Hypertension

1. Hypertension By: Samantha Pell

2. What is Hypertension? • Means the pressure created by the blood in the arteries is too high • Condition commonly called “silent killer”

3. What is blood pressure? • Nervous system – maintains blood pressure • Adjusts the size of the blood vessels and influences the hearts pumping action • Kidneys – regulate blood pressure • Adjusts mechanisms that change the blood volume • Blood pressure – determined by 2 factors • The force of the heart pumping blood to the body • Arteries resistance to blood flow • Blood pressure is made up of a combination • systolic pressure & diastolic pressure • Systolic pressure – blood pressure measured in the arteries as the heart contracts and pumps blood into the blood vessels • Marks maximum pressure in arteries • Diastolic pressure – blood pressure measured in the arteries between heart beats when the heart relaxes • Marks minimum pressure in arteries • First higher number in BP reading – systolic pressure • Second lower number in BP reading – diastolic pressure • Unit of measurements – millimeters of mercury (mmHg) • Represents column of mercury used in blood pressure gauges • the Higher the blood pressure - longer the condition of Hypertension persists • greater the damage

4. Blood Pressure Category Systolic Diastolic Normal up to 120 & up to 80 Pre hypertension 120 – 139 or 80 – 89 Hypertension Stage 1 140 – 159 or 90 – 99 Stage 2 160 – 179 or 100 – 109 Stage 3 180 and up or 110 and up • only one number need to be high to have hypertension, systolic or diastolic

5. What causes Hypertension? • No identifiable medical cause - different factors per different people • High levels of insulin – development of hypertension - Most likely to occur in people with diabetes mellitus type II • Age – Adults over 60 - sedentary lifestyle • Heredity – If close relatives (parents ) suffer • Gender – men - younger adulthood and early middle age – women - after age of 60 • Obesity – precipitates hypertension - Causes extra miles of capillaries for blood to be pumped • Smoking, stress, alcoholism • Diet – high in salt or saturated fat • Genetic factors - Family history of: hypertension , stroke, heart attack or kidney failure, use of contraceptive pills, steroids or decongestants

6. How do you know if you have it? • Normally has no visible symptoms in early stages • Symptoms typically appear after complications or damage have already occurred • In some cases (severe hypertension): • Sever headaches • Fatigue or confusion • Sleeping disorders • Vision problems • Chest pain • Difficulty breathing • Irregular heart beat • Blood in urine • Obesity • High LCD cholesterol • High blood pressure • Dizziness

7. Diagnosis • Check blood pressure • Checks need to be repeated over time to be confirmed • Physical exam • Tests to look for blood in urine or heart failure • Doctor will look for signs of complications in: heart, kidneys, eyes, other organs in body • Tests include: chem-20, echocardiogram, urinalysis, x ray of kidneys

8. How can Hypertension be prevented? • Exercise - 25 – 50 % lower risk of hypertension • Hypertension from unknown causes • Not preventable at present • Obtain frequent blood pressure checks • If detected early – treatment – diet, exercise, stress management, medication – can prevent complications • 30% of hypertension cases attributes to genetic factors • Those with hypertensive parents are two times as likely to get it

9. How to treat • Can be controlled with medicine and lifestyle changes • see your physician regularly • use standard medicines as necessary • DON’T take non prescription cold and sinus remedies , contain drugs that raise BP • adopt the specially modified DASH diet • exercise regularly to maintain your ideal weight • reduce alcohol intake to a reasonable level • cut back on caffeine • say goodbye to smoking and tobacco • distress your life by practicing relaxation techniques • Learn to take own BP • Seek medical advice about any lifestyle changes

10. Medication • Doctor will account variety of factors to establish which type is best • Often doctors will recommend multiple drugs • May take experimenting to find best medication • Medication works best with lifestyle changes • 20% of patients do not respond positively to any medication treatment • Blood pressure lowering medication is injected right into blood stream during an emergency • Medications – vasodilators, alpha & beta blockers and ACE inhibitors when to go to prescription • over the age of 60 • male • postmenopausal woman

11. What does it lead to? • uncontrolled HB – increases risk of stroke, heart attack, heart failure, kidney failure, eye problems cardiovascular complications • narrowing of the arteries (arteriosclerosis) • fatty substances – build up on artery’s inner lining – hardening and thickening it • buildup – plaque – reduces blood flow through arteries • expansion of main artery (aortic aneurism) • bulge in aorta – may burst • usually occur in abdomen – below kidneys also in chest • thickening of the hearts left chamber ( left ventricular hypertrophy) • higher pressure in blood vessels – increase hearts workload • may lead to heart failure • all may damage vital organs brain • stroke – blood flow to brain cut off • brain cells die – possible brain damage • hypertension increases risk of stroke by 4 – 6 times • two types of strokes • ischemic stroke – clots from blood vessels to brain block blood flow to brains cells – or when too much plaque clogs blood vessels • hemorrhagic stroke – blood vessels in brain breaks or ruptures – blood seeps to brain tissue – damage to brain cells • HBP and brain aneurisms – most common cause

