ASSIGNMENT

ON
HYPERTENSION & DIABETES

Submitted to: Mr. Ehtesham Sarwar

ZSM Novartis Pharma Pakistan ltd
Submitted by: Mohammad Bilal Rashid

HYPERTENSION
DEFINITION

Hypertension or High blood pressure(HBP) is a

common condition in which the force of the
blood against your artery walls is high enough
that it may eventually cause health problems,
such as heart disease.
Blood pressure is summarized by two
measurements, systolicanddiastolic, which
depend on whether the heart muscle is
contracting (systole) or relaxed between beats
(diastole). This equals the maximum and
minimum pressure, respectively.

TYPES OF HYPERTENSION
The two major types are:
Primary or essential hypertension
Secondary hypertension
The other types include:
Malignant Hypertension.
Isolated Systolic Hypertension
Renal Hypertension

PRIMARY HYPERTENSION
This type is also called essential hypertension,
and it is by far the most common type of
hypertension, and is diagnosed in about 95% of
cases. Essential hypertension has no obvious or
yet identifiable cause.
prevalence:
children...about 4 %
middle age ... 11-21 %
50-59 years old ... approximately 44 %
60-69 years old ... approximately 54 %
more than 70 years old ... 64 %

SECONDARY HYPERTENSION

In about 5-10% of people,high blood

pressureis caused by another
disease. If that is the case, it is called
secondaryhypertension. In such
cases, when the root cause is
treated, blood pressure usually
returns to normal or is significantly
lowered.

Malignant Hypertension
The most severe form of hypertension, is severe
and progressive.It rapidly leads to organ
damage.Unless properly treated, it is fatal
within five years for the majority of patients.
Isolated Systolic Hypertension
In this case the systolic blood pressure, (the top
number), is consistently above 160 mm Hg, and
the diastolic below 90 mm Hg.
Renal Hypertension
also called renovascular hypertension, is
elevated blood pressure caused bykidney
disease.

MEASURMENT
Blood pressure measurements fall into four general
categories:
Normal blood pressure.Your blood pressure is normal
if it's below 120/80 mm Hg.
Prehypertension.Prehypertension is a systolic
pressure ranging from 120 to 139 mm Hg or a diastolic
pressure ranging from 80 to 89 mm Hg.
Prehypertension tends to get worse over time.
Stage 1 hypertension.Stage 1 hypertension is a
systolic pressure ranging from 140 to 159 mm Hg or a
diastolic pressure ranging from 90 to 99 mm Hg.
Stage 2 hypertension.More severe hypertension,
stage 2 hypertension is a systolic pressure of 160 mm
Hg or higher or a diastolic pressure of 100 mm Hg or
higher.

SIGNS & SYMPTOMS of HBP

Most people with high blood pressure have
no signs or symptoms, even if blood
pressure readings reach dangerously high
levels.
Although a few people with early-stage high
blood pressure may have dull headaches,
dizzy spells or a few more nosebleeds than
normal, these signs and symptoms usually
don't occur until high blood pressure has
reached a severe or life-threatening stage.

CAUSES OF HBP

Chronic kidney disease

Sleep apnea
Tumors or other diseases of the adrenal gland
Pregnancy
Obesity
Sodium (salt) sensitivity
Alcohol use
Birth control pills (oral contraceptive use)
Lack of exercise (physical inactivity)
Drugs

Pharmacologic treatment of
HBP
DRUG CLASS
DIURETICS

DRUG NAME

MECHANISIM OF
ACTION

Furosemide
increase the
Antihypertensives
Hydroclorothizi
ed

kidney's excretion
of sodium

BETA BLOCKER

Propranolol
Alenolol,
Bisoprolol
Labitalol

reduce the
workload on your
heart and open
your blood vessels

CALCIUM CHANNEL
BLOCKERS

amlodipine,laci
dipine
lercanidipine

help relax the

muscles of your
blood vessels

ANGIOTENSIN
CONVERTING
ENZYME(ACE)
INHABITORS

Captropril
Lisinopril
enalapril
perindopril

help relax blood

vessels by blocking
the formation of a
natural chemical
that narrows blood
vessels

ALPHA BLOCKING

Prazosin

block alpha

Nonpharmacological Treatment HBP

Change of life-style:
intake of salt ... 5 6 g per day
prevention of obesity dietetic
modification
smoking stop
physical activity
psychical relaxation

DIABETES DEFINITION
Diabetes is the condition in which the
body does not properly process food for
use as energy. Most of the food we eat
is turned into glucose, or sugar, for our
bodies to use for energy. The pancreas,
an organ that lies near the stomach,
makes a hormone called insulin to help
glucose get into the cells of our bodies.
When you have diabetes, your body
either doesn't make enough insulin or
can't use its own insulin as well as it
should. This causes sugars to build up
in your blood. This is why many people
refer to diabetes as sugar.

