HYPERTENSION(regular);

1) INTRODUCTION : Hypertension is a blood pressure(BP) persistently equal to or greater than 140/90mmHg( Note: the upper value is called systolic BP while the lower is the diastolic BP, both measured in mmHg i.e millimeters of mercury) and is categorized/graded as follows;

CATEGORY Normotension; (1)Optimal ; (2)Normal ; (3)High Normal(prehypertensive) ; Hypertension; (4)Grade 1 (mild) (5)Grade 2 (moderate) (6)Grade 3 (severe)

BLOOD PRESSURE(mmHg)

Less than 120/80 Less than 130/85 130/85 139/89

140/90 149/99 160/100 179/109 Equal-to or greater-than 180/110.

Note;there are instances whereby only the systolicBP is elevated beyond normal

2)TYPES OF HYPERTENSION( & PREDISPOSING FACTORS); *Essential Hypertension. *Secondary Hypertension. 2.1) Essential Hypertension; In this case the cause is unknown. The majority (>90%) of adult patients with hypertension have this and can be ameliorated only by life-long drug use. It tends to occur in individuals with; a)Positive family history of hypertension(esp. in siblings and parents). b)Obesity. c)Excessive alcohol intake. d)High sodium(salt) intake. e)Low birthweight, due to poor nutrition and care during pregnancy. f)Diabetes Mellitus. g)Acute pain, physical or emosional stress can worsen an hypertensives BP and transiently increase the BP of an hitherto normotensive individual. 2.2)Secondary Hypertension: This is when blood pressure elevation is caused by a known and potentially treatable condition, such as; a)Kidney diseases; this is the most common cause. b)Hormonal/Endocrine causes e.g acromegaly. c)Congenital heart diseases. d)Drugs e.g oral contraceptives, steroids, NSAIDS.

e)Pregnancy; this is known as pregnancy induced hypertension.It presents during the second half of pregnancy and usually resolves after delivery. When detected in the first half of pregnancy or persisting after delivery, It is usually due to pre-existing essential hypertension. Hypertension in Pregnancy is one of the leading causes of maternal death, thus emphasizing the importance of antenatal care.

3) PREVENSION OF HYPERTENSION; This is especially important for prehypertensive individuals, those with positive Family history &/or a combination of other predisposing factors. a) Reduction of salt intake. b) Abstainance from cigarette smoking. c) Reduction of alcohol consumption. d)Weight loss. e) Regular exercise and adequate stress management. f) Consumption of diet adequate in minerals and vitamins by taking more of fresh fruits and vegetables. g) Reduction of cholesterol and saturated fat in diet by reducing the intake of red meat(beef, goat-meat), fat and canned food.Rather, take fish,bush-meat, chicken(with its skin removed), snail and rabbit meat. g) Regular BP check-up.

4) DIAGNOSIS OF HYPERTENSION; 4.1) Symptoms; There are no symptoms but sometimes patients complain of non-specific symptoms e.g headache. However symptoms such as headache, epistaxis, nocturia, breathlessness, disorientation, visual disturbances, fits, transient or complete loss of consciousness e.t.c occur when complications have developed. 4.2)Investigations; This is basically by the assessment of an individuals BP using a sphygmomanometer, though investigations such as electrocardiography, serum E/U/Cr assay, blood sugar test, urinalysis, chest x-ray and several others might need to be done for the detection of complication and assessment of the cause of the high blood pressure(in case of secondary hypertension) for adequate management.

5)MANAGEMENT OF HYPERTENSION; 5.1)Drug treatment; This consist of the use of antihypertensives. It should be noted that drug use is for life(in treating essential hypertension) and adhering to your doctors prescriptions (and dosage) only is very important. 5.2)Supportive treatment; These are same as the preventive principles outlined above(no 3) and should be adhered to, to ensure an optimal BP control. This is also all that is needed in treating grade 1(mild) hypertension. 5.3)Treatment of underlying cause of high BP; This is applicable only in the treatment of secondary hypertension.

6)COMPLICATIONS OF HYPERTENSION; a)Stroke. b)Heart failure. c)Kidney failure. d)Transient ischaemic attack. e)Bleeding into the brain(Subarachnoid haemorrhage), e.t.c.

7)CONCLUSION;

References; Harrisons Principle of Internal Medicine 16th Edition Textbook of Internal Medicine. Kumar and Clark Textbook of Tropical Medicine by Falase.

Compiled by; Dr Adewumi Ayobanji OluyomiCode; OD/11A/0984. Email;ucornonline@yahoo.com...Phone;08036362815. (NYSC/MDGs Community Development Project, 2011).