Components of cardiovascular risk factors in patients with hypertension
CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.
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Transcript of CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.
CARDIOVASCULAR MODULE: HYPERTENSION
Adult Medical-Surgical Nursing
Hypertension: Description
Blood pressure elevated above recognised normal value for age on several separate occasions
Hypertension: Classification
Primary hypertension (90 – 95% of cases)
Secondary hypertension (5 -10%)
Primary Hypertension: Aetiology
Unknown cause but may relate to:Stress AtherosclerosisHyperlipidaemiaFamily historySmokingObesity Diabetes Mellitus (macrovascular)
Secondary Hypertension: Aetiology
Chronic renal disease
Primary Hypertension: Pathophysiology
Interaction of hyperlipidaemia and atherosclerosis
Hypertension contributes to rate at which plaque develops, therefore:
Prolonged hypertension damages blood vessels supplying target organs: heart, kidneys (renal arteries), brain, eyes, peripheral vessels
Secondary Hypertension: Pathophysiology
Chronic renal disease →Increased fluid volumeSodium retentionImbalance of renin - angiotensin system:→Increased vasoconstriction and blood volume
Hypertension: Clinical
Manifestations
May be asymptomaticHeadache often frontalSymptoms related to associated medical
conditions:Cardiac diseaseRenal diseaseStrokeImpaired vision
Hypertension: Diagnosis
BP: serial measurementECGKidney function testsLiver function testsLipid profileBlood glucoseSerum electrolytes
Hypertension: Management
Calcium channel blockersβ blockersAlpha blockersCentral action anti-hypertensivesACE inhibitorsDiuretics
Hypertension: Management
Calcium channel blockers:
Vasodilation (oppose vasospasm) Reduce peripheral constriction, opening up
peripheral circulation to allow redistribution of blood
↓ afterload
Hypertension: Management
β blockers: Slow heart rate (↓ sympathetic action) Vasodilation
Alpha blockers: Peripheral vasodilation (↓ sympathetic action)
Hypertension: Management
Central acting hypotensives:
Reduce sympathetic activity from the level of the medulla (cardiac centre) in the brain
Hypertension: Management
ACE inhibitors:
Block the conversion of Angiotensin I → II
Vasodilation
↓ Na - retaining effect of Aldosterone
Hypertension: Management
Diuretics:
Diuresis relieves pressure of fluid overload
Frusemide also acts as a vasodilator
Aldactone: inhibits Na re-absorption (competes with Aldosterone)
Hypertension: Nursing
Considerations
Health education related to a healthy lifestyle:
Diet (low salt, low fat, high fruit and fibre)Anti-stress relaxation therapyExerciseAvoid smokingRegular BP check/ adherence to medication