Hypertension (HTN). What Is Hypertension Persistent blood pressure that is higher than the recommended blood pressure range Persistent blood pressure.

Hypertension (HTN)Hypertension (HTN)

What Is HypertensionWhat Is Hypertension

Persistent blood pressure that is Persistent blood pressure that is higher than the recommended blood higher than the recommended blood pressure rangepressure range

About 60% of all Americans have About 60% of all Americans have some form of high blood pressure some form of high blood pressure (pre-hypertension or hypertension)(pre-hypertension or hypertension)

HTN means the heart is working HTN means the heart is working harder than normal putting extra harder than normal putting extra strain on the heart and vessels.strain on the heart and vessels.

Blood Pressure RangesBlood Pressure Ranges

Normal blood pressure range < 120/80Normal blood pressure range < 120/80 Pre-Hypertension >120/80 but <140/90Pre-Hypertension >120/80 but <140/90 Hypertension - >140/90Hypertension - >140/90 Both systolic and diastolic pressures do Both systolic and diastolic pressures do

not have to be out of rangenot have to be out of range Only Systolic or Diastolic must be out of Only Systolic or Diastolic must be out of

range to qualify as hypertensionrange to qualify as hypertension

Two Stages of HTNTwo Stages of HTN

Stage 1 HTN >140/90 but <160/100Stage 1 HTN >140/90 but <160/100 Stage 2 HTN >160/100Stage 2 HTN >160/100

What Causes HTNWhat Causes HTN

90%-95% of the time hypertension is 90%-95% of the time hypertension is elevated blood pressure without an elevated blood pressure without an identifiable cause.identifiable cause.

Exact cause is unknownExact cause is unknown Many contributing factors have been Many contributing factors have been

identified as predisposing factors to identified as predisposing factors to HTNHTN

Predisposing Factors for Predisposing Factors for HTNHTN

Hereditary Predisposition (Family History)Hereditary Predisposition (Family History) Sodium intakeSodium intake WeightWeight Diabetes MellitusDiabetes Mellitus Alcohol ConsumptionAlcohol Consumption SmokingSmoking Serum Lipid Levels (Cholesterol and LDL)Serum Lipid Levels (Cholesterol and LDL) Sedentary LifestyleSedentary Lifestyle EthnicityEthnicity AgeAge GenderGender Socioeconomic StatusSocioeconomic Status StressStress

Signs and SymptomsSigns and Symptoms

Known as the Silent killerKnown as the Silent killer If BP is very high, you may If BP is very high, you may

experience:experience: -fatigue-fatigue -decreased activity tolerance-decreased activity tolerance -dizziness-dizziness -palpitations-palpitations -angina-angina -dyspnea-dyspnea

How HTN is diagnosedHow HTN is diagnosed

Based on the Based on the average of 2+ average of 2+ seated BP seated BP measurements at measurements at the MD’s officethe MD’s office

Must be averagedMust be averaged Must be seated BP Must be seated BP

measurementsmeasurements Must be in the Must be in the

MD’s officeMD’s office

Complications Related to Complications Related to HTNHTN

Heart FailureHeart Failure Enlarged Left Side of the HeartEnlarged Left Side of the Heart Coronary Artery DiseaseCoronary Artery Disease Cerebrovascular disease (Brain)Cerebrovascular disease (Brain) Peripheral Vascular DiseasePeripheral Vascular Disease Kidney FailureKidney Failure Retinal Damage (Eyes)Retinal Damage (Eyes)

Treatment of HTNTreatment of HTN Different types require different treatmentsDifferent types require different treatments Pre-Hypertension – Lifestyle modificationsPre-Hypertension – Lifestyle modifications Stage I Hypertension – Lifestyle Stage I Hypertension – Lifestyle

modifications and a thiazide-type diureticmodifications and a thiazide-type diuretic Stage II Hypertension – Lifestyle Stage II Hypertension – Lifestyle

modifications, thiazide-type diuretic and modifications, thiazide-type diuretic and one another antihypertensive drugone another antihypertensive drug

Not definitiveNot definitive Treatment is personalizedTreatment is personalized

How to Prevent HTNHow to Prevent HTN Lifestyle modifications prevent HTN and include:Lifestyle modifications prevent HTN and include: -Maintaining a Healthy Weight-Maintaining a Healthy Weight -Reduce Salt/Sodium Intake-Reduce Salt/Sodium Intake -Increase Physical Exercise-Increase Physical Exercise Smoking CessationSmoking Cessation Limit Alcohol ConsumptionLimit Alcohol Consumption Limit Fat IntakeLimit Fat Intake Control DiabetesControl Diabetes Stress Relieving TechniquesStress Relieving Techniques Take BP Meds as OrderedTake BP Meds as Ordered Home Monitoring of BPHome Monitoring of BP

ReferencesReferences

Lewis, S. L., Heitkemper, M. M., Lewis, S. L., Heitkemper, M. M., Dirksen, S. R., O’Brien, P. G., & Dirksen, S. R., O’Brien, P. G., & Bucher, L. (2007). Bucher, L. (2007). Medical-Srugical Medical-Srugical Nursing: Assessment and Nursing: Assessment and Management of Clinical Problems.Management of Clinical Problems. Missouri: Mosby.Missouri: Mosby.