Hypertension-: Hypertension
Raised blood pressure (BP) has emerged as the most important risk factor for global morbidity and mortality. The latest iteration of Global Burden of Diseases (GBD) study has reported that high systolic BP, poor dietary intake and tobacco use are most important risk factors for mortality as well as morbidity.
Definition-:Hypertension
, based on the average of two or more blood pressure measurements taken in two or more contacts with the health care provider after an initial screening.
| CATEGORY | SYSTOLIC (mm Hg) | DIASTOLIC (mm Hg)
|
| Optimal | <120 | <80 |
| Normal† | <130 | <85 |
| High-normal | 130–139 | 85–89 |
| Hypertension | ||
| Stage 1 | 140–159 | 90–99 |
| Stage 2 | 160–179 | 100–109 |
| Stage 3 | >180 | >110 |
Hypertension is sometimes called “the silent killer” because people who have it are often symptom free.
Risk factors for hypertension: Hypertension
- Obesity
- Diabetes
- High salt and/or fat diet
- More than moderate intake of alcohol Cigarette smoking
- Sedentary life style
- Stress
- Family history of hypertension,
- age, gender and race (non modifiable risk)
Secondary Risk factors =: Hypertension
| Source or category of cause | Possible causes |
| Renal diseases | · Renal parenchymal disease
· Polycystic kidney · Urinary tract obstruction · Rennin-producing tumor · Liddle syndrome |
| Renovascular hypertension | · Renal artery stenosis
· Connective tissue disease Glomerulonephritis |
| Vascular | · Coarctation of aorta Vasculitis/polycythemia
· Collagen vascular disease |
| Hormone and steroid intake | · Oral contraceptives
· Estrogen replacement therapy · Oral and Depot contraceptives, · Steroid medication |
| Adrenal | · Primary aldosteronism
· Cushing syndrome · Pheochromocytoma · Congenital adrenal hyperplasia |
| Other endocrine disorders | · Hyperthyroidism and hypothyroidism Hyperparathyroidism
· Acromegaly |
| Neurogenic | · Brain tumor
· Lesions of brainstem or hypothalamus Raised intracranial pressure |
| Prohypertensive substances | · Adrenergic medication,
· Nasal decongestants · Nonsteroidal anti-inflammatory drugs · Anti-depressants (tricyclic, MAOI), · Alcohol, · Cyclosporine and Tacrolimus, erythropoietin |
| Other | · Pregnancy
· Hypercalcemia · Sleep Apnea |
Medication Therapy for Hypertension-:Hypertension
Diuretics and Related Drugs
- Thiazide Diuretics-: Chlorthalidone, Quinethazone, Chlorothiazide, Hydrochlorothiazide
- Loop Diuretics-: Furosemide (Lasix), Bumetanide
- Potassium-Sparing Diuretics-: Spironolactone (Aldactone),Ttriamterene (Dyrenium)
Adrenergic Agents
- Peripheral Agents-: Reserpine (Serpasil)
- Central Alpha Agonists-: Methyldopa (Aldomet), Clonidine hydrochloride (Catapres), Guanfacine (Tenex)
Beta-Blockers
- Propranolol (Inderal)
- Metoprolol (Lopressor)
- Nadolol (Corgard)
Alpha Blocker
- Prazosin hydrochloride (Minipress)
Combined Alpha and Beta Blocker
- labetalol hydrochloride (Normodyne, Trandate)
Vasodilators
Fenoldopam mesylate, Hydralazine hydrochloride (Apresoline), Minoxidil, Sodium Nitroprusside, Nitroglycerin diazoxide
Angiotensin-Converting Enzyme Inhibitors
- Benazepril (Lotensin)
- Captopril (Capoten)
- Enalaprilat (Vasotec IV)
- Enalapril (Vasotec)
- Lisinopril (Prinivil, Zestril)
- Ramipril (Altace)
- Trandolapril (Mavik)
Angiotensin II Receptor Blockers
- Candesartan (Atacand)
- Losartan (Cozaar)
- Valsartan (Diovan)
- Irbesartan (Avapro
Lifestyle Modifications for Hypertension Prevention and Management
- Lose weight if overweight.
- Avoid alcohol
- Increase aerobic physical activity (30 to 45 minutes most days of the week).
- Reduce sodium intake to no more than 100 mmol per day (2.4 g sodium or 6 g sodium chloride).
- Maintain adequate intake of dietary potassium (approximately 90 mmol per day).
- Maintain adequate intake of dietary calcium and magnesium for general health.
- Stop smoking
- Reduce intake of dietary saturated fat and cholesterol for overall cardiovascular health.
