HYPERTENSION

A BIG PROBLEM IN THE PHILIPPINES

Hypertension Kills!
Hypertension if uncontrolled causes damage to various organs in the body Organs affected includes: - Heart- heart attack and heart failure - Brain- lead to stroke and internal bleeding - Kidneys- renal failure - Eyes- blindness - Peripheral blood vessels- claudication & gangrene

Statistical Significance
21% prevalence in the Philippines Heart Disease death No.1 in the century Roughly 8.6% of Filipinos are hypertensive 59% have target organ damage: Heart attacks : 3.4%, Stroke: 11.5 %, Kidney damage: 53 % Only 13.6 %of hypertensives are aware they have the disease.

Definition
Hypertension is an abnormal condition of the small vessels of the arterial system in which the systolic or diastolic pressure is elevated. Normal BP reading during rest: below 140/90 mm.Hg Systolic pressure- is always higher and measures the pressure during heart beat Diastolic pressure- measures the pressure in the arteries while the heart is relaxed

Types of Hypertension
1. Primary (Essential) Hypertension - Most common form (90%) - the cause remains unidentifiable - onset is insidious with slow, progressive increase in BP over the years 2. Secondary Hypertension- elevated BP due to some underlying condition (510%)

Phases of Primary Hypertension

PHASE
1. Prehypertensive

BP RANGE <160/9095

CHARACTERIS TICS

THERAPY Relief of Symptoms only

BP elevationno vascular change BP elevated intermittently Headache, giddiness, insomnia, forgetfullness, irritability, epistaxis

Phases of Primary Hypertension

Phase BP Range Characteris tics Headache giddiness, insomnia, forgetfulnes s, irritability, epistaxis, blurring of vision Therapy periodic check-up antihypertensiv e drugs

2. Benign <200/90 Hypertensi- mm.Hg on

Benign Hypertension
Phase Mild BP Range Diastole 90-104 Diastole 105-114 Diastole >115 mm.Hg Initiate treatment Occurs in older adults in high risk patients Characteris Therapy tics

Moderate Severe

Phases of Primary Hypertension

3.Malignant Diastole Hypertensi >130 on mm.Hg occurs in young adults charaterize d by sudden rise in BP & rapid decline of renal function

Phases of Primary Hypertension

Acute Hypertensi on Diastole >140mm. Hg Physical findings of encephalop aty, confusion, headache, coma, seizures

Risk factors of Primary Hypertension

a. Age- highest incidence age 30-40 b. Race- incidence twice as high in blacks 3x greater for black men 5x greater for black women c. Gender- complications more in men d. Family history- 75% with familial history e. Obesity- increases risk of hypertension f. Serum lipids- high triglycerides or cholesterol g. Diet: high sodium, high fat, high caloric diet h. smoking

Classification of High Blood Pressure

CATEGORY RANGE

Normal Blood Pressure Borderline

Isolated Systolic Hypertension Mild Hypertension Moderate Hypertension

Below 140/90 140-159/85 to 89

Above 160 90-104 Diastolic BP 105-114 Diastolic BP

Severe Hypertension

115 or more DBP

Contributory Factors for the Development of Hypertension

1. Obesity- 20% over Ideal weight adds to Cardiac overload 2. Cigarette smoking due to inhalation of nicotine and carbon monoxide -nicotine- a vasoconstrictor -Carbon monoxide- reduces the oxygen carrying capacity of the blood

Complications of Hypertension
1. Hypertensive crisis -severe increase in blood pressure that can lead to a stroke>180/110 2. Coronary Artery Disease -is a condition in which plaque builds up inside the coronary arteries 3. Congestive Heart Failure -a condition in which the heart can't pump enough blood to the body's other organs.

