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Hypertension •Hypertension presentation

•By : Amani Hussein

&Sondos Abul-haija

•Supervised by : Dr . Samar

•Faculty of medicine

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Definition

Blood pressure is the force of blood against your artery walls as it circulates through your body. Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time.

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•High blood pressure is called the "silent killer" because many people don't realize they have it. High blood pressure often has no warning signs or symptoms.

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Blood Pressure Levels(CDC)

Normal

Systolic: less than 120 mmHgDiastolic: less than 80 mmHg

At risk (prehypertension)

Systolic: 120–139 mmHgDiastolic: 80–89 mmHg

High

Systolic: 140 mmHg or higherDiastolic: 90 mmHg or higher

 

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Diagnosis for hypertension is obtained by sphygmomanometer on the basis of three separated visits at least 1 wk apart

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Risk factors: Sedentary lifestyle & physical inactivity.

Smoking.

Stress .

Obesity .

potassium deficiency (hypokalemia).

Salt (sodium) sensitivity .

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Cont. Alcohol intake

Risk also increases with aging &differ by sex .

Some inherited genetic mutations . And having a family history of hypertension .

Race or Ethnicity

Vitamin D deficiency that increase the risk of developing hypertension

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Levels Vary by sex & age

Women are about as likely as men to develop high blood pressure during their lifetimes. However, for people under 45 years old, the condition affects more men than women. For people 65 years and older, it affects more women than men.

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Levels Vary by Race and Ethnicity

African Americans develop high blood pressure more often, and at an earlier age, than whites and Mexican Americans do. Among African Americans, more women than men have the condition.1

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Primary prevention Weight reduction and regular aerobic exercise

(e.g., walking).

Reducing dietary sugar.

Reducing sodium (salt) in the body

Discontinuing tobacco use and alcohol consumption

Reducing stress .

Increasing omega 3 fatty acids can help lower hypertension.

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Secondary prevention:

Get your blood pressure checked regularly when you visit the doctor

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Screening for High Blood Pressure: according to U.S. Preventive Services Task Force Recommendation

Screening tests:

High blood pressure (hypertension) is usually defined in adults as:

systolic blood pressure (SBP) of 140 mm Hg or higher, or diastolic blood pressure (DBP) of 90 mm Hg or higher.

Due to variability in individual blood pressure measurements, it is recommended that hypertension be diagnosed only after 2 or more elevated readings are obtained on at least 2 visits over a period of 1 to several weeks.

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Screening intervals:

The optimal interval for screening adults for hypertension is not known.

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends:

• Screening every 2 years with BP <120/80 mm Hg

• Screening every year with SBP of 120–139 mm Hg or DBP of 80–90 mm Hg

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Adults with hypertension should be screened for diabetes.

Adults should be screened for hyperlipidemia (depending on age, sex, risk factors) and smoking.

Clinicians should discuss aspirin chemoprevention with patients at increased risk for cardiovascular disease.

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Tertiary prevention:

medication ex: Vasodilators such as niacin

Set up a plan with your doctor involving lifestyle changes

Follow-up on a regular schedule to make sure you stay on top of your plan

DASH diet

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DASH Diet The DASH diet focuses on lowering

your blood pressure and keeping it under control. DASH, which stands for Dietary Approaches to Stop Hypertension .

This diet has been shown to be effective based on research sponsored by the National Heart, Lung, and Blood Institute(NHLBI)

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DASH :

Rich in fruits and vegetables .

Low-fat or fat-free dairy.

Increase in dietary potassium, which offsets the effect of sodium has been shown to be highly effective in reducing blood pressure .

It can be applied on different amount of calories depending on the individual.

It was resulted from 2 studies on random people with/without hypertension.

The effects of the DASH appear 2 wks after starting it.

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•Americans usually consume 3,300mg Na/day

According to DASH the recommended is:• 2,300mg/day for normal & prehypertension persons

•1,500 mg/day for people already with hypertension

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Hypertension vaccine:

The experimental vaccine doesn't have a brand name yet. It's designed to help treat -- not prevent -- high blood pressure (hypertension).

