2. INTRODUCTION
• Hypertension (high blood preassure) also
called silent killer is a chronic medical condition
characterized by constant elevation of the systolic
or diastolic pressure above 140/90 mmHg.
• Because hypertension is almost
without symptoms except for headaches in some
patients, it hides in the body without knowing it.
•The fact that hypertension is asymptomatic makes it
difficult for patients to accept the diagnosis and comply
with treatment.
3. In India more than over 140 million people
are believed to be suffering from high blood
pressure in the country and the number is
expected to cross the 214 million mark in
2030.
Hypertension is a major risk factor for
cardio-vascular diseases.
INTRODUCTION
4. OBJECTIVES
At the end of this presentation you should
understand
Define,classify and diagnosis of
hypertension
Types of HT
Identify risk factors &complications
Treatment guidelines
Complications and prevention methods
5. DEFINITION
Hypertension is defined as a systolic blood
pressure (SBP) of 140 mm Hg or more, or a
diastolic blood pressure (DBP) of 90 mm
Hg.
6. Blood pressure is the force applied against the walls of
the arteries as the heart pumps blood through the body.
The pressure is determined by the force and amount of
blood pumped and the size and flexibility of the arteries.
15. TYPES
Primary Hypertension-unknown
etiology
Secondary Hypertension-due to some
other medical condition
Hypertension in pregnancy
Malignant Hypertension with end
organ damage
Paraoxysmal Hypertension
16.
17.
18.
19. SIGNS AND SYMPTOMS
Severe headache
Nausea or vomiting
Bad headache
Confusion
Changes in your vision
Nosebleeds
21. Measurement of BP
The patient must be properly prepared
and positioned
Caffeine,exercise and smoking should
be avoided for atleast 30 minutes
before.
Average of atleast three readings on
three different occassions should be
recorded.
29. A-B-C-D Blood Pressure
Medications:
A: ACE inhibitors (angiotensin converting enzyme)prevent the formation
of the hormone angiotensin 2 which causes blood vessels to become
narrow making the vessels relax, becoming wider, lowering your blood
pressure.
B: Beta Blockers reduce nerve impulses to the heart and blood vessels
making the heart beat slower with less force to drop your blood pressure
and the heart doesn't work a hard.
C: Calcium channel blockers block calcium from entering the muscle cells
of the heart and blood vessels making them relax and lowering your blood
pressure.
D: Diuretics, or water pills, work in the kidney by flushing out excess water
and sodium from the body.
30.
31. Beta Blocker
ATENOLOL
Decreases myocardial contractility
Fall in cardiac output
Decreases blood pressure
Additionally it reduces renin secretion
Dosage-
Atenolol 25-100mg once daily
33. ACE INHIBITORS
Enalapril
Acts by inbiting the conversion of
angiotensin 1 to angiotensin 2 thus
preventing the vasoconstriction
Used in diabetics.
Dosage
Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally
per day in 1 to 2 divided doses.
34. Side effects-
First dose hypotension
Dry cough
Urticaria
Contraindiation
Renal failure
Pregnancy
ACE INHIBITORS
35. CALCIUM CHANNEL BLOCKER
Amlodipine
Acts by relaxing the smooth muscle in
the arterial wall, decreasing total peripheral
resistance thereby reducing blood pressure;
in angina, amlodipine increases blood flow
to the heart muscle.
Initial dose: 2.5 -5 mg orally once a day
Maintenance dose: 5 to 10 mg orally once a
day
39. TREATMENT IN DIABETICS
Blood Pressure No diabetes Diabetes No diabetes Diabetes
Optimal <140/85 <140/80 <130/80 <130/75
Audit Standard <150/90 <140/85 <140/85 <140/80
Measured in clinic Mean daytime ABPM
or home measurement
