Hypertension - Lecture Notes PDF

# Lec.2. 2nd Adult Nursing ## Hypertension ### Lecturer: Haroon M. Hypertension, or high blood pressure (BP), defined as a persistent systolic blood pressure (SBP) greater than or equal to 140 mm Hg, diastolic blood pressure (DBP) greater than or equal to 90 mm Hg, or current use of antihypertensi...

# Lec.2. 2nd Adult Nursing ## Hypertension ### Lecturer: Haroon M. Hypertension, or high blood pressure (BP), defined as a persistent systolic blood pressure (SBP) greater than or equal to 140 mm Hg, diastolic blood pressure (DBP) greater than or equal to 90 mm Hg, or current use of antihypertensive medication. There is a direct relationship between hypertension and cardiovascular disease (CVD). ### Contributing factors to the development of hypertension include cardiovascular risk factors combined with socioeconomic conditions and ethnic differences. Hypertension is generally an asymptomatic condition. It is the most important modifiable risk factor for stroke. ## Complications of hypertension ### Main complications of persistent high blood pressure * **Brain** * Cerebrovascular accident (strokes) * Hypertensive encephalopathy: * Confusion * Headache * Convulsion * **Blood** * Elevated sugar levels * **Retina of eye:** * Hypertensive retinopathy * **Heart:** * Myocardial infarction (heart attack) * Hypertensive cardiomyopathy: heart failure * **Kidneys:** * Hypertensive nephropathy: chronic renal failure ## Etiology of Hypertension * **Primary (essential or idiopathic) hypertension**: elevated BP without an identified cause; accounts for 90% to 95% of all cases of hypertension. * **Secondary hypertension**: elevated BP with a specific cause; accounts for 5% to 10% of hypertension in adults. ## Classification of Blood Pressure | Category | Systolic | Diastolic | |:---|:---|:---| | Optimal | < 120 | < 80 | | Pre-hypertensive | 120-139 | 80-89 | | Hypertensive: | ≥ 140 | ≥ 90 | | Stage 1 | 140-159 | 90-99 | | Stage 2 | ≥ 160 | ≥ 100 | ## Drug Therapy * Drug therapy is not recommended for those persons with prehypertension unless it is required by another condition, such as diabetes mellitus or chronic kidney disease. * Drugs currently available for treating hypertension work by: * Decreasing the volume of circulating blood, and/or * Reducing SVR (Systemic Vascular Resistance). ## Nursing and Collaborative Management 1. Treatment goals are to lower BP to less than 140 mm Hg systolic and less than 90 mm Hg diastolic for most persons with hypertension (less than 130 mm Hg systolic and less than 80 mm Hg diastolic for those with diabetes mellitus and chronic kidney disease). 2. Lifestyle modifications are indicated for all patients with prehypertension and hypertension and include the following: * **Weight reduction**: A weight loss of 10 kg may decrease SBP by approximately 5 to 20 mm Hg. * **Dietary Approaches to Stop Hypertension (DASH) eating plan**: Involves eating several servings of fish each week, eating plenty of fruits and vegetables, increasing fiber intake, and drinking a lot of water. The DASH diet significantly lowers BP. * **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**: e.g., brisk (fast) walking] at least 30 minutes a day most days of the week. Moderately intense activity such as brisk walking, jogging, and swimming can lower BP, promotes relaxation, and decrease or control body weight. * **It strongly recommended that tobacco use be avoided.** * **Relaxation therapy for stress.** The image describes an anatomical diagram of the body showing the health effects of hypertension on the brain, blood, retina of the eye, heart, and kidneys. High blood pressure is shown as a large red arrow flowing over the heart, brain, eyes, and kidneys.