Hypertension

Hypertension

Worldwide prevalence is projected to increase from approximately 1.0 billion in 2000 to 1.5 billion by 2025. It is a major, independent risk factor for cardiovascular disease (CVD), and the chief risk factor for stroke (accounted for about 62% of strokes).

It’s often called “the silent killer” because it can be asymptomatic for many years, and people suffering of this problem can have a sudden fatal heart attack

Definition

Hypertension(High Blood Pressure (BP)) is a disease of vascular regulation in which the mechanisms that control arterial pressure with in the normal range are altered. (The systolic pressure is above 140 mm Hg and the diastolic pressure is above 90 mm Hg).

Classification of Blood pressure for adults

Causes

·              Increased Cardiac output

·              Excessive dietary sodium intake

·              Endocrine disturbances

·              Medications like Antidepressant steroids.

·              Stroke

Risk factors

·              Age between 30-70

·              Diabetes Mellitus

·              Metabolic syndrome

·              Over weight

·              Family history

·              Smoking and alcohol

·               Sedentary lifestyle.

Signs and Symptoms

·              Usually asymptomatic

·              Head ache and dizziness, Blurred vision

·              high BP

·              Confusion

·              Shortness of breath

·              Nose bleeds

·              Chest pain

·              Irregular heart beat

Diagnosis

·              BP measurements.

·              ECG

·              Chest X-ray

·              BUN (Blood urea nitrogen) test and creatinine levels

·              Proteinuria

·              Urine (24-hours) for catecholamine’s

·              Renal scan to detect renal vascular diseases

Management

·              Lose weight

·              Avoid alcohol

·              Regular aerobic exercise

·              Lower sodium intake (2.4 gram or less per day)

·              Stop smoking

·              Reduce cholesterol and trans fat diet

Drug therapy

·              Diuretics

·              Beta-adrenergic blockers

·              Alpha-receptor blockers

·              Central alpha agonists

·              Peripheral adrenergic agents

·              Angiotensin converting enzyme (ACE) inhibitors

Nursing management

·               Provide comfortable bed

·               Measuring monitoring and charting BP.

·              Advice low fat and low cholesterol diet

·              Vital signs.

·              Advice life style modification

·              Regular follow up

Complications

·              Myocardial infarction (MI)

·              Heart failure

·              Renal failure

·              Stroke, hemorrhage

·              Retinopathy