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Hypertension

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Hypertension:

Blood pressure (BP) is the pressure of circulating blood against the blood vessels walls.
Blood pressure is usually expressed in terms of the systolic pressure (maximum pressure
during one heartbeat) over diastolic pressure (minimum pressure between two heartbeats).
It is measured in millimeters of mercury (mmHg) .
Blood pressure is one of the vital signs together with respiratory rate, heart
rate, oxygen saturation, and body temperature, Blood pressure measured by instrument called
sphygmomanometer,
Normal resting blood pressure, in an adult is 120 millimeters of mercury systolic / 80
millimeters of mercury diastolic, recorded 120/80 mmHg.
Hypertension (high blood pressure), is a medical condition in which the blood
pressure in the arteries is persistently elevated, high blood pressure is present if the resting
blood pressure is persistently at or above 140/90 mmHg.

Types of Hypertension:
1.
Essential hypertension (primary hypertension) is the form of hypertension that
has no identifiable secondary cause. It is the most common type affecting 90-95 % of
those with high blood pressure.
2. Secondary hypertension is a type of hypertension caused by an identifiable
underlying primary cause , affecting only 5-10% of hypertensive patients. It has many
different causes including endocrine diseases, kidney diseases and side effect of
many medications.

Signs and symptoms

Hypertension is rarely accompanied by symptoms, and its identification is when seeking


healthcare for an unrelated problem. Some people with high blood pressure
report headaches. Lightheadedness, vertigo, altered vision or fainting episodes.

On examination patient has blood pressure at or more than 140/80 mmHg.

Complications:

Hypertension is the most important preventable risk factor for premature death. It increases
the risk of:

o Atherosclerosis cause coronary artery disease and


stroke
o Cardiomegaly and heart failure
o Hypertensive retinopathy
o Hypertensive nephropathy

1
Investigations:

1) Tests to identify possible cause of hypertension and associated medical problems:

Renal function test, serum lipid, complete blood count .serum uric acid, blood sugar .thyroid
function test , adrenalin hormones ,

2) Tests to identify complications:

ECG , chest x-ray , eye examination by ophthalmoscopy.

Treatment:

The goal of treatment is to maintain blood pressure at optimal measurement 120/80 mmHg.

Lifestyle modifications
o Weight loss
o Dietary changes shown to reduce blood pressure include diets with low sodium and
plant-based diets.
o Physical exercise
o Psychological Stress reduction

Medications
Several classes of medications, collectively referred to as Antihypertensive medications, are
available for treating hypertension. Most people require more than one medication to control
their hypertension.

Hypertensive emergency

Is very high blood pressure with potentially life-threatening symptoms and signs of
acute damage to one or more organ systems (especially brain, eyes, heart, aorta, or
kidneys).

Blood pressure is often above 200/120 mmHg,

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