2. DEFINITION
Hypertension (HTN or HT), also
known as high blood pressure (HBP),
is a long term medical condition in
which the arteries is persistently
elevated.
The SBP (systolic blood pressure)
will be more than or equal of 140
mmHg and DBP (diastolic blood
pressure)
3. Key facts
An estimated 1.28 billion adults aged 30–
79 years worldwide have hypertension,
most (two-thirds) living in low- and
middle-income countries
An estimated 46% of adults with
hypertension are unaware that they have
the condition.
Less than half of adults (42%) with
hypertension are diagnosed and treated.
4. Conti…
Approximately 1 in 5 adults (21%) with
hypertension have it under control.
Hypertension is a major cause of premature
death worldwide.
One of the global targets for
noncommunicable diseases is to reduce the
prevalence of hypertension by 33%
between 2010 and 2030.
5. TYPES
Pre-hypertension:
SBP: 120-139 mmHg
DBP: 80-89 mmHg
Hypertension stage I:
SBP: 140-159 mmHg
DBP: 90-99 mmHg
Hypertension stage II:
SBP: More or equal to 160 mmHg
DBP: More or equal to 100 mmHg
Pregnancy induced HTN: because of
increased production of hormones and
enzyme during pregnancy.
6. ETIOLOGY
A number of factors increase BP,
including:-
Obesity
insulin resistance
high alcohol intake
high salt intake (in salt-sensitive patients)
aging and perhaps
sedentary lifestyle
Stress
low potassium intake
low calcium intake.
7. CONTI…..
Primary HTN:- it is the elevation in BP
without and identified Cause.
Secondary HTN:- it is the elevation in BP
with an exact cause. This type is account
for 5-10% of total cases.
The causes of secondary HTN includes:
Congenital narrowing of aorta.
Renal disease
Endocrine disorder
Neurological disorder like brain
tumor
9. RISK FACTOR
Modifiable risk factor:-
Alcohol intake
Obesity
Stress
Sedentary life style
Excessive salt intake
Non-modifiable risk factor:-
Age
Sex
Family history
Genetic
10. PATHOPHYSIOLOGY
The normal blood pressure is maintained by
four mechanisms
Sympathetic nervous system activities.
Activities of vascular endothelium.
Activities of renal system.
Activities of endocrine system.
11. SYMPATHATIC NERVOUS SYSTEM
ACTIVITIES
When the BP in decreasing the activation of SNS
activity increase the heart rate and cardiac
contraction.
The increased the heart rate and cardiac contraction
produce vasoconstriction in the peripheral arterioles
and promotes the release of renin from kidney.
The net effect of SNS activation is to increase the
arterial blood pressure by increasing cardiac output
and systemic vascular resistance.
BP= CO X SVR
12.
13. ACTIVITIES OF VASCULAR
ENDOTHELIUM
The vascular endothelium is a single cell layer
that lines the blood vessel.
It will produce vasoactive substance and growth
factors like nitric acid , endothelia etc.
These substance are potent vasoconstriction
and causes increase blood pressure level.
14. ACVITIES OF RENAL
SYSTEM
The kidneys regulate circulatory volume by
controlling sodium and water balance, thus
maintaining extracellular fluid volume (ECFV)
homeostasis. Simply put, an increase in sodium and
water consumption leads to an increase in ECFV,
which in turn increases blood volume.
15. ACVITIES OF ENDOCRINE
SYSTEM
The endocrine system is a series of glands that secrete
hormones that the body uses for a wide range of
functions, including regulating blood pressure.
Adrenal glands: If the adrenal glands make too much
aldosterone, cortisol, or hormones similar to
adrenaline, it can cause high blood pressure.
16. CLINICAL FEATURES
Severe headaches
Chest pain
Dizziness
Difficulty breathing
Nausea
Vomiting
Blurred vision or other vision changes
Anxiety
Confusion
Buzzing in the ears
Nosebleeds
Abnormal heart rhythm
18. MANAGEMENT
Mainly the management of hypertension is
possible by two ways, which includes
1. Life style modification
2. Pharmacological therapy
19. LIFE STYLE MODIFICATION
Eat more vegetables and fruits.
Sit less.
Be more physically active, which can include
walking, running, swimming, dancing or activities
that build strength, like lifting weights.
Lose weight if you’re overweight or obese.
Take medicines as prescribed by your health care
professional.
Keep appointments with your health care
professional.
20. PHARMACOLOGICAL
TREATMENT
Diuretics: it helps the kidney to inhibit the sodium
reabsorption in the distal convoluted tubules,
ascending limb and loop of henle.
Eg: chlorothiazide, furosemide.
Beta blockers: these medications reduces the
workload of the heart and blood vessels and causing
the heart to beat slowly and with less force.
Eg: Atenolol, Propanolol
21. CONTI….
Alpha blockers: These medication causes the
peripheral vasodilation of blood vessels.
Eg: Prazosin
Vasodilator: these medication acting directly on the
muscles in the wall of arteries and preventing the
muscles from tightening and arteries from narrowing.
Eg: Nitroglycerin, sodium nitro prusside
22. Conti…
ACE Inhibitors: this group of medication will
reduce the conversion of A-I to A-II and prevents
vasoconstriction.
Eg: Captopril, Ramipril
Calcium channel blockers: these medicines will
block the movement of extra cellular calcium into the
cells and causing vasodilation and decreased heart
rate.
Eg: Amlodipine, Verapamil
23. NURSING MANAGEMENT
Proper history collection should be done which
includes family history also.
Dietary habits should be assessed
Identify the medical history such as diabetes, CAD,
renal disease etc.
Instruct the patient to avoid smoking and alcoholism
Auscultate heart rate and palpate peripheral pulses.
24. CONTI….
Identify the use of medications such as
contraceptives, steroids, NSAID Etc.
Monitor vital sign frequently.
Provide diet which is low in sodium and rich with
fruits and vegetables.
Monitor the blood cholesterol level frequently.
