Hypertension

Question 1

Hypertension

Answer 1

Hypertension is defined as systolic blood pressure of 140 mmHg or greater, diastolic blood pressure of 90 mmHg or greater, or taking antihypertensive medication

Question 2

Types of Hypertension

Answer 2

Essential hypertension

• 95%
• No underlying cause

Secondary hypertension
- Underlying cause

Question 3

Causes of secondary hypertension

Answer 3

• Renal
  
  • Parenchymal
  • Vascular
  • Others
• Endocrine
• Miscellaneous
• Unknown

Question 4

Blood pressure chart

Answer 4

Diastolic/ systolic

Normal -> Less than 120/80
Elevated -> 120-129/80
Hypertensive stage 1 -> 130 - 139/ 80-89
Hypertensive stage 2 -> 140 or higher / 80 or higher
Hypertensive crisis -> Higher than 180/ Higher than 120

Question 5

Predisposing factors

Answer 5

• Advancing Age
• Sex (men and postmenopausal women)
• Family history of cardiovascular disease
• Sedentary life style & psycho-social stress
• Smoking ,High cholesterol diet, Low fruit consumption
• Obesity & wt. gain
• Co-existing disorders such as diabetes, and
hyperlipidemia
• High intake of alcohol

Question 6

Diseases attributable to hypertension

Answer 6

Heart failure 
Gangrene of the lower extremities 
Aortic aneurysm 
Blindness 
Chronic kidney failure 
Stroke 
Preeclampsia/eclampsia
Cerebral hemorrhage 
Hypertensive encephalopathy 
Coronary heart disease 
Myocardial infarction 
Left Ventricular hypertrophy

Question 7

Clinical manifestations

Answer 7

• No specific complains or manifestations other than elevated systolic and/or diastolic BP (Silent Killer )
• Morning occipital headache
• Dizziness
• Fatigue
• In severe hypertension, epistaxis or blurred vision

Question 8

Self measurement of BP

Answer 8

Provides information on:

1. Response to antihypertensive therapy
2. Improving adherence with therapy
3. Evaluating white-coat HTN

Home measurement of >135/85 mmHg is generally considered to be hypertensive.

Home measurement devices should be checked regularly.

Question 9

Dietary Management of Hypertension

Answer 9

DASH stands for Dietary Approaches to Stop Hypertension (high blood pressure). The diet is
simple:

• Eat more fruits, vegetables, and low-fat dairy foods
• Cut back on foods that are high in saturated fat, cholesterol, and trans fats
• Eat more whole-grain foods, fish, poultry, and nuts
• Limit sodium, sweets, sugary drinks, and red meats
• In research studies, people who were on the DASH diet lowered their blood pressure within 2 weeks
• Another diet – DASH-Sodium – calls for cutting back sodium to 1,500 milligrams a day (about 2/3 teaspoon). Studies of people on the DASH-Sodium plan lowered their blood pressure as well.

Question 10

DASH DIET TIPS

Answer 10

• Add a serving of vegetables at lunch and at dinner.
• Add a serving of fruit to your meals or as a snack. Canned and dried fruits are easy to use, but check that they don’t have added sugar.
• Use only half your typical serving of butter, margarine, or salad dressing, and use low-fat or fat-free condiments.
• Drink low-fat or skim dairy products any time you would normally use full-fat or cream.
• Limit meat to 6 ounces a day. Make some meals vegetarian.
• Add more vegetables and dry beans to your diet.
• Instead of snacking on chips or sweets, eat unsalted pretzels or nuts, raisins, low-fat and fat-free yogurt, frozen yogurt, unsalted plain popcorn with no butter, and raw vegetables.
• Read food labels to choose products that are lower in sodium.

Question 11

NON-PHARMACOLOGIC STRATEGIES

Answer 11

• Weight management
• Low sodium diet
• Low fat diet
• Smoking cessation
• Restrict alcohol and caffeine
• Regular aerobic exercise
• Stress management