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Hypertension

Prepared by Dr.Mustafa AlShehabat

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What is Blood Pressure? Pressure created by the heart as it pumps blood

through the arteries and the circulatory system What do Blood Pressure Numbers Mean?

Top number (Systolic)= Pressure while heart isbeating

Bottom number (Diastolic)= Pressure while heart isresting between beats

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Normal Blood Pressure

Blood Pressure of < 140/ 90

Blood Pressure of 130 to 139/ 85 to 89 should be

closely watched

High Blood Pressure

Blood Pressure > 140/ 90

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How can I tell if I have High Blood

Pressure? Usually NO SYMPTOMS!

The Silent Killer

May have:Headache

Blurry visionChest PainFrequent urination at night

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Blood Pressure Measurement Sphygmomanometer

Systolic pressure= pressure when 1st

sound isheard

Diastolic pressure= pressure when last soundis heard

Blood Pressure Cuff Size Small children and small adults

Average

Large overweight and large adults

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BPCategory

Systolic(mmHg)

Diastolic(mmHg)

Follow-up

Optimal < 120 and < 80 Recheck

2 yearsNormal < 130 and < 85 Recheck 2

years

High Normal 130-139 or 85-89 Recheck 1year

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BPCategory

Systolic(mmHg)

Diastolic(mmHg)

Follow-up

Stage 1

(mild HTN)

140-159 or 90-99 Confirm within

months

Stage 2(moderate HTN)

160-179 or 100-109 Evaluate within 1month

Stage 3(severe HTN)

180 or > or 110 or > Evaluateimmediately

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What Causes High BloodPressure? Cause unknown in 90 to 95% of cases = Primary

Hypertension

Secondary Hypertension = 5 to 10%Kidney AbnormalitiesNarrowing of certain arteries

Rare tumorsAdrenal gland abnormalitiesPregnancy

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What Causes High Blood

Pressure? Controllable Risk FactorsIncreased salt intake

Obesity

AlcoholStress

Lack of exercise

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What Causes High Blood

Pressure? Uncontrollable Risk FactorsHeredity

AgeMen between age 35 and 50

Women after menopause

Race

1 out of every 3 African Americans

Higher incidence in non-Hispanic blacks and Mexican

Americans

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Women and High Blood Pressure

Birth Control Pill Pregnancy

Overweight

After Menopause

African Americans

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How does High Blood Pressure develop?

Certain nerve impulses cause arteries to become

larger (dilate) or smaller (contract)

If vessels wide open blood flows easily

If vessel narrows pressure inside

increases causing hypertension

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What does High Blood Pressure do to my

Body?

Stroke

Congestive heart failure

Kidney failure

Heart attack

Heart rhythm problems

Aneurysm

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What Can I Do?

High blood pressure is a lifelong disease Blood pressure can be controlled not cured

Controlling blood pressure will reduce the risk of

stroke, heart attack, heart failure and kidney

disease

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What Can I Do?

Loose weight if your overweight Get regular physical activity

Avoid excessive alcohol

Stop smoking

Manage your stress

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What Can I Do?

Decrease salt intake Eat for heart health

Discuss the use of oral contraceptives with your

doctor

Discuss the use of some medications with yourdoctor

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Ten Commandments for Blood

Pressure Control Know your blood pressureHave it checked regularly

Know what your weight should beKeep it at that level or below

Dont use excessive salt in cooking or at mealsAvoid salty foods

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Ten Commandments for Blood

Pressure Control Eat a low-fat dietAccording to AHA regulations

Dont smoke cigarettesOr use tobacco products

Take your medicine exactly as prescribedDont run out of pills even for a single day

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5

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Ten Commandments for Blood

Pressure Control Keep your appointments with the doctor

Follow your doctors advice about exercise

Make certain family members have their blood

pressure checked regularly

Live a normal life in every other way!

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Medication for High Blood

Pressure DiureticsRid the body of excess fluids and salt

Beta-blockersReduce the heart rate and the work of the heart

Calcium antagonistsReduce heart rate and relax blood vessels

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Medication for High Blood

Pressure Angiotensin II receptor blockers(ACE)Interfere with the bodies production of angiotensin,

a chemical that causes the arteries to constrict

(narrow)

VasodialatorsCause the muscle in the wall of the blood vessels to

relax, allowing the vessel to dialate (widen)

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Medication for High Blood

Pressure Sympathetic nerve inhibitorsSympathetic nerves go from the brain to all parts of

the body, including the arteries

Cause arteries to constrict raising blood pressure

These drugs reduce blood pressure by inhibitingthese nerves from constricting blood vessels

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Home Blood Pressure Monitoring Mercury sphygmomanometer

Standard for BP monitoringNo calibration

May be bulky

Need a second person to use machine

May be difficult for hearing impaired or patients witharthritis

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Home Blood Pressure Monitoring Aneroid equipmentInexpensive, lightweight and portable

Two person operation/need stethoscope

Delicate mechanism, easily damaged

Needs calibration with mercury sphygmomanometer

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Home Blood Pressure Monitoring Automatic equipment

Contained in one unitPortable with easy-to-read digital display

Expensive, fragile

Must be calibrated

Requires careful cuff placement