HYPERTENSION NOTES ( Definition, types ,cause , clinical feature, Bp measure, Treatment and complication.)

 

HYPERTENSION - (Common problems worldwidely )

HYPERTENSION :-

-Hypertension, also known as high blood pressure, is a condition in which the force of blood against the walls of the arteries is too high. It is defined as a systolic blood pressure of 140 mm Hg or higher, or a diastolic blood pressure of 90 mm Hg or higher.

 

*TYPES OF HHYPERTENSIONS;

There are two main types of hypertension: primary hypertension and secondary hypertension.

1.Primary hypertension, also known as essential hypertension, is the most common type of hypertension and is characterized by high blood pressure that develops gradually over time with no known underlying cause. 

It is usually diagnosed after other possible causes have been ruled out.

2.Secondary hypertension, on the other hand, is caused by an underlying condition or disease such as kidney disease, sleep apnea, or the use of certain medications. This type of hypertension tends to develop more quickly and is usually more severe than primary hypertension.

There are also some subtypes of hypertension, such as:

1.Isolated systolic hypertension: High systolic blood pressure and normal diastolic blood pressure.

2.White coat hypertension: Elevated blood pressure readings in a clinical setting but normal readings outside of the clinic.

3.Masked hypertension: Normal blood pressure readings in a clinical setting but elevated readings outside of the clinic.

4.Resistant hypertension: Hypertension that is not controlled by three or more antihypertensive medications at optimal doses.

CAUSES OF HHYPERTENSIONS :-

Hypertension, also known as high blood pressure, can have a variety of causes. Some of the most common causes include:

Lifestyle factors: 

A diet high in salt and unhealthy fats, lack of physical activity, and excessive alcohol consumption can all contribute to the development of hypertension.

Genetics: 

Hypertension can run in families, indicating a genetic component to the condition.

Age: 

The risk of hypertension increases as we age.

Obesity: People who are overweight or obese are more likely to develop hypertension.

Chronic kidney disease: 

- Acute glomerulonephritis,

-Chronic glomerulonephritis,

- Renal arterial stenosis,

- Renal tumor,

- Polycystic kidney disease,

- Renal failure etc

Kidneys play an important role in regulating blood pressure, and chronic kidney disease can lead to hypertension.

Endocrine disorders:

_ Hormonal imbalances, such as those caused by adrenal 

or thyroid disorders: -Hyperthyroidism,

-hypothyroidism,

- hypoparathyroidism,-and other

- Conns syndrome,

- Cushing syndrome, 

- Acromegaly  can lead to hypertension.

Certain medications: 

-Some medications, such as birth control pills, non-steroidal anti-inflammatory drugs (NSAIDs), and decongestants can raise blood pressure.

Sleep apnea:

 -This sleep disorder causes breathing to stop and start repeatedly during sleep, which can lead to hypertension.

CLINICAL FEATURE OF HHYPERTENSIONS:

The clinical features of hypertension can vary depending on the severity and duration of the condition. Some common symptoms of hypertension include:

Headaches

Dizziness

Fatigue

Blurred vision

Nosebleeds

Chest pain

Difficulty breathing

Irregular heartbeat

Blood in the urine

Hypertension Physical Examination:-

 

A physical examination for hypertension typically includes measuring the patient's blood pressure, checking for signs of end-organ damage such as retinal changes, and assessing for risk factors such as obesity and smoking.

 The healthcare provider may also listen to the patient's heart and lungs, check for peripheral edema and bruits, and perform a neurologic examination to check for symptoms of stroke.

DIAGNOSIS 

- 

Blood pressure measurement by:-

Blood pressure measurement is typically done using a device called a sphygmomanometer, which consists of an inflatable cuff to collapse and then release the artery under the cuff in a controlled manner, and a mercury or aneroid manometer to measure the pressure. 

The measurement is usually reported as two numbers, with the first (systolic) number indicating the pressure in the artery when the heart beats and the second (diastolic) number indicating the pressure in the artery when the heart is at rest between beats. Blood pressure is measured in millimeters of mercury (mmHg).

MANAGEMENT:-

A.The management of hypertension typically involves lifestyle changes, such as maintaining a healthy diet, regular exercise, and avoiding smoking, as well as medication to control blood pressure. 

B.Anti-hypertensive drugs:

There are many different types of antihypertensive drugs and the specific drug and dose that is used will depend on the individual case. Some common classes of antihypertensive drugs include:

1.Diuretics - 

These drugs increase urine production and help to remove excess fluid from the body, which can help to lower blood pressure. Examples include;

 thiazide diuretics (such as hydrochlorothiazide),

 loop diuretics (such as furosemide), and potassium-sparing diuretics (such as spironolactone).

2.ACE inhibitors -

 These drugs work by blocking the action of an enzyme called angiotensin-converting enzyme, which can help to lower blood pressure by relaxing blood vessels. 

Examples include captopril, lisinopril, and ramipril.

3.ARBs :

- These drugs work by blocking the action of a hormone called angiotensin II, which can help to lower blood pressure by relaxing blood vessels. 

Examples include losartan, valsartan, and irbesartan.

4.Calcium channel blockers - 

These drugs work by relaxing the muscles of blood vessels, which can help to lower blood pressure. 

Examples include amlodipine, diltiazem, and verapamil.

5.Beta blockers - 

These drugs work by slowing down the heart rate and relaxing blood vessels, which can help to lower blood pressure.

 Examples include atenolol, metoprolol, and propranolol.

6.Alpha blockers - 

These drugs work by relaxing the muscles in the walls of smaller blood vessels, which can help to lower blood pressure.

 Examples include doxazosin, prazosin, and terazosin.

The specific dosage for a given drug will depend on the individual case, as well as any other medical conditions or medications that the person is taking. It is important to follow the instructions of a healthcare provider when taking any medication, and to never change the dosage without consulting a doctor.

COMPLICATION OF HYPERTENSIONS:

1.Cardiovascular disease: Hypertension can damage the blood vessels in the heart and brain, leading to an increased risk of heart attack, stroke, and heart failure.

2.Kidney damage: High blood pressure can damage the small blood vessels in the kidneys, leading to kidney failure.

3.Vision loss: Hypertension can cause blood vessels in the eyes to weaken or burst, leading to vision loss or blindness.

4.Aneurysm: Hypertension can cause the walls of the aorta, the main blood vessel leading away from the heart, to weaken and bulge, increasing the risk of aortic aneurysm.

5.Cognitive decline and dementia: Hypertension is associated with an increased risk of cognitive decline and dementia in older adults.

6.Sexual dysfunction: Hypertension can cause erectile dysfunction in men, and sexual dysfunction in women.

7.Sleep apnea: Hypertension is commonly found in people who have sleep apnea, a condition where a person's breathing is repeatedly interrupted during sleep.

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