DAKTAR I ALFRED KUYI

HYPERTENSION Def: A condition in which arterial BP is chemically elevated If Bp greater than systolic 140.mm hg and diastolic 90mmHg Level of BP at which the benefits of treatment outweighs the costs and hazards. Is an asymptomatic condition and the diagnosis is made at routine examination or when a complication arises. BP check is advisable. The level of Bp is said to be abnormal when associated with a clear increase in morbidity and mortality

Essential hypertension - Cause of hypertension cannot be found Secondary Hypertension - The cause is known. SIGNS AND SYMPTOMS Hypertensive are often a symptomatic hence HTN is a silent killer Diagnosis is based on measurement of Bp Symptoms Associated with severe hypertension are: 1.Palpitation – Awareness of heartbeats 2.Chest pain

3.Syncope – Loss of Consciousness 4.Fatigue 5.Dyspnoea – Abnormal awareness of breathing Exertional dysponoea 6.Orthopnoea – Inability to breath when laying flat 7.Dizziness – Kizunguzungu 8.Syncope - Loss of consciousness 9.Headache 10.Nose bleeding

SYMPTOMS OF END ORGAN DAMAGE 1.CCC (Congestive Cardiac Failure) 2.Renal Failure 3.Cerebral Vascular Accident – Strike 4.Loss of vision 5.Norcturia 6.Oliguria 7.Myocardial infarction

Blood pressure varies with  Age  Sex  Race  Environment Hypertension is said to be a silent killer because it can cause severe organ diseases such as  Renal Failure  Heart failure  Retinopathy  Stroke  And it kill silently

EFFECTS Premature death due to:  Heart disease  Stroke  Renal failure CLASSIFICATION OF HTN SYSTOLICDIASTOLIC OPTIMAL<120MM Hg<80mmHg NORMAL<130MMHg<85mmHg HIGH NORMAL mmHg85-89mmHg

HYPERTENSION Grade 1 (Mild)140 – 159mmHg90- 99mmHg Grade 2 (Moderate)160mm – 179mmHg100 – 109mmHg Grade 3 (Severe)180mm Hg>110mmHg CAUSES 1.No known cause – Essential /Primary hypertension it accounts for 90% of all hypertensive 2.Secondary hypertension –There is identifiable Cause For Example: Renal disease e.g. GLOMERUIONEPHRITIS Endocrine disease eg DM,Oral Contraceptives, Pregnancy, Hyper/Hypothyrodism

PREDISPOSING FACTORS 1.Genetics familiar tendencies 2.Environment e.g.  High salt intake  Alcohol  Lack of exercise  Impaired intrauterine growth  Age  Gender  Smoking  Serum Cholesterol  Dm

COMPLICATIONS CVS 1.CCF(Congestive Cardiac Failure) 2.Atheroma – Coronary artery disease Thrombotic cerebral vascular disease 3.Myocardial Infarcation 4.Myocardial hypertrophy EYES 5. Blurred or impaired vision BRAIN 6.Cerebral vascular accident (stroke) 7.Paralysis 8.Coma 9.Speech difficulties

KIDNEYS Renal insufficiency i.e Proteinuria,Nocturia Renal Failure TREATMENT None pharmacological management/Patient Education 1.Stop smoking 2.Reduce weight if obese  It reduces BP  Reduces insulin resistance  Reduces serum lipid levels

3.Stop/reduce drinking alcohol 4.Restrict salt intake 5.Encourage exercise PHARMACOLOGICAL TREATMENT Involves use of drugs