Delivery is recommended at 37 weeks.
• Terminate pregnancy if there are adverse
conditions as visual disturbances, hemostatic
disorders.

16. • Hypertension is a chronic disease that requires life long
treatment.
• Screening program is recommended (Silent Killer).
• Suspect 2ry hypertension in young age or resistant
hypertension.
• Life style modification is more important than
medications.
• Treatment differs according to the special condition of
each patient.