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Hypertension

Hypertension. Blood Flow. www.sdm.scot.nhs.uk/images/pfo.jpg. Blood Pressure. Measure of pressure exerted on the wall of the blood vessels Measure of the pressure exerted when heart contracts Normal: Contraction = systole = 105-139mmHg Relaxation = disystole = 70-90 mmHg

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Hypertension

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  1. Hypertension

  2. Blood Flow www.sdm.scot.nhs.uk/images/pfo.jpg

  3. Blood Pressure • Measure of pressure exerted on the wall of the blood vessels • Measure of the pressure exerted when heart contracts • Normal: • Contraction = systole = 105-139mmHg • Relaxation = disystole = 70-90 mmHg • Hypertension greater than 140/90 mmHg • Symptoms --- often none

  4. How controlled • Controlled by mechanism in kidney • Blood flow through kidney • Cells sense the decreased volume, pressure and sodium • Produce a enzyme call “renin” • Renin breaks down protein to form angiotensin I • Angiotension I converted to Angiotensin II by another enzyme called “Angiotension Converting Enzyme” or ACE • Angiotension II increase BP and bring water and sodium into blood

  5. Types of Hypertension • Essential • No identifiable cause • Both systolic reading and disystolic readings are high • Systolic • Fewer cases/ more often in elderly • Systolic reading elevated • Secondary • Kidney disease • Cushings disease • Diabetes • Pre-eclampsia

  6. Prevalence • Less in more physically active group • When controlled for activity, income, smoking, smoking, weight, Black had odds ratio of 1.77 compared to whites (0.73) (Bassett et.al, 2002) • Higher percentage of hypertension in the Southeast- (Hall et.al, 1997) (Glover et.al, 2002) • Black men 35%; Black women 37.7% (40.5%) • White men 36.5%; White women 21.5% (27.4%) • Why? • Obesity– 25% • Diet high in sodium and fat • Lack of education • Access and utilization of health care

  7. Complications • Earlier onset • Stroke- 80% higher stroke mortality • Heart Disease– 50% higher heart disease mortality • Kidney Failure—320% greater End Stage Kidney Disease

  8. Treatment • Diet • Exercise • Drugs • Diuretics– AKA “water pills” • Beta Blockers—block receptors on heart to reduce the contractions • ACE inhibitors • Ca channel blockers • Angiotension II inhibitors

  9. Why more prevalent in African Americans? • Decreased renin • Stress • Genetics • Adaptation • Food • Lack of exercise

  10. Centers for Disease Control

  11. References • Hall, et. al. (1997) Hypertension-related morbidity and mortality in the southeatern United States • Glover et al. (2005) Racial/ethnic disparities in prevalence, treatment, and control of hypertension, MMWR weekly, January 14, 54, 7-9 • National Institutes of Health, Joint National Committee on Prevention , Detection, Evaluation and Treatment of High Blood Pressure (1999), http:// www.ncbi.nlm.nih.gov.

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