HYPERTENSION IN ENGLISH

                                                         

                                              HYPERTENSION IN ENGLISH

                          watch my YouTube video to understand this topic in easy way-

       https://www.youtube.com/watch?v=eSlJKzV-RNM

HYPERTENSION-

•        Blood pressure (BP) is defined as the force of blood exerted against the arterial wall. It reflects the blood viscosity (thickness) and resistance of blood vessel.  Two terms are used for blood pressure-

•        Systolic and Diastolic

•        Systolic blood pressure  is the highest arterial pressure when the heart contracts and pushes blood into arteries.

•        Diastolic blood pressure is the lowest arterial pressure when the heart relaxes to fill with blood and not pumping blood into arteries.

•        Hypertension is defined as a systolic blood pressure greater than 140 mm Hg and a diastolic pressure greater than 90 mm Hg based on the average of two or more accurate blood pressure measurements taken during two or more contacts with a health care provider

•        This is the reference  range for blood pressure

•        Normal -120 and 80

•        Prehypertension-  120–139 and 80–89

•        Stage 1 hypertension-  140–159 or 90–99

•        Stage 2 hypertension-  160 or 100

EFFECTS OF HYPERTENSION-

•        Hypertension is sometimes called the “silent killer” because people who have it are often symptom free. Once identified, elevated blood pressure should be monitored at regular intervals because hypertension is a lifelong condition.

•        Prolonged blood pressure elevation eventually damages blood vessels throughout the body, particularly in target organs such as the heart, kidneys, brain, and eyes.

•        uncontrolled and longterm hypertension normally results in myocardial infarction, heart failure, renal failure, strokes, and impaired vision.

PATHOPHYSIOLOGY OF HYPERTENSION-

•        Hypertension can result from an increase in cardiac output or an increase in peripheral resistance  or both. it is understood that hypertension is a multifactorial condition.

CAUSATIVE FACTORS OF HYPERTENSION-

•        Many factors have been identified as causes of hypertension:

•        •Increased sympathetic nervous system activity related to dysfunction of the autonomic nervous system

•        • Increased renal reabsorption of sodium, chloride, and water  (overloading of vascular system) . This leads to peripheral vascular resistance and finally contributing to hypertension.

•          • Increased activity of the renin–angiotensin–aldosterone system, resulting in expansion of extracellular fluid volume and increased systemic vascular resistance  leading to hypertension

•        Decreased vasodilation of the arterioles related to dysfunction of the vascular endothelium or atherosclerosis.

•        • Resistance to insulin action, which may be a common factor linking hypertension, type 2 diabetes mellitus, hypertriglyceridemia, obesity, and glucose intolerance

•        Structural and functional changes in the heart and blood vessels contribute to increases in blood pressure that occur with aging. The result of these changes is decreased elasticity of the major blood vessels.

CLINICAL MANIFESTATIONS-

•        Initially hypertension is asymptomatic, Physical examination may reveal no abnormalities other than elevated blood pressure that’s why it is known as silent killer.

•        Later on retinal changes such as hemorrhages, exudates (fluid accumulation), arteriolar narrowing, and cotton-wool spots (small infarctions) occur. In severe hypertension, papilledema (swelling of the optic disk) may be seen.

•        When specific signs and symptoms appear, they usually indicate vascular damage, with specific manifestations related to the organs served by the involved vessels. Coronary artery disease with angina and myocardial infarction are common consequences of hypertension.

•        Cerebrovascular involvement may lead to a stroke or transient ischemic attack (TIA), manifested by alterations in vision or speech, dizziness, weakness, a sudden fall, or transient or permanent paralysis on one side (hemiplegia).

DIAGNOSTIC INVESTIGATIONS-

•        To assess hypertension a thorough health history and physical examination & BP monitoring are necessary.

•        The retinas are examined and laboratory studies are performed to assess possible target organ damage.

•        Routine laboratory tests include urinalysis, blood chemistry  such as analysis of sodium, potassium, creatinine, fasting glucose, and total and high-density lipoprotein [HDL] cholesterol levels  (lipid profile)

•        A 12-lead electrocardiogram (ECG) is very useful diagnostic procedure to assess effects on heart . and

•        Left ventricular hypertrophy can be assessed by echocardiography

MANAGEMENT OF HYPERTENSION-

•        The basic goal of hypertension treatment is to prevent complications and death by achieving and maintaining the arterial blood pressure at 140/90 mm Hg or lower. 

•        Research findings demonstrate that weight loss, reduced alcohol and sodium intake, and regular physical activity are very important along with medications under guidance of a cardiologist, to reduce and manage blood pressure . Regular follow-up is necessary.