Definition:
It is the sustained elevated blood pressure above 140/80mmHg
Types:
There are two types of the hypertension
Primary hypertension
Secondary hypertension
Primary hypertension:
In this type of hypertension there is no exact known cause for the hypertension. In this type basically genes are involved. It can be treated by simply detecting the gene responsible for causing the increase in the blood pressure and then replace that gene.
Secondary hypertension:
In this type of hypertension there is a definite underlying cause. Any system may be involved in it. For example CVS may be involved. Improper vasodilation and vasoconstriction may cause the resistance.
Phases of hypertension:
Systolic phases:
Mild phase:
Its reading is 140-160mmHg.
Moderate phase:
Its reading is 160-180.
Severe phase:
Its reading is above 180.
Diastolic phase:
Mild phase:
Its reading is 80-90.
Moderate phase:
Its reading is 90-100.
Severe phase:
Its reading is above 100.
Complications:
Cerebrovascular accident
Chronic/severe headache
Glaucoma
Epistasis
Deafness
Myocardial infarction
Loss of vision
Psychogenic
Renal failure
Paralysis
Measurement of blood pressure:
Stygmomonometre plus stethoscope are used to measure the blood pressure. Stethoscope is placed on the bronchial artery and inflates the balloon up to 200. Now slowly deflate the valve. A particular sound called karat cuff’s sound is heard. Note that level. Now further deflate the valve and note that sound at which sound disappeared. First one is the systolic and the second sound is the reading of the diastolic phase.
Regulation of blood pressure:
The normal process is regulated by the Kidney and Adrenal gland. If they are not working proper than anti-hypertensive drugs are used.
In case of the adrenal gland aldosterone, corticosteroid, mineralocorticoid, androgen secreted from cortex and nor epinephrine and epinephrine secreted from medulla are responsible for regulating the blood pressure. Increase in aldosterone causes the increase in sodium and water which in turn cause the hypertension. In this case simply message goes to the center in the medulla which stimulates the aldosterone that increases the Na and water reabsorption causing increase in blood pressure and vise versa.
In case of the kidney there is a proper system known as the renin angiotensinogen system is involved. On this system renin act and convert it to angiotensin 1 on which than ACE act and convert it to the angiotensin 2. This further causes the peripheral resistance and smooth muscle contraction which causes the hypertension. NO is also present in the kidney which is a anti-hypertensive.
Etiological factors:
Hormonal imbalance
Increase salt intake
Smoking
Aging
Hyperlipidemia
Stress
Diabetes mellitus
Treatment:
First of all patient should maintain the
Dietary changes
Physical exercise
Weight loss
Medication:
Anti-hypertensive
