HYPERTENSION

Salimo, Axl Rose P.

Definition
Is the term used to describe high blood pressure. Other name: HIGH BLOOD PRESSURE

Risk Factors
Age ADVANCING AGE Gender - MALE Race- BLACK AMERICANS Family History Obesity Sedentary lifestyle Smoking/ Tobacco chewing High salt Low potassium Too much alcohol Stress Chronic diseases CKD

Etiology
Primary Hypertension NO IDENTIFIABLE CAUSE!!! Secondary Hypertension CHRONIC DISEASES

Types
Hypertension Urgency no organ damage Hypertension Emergency with organ damage

Organ Damage
Changes in mental status such as confusion Bleeding into the brain (stroke) Heart failure Chest pain (unstable angina) Fluid in the lungs (pulmonary edema) Aneurysm (aortic dissection ) Eclampsia (occurs during pregnancy)

Assessment
Subjective Dizziness Headache Nosebleed Fatigue Edema Weight gain Muscle cramps Objective Diminished peripheral pulses Murmurs S3/S4 sounds Elevated cholesterol/ glucose

Diagnosis
Blood pressure consistently exceeds 140/ 90 confirmed on at least two visits several weeks apart.

BP monitoring Sphygmomanometer and Stethoscope = mmHg

Diagnosis
Systole pressure in the arteries when the heart beats.

Diastole pressure in the arteries between heart beats.

SYSTOLE DIASTOLE

Classification

Systolic Pressure

Diastolic Pressure

Normal Pre- HTN Stage 1

Stage 2 Isolated Systolic HTN

90- 119 120- 139 140- 159

> 160 > 140

60- 79 80- 89 90- 99

>100 <90

Management:
Medications:
Thiazide diuretics Beta blockers (-olol) ACE inhibitors (-pril) Calcium channel blockers Renin inhibitors Vasodilators

Management
Lifestyle modifications - Sodium restrictions - Weight reduction - DASH ( Dietary Approaches to Stop Hypertension) - Moderation of alcohol intake - Exercise - Relaxation techniques - Smoking cessation

DASH
DASH eating plan focuses on foods that are high in calcium, potassium, and magnesium.

Food Low-fat and fat-free milk and milk products

Recommended servings 2 to 3 servings a day

Examples A serving is 8 ounces of milk, 1 cup of yogurt, or 1 1/2 ounces of cheese. A serving is 1 medium-sized piece of fruit, 1/2 cup chopped or canned fruit, 1/4 cup dried fruit, or 4 ounces (1/2 cup) of fruit juice. Choose fruit more often than fruit juice.

Fruits

4 to 5 servings a day

Vegetables

4 to 5 servings a day

A serving is 1 cup of lettuce or raw leafy vegetables, 1/2 cup of chopped or cooked vegetables, or 4 ounces (1/2 cup) of vegetable juice. Choose vegetables more often than vegetable juice.
A serving is 3 ounces, about the size of a deck of cards A serving is 1 slice of bread, 1 ounce of dry cereal, or 1/2 cup of cooked rice, pasta, or cooked cereal. Try to choose whole-grain products as much as possible.

Meat, poultry, fish

No more than 2 servings a day

Grains

7 to 8 servings a day

Complications:
Stroke Aneurysm Heart failure Kidney damage Metabolic syndrome

Nursing Management
Health teaching:
Eat healthy foods Low salt Healthy weight Increase physical activity Manage stress