Hypertension Overview and Management

Blood Pressure Basics

• Normal Blood Pressure: Commonly referenced values are 120/80 mmHg or 120/70 mmHg.

• Hypertensive Values:

  • Stage 1 Hypertension: 130/80 to 139/89 mmHg

  • Stage 2 Hypertension: 140/90 mmHg and above

• Hypotension: A value like 70/40 mmHg indicates hypotension.

Types of Hypertension

• Primary Hypertension:

  • Accounts for 90-95% of cases.

  • No identifiable cause, commonly develops gradually.

  • Risk factors include age, smoking, alcohol consumption, obesity, and genetics.

• Secondary Hypertension:

  • Caused by another condition, such as kidney disease.

  • Less common but identifiable through underlying issues.

Risk Factors for Primary Hypertension

• Age: More common in men over 45 and women over 65.

• Smoking: Raises blood pressure and damages artery walls.

• Alcohol Consumption: Excessive drinking raises blood pressure, should be limited to 2 drinks per day for men and 1 for women over 65.

• Obesity: More body weight means more blood is needed, which can raise blood pressure.

• Physical Inactivity: Lack of exercise weakens the heart and circulation.

• High Sodium Diet: Increases fluid retention, leading to higher blood pressure.

• Genetics: Family history increases risk; certain ethnicities (like African Americans) may have salt sensitivity.

Signs and Symptoms of Hypertension

• Often referred to as a silent killer, symptoms may not present until levels are significantly high (headaches, blurred vision, dizziness).

Factors Influencing Blood Pressure

• Cardiac Output (CO):

  • Formula: CO = Stroke \, Volume imes Heart \, Rate

  • Increased CO raises blood pressure.

• Peripheral Vascular Resistance (PVR):

  • Influenced by blood vessel constriction; greater resistance raises blood pressure.

• Heart Rate (HR): Elevated heart rates can indicate problems if persistently high.

• Stroke Volume: The amount of blood pumped with each heartbeat; lower stroke volume means the heart is compensating.

Stabilizing Mechanisms

• Arterial Baroreceptors: Detect changes in pressure and help regulate heart rate and vascular resistance.

• Renin-Angiotensin-Aldosterone System: Regulates blood pressure and fluid balance, releasing renin in response to low blood flow.

• Vascular Autoregulation: Ensures tissues receive adequate blood flow despite changes in systemic pressure.

Diagnosing Hypertension

• Annual Check-Ups: Regular blood pressure measurements essential as many people remain asymptomatic until serious complications arise.

• Diagnostics:

  • Urinalysis, Blood Urea Nitrogen (BUN), Creatinine, Glomerular Filtration Rate (GFR), Chest X-ray, ECG to monitor the heart condition and assess fluid in the lungs.

Management and Treatment

• Lifestyle Modifications: Healthy diet low in sodium, regular physical activity, weight management, avoid tobacco and reduce alcohol intake.

• Medications:

  • Diuretics (e.g., Hydrochlorothiazide) can lower blood volume.

  • ACE Inhibitors (e.g., Lisinopril) protect the kidneys.

  • Beta Blockers (e.g., Metoprolol) reduce heart rate and cardiac output.

  • Calcium Channel Blockers to relax blood vessels.

Patient Education

• Importance of adhering to medication regimens and managing risk factors. Monitoring and reporting changes in blood pressure and symptoms.

7u7Common Misconceptions & Issues

• White Coat Syndrome: Elevated blood pressure levels due to anxiety in clinical settings.

• Cost and Accessibility: Financial issues and access to healthcare impact treatment compliance.