HYPERTENSION

HYPERTENSION (HTN)

or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Blood pressure is summarised by two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole).

HYPERTENSION

is classified as either primary (essential) hypertension or secondary hypertension; about 90–95% of cases are categorized as "primary hypertension" which means high blood pressure with no obvious underlying medical cause.[1] The remaining 5–10% of cases (secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart or endocrine system.

Hypertension puts strain on the heart, leading to hypertensive heart disease and coronary artery disease if not treated. Hypertension is also a major risk factor for stroke, aneurysms of the arteries (e.g. aortic aneurysm), peripheral arterial disease and is a cause of chronic kidney disease. A moderately high arterial blood pressure is associated with a shortened life expectancy while mild elevation is not. Dietary and lifestyle changes can improve blood pressure control and decrease the risk of health complications, although drug treatment is still often necessary in people for whom lifestyle changes are not enough or not effective

Understanding Blood Pressure

The circulatory system is made up of the heart and blood vessels that carry blood through the body. Your heart is the pump for this system. With each heartbeat (contraction), the heart sends blood out through large blood vessels

called arteries. Blood pressure is a measure of how hard the moving blood pushes against the

walls of the arteries.

Measuring Blood Pressure

Your blood pressure is too high if it measures 140/90

(140 over 90) or higher most of the time. The top number

is the pressure of blood against the artery walls

during a heartbeat (systolic). The bottom

number is the pressure of blood against artery walls

between heartbeats (diastolic).

Types of hypertension

1. Malignant Hypertension

Malignant hypertension is extremely high blood pressure that develops

rapidly and causes some type of organ damage. "Normal" blood pressure is

below 140/90. A person with malignant hypertension has a blood pressure that's

typically above 180/120. Malignant hypertension should be treated as a

medical emergency.

2.Secondary Hypertension

Secondary Hypertension In about 10% of people, high blood pressure is

caused by another disease. If that is the case, it is called secondary

hypertension. In such cases, when the root cause is treated, blood pressure

usually returns to normal or is significantly lowered.

3.Renal Hypertension

Renal Hypertension Renal hypertension, also called renovascular hypertension, is elevated

blood pressure caused by kidney disease. It can usually be controlled by blood pressure drugs. Some people with renal hypertension can be helped by angioplasty, stenting, or surgery on

the blood vessels of the kidney.

What causes hypertension?Though the exact causes of hypertension are usually unknown, there are several factors that have been highly associated with the condition. These include:

•Smoking •Obesity or being overweight•Being obese/overweight as a child •Diabetes•Sedentary lifestyle•Lack of physical activity •High levels of salt intake (sodium sensitivity)

• Insufficient calcium, potassium, and magnesium consumption

• Vitamin D deficiency• High levels of alcohol consumption • Stress • Aging • Medicines such as birth control pills• Genetics and a family history of

hypertension• Chronic kidney disease • Adrenal and thyroid problems or tumors

One of the most dangerous aspects of hypertension is that

you may not know that you have it. In fact, nearly one-third of

people who have high blood pressure don't know it. The only way to know if your blood

pressure is high is through regular checkups. This is

especially important if you have a close

relative who has high blood pressure.

Symptoms

Extremely high blood pressure may lead to some symptoms, however, and these include: • Severe headaches • Fatigue or confusion • Dizziness • Nausea• Problems with vision • Chest pains • Breathing problems • Irregular heartbeat • Blood in the urineUntreated hypertension can lead to serious diseases including stroke, heart attack, kidney failure and eye problems.

PREGNANCY

Hypertension occurs in approximately 8–10% of pregnancies.[5] Two blood pressure measurements six hours apart of greater than 140/90 mm Hg is considered diagnostic of hypertension in pregnancy.[8] Most women with hypertension in pregnancy have pre-existing primary hypertension, but high blood pressure in pregnancy may be the first sign of pre-eclampsia, a serious condition of the second half of pregnancy and puerperium.[5] Pre-eclampsia is characterised by increased blood pressure and the presence of protein in the urine.[5] It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally.[5] Pre-eclampsia also doubles the risk of perinatal mortality.[5] Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of pre-eclampsia occur the most common are headache, visual disturbance (often "flashing lights"), vomiting, epigastric pain, and edema.

