This document discusses hypertension and was presented by Dr. Athar Khan of the Department of Community Medicine at Liaquat College of Medicine & Dentistry. The objectives are to classify hypertension, describe its epidemiology, and discuss prevention and control. Hypertension is defined as persistently raised blood pressure by WHO. The document discusses types and risk factors of hypertension. It also covers classification of hypertension, the concept of hypertension as an "iceberg disease," and the "rule of half" related to treatment rates. Prevention strategies discussed include targeted high-risk group approaches and population-based approaches emphasizing lifestyle changes like the DASH diet. White-coat hypertension and masked hypertension are defined in relation to office vs ambulatory blood pressure monitoring

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2. Hypertension
Dr Athar Khan
Department of Community Medicine
Liaquat College of Medicine & Dentistry
matharm@yahoo.com

3. LEARNING OBJECTIVES
• Classify Hypertension
• Describe Epidemiology of hypertension
• Discuss Prevention and Control
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6. Define Hypertension
• Hypertension, also known as high or raised
blood pressure, is a condition in which the
blood vessels have persistently raised
pressure.(WHO)
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9. Types of Hypertension
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10. Risk Factors of Hypertension
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13. Classification of Hypertension
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16. Hypertension is an Iceberg Disease
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17. Rule of Half in Hypertension
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20. 50% or Half
50% or Half
50% or Half
50%
Of the total population, 50% have hypertension both diagnosed and
undiagnosed. Only 50% out of all hypertensive cases 50% seek medical
attention. Of the total 50% of diagnosed cases, 50% take medicine and 50% do
not. Of the 50% who take medicine, only 50% are adeuately treated and the
rest 50 % are not.
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23. Prevention of Hypertension
Targeted
Approach
Population
Based
Approach
2 mm Hg general population DBP
17% incidence of hypertension
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24. Prevention of Hypertension
• High risk group is
detected
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25. Prevention of Hypertension
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26. Prevention of Hypertension
▪ The Dietary Approaches to Stop Hypertension
(DASH) eating plan is especially effective for
lowering BP.
▪ The DASH diet is rich in fruits, vegetables, whole
grains, nuts, legumes, lean protein, and low-fat dairy
products, and is markedly reduced in refined sugar,
saturated fat, and cholesterol.
▪ The combination of low sodium intake and the
DASH diet provides substantially greater BP
reduction
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37. Post Graduate Qualifications in Cardiology
• FCPS
• MCPS
• FRCP
• MRCP
• Diplomate/Fellow American Board in
Cardiovascular Diseases
• MD/MSc /Diploma in Cardiology
• Etc.
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44. Post Graduate Qualifications in Cardiology
• FCPS
• MCPS
• FRCP
• MRCP
• Diplomate/Fellow American Board in
Cardiovascular Diseases
• MD/MSc /Diploma in Cardiology
• Etc.
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50. White-coat hypertension refers to the
untreated condition in which BP is
elevated in the office, but is normal
when measured by ABPM, HBPM, or
both.
White-coat Hypertension and Masked Hypertension
Masked hypertension refers to
untreated patients in whom the BP is
normal in the office, but is elevated
when measured by HBPM or ABPM.
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51. White-coat Hypertension and Masked Hypertension
Ambulatory blood pressure monitoring provides the
average of BP readings over a defined period, usually
24 hrs.
Home blood pressure monitoring is the average of all
BP readings performed with a semiautomatic, validated
BP monitor, for at least 3 days and preferably for 6–7
consecutive days before each clinic visit, with readings
in the morning and the evening, taken in a quiet room
after 5 min of rest, with the patient seated with their
back and arm supported. Two measurements should
be taken at each measurement session, performed 1–2
min apart.
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52. WCHT can be tested in 1 of 2 ways – either as the
difference between the daily average ambulatory BP
and physician office BP or the BP change from directly
before the visit to during the visit.
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