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Define Hypertension
- Systolic BP: > 140 mmHg
- Diastolic BP: > 90 mmHg
- -based on the average of two or more accurate blood pressure measurements.
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Normal BP:
- Systolic: < 120 mmHg
- Diastolic: < 80 mmHg
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Prehypertension
- Systolic: 120-139
- Diastolic: 80-89
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Stage 1 htn:
- Systolic: 140-159
- Diastolic: 90-99
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Stage 2 htn:
- Systolic: > or = to 160
- Diastolic: > or = 100
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Define primary hypertension:
also called essential htn; denotes high BP from an unidentified cause
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Define secondary hypertension:
High BP related to identified causes, such as renal disease, narrowing of the renal arteries, renal parenchymal disease, hyperaldosteronism, certain medications, pregnancy, and coarctation of the aorta.
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Risk factors:
- -atherosclerotic heart disease
- -dyslipidemia (abnormal blood fat levels)
- -obesity
- -diabetes mellitus
- -metabolic syndrome
- -sedentary lifestyle
- -heart failure
- -coronary artery disease
- -hx of stroke
- -smoking
- -age > 60
- -family hx of htn
- -excessive caloric intake
- -high salt or caffeine intake, low K, Ca, Mg intake
- -Gender-women after menopause have higher rates
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Right-sided Heart failure
Systemic circulation: Peripheral edema
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Left-sided Heart failure
Pulmonary: edema in the lungs
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Htn as a sign:
Nurses and other health care professionals use blood pressure to monitor a patient's clinical status. Elevated pressure may indicate an excessive dose of vasoconstrictive medication or other problems.
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Htn as a risk factor:
Htn contributes to to the rate at which atherosclerotic plaque accumulates within arterial walls, retinal problems, heart, kidneys.
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Htn as a disease:
Htn is a major contributor to death from cardiac, cerebrovascular, renal, and peripheral vascular disease.
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Prolonged BP elevation damages:
- Blood vessels throughout the body, particularly in target organs such as the:
- heart
- kidneys
- brain
- eyes
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Usual consequences of prolonged, uncontrolled htn:
- Myocardial Infarction
- Heart failure
- Renal failure
- Strokes
- Impaired vision
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Manifestations of target organ damage
- Heart - CAD, MI, Angina
- Brain - headache, tingling, numbness on one side of the body
- Kidney - proteinuria, ^ BUN
- Peripheral arteries - venous pooling, edema
- Retina - vision changes
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b Define hypertrophy
Enlargement of the left ventricle of the heart may ocur as it works to pump blood against the elevated pressure
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N102 med therapy for htn:
- thiazide diuretics (hydrochlorothiazide)
- Loop diuretics - furosemide (Lasix)
- Potassium-sparing diuretics
- Aldosterone receptor blockers
- Central Alpha2-Agonists and other centrally acting drugs
- Beta blockers - (slows HR)
- -Propanolol (Inderal)
- -Metoprolol (lopressor)
- Vasodilators
- -Nitroglycerine (only in hypertensive emergencies)
- ACE-Angiotensin Converting Enzymes Inhibitors - stops vasoconstriction
- -Ramipril (Altace)
- -Captopril (Capoten)
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