Hypertension (HTN)

What Is Hypertension Persistent blood pressure that is higher than the recommended blood pressure range Persistent blood pressure that is higher than the recommended blood pressure range About 60% of all Americans have some form of high blood pressure (pre-hypertension or hypertension) About 60% of all Americans have some form of high blood pressure (pre-hypertension or hypertension) HTN means the heart is working harder than normal putting extra strain on the heart and vessels. HTN means the heart is working harder than normal putting extra strain on the heart and vessels.

Blood Pressure Ranges Normal blood pressure range < 120/80 Normal blood pressure range < 120/80 Pre-Hypertension >120/80 but 120/80 but <140/90 Hypertension - >140/90 Hypertension - >140/90 Both systolic and diastolic pressures do not have to be out of range Both systolic and diastolic pressures do not have to be out of range Only Systolic or Diastolic must be out of range to qualify as hypertension Only Systolic or Diastolic must be out of range to qualify as hypertension

Two Stages of HTN Stage 1 HTN >140/90 but 140/90 but <160/100 Stage 2 HTN >160/100 Stage 2 HTN >160/100

What Causes HTN 90%-95% of the time hypertension is elevated blood pressure without an identifiable cause. 90%-95% of the time hypertension is elevated blood pressure without an identifiable cause. Exact cause is unknown Exact cause is unknown Many contributing factors have been identified as predisposing factors to HTN Many contributing factors have been identified as predisposing factors to HTN

Predisposing Factors for HTN Hereditary Predisposition (Family History) Hereditary Predisposition (Family History) Sodium intake Sodium intake Weight Weight Diabetes Mellitus Diabetes Mellitus Alcohol Consumption Alcohol Consumption Smoking Smoking Serum Lipid Levels (Cholesterol and LDL) Serum Lipid Levels (Cholesterol and LDL) Sedentary Lifestyle Sedentary Lifestyle Ethnicity Ethnicity Age Age Gender Gender Socioeconomic Status Socioeconomic Status Stress Stress

Signs and Symptoms Known as the Silent killer Known as the Silent killer If BP is very high, you may experience: If BP is very high, you may experience: -fatigue -fatigue -decreased activity tolerance -decreased activity tolerance -dizziness -dizziness -palpitations -palpitations -angina -angina -dyspnea -dyspnea

How HTN is diagnosed Based on the average of 2+ seated BP measurements at the MD’s office Based on the average of 2+ seated BP measurements at the MD’s office Must be averaged Must be averaged Must be seated BP measurements Must be seated BP measurements Must be in the MD’s office Must be in the MD’s office

Complications Related to HTN Heart Failure Heart Failure Enlarged Left Side of the Heart Enlarged Left Side of the Heart Coronary Artery Disease Coronary Artery Disease Cerebrovascular disease (Brain) Cerebrovascular disease (Brain) Peripheral Vascular Disease Peripheral Vascular Disease Kidney Failure Kidney Failure Retinal Damage (Eyes) Retinal Damage (Eyes)

Treatment of HTN Different types require different treatments Different types require different treatments Pre-Hypertension – Lifestyle modifications Pre-Hypertension – Lifestyle modifications Stage I Hypertension – Lifestyle modifications and a thiazide-type diuretic Stage I Hypertension – Lifestyle modifications and a thiazide-type diuretic Stage II Hypertension – Lifestyle modifications, thiazide-type diuretic and one another antihypertensive drug Stage II Hypertension – Lifestyle modifications, thiazide-type diuretic and one another antihypertensive drug Not definitive Not definitive Treatment is personalized Treatment is personalized

How to Prevent HTN Lifestyle modifications prevent HTN and include: Lifestyle modifications prevent HTN and include: -Maintaining a Healthy Weight -Maintaining a Healthy Weight -Reduce Salt/Sodium Intake -Reduce Salt/Sodium Intake -Increase Physical Exercise -Increase Physical Exercise Smoking Cessation Smoking Cessation Limit Alcohol Consumption Limit Alcohol Consumption Limit Fat Intake Limit Fat Intake Control Diabetes Control Diabetes Stress Relieving Techniques Stress Relieving Techniques Take BP Meds as Ordered Take BP Meds as Ordered Home Monitoring of BP Home Monitoring of BP

References Lewis, S. L., Heitkemper, M. M., Dirksen, S. R., O’Brien, P. G., & Bucher, L. (2007). Medical- Srugical Nursing: Assessment and Management of Clinical Problems. Missouri: Mosby. Lewis, S. L., Heitkemper, M. M., Dirksen, S. R., O’Brien, P. G., & Bucher, L. (2007). Medical- Srugical Nursing: Assessment and Management of Clinical Problems. Missouri: Mosby.