HYPERTENSION

Prepared by: Prof. Gloria Shiela Edmilao- CoyocaHYPERTENSIONOver 276 Filipinos die of heart disease everyday.;

At least one Filipino suffers from stroke every nine minutes

Reference: (Department of Health, 2014)

https://www.google.com.phStatistics from the Department of Health (DOH) show that over 276 Filipinos die of heart disease everyday and at least one Filipino suffers from stroke every nine minutes, making both among the top leading causes of death in the country(Manongdo, J.F, 2014)

Source of picture: https://www.google.com.ph/search?q=increasing+incidence+of+hypertension+among+filipinos&espv=2&biw=1366&bih=667&source=lnms&tbm=isch&sa=X&ved=0

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Escalate to 1.56 billion (2025)

Reference: World health report 2002The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1.56 billion(1.54 1.58 billion/ 3What is Blood Pressure? is the product of cardiac output multiplied by peripheral resistance.

Cardiac output is the product of the heart rate multiplied by the stroke volume. In normal circulation, pressure is exerted by the flow of blood through the heart and blood vessels. High blood pressure, known as hypertension, can result from a change in cardiac output, a change in peripheral resistance, or both. 4Cardiac outputis the volume of blood pumped by the heart per minute (mL blood/min).

is the volume of blood pumped by the heart per minute (mL blood/min). Cardiac output is a function of heart rate and stroke volume. The heart rate is simply the number of heart beats per minute. The stroke volume is the volume of blood, in milliliters (mL), pumped out of the heart with each beat.

The medications used for treating hypertension decrease peripheral resistance, blood volume, or the strength and rate of myocardial contraction.

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DIURETCSClorpres

Hyzaar

Dyazide

Lasix

Demadex

Approved Herbal Medicine By Philippine Department Of HealthBanaba Herb

Banaba Herb is a medicinal herb endorsed by the Philippine Department of heath that has medicinal value for diabetes treatment and weight loss

7Sambong (Blumea balsamifera L.)

Health Benefits of Sambong:

Good as a diuretic agent Effective in the dissolving kidney stones Aids in treating hypertension & rheumatism Treatment of colds & fever Anti-diarrheic properties Anti-gastralgic properties Helps remove worms, boils Relief of stomach pains Treats dysentery, sore throat8Lemongrass (fever grass)

Vitamins A &C, folate, zinc, iron, potassium,phosphorus, calcium

Nutritionally, lemongrass is a good source of vitamins A and C, folate, folic acid, magnesium, zinc, copper, iron, potassium, phosphorus, calcium and manganese. It also has minute traces of B vitamins.

Along with its culinary uses, lemongrass is useful in alternative or complementary remedies for a wide range of ailments.

9Peripheral vascular resistance a resistance to the flow of blood determined by the tone of the vascular musculature and the diameter of the blood vessels.

It is responsible for blood pressure when coupled with stroke volume.The medications used for treating hypertension decrease peripheral resistance, blood volume, or the strength and rate of myocardial contraction.

10What is Hypertension? is a condition where the persons blood pressure is persistently elevated beyond what is medically considered normal level.

Hypertension is a systolic blood pressure greater than 140 mm Hg and a diastolic pressure greater than 90 mm Hg over a sustained period, based on the average of two or more blood pressure measurements taken in two or more contacts with the health care provider after an initial screening (Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [JNC VI], 1997).

High Blood Pressure, or Hypertension, is a condition where the persons blood pressure is persistently elevated beyond what is medically considered normal level. - See more at: http://asianjournal.com/lifestyle/high-blood-pressure-the-silent-killer/#sthash.EUSNlaGH.dpuf11CATEGORYBlood Pressure mmHgNormalSBP 90 -119 or DBP 60 -79Pre hypertensionSBP 120- 129 or DBP 80 - 89Stage 1 HTNSBP 130 159 or DBP 90 - 99Stage 2 HTN SBP >160 or DBP>100Types of HypertensionPrimary hypertension

Between 20% and 25% of the adult population in the United States has hypertension (Burt et al., 1995b). Of this population, between 90% and 95% have primary hypertension, meaning that the reason for the elevation in blood pressure cannot be identified. The remaining 5% to 10% of this group have high blood pressure related to specific causes, such as narrowing of the renal arteries, renal parenchymal disease, hyperaldosteronism (mineralocorticoidhypertension) certain medications, pregnancy, and coarctation of the aorta (Kaplan, 2001). Secondary hypertension is the term used to signify high blood pressure from an identified cause.13Secondary hypertension

The remaining 5% to 10% of this group have high blood pressure related to specific causes, such as narrowing of the renal arteries, renal parenchymal disease, hyperaldosteronism (mineralocorticoidhypertension) certain medications, pregnancy, and coarctation of the aorta (Kaplan, 2001). Secondary hypertension is the term used to signify high blood pressure from an identified cause.

