ESSENTIAL

HYPERTENSION
DEFINTION :

Essential hypertension
refers to high blood
pressure with no
identifiable cause.
CLASSIFICATION :
 CAUSES :

Many factors affect blood pressure, including:

 The amount of water in the body

 The amount of salt in the body
 The condition of the kidneys, nervous system, and
blood vessels
 Family History
CAUSES
 Advancing age
 Diabetes mellitus

 Excess renin

 Obesity

 Race(most common in Blacks)

 Stress

 Sedentary lifestyle
PATHOPHYSIOLOG
Y:
RISK FACTORS:

Diabetes Mellitus
Family History
Advance age
Obesity
Sedentary Lifestyle
Stress
Smoking
High intake of Na, saturated fats and alcohol

Kidney release RENIN into the bloodstream

RENIN helps convert angiotensin I in liver

Angiotensin I is converted to angiotensin II (a potent vasoconstrictor) in lungs

Angiotensin II

Aldosterone: Causes Na and water

retension

Retained Na and Water Increased Blood Volume

Arteriolar constriction Increased Peripheral vascular resistance

Increased Blood pressure and vascular resistance to hypertension

SYMPTOMS :

 Fatigue
 Confusion
 Visual changes
 Nausea and vomiting
 Anxiety
 Perspiration
 Pale or red skin
 Angina-like pain, crushing chest pain

Note: There are usually no symptoms which is why it is sometimes called the
silent killer.
EXAMS AND
TESTS:

 Blood Pressure
 ECG
 Urinalysis
TREATMENT:
 Lifestyle changes
 Weight reduction

 Alcohol, smoke and salt restriction

 Promote compliance of medication

Many different medicines are used to control blood pressure.

 Angiotensin converting enzyme (ACE) inhibitors

 Angiotensin receptor blockers (ARBs)

 Beta-blockers

 Calcium channel blockers

 Direct renin inhibitors, including aliskiren (Tekturna)

 Diuretics

 Vasodilator
 NURSING MANAGEMENT :
 Ask patient if he/she is taking prescribed hypertensive drugs.
 Monitor Blood pressure.

 Monitor Pulse pressure.

 Teach patient to avoid things that can provoke increased blood

pressure like prohibition of alcohol, smoking, salt-intake, fatty-
foods, and high cholesterol foods and also avoid caffeine-
beverages.
 Promote Health Teachings on proper compliance of medication
and prohibition.
POSSIBLE COMLICATIONS:

Untreated hypertension can lead to:

 Aneurysms
 Blood vessel damage (atherosclerosis)
 Congestive heart failure
 Heart attacks and other heart damage
 Loss of vision
 Kidney damage
 Stroke
COMMONLY PRESCRIBE DRUGS FOR
ESSENTIAL HYPRETENSION
 Losartan-
Blocks vasoconstricting and aldosterone-secreting effects of
angiotensin II at various receptor sites, including vascular
smooth muscle and adrenal glands. Also increases urinary
flow and enhances excretion of chloride, magnesium, calcium,
and phosphate. When used during second or third trimester of
pregnancy, drug may cause fetal harm or death. Discontinue
as soon as pregnancy is detected.
 Captopril-
Prevents conversion of angiotensin I to angiotensin II,
which leads to decreased vasoconstriction and,
ultimately, to lower blood pressure. Also decreases blood
pressure by increasing plasma renin secretion from
kidney and reducing aldosterone secretion from adrenal
cortex. Decreased aldosterone secretion prevents sodium
and water retention.
 Atenolol-
Selectively blocks beta1-adrenergic (myocardial)
receptors; decreases cardiac output, peripheral
resistance, and myocardial oxygen consumption. Also
depresses renin secretion without affecting beta2-
adrenergic (pulmonary, vascular, uterine) receptors.
Report by :

MARK STEVEN A. BORRES

PCHS GROUP B2

OB WARD