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Understanding Blood Pressure & Hypertension

Learn about blood pressure, its measurement, regulation, and the different types of hypertension. Discover the signs, symptoms, complications, diagnosis, and treatment options for this chronic medical condition. Also, explore preventive measures to maintain a healthy blood pressure level.

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Understanding Blood Pressure & Hypertension

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  1. BLOOD PRESSURE & HYPERTENSION Dijana Vidović Mentor: A. Žmegač Horvat

  2. Blood pressure • Force exerted by circulating blood on the arterial walls • One of principal vital signs • Maximum (systolic) pressure – pressure in the artery when the left ventricle is contracting to force the blood into aorta and other arteries • Minimum (diastolic) pressure – pressure in the artery when the ventricles are relaxing and the heart is filling up, receiving blood from veins • Sphygmomanometer

  3. SPHYGMOMANOMETER • Uses the height of a column of mercury to reflect the circulating pressure • Blood pressure values – millimeters of mercury(mm/Hg) • Aneroid and electronic devices do not use mercury

  4. sphygmomanometer

  5. Sphygmomanometer

  6. BLOODPRESSUREVALUES

  7. REGULATIONOFBLOODPRESSURE • Baroreceptor reflex – changes in arterial pressure – medulla (brain stem) • Location : left and right carotid sinuses, aortic arch • Renin – angiotensin system (RAS) • Long – term adjustment of arterial pressure • Kidney - compensation • Endogenous vasoconstrictor – angiotensin I • Aldosterone release (adrenal cortex) • Stimulates sodium retention and potassium excretion by the kidney • Increases fluid retention and indirectly arterial pressure

  8. HYPERTENSION • Chronic medical condition in which blood pressure is elevated • Systemic, arterial hypertension • Essential (primary) hypertension • Secondary hypertension

  9. PRIMARYHYPERTENSION • No medicalcause • Riskfactors : • Sedentarylifestyle • Obesity ( bodymassindexgreaterthan25) • Salt ( sodium) sensitivity • Alcohol, smoking • Familyhistory

  10. SECONDARYHYPERTENSION • High blood pressure is a result of another condition • Adrenal cortical abnormalities : • Cushing’s syndrome ( adrenal glands overproduce the hormone cortisol) • More than 85 % of patients with Cushing’s syndrome have hypertension • Primary aldosteronism( overproduction of aldosterone by adrenal glands) • Aldosteronism causes sodium and water retention, potassium excretion in the kidneys - arterial hypertension • Diseases of the kidney (polycystic kidney disease – genetic disorder of the kidneys) • Diseases of the renal arteries supplying the kidney – RENOVASCULAR HYPERTENSION • Neuroendocrine tumors (pheochromocytoma) • Medication side effects (NSAID)

  11. pathophysiology • Inability of the kidneys to excrete sodium • An overactive renin – angiotensin system, vasoconstriction and retention of sodium and water – hypertension • An overactive sympathetic nervous system

  12. SIGNSANDSYMPTOMS • No symptoms – many people unaware they have hypertension, accidentally found; complications: • Non–specific symptoms – mild symptoms • Headache • Morning headache • Tinnitus – ringing in ears • Dizziness • Confusion • Fatigue • Shortness of breath • Changes in vision - blindness • Nausea

  13. SIGNSANDSYMPTOMS • Anxiety • Nose bleeds • Heart palpitations • Flushed skin • Pale skin • Chest pain

  14. COMPLICATIONSOFHYPERTENSION

  15. DIAGNOSIS • History • Physical examination • Measuring blood pressure – diagnosis of hypertension is based on a persistently high blood pressure

  16. TREATMENT • Antihypertensive drugs – act by lowering blood pressure • Aim of treatment - <140/ 90 • Reduction of blood pressure by 5-6 mm/Hg decreases the risk of stroke by 40%, coronary heart disease by 15- 20%, heart failure and mortality from vascular disease • Groups of antihypertensive drugs: • ACE inhibitors (captopril, ramipril, lisinopril) • Angiotensin II receptor antagonist (losartan, valsartan) • Calcium channel blockers (amlodipine) • Diuretics (hydrochlorothiazide) • Additional diuretics such as furosemide or spironolactone • Alpha blockers • Beta blockers (atenolol, propranolol) • Renin inhibitors (aliskiren)

  17. PREVENTION • Weight reduction • Aerobic exercise (e.g. walking) • Reducing sugar intake • Reducing sodium (salt) • Fruits, vegetables • Lowfat or fatfree food • Stopping smoking • Reducing stress (relaxation therapy – meditation)

  18. conclusion • High blood pressure - major public health problem • Affects approximately one in three adults in the United States – 73 million people • Affects about 2 million American teens and children (many underdiagnosed) • Normalize blood pressure and prevent complications!

  19. references • http://en.wikipedia.org/wiki/Blood_pressure • Kumar P. i sur. Clinical medicine VI izd. Elsevier- Saunders, Edinburgh 2005 • Vrhovac B. i sur. Interna medicina IV izd. Naklada Ljevak, Zagreb 2008

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