hypertension

Question 1

what is hypertension and its grades

Answer 1

hypertension is the abnormal elevated blood pressure and is a major cause of CVD.
Blood pressure is a characteristic of each individual, like
height and weight, with marked interindividual variation
can be defined by a reading of 130/80 mmhg or higher

Grade 1 (mild) 140–159 and/or 90–99
Grade 2 (moderate) 160–179 and/or 100–109
Grade 3 (severe) ≥180 ≥110

can be defined as primary or secondary
- secondary is an underlying condition: adrenal gland tumour, medicines, cocaine, kidney disease.

Question 2

who is affected by hypertension

Answer 2

present in 20 to 30% of the adult population.
- higher in the black african community
(majority have primary elevation of BP)

Question 3

what are the causes of Hypertension

Answer 3

MULTIFACTORAL AETIOLOGY
- Genetic factors - tends to run in families and children of hypertensive parents tend to have higher blood pressure, may be explained by environmental influences
- Fetal factors - Low birth weight is associated with subsequent high blood
pressure
- environmental factors - OBESITY, ALCOHOL, SODIUM (processed foods), STRESS
- humoral mechanisms - autonomic nervous system renin-angiotensin, natriuretic peptide, and kallikrein-kinin system, plays a role in the physiological regulation of short-term changes in blood pressure.
- INSULIN RESISTANCE.

Question 4

PATHO of hypertension

Answer 4

cardiac changes
- with an increase in wall thickness and a reduction in the vessel lumen diameter, increased peripheral resistance that maintains increased BP.
- Large vessel changes occur
- pulse wave velocity - a measure of arterial stiffness
and is inversely related to distensibility
- left ventricular hypertrophy

Renal changes
- changes in the renal vasculature lead to a reduced renal perfusion, reduced glomerular filtration rate and, finally, a reduction in sodium and water excretion.

Cerebral changes - in small vessel cause lacunae (small
infarcts) and reversible neurological deficits.

Question 5

what are the symptoms of hypertension

Answer 5

HIGH BLOOD PRESSURE
- most have no symptoms
- headaches, shortness of breath, nosebleeds
- abnormal blood pressure

Question 6

how is Hyper tension diagnosed and treated

Answer 6

• blood pressure is taken
• tests involved are the ambulatory monitoring test, 24 hour check of blood pressure
  investigations include: urine test for protein and blood, fasting blood for lipids, ECG

treatment is aimed at lowing Blood pressure
- lifestyle changes - less salt, exercise, weight loss, not smoking.
- ACE inhibitors -These drugs block the conversion of angiotensin I to angiotensin II, which is a potent vasoconstricton
- Alpha-blockers
- diuretics - reduces stroke
- calcium channel blockers