hypertension فشار بلند ابتدایی

الرحمن الله بسمالرحيم

Design by:Mohammad Mujtaba(Daqiq)

مجتبی

What is blood pressure?

Measures force of blood in the arteries

High blood pressure (HBP) = hypertension (HTN)

How is BP measured?

Blood pressure cuffmm mercury2 numbers shown as a fraction

Systolic/Diastolic Ex. 120/80

Systolic

The top number in blood pressure readingsMeasures the pressure in arteries when

heart is beating

Diastolic

The bottom number in blood pressure readings

Measures pressure when heart is at rest

HypertensionDefinition

Hypertension is sustained elevation of BP Systolic blood pressure 140 mm Hg Diastolic blood pressure 90 mm Hg

HypertensionComplications

Cerebrovascular Disease• Stroke

Peripheral Vascular Disease Nephrosclerosis Retinal Damage

HypertensionComplications

Hypertensive Heart Disease

• Coronary artery disease• Left ventricular hypertrophy• Heart failure

Hypertension: Complications

Complications are primarily related to development of atherosclerosis (“hardening of arteries”), or fatty deposits that harden with age

Left Ventricular Hypertrophy

Fig. 32-3

Kieran McGlade Nov 2001Department of General Practice QUB

This left ventricle is very thickened (slightly over 2 cm in thickness), but the rest of the heart is not greatly enlarged. This is typical for hypertensive heart disease. The hypertension creates a greater pressure load on the heart to induce the hypertrophy.

Kieran McGlade Nov 2001Department of General Practice QUB

The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy.

Hypertension

For persons over age 50, SBP is more important than DBP as a CVD risk factor

Starting at 115/75 mmHg, CVD risk doubles with each increment of 20/10 mmHg throughout the BP range

HypertensionComplications

The common complications are Target organ diseases occurring in the

HeartBrainKidneyEyes

جاوید

Who is at risk for HBP?

Individuals With Family History Parents, brother, sister

Increasing ageGender

Women - after menopause Early middle age more common in men

Race More common among blacks (Occurs earlier)

These factors are beyond our control.

Risk Factors

Factors Within our Control Excess weight

Increases volume of blood Increases pressure/resistance that heart has to pump

against---enlarged heart muscle Inactivity

Heart is not used to “work” = heart beats harder/faster = more force on arteries = uses more oxygen per beat = higher heart rate at rest

Tobacco use Can lead to damage of artery wall, increases heart rate,

encourages narrowing of arteries Stress

Causes unpredictable blood pressure and pulse increases along with potential inflammation in the vessel walls.

Risk Factors

More Factors Within Our Control Sodium intake

Leads to more fluid/water in the vessels = increased blood pressure

Low potassium intake Potassium helps balance sodium in

cells and control heart rhythm Excessive alcohol

Long term: damages liver and pressure within our circulation and heart.

How do I know if I have it?

Very few people experience symptoms. This is a silent disease.

Damage is done before symptoms develop.

Some symptoms may be: Headaches Dizzy spells More nosebleeds than normal

This is why we screen for HBP!

Risk Factors for Primary Hypertension

Age (> 55 for men; > 65 for women)AlcoholCigarette smokingDiabetes mellitusElevated serum lipidsExcess dietary sodiumGender

Risk Factors for Primary Hypertension

Family historyObesity (BMI > 30)Ethnicity (African Americans)Sedentary lifestyleSocioeconomic statusStress

شفیع

Blood Pressure Classification

BP Classification SBP mmHg DBP mmHg

Normal < 120 and < 80

Pre-hypertension* 120-139 or 80-89

Stage 1 Hypertension 140-159 or 90-99

Stage 2 Hypertension > 160 or > 100

*newly recognized, requiring lifestyle modifications

Classification of Hypertension

Primary Hypertension- Contributing factors:

• SNS activity • Diabetes mellitus

• Sodium intake • Excessive alcohol intake

Classification of Hypertension

• Secondary Hypertension- Contributing factors:

• Coarctation of aorta• Renal disease• Endocrine disorders• Neurologic disorders

- Rx: Treat underlying cause

Classification of Hypertension

Primary (Essential) Hypertension- Elevated BP with unknown cause- 90% to 95% of all cases

Secondary Hypertension- Elevated BP with a specific cause- 5% to 10% in adults

HypertensionDiagnosis

• Diagnosis requires several elevated readings over several weeks (unless > 180/110)

• BP measurement in both arms- Use arm with higher reading for subsequent measurements

HypertensionDiagnosis

Ambulatory BP Monitoring For “white coat” phenomenon, hypotensive or

hypertensive episodes, apparent drug resistance

Supporting Materials

Website www.nhlbi.nih.govFor patients and the general public

• Facts About the DASH Eating Plan• Your Guide to Lowering Blood Pressure

• For health professionals• Reference Card

پايانThanks,for you

Design by:Mohammad Mujtaba(Daqiq)