Hypertension/Symptoms of HTN/Complications of HTN

Persistent rise of Blood Pressure above the upper limit of normal level, according to the age & sex of the patient is called Hypertension.

Normal limit of BP:

Systolic: 100 – 140 mm of Hg (120 + 20)

Diastolic: 60 – 90 mm of Hg (75+15)

Aetiology of Hypertension/ Types:

1. Primary/ Essential hypertension:

Idiopathic > 95%

Factors influencing the development of essential hypertension are

1. Genetic & families (40-60%)
2. Socio – economic factors.
3. Dietary factors; obesity, high, salt intake, caffeine.
4. Lake of exercise.
5. Hormonal factors: High renin.
6. Neurotransmitters – Accetylcholine, noradrenaline
7. Secondary hypertension (5% case only)
8. Vascular: Coarctation of aorta.
9. Renal disease:

• Acute glomerulo-nephritis.
• Chronic (GN).
• Chronic pyelonephritis.
• Renal artery disease

3. Endocrine disease:

• Chusing-Syndrome.
• Acro-megally.

4. Drugs:

• Oral contraceptive containing destrogen.
• Corticosteroids

5. Alcohol.
6. Obesity.
7. Gestational: pregnancy with pre- eclampsia.

 Mechanisms of Hypertension

Clinical features of Hypertension

Symptoms of HTN :

1. Asymptomatic: Most of the case symptoms appear after delection of HTN.
2. Symptoms due to complication:

• Anxinal pain
• Breathlessness due to left ventricular failure.
• Blurring of vision
• Hemiplegia due to cardio vascular disease.

3. Symptoms of etiological factors:

• Headache
• Vertigo
• Palpitation
• Dizziness

4. Family history of hypertension.
5. Patient history of renal disease.
6. Patients gives history of smoking.

Sign of HTN:

Physical examination of

• To identify any underlying causes.
• To defects complications already present:

1. Pulse:Usually normal but may have high volume.
2. BP raised.

Complications of HTN :

1. Central nervous systems:

• Stroke
• Hypertensive encephalopathy
• Subarachnoid haemorrhage
• Carotid atheroma

2. Retina: Hypertensive retinopathy.
3. Heart:

Left ventricular hypertrophy leading to LVF

Ischaemic Heart Diseae

Atrial fibrillation

4. Kidney

Proteinuria

Principles of treatment

1. To keep the diastolic pressure around about 90 mmhg
2. Satisfactory control 90-100 mmhg (DBP)

Treatment

Non drug therapy/general measure

1. Relief of stress

• praying
• meditation

2. Diet

• Reduced weight (in obese & overweight)
• Avoid excess salt consumption
• Avoid alcohol consumption
• Eat a mixed diet rich in fresh vegetables & fruit

3. Regular physical exercise like-walking, jogging
4. Avoid smoking
5. Investigation lipid profile & treatment according to guidelines
6. Investigation & management of real & endocrine causes

Drug therapy

1. Diuretic

• Thiazide diuretic
• Potassium sparing diuretic: spironolactone
• Loop diuretic: Frusemide

  2.Beta -blockers

1. a) Cardio-selective drugs

• o Atenolol
• o Metoprolol
• o Bisoprolol

1. b) Non-cardio-selective drugs

• o Propranolol
• o Pindolol

1. C) combined &beta adrenoceptor antagonists:

• o Labetalol
• o Carvedilol

3. Angiotensin converting enzyme(ACE inhibitors)

• Captopril
• Ramipril

4. Angiotensin two receptor blocker

• o Losartan
• o Valsartan

5. Calcium antagonists

• o Amlodipine

6. Other drugs
7. a) Alph- 1 blockers
8. b) Drugs acting directly on vascular smoot muscle

 Systolic                             diastolic

Optimal BP                          <120                                < 80mmhg

Normal                                    <130 mmhg                <85mmhg

High normal BP                        130/79 mmhg                   5-89

Classification of hypertension

Grade 1 ( mild) 140-159 mmhg 90-99 mmhg

Grade 2 160-179 mmhg 100-109 mmhg

Grade 3 > 180, >110

Isolated systolic

Grade-1                   systolic                                            Diastolic

                                   140-159                                                 >90

Grade-2                       >160                                                    <90

If you want more & more information about Human Diseases you can visit my website Purely Health Tips.

Prevention of Hypertension the World Health Organization ( WHO) working . WHO is the world largest Heath Organization. They provide various information.