TYPES OF DIABETES
TYPE 1 DIABETES
Type 1 diabetes develops when the bodys
immune system destroys pancreatic beta cells,
the only cells in the body that make the hormone
insulin that regulates blood glucose.
This form of diabetes usually strikes children and
young adults, although disease onset can occur at
any age.
Was previously called insulin-dependent diabetes
mellitus (IDDM) or juvenile-onset diabetes.
Type 1 diabetes may account for 5% to 10% of all
diagnosed cases of diabetes.

TYPE 2 DIABETES
Was previously called non-insulin-dependent
diabetes mellitus (NIDDM) or adult-onset
diabetes.
Type 2 diabetes may account for about 90% to
95% of all diagnosed cases of diabetes.
It usually begins as insulin resistance, a disorder
in which the cells do not use insulin properly. As
the need for insulin rises, the pancreas gradually
loses its ability to produce insulin.
Type 2 diabetes is increasingly being diagnosed
in children and adolescents.

MEASURMENT OF DIABETES
Normal blood glucose levelin humans is about 4 mM
(4 mmol/L or 72 mg/dL)
When operating normallythe body restores blood
sugar levels to a range of 4.4 to 6.1 mmol/L (82 to 110
mg/dL)
Shortly after a mealthe blood glucose level may rise
temporarily up to 7.8 mmol/L (140 mg/dL)
For people with diabetes, blood sugar level targets
are as follows:
Before meals: 4 to 7 mmol/L for people with type 1 or
type 2
After meals: under 9 mmol/L for people with type 1 and
8.5mmol/L for people with type 2

SIGNS & SYMPTOMS OF

DIABETES

Frequent urination
Excessive thirst
Unexplained weight loss
Extreme hunger
Sudden vision changes
Tingling or numbness in hands or feet
Feeling very tired much of the time
Very dry skin
Sores that are slow to heal
More infections than usual

CAUSES OF DIABETES

Genetic Susceptibility
Autoimmune Destruction of Beta Cells
Environmental Factors
Viruses and infections
Infant feeding practices.
Obesity and Physical Inactivity
Abnormal Glucose Production by the Liver
Medications and Chemical Toxins

PHARMACOLOGICAL TREAMENT OF
DIABETES
There are currently four classes of oral
anti-diabetic agents:
i. Biguanides
ii. Insulin Secretagogues Sulphonylureas
iii. Insulin Secretagogues Nonsulphonylureas
iv. -glucosidase inhibitors
v. Thiazolidinediones (TZDs)

PHARMACOLOGICAL TREAMENT OF
DIABETES
DRUG CLASS

DRUG NAME

MECHANISIM OF
ACTION

Biguanides

Metformin

Inhibit glucose
production by
the liver

Sulfonylureas
(second
generation)

Glimepiride
Glipizide
Glyburide

Increase insulin
secretion by
pancreatic beta
cells

Meglitinides

Repaglinide
Nateglinide

Increase insulin
secretion by
pancreatic beta
cells

Thiazolidinedione Pioglitazone
s (TZDs)
Rosiglitazone

Increase glucose
uptake by

NON PHARMACOLOGICAL
TREATMENT

Eat starchy foods regularly

Eat more fruit and vegetables
Reduce animal or saturated fat
Cut down on sugar
Reduce salt
Together with dietary treatment, a
programme of regular physical activity
and exercise should be considered for
each person.

SUMMARY
Both hypertension and diabetes are the
conditions on the human body that
causes many diseases. To overcome and
escape from these conditions we have to
change our life style by taking mandatory
measures on our diet which are not good
for health, by adopting regular physical
activities, by overcome on obesity etc.
THANK YOU