Hypertension

Reported by:
high blood
J a l e m , Fpressure
ely
Geralde, Jessa
Macalua, Crislyn
Mawili, Jannalou
Mutia, Angel Lou
 INTRODUCTION
Hypertension, also known as high or raised blood pressure, is a condition
in which the blood vessels have persistently raised pressure. Blood is
carried from the heart to all parts of the body in the vessels. Each time the
heart beats, it pumps blood into the vessels. Blood pressure is created by
the force of blood pushing against the walls of blood vessels (arteries) as it
is pumped by the heart. The higher the pressure, the harder the heart has to
pump.
 DEFENITION OF
• Blood Pressure. Is the measure of the pressure exerted by the blood as it pulsates through the

TERMS
arteries.
• Systolic Pressure. Is the pressure of blood as a result of contraction of the ventricles (100-140
mmHg).
• Diastolic pressure. Is the pressure when the ventricles are at rest (60-90 mmHg).
• Pulse Pressure. Is the difference between the systolic and diastolic pressures (S-D-P.P.)
Normal is 30-40 mmHg.
• Hypertension. Is an abnormally high blood pressure over 140 mm Hg systolic and or above
90 mm Hg diastolic for at least two consecutive readings.
• Hypotension. Is an abnormally low blood pressure, systolic pressure below 100/60 mm Hg.
• Sphygmomanometer: a device that is used to measure blood pressure. The
sphygmomanometer consists of an arm cuff, dial, pump, and valve.
 DEFENITION OF
• Orthostatic Hypotension. Is a drop in systolic pressure more than 20mmHg. It occurs with a

TERMS
quick change to a standing position.
• Blood volume refers to the total amount of fluid circulating within the arteries, capillaries,
veins, venules, and chambers of the heart at any time. The average human adult has nearly 5
liters of circulating blood.
• Peripheral vascular resistance (systemic vascular resistance, SVR) is the resistance in the
circulatory system that is used to create blood pressure, the flow of blood and is also a
component of cardiac function.
• Cardiac output (CO). Is the amount of blood pumped by the heart minute and is the
mechanism whereby blood flows around the body, especially providing blood flow to the
brain and other vital organs. 5-6 L/min in an at-rest to more than 35 L/min in elite athletes
during exercise.
 DEFENITION OF
• Elasticity or Compliance of Blood Vessels. The ability of vessel walls to revert to their

TERMS
original shape after being squeezed and stretched- elasticity. Compliance is the ease with
which an elastic structure stretches. Compliance is, therefore, basically a measurement of the
elastic resistance of a system.
• Blood viscosity. Is the thickness or stickiness of blood.
• Stroke: an interruption of the blood supply to the brain, resulting in damaged brain tissue. An
interruption can be caused by clots that block blood flow, or by bleeding in the brain from a
ruptured blood vessel or a significant injury.
• Proteinuria: the presence of protein in the urine. This may indicate kidney disease or damage.
 DEFENITION OF
• Potassium: an electrolyte that is vital in ensuring that cells can function properly. It is used to

TERMS
make energy for all muscles, including heart muscles.
• Kidney Failure (end-stage renal disease): a condition in which the kidney cannot filter and
excrete waste products.
• Ischemic Heart Disease: a condition caused by a decrease in blood flow to the heart. This
decrease is usually the result of narrowed coronary arteries, which impede the blood flow.
• Hypertrophic Cardiomyopathy: a condition in which the heart muscle becomes enlarged and
thickened and may lead to dangerous heart rhythms.
• Congestive Heart Failure: the inability of the heart to adequately pump blood. This can be
caused by a number of problems, including untreated high blood pressure, heart attacks, or
infections.
 DEFENITION OF
• Hypertensive Urgency:

TERMS
a form of hypertensive crisis, a spectrum of situations that includes high blood pressure and progre
ssive or impending organ damage caused by high blood pressure.
• Hypertensive Retinopathy: damage to the blood vessels in the retina (the area at the back of the
eye) caused by high blood pressure.
• Hypertensive Emergency: a severe elevation in blood pressure that can lead to organ damage,
including encephalopathy (brain damage), heart attack, heart failure, hemorrhagic stroke (bleeding
into the brain), eclampsia (a condition in which pregnant women have water retention, high blood
pressure, protein in the urine, and seizures), kidney damage, and arterial bleeding.
• Heart Attack: damage to the heart muscle caused by lack of blood flow to the heart muscle
resulting in heart muscle death.
ANATOMY
Hypertension, also known as high
or raised blood pressure, is a
condition in which the blood
vessels have persistently raised
pressure. Blood is carried from
the heart to all parts of the body in
the vessels.
PATHOPHYSIOL
OGY
 CLINICAL
MANIFESTATIONS
DIAGNOSTIC
1. TESTS
AMBULATORY BP
MONITORING
2. CBC & URINALYSIS
3. ELECTROCARDIOGRAM
4. ULTRASOUND OF THE
KIDNEYS
5. ECHOCARDIOGRAM
6. CHEST XRAY
MEDICATIONS
Angiotensin-converting enzyme (ACE)
inhibitors reduce blood pressure by
relaxing your blood vessels, e.g.
enalapril, lisinopril, perindopril.
ACE Inhibitors
Angiotensin II receptor blockers help
relax your blood vessels which lower
your blood pressure and makes it easier
for your heart to pump blood,e.g.
losartan, valsartan.
Angiotensin II receptor blockers
MEDICATIONS
Calcium channel blockers keep
Sometimes known as water pills,
calcium from entering the muscle cells
diuretics work by flushing excess
of the heart and blood vessels. This
water and salt from the body through
widens your arteries and reduces your
urine, e.g. amiloride, frusemide,
blood pressure, e.g. diltiazem,
indapamide.
nifedipine and amlodipine.

Diuretics
Calcium channel blockers
MEDICATIONS
Beta-blockers work by making your
Sometimes known as water pills,
heart beat more slowly and with less
diuretics work by flushing excess
force, thereby reducing blood pressure,
water and salt from the body through
e.g. atenolol, metoprolol, propanolol.
urine, e.g. amiloride, frusemide,
indapamide.

Beta-blockers
Alpha-blockers
 MEDICATIONS
Centrally acting antihypertensive drugs, like
Vasodilators reduce blood pressure by
methyldopa and clonidine, act by stimulation of
alpha 2 adrenoceptors in the central nervous system dilatation of blood vessels, e.g.
which results in a reduction in sympathetic tone hydralazine.
and a fall in blood pressure. Methyldopa may be
used for the management of hypertension in
pregnancy.
Vasodilators
Centrally acting antihypertensive drugs
 NURSING
• Lifestyle modifications are indicated for all patients with prehypertension and

MANAGEMENT
hypertension and include the following:
⚬ Weight reduction.
⚬ Dietary Approaches to Stop Hypertension (DASH) eating plan
⚬ Restriction of dietary sodium to less than 6 g of salt (NaCl) or less than 2.4 g of
sodium per day.
⚬ Restriction of alcohol
⚬ Regular aerobic physical activity at least 30 minutes a day most days of the week.
⚬ Tobacco use be avoided.
⚬ Relaxation therapy, guided imagery, and biofeedback may be useful in helping
patients manage stress, thus decreasing BP.
 NURSING
• Lifestyle modifications are indicated for all patients with prehypertension and

MANAGEMENT
hypertension and include the following:
⚬ The primary nursing responsibilities for long-term management of hypertension
are to assist the patient in reducing BP and complying with the treatment plan.
Nursing actions include patient and family teaching, detection and reporting of
adverse treatment effects, compliance assessment and enhancement, and evaluation
of therapeutic effectiveness.
⚬ Patient and family teaching includes the following: (1) nutritional therapy, (2) drug
therapy, (3) physical activity, (4) home monitoring of BP (if appropriate), and (5)
tobacco cessation (if applicable).
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