How is hypertension diagnosed?

Hypertension may be diagnosed by a health professional who measures blood pressure with a device called a sphygmomanometer - the device with the arm cuff, dial, pump, and valve. The systolic and diastolic numbers will be recorded and compared to a chart of values. If the pressure is greater than 140/90, you will be considered to have hypertension.

A high blood pressure measurement, however, may be spurious or the result of

stress at the time of the exam. In order to perform a more thorough diagnosis,

physicians usually conduct a physical exam and ask for the medical history of you

and your family. Doctors will need to know if you have any

of the risk factors for hypertension, such as

smoking, high cholesterol, or diabetes.

If hypertension seems reasonable, tests such as electrocardiograms (EKG) and echocardiograms will be used in order to measure electrical activity of the heart and to assess the physical structure of the heart. Additional blood tests will also be required to identify possible causes of secondary hypertension and to measure renal function, electrolyte levels, sugar levels, and cholesterol levels.

How can hypertension be prevented? Hypertension can best be prevented by adjusting your

lifestyle so that proper diet and exercise are key components. It is important to maintain a healthy

weight, reduce salt intake, reduce alcohol intake, and reduce stress.

In order to prevent damage to critical organs and conditions such as stroke, heart attack, and kidney

failure that may be caused by high blood pressure, it is important to screen, diagnose, treat, and control hyper

tension in its earliest stages. This can also be accomplished by increasing public awareness and

increasing the frequency of screenings for the condition.

How is treated?The main goal of treatment for hypertension is to lower blood pressure to less than 140/90 - or even lower in some groups such as people with diabetes,

and people with chronic kidney diseases. Treating

hypertension is important for reducing the risk of stroke,

heart attack, and heart failure.

Lifestyle Changes to Treat High Blood Pressure• A critical step in preventing and treating high blood pressure is a

healthy lifestyle. You can lower your blood pressure with the following lifestyle changes:

• Losing weight if you are overweight or obese.• Quitting smoking.• Eating a healthy diet, including the DASH diet (eating more fruits,

vegetables, and low fat dairy products, less saturated and total fat).• Reducing the amount of sodium in your diet to less than 1,500

milligrams a day if you have high blood pressure. Healthy adults should try to limit their sodium intake to no more 2,300 milligrams a day (about 1 teaspoon of salt).

• Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week).

• Limiting alcohol to two drinks a day for men, one drink a day for women.

High Blood Pressure Treatment Follow-Up• After starting high blood pressure drug

therapy, you should see your doctor at least once a month until the blood pressure goal is reached. Once or twice a year, your doctor may check the level of potassium in your blood (diuretics can lower this, and ACE inhibitors and ARBs may increase this) and other electrolytes and BUN/creatinine levels (to check the health of the kidneys).• After the blood pressure goal is reached,

you should continue to see your doctor every three to six months, depending on whether you have other diseases such as heart failure.

• However, your doctor may start a medicine other than a diuretic as the first line of therapy if you have certain medical problems. For example, ACE inhibitors are often a choice for a people with diabetes. If one drug doesn't work or is disagreeable, additional medications or alternative medications may be recommended.• If your blood pressure is more than 20/10 points higher

than it should be, your doctor may consider starting you on two drugs or placing you on a combination drug.

Drugs to Treat High Blood Pressure

• There are several types of drugs used to treat high blood pressure, including:• Angiotensin-converting enzyme (ACE) inhibitors• Angiotensin II receptor blockers (ARBs)• Diuretics• Beta-blockers• Calcium channel blockers• Alpha-blockers• Alpha-agonists• Renin inhibitors• Combination medications• Diuretics are often recommended as the first line of therapy for most people who

have high blood pressure.

Worked:• Erisa Hoxha• Jonida Xhafa•Kamila Hasanbega•Gerla Xhelili• Inva Duka •Gerta Shllaku