HYPERTENSION

DEFINITION: Ito rin ay kilala sa tawag na high blood pressure na kung saan ang tension sa malaking ugat sa ating puso ay tumataas. Karaniwan itong tinatawag na "the silent killer" sapagkat kadalasang umaabot muna ng ilang taon bago tuluyang pinsalain ang kritikal na organ ng ating katawan.

Anatomy and Physiology of the Heart

The essential function of the heart is to pump blood to various parts of the body. The four chambers: right and left atria and right and left ventricles. The two atria act as collecting reservoirs for blood returning to the heart while the two ventricles act as pumps to eject the blood to the body.

NORMAL BLOOD CIRCULATION

Deoxygenated blood returns to the heart via the major veins (superior and inferior vena cava), Enters the right atrium Passes into the right ventricle From there is ejected to the pulmonary artery on the way to the lungs. Oxygenated blood returning from the lungs Enters the left atrium via the pulmonary veins

Passes into the left ventricle

Then ejected to the aorta.

ETIOLOGY:

Ito ay may dalawang klasipikasyon: a. Primary hypertension - Walang partikular na dahilan ang makita upang maipaliwanag ang kondisyon ng pasyenteng may ganitong sakit. 2

2 Klaseng Primary H. 1. HINDI NABABAGO (Karaniwang namamana) 2. NABABAGO

b. Secondary hypertension - Ang pagtaas ng blood pressure ay resulta ng ibang sakit tulad ng sakit sa bato o tumor.

PATHOPHYSIOLOGY OF HYPERTENTION

When the heart releases blood in to the main artery, the surge of blood creates pressure against the vessel wall. The harder the heart muscle has to work, the greater the pressure exerted on the artery walls.

When arteries lose their elasticity or they become narrowed, resistance to blood flow increases and additional force is needed to push the blood through the vessels. The increase force can contribute to the development of hypertension.

When blood pressure falls the glomerular filtration rate falls as well, and promotes the retention of sodium, chloride and water. Na and water retention increases the blood volume and venous return to the heart, causing an increased CO and raising the systemic blood pressure. When atherosclerosis ( fatty deposits) and artheriosclerosis ( hardening of the tissues) that contributes blockage and narrowing of the blood vessels.

Prehypertension:
First real stage of hypertension. Patients with this condition experience only a slight elevation in blood pressure. Normal and healthy blood pressure measurements in average patients are a systolic blood pressure of less than 120 mmHg and a diastolic blood pressure of less than 80 mmHg. In prehypertension the systolic number has risen between 120 and 139 mmHg and the diastolic number is up anywhere between 80 and 89 mmHg. Prehypertension has no signs or symptoms of the condition, so regular blood pressure monitoring is the best method of detection. Patients with this condition are more likely to develop hypertension if changes in lifestyle are not made; a well-balanced diet, limited salt consumption, increased exercise, healthy weight, reduced alcohol consumption and smoking cessation are strongly advised.

Stage 1 Hypertension
Second stage hypertension condition in which a greater elevation in blood pressure occurs than with prehypertension. Systolic and diastolic readings are between 140 to 159 mmHg and 90 to 99 mmHg, respectively. As with prehypertension stage 1 hypertension doesn't typically present any signs or symptoms. The same lifestyle changes advised for blood pressure reduction in prehypertension also apply to stage 1 hypertension and are usually effective alone. Medications such as diuretics, beta-blockers, ACEinhibitors and calcium channel blockers may be prescribed in some cases for better blood pressure control in addition to dietary, exercise and habit changes.

Stage 2 Hypertension
Escalation of blood pressure to higher readings indicate stage 2 hypertension; systolic is now over 160 mmHg and diastolic is over 100 mmHg. Consistently elevated levels put patients at a greater risk for heart failure, kidney failure, heart attack or stroke. Symptoms such as dizziness, headache and nosebleeds are evident in this stage of hypertension. As these symptoms may not always occur, regular blood pressure monitoring is crucial, especially as you age. Unlike prehypertension and stage 1 hypertension, stage 2 high blood pressure is rarely remedied only by lifestyle changes. Changes in diet and exercise are still vital, but are accompanied by more aggressive medications like alpha-blockers, alpha-beta blockers and vasodilators to further reduce blood pressure to a safer range.

Anu-ano ang mga sintomas ng hypertension?

kadalasan, ang may heypertension ay:

magagalitin nananakit ang batok nahihilo malulalin makapal ang noo (sa pakiramdam)

Chest pain Confusion Ear noise or buzzing Irregular heartbeat Nosebleed Tiredness Vision changes

There are many different medicines that can be used to treat high blood pressure, including:

Alpha blockers Angiotensin-converting enzyme (ACE) inhibitors Angiotensin receptor blockers (ARBs) Beta-blockers

Renin inhibitors, including aliskiren (Tekturna)

Vasodilators
Calcium channel blockers Central alpha agonists Diuretics

INTERVENTIONS AND PRACTICES CONSIDERED Diagnosis/Assessment Regular, accurate blood pressure measurement using a calibrated monitor Patient education regarding self/home blood pressure monitoring including community-based self monitoring devices and ambulatory blood pressure monitoring

Lifestyle interventions/modifications
Assessment of dietary risk factors, weight, body

mass index (BMI), waist circumference, physical activity level, alcohol use status, tobacco use status
Diet modifications including DASH (Dietary

Approaches to Stop Hypertension) and limitations on sodium intake

Weight reduction strategies Increased exercise

Maximum alcohol consumption amounts Brief Tobacco Interventions Nicotine replacement therapies Stress management strategies

Obtain medication history and provide patient education regarding medication Assessment and promotion of adherence to treatment plan Follow-up and documentation of management