source: your guide to lowering blood pressure, pathophysiology bms 243 hypertension dr. aya m....

Source: Your Guide To Lowering Blood Pressure, www.nhlbi.nih.govc

PathophysiologyBMS 243

HypertensionDr. Aya M. Serry

2015/2016


Blood Pressure

Blood pressure is the force of blood pushing against

the arteries.

Blood is carried to all parts of the body in vessels called arteries.


Each time the heart beats (about 60-70 times a

minute at rest), it pumps out blood into the arteries.

Blood Pressure

The blood pressure is at its highest level when the heart beats, pumping the blood.

When the heart is at rest, between beats, the blood pressure falls.

The blood pressure is always given as these two numbers with one above or before the other.

This is called SYSTOLIC pressure.120/To

p

num

ber

80This is called DIASTOLIC pressure.

Bottom number


CategorySystolic

(Top Number)Diastolic

(Bottom Number)

Normal Less than 120 Less than 80

Normal Blood Pressure

“Normal” blood pressure is when both numbers are lower than 120/80.


If the blood pressure is in the prehypertensive range:

It means that the patient does not have high blood pressure now, but he is likely to develop it in the future.

Unless he takes ACTION to prevent it!

“Prehypertension”

Prehypertension 120-139 80-89

NEW!!!


High Blood PressureWhen blood pressure stays elevated over a long period of time it is called high blood pressure or “hypertension”.

High blood pressure is dangerous because it makes the heart work too hard and contributes

to hardening of the arteries .


High Blood Pressure

A blood pressure of 140/90 is considered high blood pressure.

High Blood Pressure Systolic Diastolic

Stage 1 140-159 90-99

Stage 2 160 or higher 100 or higher

“Hypertension”


High Blood Pressure

Warning Signs:

1.2.3.4.“Silent Killer”

“Silent Killer”


Hypertension etiology

The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development, including:

1. Smoking

2. Being overweight or obese

3. Lack of physical activity

4. Too much salt in the diet

5. alcohol consumption

6. Stress

7. Older age

8. Genetics (Family history of high blood pressure)

9. Chronic kidney disease

10.Adrenal and thyroid disorders.


Hypertension Complications

Increases your risk for :

Heart disease & StrokeHeart disease & Stroke

If left uncontrolled, hypertension can also cause:

Heart failure

Heart Attack

Kidney disease

Blindness


Complications of Hypertension

Heart AttackHigh blood pressure is a major risk factor for heart attack. The arteries bring oxygen-carrying

blood to the heart muscle. If the heart cannot get enough

oxygen, chest pain, can occur. If the flow of blood is blocked,

a heart attack results. BlindnessHigh blood pressure can eventually cause blood

vessels in the eye to bleed. Vision may become blurred or otherwise impaired and

can result in blindness.

Kidney diseaseKidneys act as filters to rid

the body of waste. High blood pressure can narrow

and thicken the blood vessels of the kidneys. The kidneys filter less fluid and

waste builds up in the blood. The kidneys may fail

altogether.

High blood pressure is the most important risk factor for stroke. Very high pressure can cause a

break in a weakened blood vessel, which then bleeds in the brain. This can cause a stroke. If

a blood clot blocks one of the narrowed arteries, it can also

cause a stroke.

Stroke

As people get older, arteries throughout the

body "harden," especially those in the heart, brain, and kidneys. High blood

pressure is associated with these "stiffer" arteries.

This, in turn, causes the heart to work harder.

Arteries

Heart failureThe heart is unable to pump enough blood to supply the body's

needs.


Pathophysiology of hypertension

1

•Renin angiotensin aldosteron System(RAAS)

2

•Sympathetic control

3

•Endothelial control


Renin-Angiotensin-Aldosterone System

Renin is a proteolytic enzyme produced by cells of kidney.

It is secreted in response to:

• Decrease in arterial blood pressure.• Decrease Na+ .• Increased sympathetic nervous activity.

Renin acts on a protein ( Angiotensinogen) and cleaves it

to produce Angiotensin-I.

Angiotensin-I is rapidly converted to Angiotensin-II by ACE (angiotensin converting enzyme)

Angiotensin-II stimulates Aldosterone secretion from Adrenal Cortex which causes sodium and water retention..


Vasoconstriction

Renin-Angiotensin-Aldosterone System

Angiotensinogen

Angiotensin I

Angiotensin II

ACE

Renin

Aldosterone secretionSodium & fluid

retention

Fromkidney

From liver

Sympathetic control of blood pressure

Sympathetic stimulation and catcholamines

(Adrenaline and nor adrenaline )

Stimulation of Beta receptors

vasodilatation

Stimulation ofAlpha receptors vasoconstriction

Vasoconstriction activated by -adrenergic receptors would override vasodilatation by -adrenergic receptors.

BP

BP

Endothelial control

Endothelin

Thromboxane A2

Vasoconstriction

BP

Prostacyclin

Bradykinin

Histamine

Serotonin

Vasodilatation

BP

Treatment of hypertension


1. Diuretics: Acts on Kidneys to increase excretion of Na and H2O – decrease in blood volume – decreased BP.

2. Angiotensin-converting Enzyme (ACE) inhibitors:

Inhibit synthesis of Angiotensin II –decreased BP.

3. α-adrenergic blockers:

Bind to alpha adrenergic receptors and blocks the activity, vasodilatation- decreased BP.

Treatment of hypertension


Non pharmacological prevention of Hypertension

You can take action to prevent getting high blood pressure or take steps to control it!

See your doctor for regular blood pressure check ups

Maintaining a healthy weight

Get physically active

Eat a healthy diet rich in vegetables and fruits, and low fat dairy foodsChoose and prepare foods with less salt

If you smoke, think about quitting


1. GET YOUR BLOOD PRESSURE CHECKED.

2. EAT HEALTHY FOODS.

3. GET PLENTY OF EXERCISE.

Our heart health depends on it!

Live Healthy


source: your guide to lowering blood pressure, pathophysiology bms 243 hypertension dr. aya m....

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