Complications of Hypertension
4. Aortic Aneurysm and dissection 5. CVA 6. Renal Disease 7. Peripheral vascular Disease 8 Sudden Death

Prevention and Control

1. Balancing control and rest a. modify lifestyle- to achieve physical & emotional rest b. modify activities- restricting strenuous or severe physical exertion c. stress management d. relaxation exercises

Prevention and Control

2. Reducing Circulatory load -limit dietary load of sodium to control water retention - low caloric diet to prevent obesity -low cholesterol, low fat diet to prevent atherosclerosis

Prevention and Control

3. Regular BP monitoring - must keep record of blood pressure taken everyday 4. Importance of Antihypertensive therapy - follow strictly the doctors instruction -always take the medication even if feeling well

CARDIOVASCULAR DISEASES

Cardiovascular Diseases
- Problems that may occur in the heart and blood vessels consisting of 3 independent parts: the heart ( pumping mechanism), the blood vessels( flow regulating mechanism) and blood (delivery and regulatory mechanism)

Cardiovascular Risk Factors

A. Major risks that cannot be changed Heredity- tendency toward heart disease runs in families Race- blacks Sex -males have higher risk of heart attack and stroke than women Age- 50% heart attacks occur in people age 65 or older

Cardiovascular Risk Factors

B. Major risks that can be changed a. smoking- smokers have 2x more heart attacks than non-smokers b. high blood pressure -leads to heart enlargement and failure c. Blood cholesterol level- increase the risk of heart disease

Other Risk Factors

Diabetes- raises blood cholesterol level thus increasing the risk of heart attack Obesity- defined as 30% or more over your ideal body weight Physical inactivity Stress Oral contraceptives- can raise blood cholesterol level and increase blood pressure Alcohol-can cause high blood pressure

What a Heart Attack Feels like?

-Heart attack starts with only mild discomfort, hours, days or even weeks as nasty bouts of heartburns, stomach pain and unusual tiredness - Sudden shortness of breath - Sudden sweating and/or flu-like symptomsnausea, clamminess or cold sweats - Unusual fatigue, light-headedness, weakness or dizziness - Pain in the upper back, neck, jaw or between shoulder blades - Classic chest pain or feeling of fullness

Stroke Alert
Transient ischemic attack (TIA) or mini stroke is a warning of an impending stroke Warning signs: a. Sudden blurred or decreased vision in one or both eyes b. Sudden numbness, weakness or paralysis of the face, arm, leg or both sides of the body c. Sudden confusion, trouble in speech and comprehension d. Sudden difficulty in walking, loss of balance and coordination e. Difficulty of swallowing f. Sudden severe headache

When Stroke Strikes

Get medical help! While waiting for help and if victim is conscious: a. lay the person down with head and shoulders slightly raised b. lay the person on the weak side so saliva can drain from mouth c. loosen clothing at the neck, chest and waist d. restore breathing by mouth to mouth resuscitation e. do not offer anything to eat or drink f. assure victim that help is on the way

If victim becomes unconscious:

Put the victim in the lateral recumbent position- to prevent blood, saliva or tongue from blocking the windpipe and choking the victim. Carefully roll the victim to his stomach, the arm and leg on one side . Tilt the victims chin back to straighten the throat.

BRAIN ATTACK (STROKE)

The human brain has 100 billion nerve cells and million of nerve cell connection. The brain uses 70% of our bodys oxygen and nutrients but it cannot store them Stroke occurs when the blood supply is altered and brain tissue is starved of blood

Main Types of Stroke

A. Ischemic Stroke- Dry Type - 80% are caused by atheroclerosis (cholesterol plaque) which roughens the inner side of arteries- turbulence- clot formation -usually affects the cerebrum, the part of the brain that controls movement, speech and senses

Main Types of Stroke

B. Hemorrhagic Type- Wet Type - occurs when a blood vessel in the brain leaks or ruptures. Blood from the hemorrhage spills into the surrounding brain tissue causing damage. - brain cells beyond the leak or rupture are deprived of blood and are also damaged -less common but more deadly - typically occurs in young adults

Causes of Hemorrhagic Stroke

Rupture of aneurysm Hypertension- can weaken blood vessel walls which can rupture and cause hemorrhage Rupture of arterio-venous malformation- a congenital malformation of thin walled blood vessels which can rupture and cause damage to brain tissues.

Prevention of Stroke
Choose a healthy lifestyle Exercise regularly Watch your weight Keep stress under control Stop smoking Limit alcohol Avoid extra caffeine Cut down on salt and cholesterol intake

End of my lecture Thank You!