HYPERTENSION

 Hypertension is a chronic
condition of concern due to
its role in causation of
coronary heart disease,
stroke and other vascular
complications
It is one of the major risk
factors for cardiovascular
mortality,which accounts
for 20-50% of all deaths
WHAT IS BLOOD
PRESSURE?
• The force of blood against the wall of the
arteries.
• Systolic- as the heart beats
• Diastolic - as the heart relaxes
• Written as systolic over diastolic.
• Normal Blood pressure is less than 130 mm Hg
systolic and less than 85 mm Hg diastolic.
HIGH BLOOD PRESSURE
• A consistent blood pressure of 140/90
mm Hg or higher is considered high
blood pressure.
• It increases chance for heart disease,
kidney disease, and for having a stroke.
• 1 out of 4 Americans have High BP.
• Has no warning signs or symptoms.
 CATEGORIES OF HIGH
BLOOD PRESSURE

High Blood Pressure (mm of Hg)

• Pre hypertension 120-139/80-90
• Stage 1 140–159 /90–99
• Stage 2 160–179 /100–109
• Stage 3 180 /110
EPIDEMIOLOGY

• In Pakistan there are 10.8 million

hypertensive (national health survey,1994)
and according to 1998 estimates 12 million
suffer from hypertension.
• More than 70% are not aware that they are
suffering from HTN ,as compared to 30% in
the USA .
• Only 3% are adequately controlled.
• More than 17.9% above the age of 15.
• 1 in 3 person above the age of 45 suffers
from high blood pressure
• Any level of HTN is directly related to
increased morbidity and mortality.
 CLASSIFICATION OF
HYPERTENSION
Primary – 90-95% of cases – also termed
“essential” of “idiopathic”
Secondary – about 5% of cases
 Renal or renovascular disease
 Endocrine disease
▪ Phaeochomocytoma
▪ Cushings syndrome
▪ Conn’s syndrome
▪ Acromegaly and hypothyroidism
 Coarctation of the aorta
 Iatrogenic
▪ Hormonal / oral contraceptive
▪ NSAIDs
Department of General
Practice QUB
RISK FACTORS FOR
HYPERTENSION

Non-modifiable risk factors

Modifiable risk factors
MODIFIABLE RISK FACTORS
1. Obesity
2. Salt intake
3. Saturated fat
4. dietary fiber
5. Alcohol
6. Heart disease
7. Physical activity
8. Environmental stress
9. Socio economic status
10.Other factors like OCPS,Noise,Viberation
PREVENTION OF
HYPERTENTION

1. PRIMARY PREVENTION
2. SECONDARY PREVENTION
PRIMARY PREVENTION

a)Population strategy
1)Nutrition
2)weight reduction
3)exercise promotion
4)behavioral change
5)health education

b)High risk strategy

 POPULATION STRATEGY
Nutrition
Dietary changes are of paramount importance.

These comprise of
1. Reduction of salt intake to an average of not more than
5g/day
2. Moderate fat intake
3. Avoid high alcohol intake
4. Restriction of energy intake appropriate to body needs
 WEIGHT REDUCTION

The prevention and correction of

obesity
EXERCISE PROMOTION
• Regular exercise leads to fall in
body weight, blood lipids as
well as blood pressure.
BEHAVIORAL CHANGE
Reduction of stress, smoking ,modification of life
style.
HEALTH EDUCATION
 The general population requires advice on all risk factors
and related health behavior.

SELF CARE
 Patient should be educated how to take his own blood
pressure and keep its record.
HIGH RISK STRATEGY

The aim of this approach is to

prevent the attainment of levels
of blood pressure at which
institution of treatment would be
considered.
SECONDARY PREVENTION
OF HYPERTENSION

Early case detection and

remove the cause.
Treatment
Patient compliance
DRUG THERAPY
1. DIURETICS
2. Ca CHANNEL BLOCKERS
3. ACE INHIBITORS
4. ARB
5. BETA BLOCKERS
6. NO ANTI HYPERTENSIVE IS AN IDEAL DRUG IT
VARRIES FROM CASE TO CASE