Arterial Hypertension simply stated is high blood pressure. It is defined as a persistent elevation of the systolic blood pressure (SBP) greater than 140 mm Hg or higher and the diastolic blood pressure (DBP) greater than 90 mm Hg or higher. types of hypertension PRIMARY HYPERTENSION and SECONDARY HYPERTENSION . Primary Hypertension or also known as essential or idiopathic Hypertension. The cause of essential hypertension is unknown; however, there are several areas investigation. It is more common type of hypertension it accounts for 90 to 95 % of all cause of HTN. In this condition the BP is elevated from an unidentified cause.

3. Definition

4. Classification of blood pressure for adults

5. RISK FACTORS FOR HYPERTENSION

6. •Family history
•Age
•Gender
•Ethnicity

7. •Diabetes mellitus
•Stress
•Obesity
•Sedentary life style
•Socio economic status
•Elevated serum lipids levels
•Nutrients (increase sodium consumption.)
•Substance abuse

8. PATHOPHYSIOLOGY
•Although the precise cause for most cases of
hypertension cannot be identified, it is understood
that hypertension is a multifactorial condition.
•Although the exact cause of HTN is unknown in
most cases of HTN.
•It is understood that HTN is a multifactorial
condition.
•Increased sympathetic nervous system activity
related to dysfunction of the autonomic nervous
system.

9. PATHOPHYSIOLOGY
•Increased renal reabsorption of sodium.
Chloride, and water related to a genetic
variation in the pathways by which the kidneys
handle sodium.
•Resistance to insulin action, which may be a
common factors linking HTN, type 2 DM,
hypettriglycerdemia, obesity and glucose
intolerance.

10. PATHOPHYSIOLOGY
• The predominant mechanisms of blood pressure
control are the central nervous system (CNS),the
renin-angiotension-aldosterone system, and
extracellular fluid volume. Why these mechanisms
fail is not known.

12. •Primary Hypertension or also known as essential or
idiopathic Hypertension.
• The cause of essential hypertension is unknown;
however, there are several areas investigation.
•It is more common type of hypertension it accounts
for 90 to 95 % of all cause of HTN.
•In this condition the BP is elevated from an
unidentified cause.

13. •Although the exact cause of primary HTN is
unknown. Several contributing factors including… .
•Increased SNS activity.
•Over production of sodium retaing hormones and
vasoconstrictors
•Increased sodium intake.
•Greater than body weight and and excessive
alcohol consumption.

14. •In this type of hypertension the BP is elevated
with a specific cause that often can be
identified and corrected. Or high blood
pressure from an identified cause.
•It accounts for 5 to 10% of hypertension.

15. •Endocrine disorder (Cushing syndrome)
• Renal disease ( CRF)
•Neurological disorder (brain tumor and HI)
•Sleep apnea, cirrhosis and pregnancy induced
hypertension (PIH).
• Prescription medications such as estrogen and
steroids ( cause fluid retention), sympathomimetic (
cause vasoconstriction and tachycardia)

16. 1. Hypertension can cause intimal wall injury in the arteries,
which can lead to arteriosclerosis in which smooth muscle cell
proliferation, lipid infiltration, and calcium accumulation occur
in the vascular endothelium.

17. • Prolonged hypertension damages small blood vessels in the
brain, eyes, heart, and kidneys.

18. •

19. •History collection ( family history of HTN, DM, CAD
or renal disease, medications and dietary history)
•Smoking history, dietary history and stress and
coping. Etc.
•Previous documentation of HBP including age, at
one St, level of elevation and currently prescribed
medication.
•History of all prescribed and OTC medications.

20. •History of any disease or trauma and target
organs.
•Results /side effects of previous anti
hypertensive therapy.
•History of recent weight gain, sodium intake,
fat intake, alcohol use and smoking.

21. •Vital signs and weight
•Blood work measurement : use appropriate
cuff size will ensure an accurate measurement.
•BP measurement should be taken with a
mercury sphygmomanometer.
•Both SBP and DBP should be record.

22. 1. ECG ( to determine effects of HTN on the
heart)
2. Chest x-ray

23. …
•Routine urinalysis
•Serum potasium and Sr, sodium levels.
•BUT and Sr, creatine
•FBGL and Sr, cholesterol (HDL and LDL)
•ECG and CXR
•LFT
•Sr.TSH

24. The goal of hypertension treatments is to
prevent complications and target organs
damage by achieving and maintain the blood
pressure at 140/90 mm Hg or lower. And
reduce risk factors.

28. )

29. )
Food groups Number of servings
per day
Grains and grain products 7 or 8
Vegetables 4 or 5
Fruits 4 or 5
Low fat or fat free dairy foods 2 or 3
Meat, fish ,and poultry 2 or fewer
Nuts ,seeds. And dry beans 4 0r 5 weekly

31. •Many therapeutic agents can be used for the
pharmacologic management of hypertension.

32. 1. Diuretics and related drugs (e.g. Thiazide
diuretics ( Lower BP by promoting urinary exerction
of water and sodium to lower blood volume.)
2. Loop diuretics ( e.g. Furosimide (Lasix), for semi
detached (Demadex)
3. Potassium sparing diuretics (e.g. amiloride)

34. 4. Beta blockers ( e.g. stenosis, metrolrolol)

35. •Vasodilators
•Calicum channel blockers
•ACE inhibitors (angiotension- converting
enzyme)

38. 1.

39. •Explain in simple terms what is the HTN.
•Causes and prevention measures.
•Explain hypertension means HBP and not related
to hyper personality.
•Describe the normal range of blood pressure,
hypotension and hypertension.
•Educate regarding medications and it’s side
effects

40. • Develop a plan of instruction for medication self –
management.
• Determine recommended dietary plans and provide
dietary education, as appropriate.
• Importance of life style changes.
• Complications and its prevention.
• Ambulatory BP monitoring.

41. •
•