Hypertension Management Quiz

Hypertension Management

• Hypertension is consistently high blood pressure against artery walls, leading to serious health issues like heart disease, stroke, and kidney damage.

Lifestyle Modifications

• Lifestyle changes are crucial in managing hypertension, especially in mild to moderate cases. These changes may even reduce the need for medication.

• Dietary Modifications

  • DASH Diet (Dietary Approaches to Stop Hypertension): Emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy, reducing saturated fats, cholesterol, and sodium.
  • Reduce Salt Intake: Limit sodium to less than 2,300 mg per day (ideally 1,500 mg for those with high blood pressure).
  • Increase Potassium: Consume potassium-rich foods (bananas, sweet potatoes, spinach) to help balance sodium.

• Weight Loss: Losing even 5-10% of body weight can help reduce blood pressure. Regular physical activity, like 30 minutes of moderate exercise 5 days a week (walking, cycling, swimming) is beneficial.

• Reduce Alcohol Intake: Limit to one drink per day for women and two for men.

• Quit Smoking: Smoking increases blood pressure and is a contributing factor to cardiovascular disease. Quitting is crucial.

• Stress Management: Techniques like yoga, meditation, and deep breathing exercises can help manage hypertension.

• Adequate Sleep: Getting 7-9 hours of sleep per night is recommended for managing hypertension. Poor sleep can worsen hypertension.

Pharmacological Management

• Medications are used when lifestyle changes are insufficient or if blood pressure is significantly high.
• Diuretics (Thiazide diuretics): Common first-line treatment to eliminate excess salt and water to reduce blood volume.
• ACE Inhibitors: Relax blood vessels by blocking the hormone angiotensin II, preventing constriction.
• Angiotensin II Receptor Blockers (ARBs): Similar to ACE inhibitors but with fewer side effects.
• Calcium Channel Blockers: Relax blood vessels by reducing heart rate, lowering blood pressure.
• Beta-Blockers: Slow heart rate and reduce the heart's workload, resulting in lower blood pressure.
• Renin Inhibitors: Reduce the production of renin, an enzyme that raises blood pressure by increasing angiotensin II.
• Alpha-Blockers: Relax blood vessels and increase blood flow.
• Central Alpha Agonists: Decrease nerve signals that tighten blood vessels.

Combination Therapy

• A combination of two or more medications is often used to achieve better blood pressure control.

Monitoring and Follow-Up

• Regular blood pressure monitoring is essential to assess treatment effectiveness.
• Follow-up appointments are needed for adjustments to the treatment plan.
• Ambulatory Blood Pressure Monitoring (ABPM) can provide more accurate results.

Managing Hypertension in Special Populations

• In the elderly, a gradual approach to lowering blood pressure is recommended to avoid complications.
• Patients with comorbidities (such as diabetes or CKD) may require specific medication adjustments (e.g. ACE inhibitors, ARBs), protecting the kidneys.
• Hypertension during pregnancy (gestational hypertension) requires careful monitoring.

Treatment Goals

• The goal for most adults is to lower blood pressure to less than 130/80 mmHg.

Emergency Care

• Hypertensive crisis (blood pressure above 180/120 mmHg) is a medical emergency that requires immediate medical attention. Symptoms include severe headache, chest pain, shortness of breath, blurred vision, and nausea.