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Hypertension
Prepared by Dr.Mustafa AlShehabat
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What is Blood Pressure? Pressure created by the heart as it pumps blood
through the arteries and the circulatory system What do Blood Pressure Numbers Mean?
Top number (Systolic)= Pressure while heart isbeating
Bottom number (Diastolic)= Pressure while heart isresting between beats
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Normal Blood Pressure
Blood Pressure of < 140/ 90
Blood Pressure of 130 to 139/ 85 to 89 should be
closely watched
High Blood Pressure
Blood Pressure > 140/ 90
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How can I tell if I have High Blood
Pressure? Usually NO SYMPTOMS!
The Silent Killer
May have:Headache
Blurry visionChest PainFrequent urination at night
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Blood Pressure Measurement Sphygmomanometer
Systolic pressure= pressure when 1st
sound isheard
Diastolic pressure= pressure when last soundis heard
Blood Pressure Cuff Size Small children and small adults
Average
Large overweight and large adults
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BPCategory
Systolic(mmHg)
Diastolic(mmHg)
Follow-up
Optimal < 120 and < 80 Recheck
2 yearsNormal < 130 and < 85 Recheck 2
years
High Normal 130-139 or 85-89 Recheck 1year
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BPCategory
Systolic(mmHg)
Diastolic(mmHg)
Follow-up
Stage 1
(mild HTN)
140-159 or 90-99 Confirm within
months
Stage 2(moderate HTN)
160-179 or 100-109 Evaluate within 1month
Stage 3(severe HTN)
180 or > or 110 or > Evaluateimmediately
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What Causes High BloodPressure? Cause unknown in 90 to 95% of cases = Primary
Hypertension
Secondary Hypertension = 5 to 10%Kidney AbnormalitiesNarrowing of certain arteries
Rare tumorsAdrenal gland abnormalitiesPregnancy
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What Causes High Blood
Pressure? Controllable Risk FactorsIncreased salt intake
Obesity
AlcoholStress
Lack of exercise
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What Causes High Blood
Pressure? Uncontrollable Risk FactorsHeredity
AgeMen between age 35 and 50
Women after menopause
Race
1 out of every 3 African Americans
Higher incidence in non-Hispanic blacks and Mexican
Americans
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Women and High Blood Pressure
Birth Control Pill Pregnancy
Overweight
After Menopause
African Americans
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How does High Blood Pressure develop?
Certain nerve impulses cause arteries to become
larger (dilate) or smaller (contract)
If vessels wide open blood flows easily
If vessel narrows pressure inside
increases causing hypertension
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What does High Blood Pressure do to my
Body?
Stroke
Congestive heart failure
Kidney failure
Heart attack
Heart rhythm problems
Aneurysm
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What Can I Do?
High blood pressure is a lifelong disease Blood pressure can be controlled not cured
Controlling blood pressure will reduce the risk of
stroke, heart attack, heart failure and kidney
disease
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What Can I Do?
Loose weight if your overweight Get regular physical activity
Avoid excessive alcohol
Stop smoking
Manage your stress
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What Can I Do?
Decrease salt intake Eat for heart health
Discuss the use of oral contraceptives with your
doctor
Discuss the use of some medications with yourdoctor
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Ten Commandments for Blood
Pressure Control Know your blood pressureHave it checked regularly
Know what your weight should beKeep it at that level or below
Dont use excessive salt in cooking or at mealsAvoid salty foods
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Ten Commandments for Blood
Pressure Control Eat a low-fat dietAccording to AHA regulations
Dont smoke cigarettesOr use tobacco products
Take your medicine exactly as prescribedDont run out of pills even for a single day
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5
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Ten Commandments for Blood
Pressure Control Keep your appointments with the doctor
Follow your doctors advice about exercise
Make certain family members have their blood
pressure checked regularly
Live a normal life in every other way!
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Medication for High Blood
Pressure DiureticsRid the body of excess fluids and salt
Beta-blockersReduce the heart rate and the work of the heart
Calcium antagonistsReduce heart rate and relax blood vessels
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Medication for High Blood
Pressure Angiotensin II receptor blockers(ACE)Interfere with the bodies production of angiotensin,
a chemical that causes the arteries to constrict
(narrow)
VasodialatorsCause the muscle in the wall of the blood vessels to
relax, allowing the vessel to dialate (widen)
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Medication for High Blood
Pressure Sympathetic nerve inhibitorsSympathetic nerves go from the brain to all parts of
the body, including the arteries
Cause arteries to constrict raising blood pressure
These drugs reduce blood pressure by inhibitingthese nerves from constricting blood vessels
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Home Blood Pressure Monitoring Mercury sphygmomanometer
Standard for BP monitoringNo calibration
May be bulky
Need a second person to use machine
May be difficult for hearing impaired or patients witharthritis
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Home Blood Pressure Monitoring Aneroid equipmentInexpensive, lightweight and portable
Two person operation/need stethoscope
Delicate mechanism, easily damaged
Needs calibration with mercury sphygmomanometer
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Home Blood Pressure Monitoring Automatic equipment
Contained in one unitPortable with easy-to-read digital display
Expensive, fragile
Must be calibrated
Requires careful cuff placement
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