12. What does it lead to? Heart • Hypertensive heart failure – hearts pumping power – weaker than normal • Blood moving through hearts and arteries slower – pressure in heart increases • Result – heart cannot pump enough oxygen and nutrients • Heart chamber stretch as response to hold more blood • Heart muscle walls weaken – not able to pump as strongly • Kidneys then cause body to retain fluid and sodium • Causes body to become congested – leads to congestive heart failure • Symptoms of heart failure – shortness of break, swelling in the feet, ankles or abdomen, fatigue, greater need to pee at night Kidneys • Hypertension – weakens/narrows blood vessels in the kidneys • Affects function of waste removal Eyes • Hypertension – damages blood vessels in retina – hypertensive retinopathy – may lead to damage to eyesight / possible loss of vision • May cause headaches – vision problems if sever • Hypertension – may reduce ability to think, remember and learn • Uncontrolled HBP – linked to cognitive decline and senile dementia

13. Types of Hypertension Secondary hypertension • Accounts for 5% hypertension cases • Diagnose when HBP caused by a specific disease in body’s organs or systems • May be cured if cause is dealt with Renal hypertension • Kidneys unable to get rid of salt and other wastes in a normal way • Blood vessels may be scarred or tightened • Narrowing of renal artery • Leads to release of hormones Adrenal • Caused by glad tumors (pheochromocytoma) • Rare tumor of the adrenal glands • Less common type of hypertension • Causes excessive amounts of adrenal hormones Co Aration of the aorta • Rare hereditary disorder • Main large artery from heart is narrowed • Usually detected and treated in childhood • Most common cause in children

14. Types of Hypertension Hypertension during pregnancy • 12 – 22 % of pregnancies • After 20th week • Arteries in body and placenta tighten • Unpredictable blood clotting may result • Untreated – serious complications to mother and baby Isolated systolic hypertension • Caused by blood vessels losing elasticity • Occurs when systolic pressure is above 140 mmHg • May lead to stroke and heart disease High systolic BP • just as dangerous as diastolic BP White coat hypertension • When HBP is misread at the doctors office • Caused by anxiety during examination – temporary symptoms of stress • Should be dealt with cautiously • May be absolutely harmless – should be aware that other stressful situations could cause the same results • If suffering – monitor BP from home

15. Types of Hypertension Labile Hypertension • Abrupt and repeated fluctuation of BP • Effects those with high emotion stress • Treated by medication for lowering anxiety Malignant hypertension • Rasies BP to dangerous levels • Most threatening form of hypertension • Extremely rare • Causes unknown- but sometimes related to drug abuse • Calls for immediate hospitalization Accelerated progressive • marked by changes of malignant hypertension Borderline • arterial BP when in nomotensive range or hypertensive range Chronic thromboembolic pulmonary • obstruction of a major pulmonary artery

16. Types of Hypertension Essential • occurring without cause Familial dyslipidemic • inherited Goldblatt • experimentally enduced Idiopathic • Essential Low-rennin • essential Secondary • due to primary diseases Splenoportal • results in anlargment of liver Systemic venous • detected by inspection of the jugular veins

17. Types of Hypertension Intracranial • a few neurologic symptoms Hypertensive • increase tension of pressure, causes hypertension

18. Sources Photos • http://rosenblumtv.files.wordpress.com/2007/12/hypertension.jpg • http://images.jupiterimages.com/common/detail/05/03/23240305.jpg Points • “Medicweb Hypertension”. http://hypertension.medicweb.org/(13,April.2008). • Dorland’s Illustrated Medical Dictionary Over 100 Years in Print 30th Edition Saunders, Philadelphia The Curtis Center Independence Square West Philidalphia, PA 10196 • Houston, Mark. Fox, Barry. Taylor, Nadine. What Your Doctor May Not Tell You About Hypertension. New York: Warner Books, Inc. 2003. • Weinrauch, Larry A. “High Blood Pressure (Hypertension)” http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm(6/4/2007). • “Hypertension(High Blood Pressure).” www.mdadvice.com/library/symp/illness287.html(13,April,2008).