Transcript Hypertension

‫وزارة التعليم العلي والبحث العلمي‬
‫جامعة الكوفة‬
‫مركز تطوير التدريس والتدريب الجامعي‬
‫‪Hypertension & Its‬‬
‫‪Impacts on Human‬‬
‫‪Health‬‬
‫الدكتور‬
‫سامرنعمة ياسين الفتالوي‬
‫بكالوريوس طب و جراحة عامة ‪ /‬كلية الطب – جامعة الكوفة‬
‫دبلوم عالي في الطب الباطني ‪ /‬جامعة الكوفة – كلية الطب‬
‫شهادة البورد ( الدكتوراه ) في الطب الباطني ‪ /‬المجلس العراقي لالختصاصات الطبية‬
‫‪[email protected]‬‬
‫‪facebook.com/samir.alfatlawy.9‬‬
‫بسم هللا الرحمن الرحيم‬
‫َ َ َ ْ ُ َََُ ْ‬
‫و ِإذا م ِرضت فهو يش ِف ِين‬
‫صدق هللا العظيم‬
‫الشعراء ‪80‬‬
Hypertension
Definition
• Hypertension is sustained elevation of BP
– Systolic blood pressure  140 mm Hg
– Diastolic blood pressure  90 mm Hg
Blood Pressure Grades
BP grades
SBP mmHg
DBP mmHg
optimum
< 120
< 80
Normal
< 130
< 85
Pre-hypertension
130-139
85-89
grade 1 mild
140-159
90-99
Grade 2 moderate
160-179
100-109
Grade 3 severe
> 180
> 110
Classification of Hypertension
• Primary (Essential) Hypertension
- Elevated BP with unknown cause
- 90% to 95% of all cases
• Secondary Hypertension
- Elevated BP with a specific cause
- 5% to 10% in adults
Risk Factors for Primary
Hypertension
• Age, Gender, Family history & Ethnicity
(African Americans)
• Alcohol & Cigarette smoking
• Diabetes mellitus & Elevated serum lipids
• Excess dietary sodium
• Obesity (BMI > 30) & sedentary lifestyle
• Stress & Socioeconomic status
Classification of Hypertension
• Secondary Hypertension
- Contributing factors:
• Coarctation of aorta
• Renal disease
• Endocrine disorders
• Neurologic disorders
Hypertension
Clinical Manifestations
• Frequently asymptomatic until severe
and target organ disease has occurred
–
–
–
–
–
Fatigue, reduced activity tolerance
Dizziness
Palpitations, angina
Dyspnea
Headache is due to stress rather due to
hypertension
Hypertension
Complications
The common complications are
target organ diseases occurring in the
Heart
Brain
Kidney
Eyes
Retina Normal and Hypertensive
Retinopathy
A
B
C
Normal Retina
Hypertensive
Retinopathy
A: Hemorrhages
B: Exudates (Fatty
Deposits)
C: Cotton Wool Spots
(Micro Strokes)
Hypertension
Diagnosis
• Diagnosis requires several elevated
readings over several weeks (unless >
180/110)
• BP measurement in both arms
- Use arm with higher reading for
subsequent measurements
Treatment Goals
• Goal is to reduce overall cardiovascular
risk factors and control BP by the least
intrusive means possible
– BP < 140/90
– In patients with diabetes or renal
disease, goal is < 130/80
Hypertension
Lifestyle Modifications
1. Weight reduction
2. Dietary changes (DASH diet)
Dietary Approaches to Stop HTN
- Sodium restriction
-Rich in vegetables, fruits & nonfat dairy products
-Calorie restriction if overweight
3. Limitation of alcohol intake
4. Regular physical activity
5. Avoidance of tobacco use
6. Stress management
Hypertension
• Drug Therapy
• Diuretics
• ACE Inhibitors
• Calcium channel blockers
• Adrenergic inhibitors
• β - Adrenergic blockers