1. Systemic Hypertension I By Jagranzotti

2. Systemic Hypertension symptoms &signs Headache, dyspnea,dizziness, tachy-arrhythmias Encephalopathy hypertensive.( nauseas, vomiting, mental confusion seizures) at hypertensive crisis Acute pulmonary edema (rales and crakles in lungs) at hypertensive crisis systolic or dystolic murmur in aortic area Gallop rhythm (s3) Weak femural pulse palpation .in coarctation of the aorta Retinopathy(blurred vision) :on OCT hemorrages;exsudates

3. Systemic Hypertension etiology Essential Primary Hypertension Secondary Hypertension

4. Systemic Hypertension diagnosis- Lab studies Sytolic pressure > 13,5 mmHg and Dyastolic pressure > 90 mmHg stage 1 Left ventricular hypertrophy on ECG Echocardiography : Diagnosis of aorta coarctation, and evaluation of left ventricular enlargement Urinanalisys :proteinuria, hematuria, casts, could mean renal insufficiency or nephroesclerosis Abdominal Uiltrasound and RMI ( Renal diseases)

5. Systemic Hypertension essential -causes Hyperativity of symphatetic nervous system Renin- angiotensin system Decreased Natriuresis Increased sodium and calcium intracelular Exarcerbating factors : Obesity, High sodium Intake, Alcohol, hyperlipidemia,diabetes mellitus, smoking and stress

6. Systemic Hypertension Secondary -Etiology Strogen Therapy Renal Diseases ( renal insufficiency) Renal vascular Hypertension (renal artery stenosis) Pheochromocitoma Coarctation of the aorta Pregnancy NSAID

7. Systemic Hypertension Complications in untreated patients Hypertensive cardiovascular disease Hypertensive cerebrovascular disease and dementia Hypertensive renal disease Aorta dissection Atherosclerotic complications: stroke,coronary heart disease

8. Systemic Hypertension treatment non pharmacologiclife style changes sodium intake 2,5 g /day or sodium chloride 6g/day Low fat diet Weight reduction when over weight Reduction of alcohol intake aerobic activity 45 min 4 times /week Stoping smoking

9. Systemic Hypertension pharmacologic therapy Diuretics Beta adrenergic blockers Alfa adrenergic blockers Angiotensin converting enzyme Iinhibitors and other drugs therapy can reduce the risk of stroke in 50% and heart attack in 30%