14What is White-Coat Hypertension?

White-Coat Hypertension is a condition where the patients blood pressure goes up when he/she goes to visit the doctor. Somehow the White Lab Coat of the physician taking the blood pressure seems to jack up anxiety and the adrenalin level in the waiting patient, leading to a rise in the blood pressure of this patient, but only temporarily if the patient is really not a hypertensive. And when a nurse takes the blood pressure, it is back down to normal. - See more at: http://asianjournal.com/lifestyle/high-blood-pressure-the-silent-killer/#sthash.EUSNlaGH.dpuf15Silent Killer"Headache

Dizziness

blurred vision

nausea and vomiting

Chest pain & DOB

High blood pressure usually causes no symptoms and high blood pressure often is labeled "the silent killer." People who have high blood pressure typically don't know it until their blood pressure is measured.16Complications:Myocardial infarction

Heart failure

Cerebrovascular accident (stroke or brain attack)

Renal Failure

Left ventricular hypertrophy TIAs

17Abdominal aortic aneurysm A localized sac or dilation formed at a weak point in the artery.

Atherosclerosis

affects men four times more often than women

Prevalent in elderly patients

Ref: Rutherford, 2009

The most common cause of abdominal aortic aneurysm is atherosclerosis. The condition, which is more common among Caucasians, affects men four times more often than women and is most prevalent in elderly patients (Rutherford,2005). Most of these aneurysms occur below the renal arteries (infrarenal aneurysms). Untreated, the eventual outcome may be rupture and death.18

Risk factorsgenetic predisposition

tobacco use

hypertension(more than half of the patient)Risk factors include genetic predisposition, tobacco use, and hypertension; more than half of patients with aneurysms have hypertension.19Clinical ManifestationsOnly 40% have symptoms

complain that they can feel their heart beating in their abdomen when lying down

Feel an abdominal mass

Only about 40% of patients with abdominal aortic aneurysms have symptoms. Some patients complain that they can feel their heart beating in their abdomen when lying down, or they may say they feel an abdominal mass or abdominal throbbing. If the abdominal aortic aneurysm isassociated with thrombus, a major vessel may be occluded or smaller distal occlusions may result from emboli. Small cholesterol, platelet, or fibrin emboli may lodge in the interosseous or digital arteries, causing cyanosis and mottling of the toes.20Implication Avoid massage(Hilot)?

Rupture

Death

Risk factorsAgeAge-related changes in the cardiovascular system. The major age-related changes in the cardiovascular system are (a) arterial stiffening; (b) endothelialdysfunction, which promotes vasoconstriction; (c) elevated systolic blood pressure and increased pulse pressure; (d) increased left ventricular wall thickness;(e) reduced early diastolic filling of the ventricles; (f) impaired cardiac reserve; (g) alterations in heart rate rhythm; (h) prolonged cardiac action potential; and (i) a decline in renal function that contributes to improper maintenance of extracellular fluid volume and composition. These age-associated changes incardiovascular function contribute to morbidity and mortality brought about by various disease states (i.e., hypertension, atherosclerosis, heart failure, etc.).22Age-Associated Cardiovascular ChangesIncreased wall thickening & arterial wall stiffening+Endothelial dysfunction

Elevated blood pressure

Left ventricular hypertrophy

Reduction in the production of NO by the endothelial cells, it has been demonstrated that the bioavailability of NO is reducedwith aging (5). This reduction is thought to be mainly the result of an increase in oxidative stress during aging.Endothelial cells are found in the arterial walls. Endothelial cell - line the inside of every blood vessel in the body, also found on the inner walls of the heart chambers and lymphatic vessels (which carry excess blood plasma around the body).

AGE RELATED CHANGES IN HEALTHGeriatric Nursing Protocol: Age-Related Changes in Health

Constance M. Smith, PhD, RN, Valerie T. Cotter, MSN, CRNP, FAANP

Evidence-Based Content - Updated July 2012 Age-Associated Cardiovascular Changes

A. Definition(s): Isolated systolic hypertension: systolic BP >140 mm Hg and diastolic BP