Hypertension ( Blood pressure) Type,cause and treatment
- Type of Hypertension, clinical manifestation and treatment:
Blood pressure -BP is the force of blood pushing against the walls of blood vessels.
Systolic blood pressure-Pressure in arteries when heart pump the blood. (120 mm Hg)
Diastolic blood pressure-Pressure experienced in arteries when heart dialate.
Definition :Hypertension is condition in which the force of blood against arteries wall too high.
Systolic blood pressure-Pressure greater than 140 mm Hg.
Diastolic blood pressure: greater than 90 mmHg.
Types of Hypertension:
1.Normal range: Systolic B.P less than 120mmHg
Distolic B.P : less than 80 mmHg
2.Prehypertension:120-139/80-89mmHg
3.Stage 1 Hypertension:140-159 /90-89mmHg
4.Stage 2 Hypertension:more than or equal to 160mmHg/ more than or equal to 100mmHg
Cause of Hypertension:
Primary Hypertension or essential Hypertension :
- Genetic or family history
- Life style- Inactivity or sedentary life,stress,Obesity
- Tobacco, excessive salt intake especially raw salt,unhealthy dietary habits, alcohol
- Age- above 60 years-deposition of fats into wall of arteries causes narrowing of blood vessels
- Metabolic disorder-Diebetics
Secondary Hypertension:
- Narrowing of blood vessels
- Renal parenchymal disease causes retention of sodium thereby water retention as a result blood volume increases causing rise in B.P
- Adrenal gland disease
- Constriction of of aorta
- Preaclampsia - Pregnancy
- Medication- Oral contraceptive pills,over the counter drug,Cocain or amphetamines
- Obstructive- Sleep apnea
Clinical manifestation:
- Severe headache
- Dizziness
- Blurred vision
- Nausea & vomiting
- Fatique and confusion
- Epistatis ( nose bleeding)
- Chest pain and shortness of breathing
- Irregular hearts beat
- Patelledema
- Ear noise
COMPLICATIONS:
- Heart attack
- Stock
- Kidney failure
- Retinopathy-damage retina of eye
- Outpouching of aorta
- Left ventricular
- Hypertrophy of heart muscles
- Temporal hemiplegia
DIAGNOSTIC EVALUATION:
- Medical history
- Physical examination
- CBC ( Sodium, potassium level in blood,fasting glucose lipoprotein creatinine,Blood urea nitrogen
- Urine analysis
- ECG
- Ultrasound of heart
- Doppler Ultrasound
- Examination of retina
MEDICAL MANAGEMENT:
- Diuretic- Furosamide( 40mg to 240mg/ day), Chlorthalidone( 12.5 to 50 mg / day)
- Beta blockers: Proponalol ( 40 to 240 mg/ day)
- Atenolol(25-100 mg/day)
- Reserpine (0.05 - 0.25 mg/ day.
- Alpha blockers- Prazocine( 2- 30 mg/ day)
Terazocine
- Alpha- Beta blocker- eg.labital( 230 mg/day),
- Vasodilator-Hydrazoline(50-300 mg/day) Nitroglycerin
- Central acting agent: Clodine(2-12 mg/ day) ,Methyldopa( 500-3000mg/day)
- ACE inhibitors- Captopril( 125-150 mg/ day),Ramipril(125 mg/ day)
- Angiotensin II receptor blockers: Losartan
- Renin inhibitors-Tekturna
- Calcium channel blocker:Nifedifine(30 - 120mg), Nicradifine 60 mg/day)
Good knowledge
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