Intro: Good day! I am Frances Hannah V.

Bumanglag, a nurse educator applicant and today I will

be showing you my teaching demonstration and the topic is hypertension.

Slide 4: Family History. High blood pressure tends to run in families. Men with both parents
with hypertension or men with one parent who was hypertensive before the age of 55 years old
had much higher risk of developing hypertension especially at a younger age.

Age. The risk of high blood pressure increases as a person age. Until about age 64, high blood
pressure is more common in men. Women are more likely to develop high blood pressure after
age 65. Although high blood pressure is most common in adults, children may be at risk, too. For
some children, high blood pressure is caused by problems with the kidneys or heart. But for a
growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of
exercise, contribute to high blood pressure.
Gender. More common in men than women. Women more likely to develop hypertension after
menopause.
Race or ethnicity. Black people develop high blood pressure more often than white people,
Hispanics, Asians, Pacific Islanders, American Indians, or Alaska Natives do. Compared with
white people, black people also develop high blood pressure earlier in life.
Diabetes Mellitus. Two third of adults who have diabetes also have hypertension. The risk of
developing hypertension when someone has a familiar background of diabetes and obesity is 2
to 6 times greater than person without this family history. Diabetes damages arteries and makes
them targets for hardening, called atherosclerosis. That can cause high blood pressure, which if
not treated, can lead to trouble including blood vessel damage, heart attack, and kidney failure.
Other chronic diseases. High cholesterol; Kidney diseases; Sleep apnea. Hypertension combined
with other chronic diseases greatly increases risk for complications. Hypertension (high blood
pressure) and diabetes are common chronic diseases and both are risk factors for coronary
artery disease.

Slide 5: Weight. Overweight or obesity, if we have higher body mass index, our body need more
blood to supply nutrients and oxygen the tissues. As the blood volume circulation increases it
will increase the pressure in the artery walls.
Stress. High levels of stress can lead to a temporary increase in blood pressure. The body
produces a surge of hormones when in a stressful situation. These hormones temporarily
increase blood pressure by causing the heart to beat faster and blood vessels to narrow.

Unhealthy diet. Over time, excessive salt intake can lead to high blood pressure (hypertension),
which stiffens and narrows the blood vessels. Blood and oxygen flow to key organs decreases.
So the heart tries harder to pump blood throughout the body, which further increases blood
pressure.
Sedentary lifestyle. A sedentary lifestyle is a major risk factor for heart and blood vessel
(cardiovascular) disease. For example, people who are less active and less physically fit have a
30%-50% greater frequency (incidence) of hypertension (high blood pressure) than their more
active peers.

Slide 19: To measure blood pressure, two tools are used. One is a sphygmomanometer (blood
pressure cuff) that fits over a person's arm and is inflated using an attached bulb. The purpose of
the cuff is to temporarily stop blood flow. It also has a dial that measures pressure in the cuff. A
valve lets air out of the cuff.

Slide 20: A stethoscope is the other tool used to measure blood pressure. It is an iconic medical
tool used to amplify a patient's heartbeat as heard from the heart directly or as the pulse from
an artery. When used with a blood pressure cuff, you can hear the blood flowing through the
brachial artery (in the arm) in order to measure blood pressure.

Slide 21: Blood pressure is measured in mmHg (millimeters of mercury) and given as a fraction:

systolic pressure / diastolic pressure

The systolic pressure measures the force generated on the arterial walls by the contraction of
the ventricles (left ventricle is what is actually being measured). Diastolic pressure measures the
time after the ventricles contract and the chambers of the heart are refilling with blood.
Slide 23: Diuretics. Diuretics, sometimes called water pills, are medications that help your
kidneys eliminate sodium and water from the body. These drugs are often the first medications
tried to treat high blood pressure. There are different classes of diuretics, including thiazide,
loop and potassium sparing. Diuretics commonly used to treat blood pressure include
chlorthalidone, hydrochlorothiazide (Microzide) and others. A common side effect of diuretics is
increased urination, which could reduce potassium levels. If a patient have a low potassium
level, your doctor may add a potassium-sparing diuretic — such as triamterene (Dyazide,
Maxide) or spironolactone (Aldactone) — to your treatment.
Angiotensin-converting enzyme (ACE) inhibitors. These medications — such as lisinopril
(Prinivil, Zestril), benazepril (Lotensin), captopril and others — help relax blood vessels by
blocking the formation of a natural chemical that narrows blood vessels.
Angiotensin II receptor blockers (ARBs). These medications relax blood vessels by blocking the
action, not the formation, of a natural chemical that narrows blood vessels. ARBs include
candesartan (Atacand), losartan (Cozaar) and others.
Calcium channel blockers. These medications — including amlodipine (Norvasc), diltiazem
(Cardizem, Tiazac, others) and others — help relax the muscles of the blood vessels. Some slow
the heart rate. Calcium channel blockers may work better for older people and people of African
heritage than do ACE inhibitors alone. Don't eat or drink grapefruit products when taking
calcium channel blockers. Grapefruit increases blood levels of certain calcium channel blockers,
which can be dangerous.
Alpha blockers. These medications reduce nerve signals to blood vessels, lowering the effects of
natural chemicals that narrow blood vessels. Alpha blockers include doxazosin (Cardura),
prazosin (Minipress) and others.
Alpha-beta blockers. Alpha-beta blockers block nerve signals to blood vessels and slow the
heartbeat to reduce the amount of blood that must be pumped through the vessels. Alpha-beta
blockers include carvedilol (Coreg) and labetalol (Trandate).
Beta blockers. Also known as beta-adrenergic blocking agents, are medications that reduce
blood pressure. Beta blockers work by blocking the effects of the hormone epinephrine, also
known as adrenaline. These medications reduce the workload of the heart and widen blood
vessels, causing the heart to beat slower and with less force. Beta blockers include acebutolol,
atenolol (Tenormin) and others. Beta blockers aren't usually recommended as the only
medication prescribed, but they may be effective when combined with other blood pressure
medications.
Aldosterone antagonists. These drugs also are considered diuretics. Examples are
spironolactone and eplerenone (Inspra). These drugs block the effect of a natural chemical that
can lead to salt and fluid buildup, which can contribute to high blood pressure. They may be
used to treat resistant hypertension.
Renin inhibitors. Aliskiren (Tekturna) slows the production of renin, an enzyme produced by the
kidneys that starts a chain of chemical steps that increases blood pressure. Due to a risk of
serious complications, including stroke, a patient shouldn't take aliskiren with ACE inhibitors or
ARBs.

Vasodilators. These medications include hydralazine and minoxidil. They work directly on the
muscles in the walls of the arteries, preventing the muscles from tightening and the arteries
from narrowing.
Central-acting agents. These medications prevent your brain from telling the nervous system to
increase the heart rate and narrow the blood vessels. Examples include clonidine (Catapres,
Kapvay), guanfacine (Intuniv) and methyldopa.

Slide 25: Cigarette has nicotine content that cause vasoconstriction that impedes the blood flow
going to the other parts of the body. Every puff of cigarette smoke causes a slight, temporary
increase in blood pressure. The chemicals in tobacco are also known to damage blood vessels.
Alcoohol intake.Moderate to excessive alcohol consumption is linked to raised blood pressure
and an increased risk of stroke.