Sheen Mark L.
Real
BSN - 4, NA
Concept Map of Hypertension
Predisposing factors:
Age. The risk of high blood pressure increases
as you age. Through early middle age, or about
age 45, high blood pressure is more common in
men. Women are more likely to develop high
blood pressure after age 65.
Race. High blood pressure is particularly
common among blacks, often developing at an
earlier age than it does in whites. Serious
complications, such as stroke, heart attack and
kidney failure, also are more common in blacks.
Family history. High blood pressure tends to
run in families.
Changes in arteriolar bed
Increase in the
viscosity of blood
Systemic Vascular
Resistance
Afterload
(A)
September 16, 2015
Precipitating factors:
Being overweight or obese. The more you weigh
the more blood you need to supply oxygen and
nutrients to your tissues. So thus the pressure on
your artery walls increase, leading to increased
blood
Smoking. the chemicals in tobacco can damage
the lining of your artery walls. This can cause your
arteries to narrow, increasing your blood pressure.
Secondhand smoke also can increase your blood
pressure.
Stress. High levels of stress can lead to a
temporary increase in blood pressure..
Certain chronic conditions. Certain chronic
conditions also may increase your risk of high
blood pressure, such as kidney disease, diabetes
and sleep apnea.
Drinking too much alcohol. Over time, heavy
drinking can damage your heart. Having more than
two drinks a day for men and more than one drink
a day for women may affect your blood pressure.
Too much salt (sodium) in your diet. Too much
sodium in your diet can cause your body to retain
fluid, which increases blood pressure.
Too little potassium in your diet. Potassium helps
balance the amount of sodium in your cells. If you
don't get enough potassium in your diet or retain
enough potassium, you may accumulate too much
sodium in your blood.
Vasoconstriction
occurs
 (A)
Blood flow to organs

Increase in blood
pressure
Decreased renal Beta-Receptor
perfusion Activation

Activates Juxtaglomerular cells

Hyponatremia in the kidneys to release renin Hypovolemia

Production of Angiotensinogen,
a component of the renin-
angiotensin system

Thus prompting, the angiotensin -

converting enzyme to mediate and
turn Angiotensin I to Angiotensin II,
leading to vascular constriction

Arteriolar Vasoconstriction Adrenal Cortex Stimulation

Increase in Aldoseterone
Peripheral Resistance

Sodium re-absorption and

Water retention occurs

Further and continual Elevation of plasma

increase in blood pressure concentration

HYPERTENSION (B)
If left uncontrolled, can result to the following
signs and symptoms

(D) (C)
 (B) (C)
Signs and
symptoms Four general categories of blood readings
-Fatigue -Normal blood pressure. Your blood pressure is normal if
-Headache it's below 120/80 mm Hg.
-Malaise -Prehypertension. Prehypertension is a systolic pressure
-Dizziness ranging from 120 to 139 mm Hg or a diastolic pressure
ranging from 80 to 89 mm Hg. Prehypertension tends to
get worse over time.
-Stage 1 hypertension. Stage 1 hypertension is a systolic
pressure ranging from 140 to 159 mm Hg or a diastolic
pressure ranging from 90 to 99 mm Hg.
-Stage 2 hypertension. More severe hypertension, stage 2
hypertension is a systolic pressure of 160 mm Hg or higher
or a diastolic pressure of 100 mm Hg or higher.

(D)
Medications to treat high blood pressure:
-Thiazide diuretics. Are medications that act on your kidneys to help your body
eliminate sodium and water, reducing blood volume. [Hydrochlorothiazide
(Microzide), chlorthalidone and others.]
-Beta blockers. Reduces the workload on your heart and open your blood vessels,
causing your heart to beat slower and with less force. [e.g. acebutolol (Sectral),
atenolol (Tenormin) and others]
-Angiotensin-converting enzyme (ACE) inhibitors. Helps relax blood vessels by
blocking the formation of a natural chemical that narrows blood vessels. [e.g.
lisinopril (Zestril), benazepril (Lotensin), captopril (Capoten) and others]
-Angiotensin II receptor blockers (ARBs) relaxes blood vessels by blocking the
action, that narrows blood vessels. [e.g. candesartan (Atacand), losartan (Cozaar)
and others]
-Calcium channel blockers. Helps relax the muscles of your blood vessels. And also
some slow your heart rate. [e.g. amlodipine (Norvasc), diltiazem (Cardizem, Tiazac,
others]
-Renin inhibitors. Slows down the production of renin, an enzyme produced by
your kidneys that starts a chain of chemical steps that increases blood pressure.
[e.g. Aliskiren (Tekturna)]

Legend:

Disease Process Medications

Signs and symptoms

SOURCES:
-Richards, J. Haford, A (2009) Pathophysiology of hypertension
Utah medical journal, October issue, pgs. 32-37.
Categories of BP
-Thomas, W. (2011) Hypertension: Assessment, monitoring, and
management Nursing care and management, pgs. 50-66.