Hypertension

Dr Urmila Aswar

Location of the Heart

The heart is located between the lungs

behind the sternum and above the

diaphragm.

It is surrounded by the pericardium.

Its size is about that of a fist, and its weight

is about 250-300 g.

Its center is located about 1.5 cm to the left

of the midsagittal plane.

Anatomy of heart

Anatomy of the heart

The walls of the heart

are composed of

cardiac muscle, called

myocardium.

It consists of four

compartments:

the right and left atria

and ventricles

Blood circulation via heart

• The blood returns from the systemic circulation to the right

atrium and from there goes through the tricuspid valve to the right

ventricle.

• It is ejected from the right ventricle through the pulmonary valve

to the lungs.

• Oxygenated blood returns from the lungs to the left atrium, and

from there through the mitral valve to the left ventricle.

• Finally blood is pumped through the aortic valve to the aorta and

the systemic circulation..

HypertensionHypertension means high blood pressure. High

blood pressure is an increased pressure in blood

vessels.

It can be caused by many factors such as stress,

high cholesterol, and inactivity. It is classified

into mild, moderate, and severe hypertension.

The mild, moderate, or severe hypertension,

have an increased risk of having a heart attack

or a stroke.

Types of hypertension

In 90-95% of patients presenting with

hypertension, the cause is unknown. This

condition is called primary (or essential)

hypertension. The remaining 5-10% of

hypertensive patients have hypertension that

results secondarily from renal disease, endocrine

disorders, or other identifiable causes. This form

of hypertension is called secondary

hypertension.

Hemodynamic basis of hypertension

Blood pressure levels are a function ofcardiac output multiplied by peripheralresistance (the resistance in the bloodvessels to the flow of blood).

Heart rate, stroke volume

Vascular tone

Hypertension

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Hypertension

The major factors which help maintain blood pressure (BP) include the sympathetic nervous system and the kidneys.

Optimal healthy blood pressure is a systolic blood pressure of <120 mmHg and a diastolic blood pressure of <80

<120/80.

Hypertension

Category Systolic Blood

Pressure

Diastolic Blood

Pressure

Normal < 120 <80

Pre-hypertension 120-139 80-89

Hypertension –

Stage 1

140-159 90-99

Hypertension –

Stage 2

>160 >100

Hypertension

As many as 2.8 million children also have

high blood pressure.

The prevalence of hypertension increases

with age.

Prevalence of Hypertension by

Age

Age

18-29

30-39

40-49

50-59

60-69

70-79

80+

% Hypertensive

4

11

21

44

54

64

65

Hypertension

When the normal regulatory mechanisms

fail, hypertension develops.

Hypertension is dangerous because it gives

off no warning signs or symptoms.

Untreated hypertension can result in:

Arteriosclerosis --Kidney damage

Heart Attack --Stroke

Enlarged heart --Blindness

Factors Influencing the Development of

Hypertension

High-normal blood pressure

Family history of hypertension

Overweight

Factors Influencing the Development of

Hypertension

Excess Consumption of Sodium Chloride

Certain segments of the population

are ‘salt sensitive’ because their

blood pressure is affected by salt

consumption

Factors Influencing the Development of

Hypertension

Exercise: Less active

individuals are 30-50% more

likely to develop hypertension.

Alcohol consumption

Factors Influencing the Development of

Hypertension

Other Dietary Factors

Potassium:

Calcium:

Magnesium:

Treatment for Hypertension

Maintain a healthy weight, lose weight if

overweight.

Be more physically active.

Drink alcoholic beverages in moderation.

Reduce the intake of salt and sodium in the

diet to approximately 2400 mg/day.