In a preliminary study, the high blood pressure vaccine curbed early morning blood pressure in patients with mild-to-moderate hypertension.

The vaccine spurs the body to make antibodies that target a protein called angiotensin II, which helps constrict blood vessels. By sidelining angiotensin II, blood vessels stay more relaxed, keeping blood pressure lower.

There are drugs that act on angiotensin II. But some high blood pressure patients don't take their medicines as instructed, hence the interest in a blood pressure vaccine

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Cont. The patients got their first, a second dose

a month later, and the third dose three months after that. They also got their blood pressure monitored around the clock at that period and again two weeks after their last shot.

No serious side effects were linked to the vaccine. Adverse events were generally mild and included injection site reactions and flu-like symptoms

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Hypertension hazards:

Damage to your arteries

Damage to your heart

Damage to your brain

Damage to your kidneys

Diabetes type 2(every 3 yrs)

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CDC programs on hypertension :

Program name Key facts

•1998•The program stresses policy and education to promote heart-healthy and stroke-free living and working conditions.

•WISEWOMAN helps women with little or no health insurance reduce their risk for heart disease, stroke, and other chronic diseases.•The program assists women age 40 to 64 in improving their diet, physical activity, and other behaviors. WISEWOMAN also provides cholesterol tests and other screening

•The registries’ data help hospitals close the gap between stroke care guidelines and practice.•The long-term goal is to ensure that all Americans receive the highest quality stroke care available to reduce untimely deaths, prevent disability, and avoid recurrent strokes.

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Cont.•to prevent heart disease and stroke.•The National Forum for Heart Disease and Stroke Prevention implements the Action Plan.•The Forum consists of representatives of public and private health care, along with faith, advocacy, academic, and policy organizations.

Healthy People 2010, the federal government's agenda for building a healthier nation, includes 16 objectives specific to heart disease and stroke. CDC leads the heart disease and stroke programs along with the National Heart, Lung, and Blood Institute.In 2007, researchers assessed the strategies, challenges, and successes of the heart disease initiatives.Healthy People 2010 will take into account changing trends and priorities in public health

A Public Health Action Plan to Prevent Heart Disease and Stroke

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Hypertension statistics:

In 2005 according to WHO:

• 30%of the world deaths due to heart & arterial dses(7.6m are heart stroke 62%,5.7m stroke 49%)

• 80%of them in the developing countries

• In Palestine , 50% of deaths due to heart & arterial dses

• 70% of diabetic patients have hypertension

•Having high blood pressure raises your risk for heart disease and stroke, the first and third leading causes of death in the United States.

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America's High Blood Pressure Burden

About one out of three U.S. adults—31.3%—has high blood pressure.1

High blood pressure is a major risk factor for heart disease, stroke, congestive heart failure, and kidney disease.

High blood pressure was listed as a primary or contributing cause of death for 326,000 Americans in 2006. 2

In 2010, high blood pressure cost the United States $76.6 billion in health care services, medications, and missed days of work.2

About 70% of those with high blood pressure and took medication had their high blood pressure controlled. The control rate was 46.6% among all hypertensive patients.

25% of American adults has prehypertension—blood pressure numbers that are higher than normal, but not yet in the high blood pressure range.2 Prehypertension raises your risk for high blood pressure.

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Hypertension in Palestine

In 2003 the mortality rate in Palestine due to heart dses caused by hypertension was 12.8% (which means 13.4 of a 100000 pop)

In 2003, Of each 100,000 of pop the mortality rate of females was 15 while male were 11.8 compared with 2000 in which females were lower than males of 11.5 f & 14.1 of m.

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References

CDC. Health, United States, 2008. Hyattsville, MD: National Center for Health Statistics; 2008.

NIH. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.   [PDF–223K] . Bethesda, MD: National Heart, Lung, and Blood Institute; 2003.

http://www.cdc.gov/nchs/fastats/hyprtens.htm

http://www.who.int/cardiovascular_diseases/guidelines/en/

http://www.uspreventiveservicestaskforce.org/