1 Hypertension 2002: An Overview

2 Leading Risks For Death (World Health Organization 1995)

3 What Is Blood Pressure?  Blood pressure is the amount of force on the walls of the arteries as the blood circulates around the body.

4  The upper number is when the heart beats (Systolic Blood Pressure SBP)  The lower number is when the heart relaxes (Diastolic Blood Pressure DBP) What Do The Numbers Mean?

5 Measured in mm Hg (millimeters of mercury) e.g. 124/82 mm Hg  Systolic=124 mm Hg  Diastolic= 82 mm Hg

6 What is Hypertension ? It is also called High Blood Pressure (HBP) Hypertension is a blood pressure of 140/90 mm Hg or greater

7 Blood pressure category Optimal<120and<80 Normal<130and <85 High normal130–139 or85–89 Hypertension Stage 1140–159 or90–99 Stage 2160–179or100–109 Stage 3>180or>110 Optimal<120and<80 Normal<130and <85 High normal130–139 or85–89 Hypertension Stage 1140–159 or90–99 Stage 2160–179or100–109 Stage 3>180or>110 Blood pressure (mmHg) Systolic Diastolic Classification of Blood Pressure for Adults

8 What Causes HYPERTENSION ?  95% ‘not known’  Genetics 40%  Environment 60% (lifestyle)  5% underlying disease

9 Your Lifestyle is Related to Hypertension  Sedentary lifestyle  Unhealthy diet  To little fresh fruit, fresh vegetables and low fat dairy products  To much salt (sodium) and saturated fats  Being overweight  Alcohol  Stress

10 Hypertension Is More Common in Older People

11 Unaware of their hypertension Not treated and not controlled Treated and not controlled Treated and controlled 22% of Adult Canadians Have Hypertension 16% 42% 23% 19%

12 Untreated Hypertension Can Cause Atherosclerosis  Strokes  Dementia  Heart failure  Kidney failure  Poor circulation – impotence, leg cramps when walking  Premature death Re Pressure related damage  Strokes  Heart failure  Kidney failure  Confusion  Premature death

13 Why Do Some Develop Heart Disease or Stroke and Others Don’t?  There are several risks that cause heart attacks and strokes  The more risks and the higher the risks, the greater the chance of developing heart disease or stroke  More than 9 in 10 Canadians with hypertension have other risks of developing heart disease and stroke

14 Cardiovascular Risks  High blood pressure  Smoking  High cholesterol  Diabetes  Low physical activity  Stress  Obesity  Diet  Excess alcohol consumption

15 What Are the Benefits of Treating Hypertension?  Heart attack by 15%  Heart failure by 50%  Stroke by 38%  Death by 10% For a decrease of 10/5 mm Hg:

16 Who Can Help You Control & Treat Your Hypertension ?  You  Your family  Family doctor  Nurse, dietitian, pharmacist, psychologist, exercise physiologist  Medical specialist

17 How Low Should Your Blood Pressure Be Lowered to?  Most people:  Less than 140/90 mm Hg when measured at the doctors office  Less than 135/85 mm Hg when measured at home  Diabetes or kidney disease  Less than 130/80 mm Hg when measured at the doctor’s office

18 9 Ways to Help Control Hypertension  Eat a healthy diet  Be active for at least minutes 4-5 times / week  Control your weight  Limit daily alcohol to 2 drinks/day or less

19 9 Ways to Help Control Hypertension(Cont..)  Cut back on salt  Don’t smoke  Take time to relax  Take medications as prescribed  Check your BP at home

20 Drugs for Hypertension

21 Antihypertensive Drugs (Drugs Used to Treat Hypertension)  risk of death and disability  Usually do not make you feel better  Usually do not make you feel worse  Usually need to be combined to normalize blood pressure

22 Antihypertensive Drugs (Cont.)  Are taken for life unless your doctor stops the medication  Need to be continued, even though you feel well  Can interact with alcohol

23 Classes of Drugs  Diuretics  Beta-Blockers  ACE inhibitors  Calcium channel blockers  Angiotensin receptor blockers (ARB’s)  Alpha blockers  Miscellaneous

Antihypertensive Medications Compliance Adherence Concordance

25 If Medication Is Not Taken As Directed  BP may not be controlled  When you don’t take your medication, your doctor may prescribe another drug since they might think the first one didn’t work or increase dosage of drugs  Side effects may be more troublesome  An adverse reaction or event may result

26 Tips To Help You Take Your Medication  Develop a practical medication schedule (timetable) with your doctor or pharmacist  Keep an up-to-date medication record listing all medical conditions and drugs you take  Keep this record in your wallet  Show your medication record to your doctor and pharmacist at each visit

27 Hints For Using Medication Wisely  Tailor your medication taking to fit your daily schedule (e.g. when you brush your teeth)  Monitor your BP to see how well your medications are working

28 Hints For Using Medication Wisely (Cont.) If you are having problems remembering your pills  Count your tablets to see how often you are forgetting them  Use a dosette (medication box)

29 Self measurement of BP AND ® UA-767 Omron ® HEM-747

30 Summary  Hypertension is a common cause of disability and death  Hypertension can be prevented and treated by changes in lifestyle  The problems caused by hypertension can be largely prevented by drug therapy if treatment goals are reached

31 Hypertension questions 1. Blood pressure measures the amount of pressure in your arteries.  TRUE FALSE

32 Hypertension questions 2. A blood pressure greater than 140 over 90 (140/90 mmHg) is generally considered too high.  TRUE FALSE

33 Hypertension questions 3. You can usually tell if your blood pressure is too high by the way you feel.  TRUE FALSE

34 Hypertension questions 4. Having one elevated blood pressure reading means than you have high blood pressure.  TRUE FALSE

35 Hypertension questions 5. High blood pressure (sometimes called hypertension) is a major risk factor for heart disease.  TRUE FALSE

36 Hypertension questions 6. The following lifestyle factors can help to treat and control high blood pressure: · Weight control or having a healthy weight · Regular exercise · Eating a healthy diet · Restricting alcohol intake  TRUE FALSE

37 Hypertension questions 7. Smoking can cause high blood pressure.  TRUE FALSE

38 Hypertension questions 8. Generally, people who do not have high blood pressure should have their blood pressure checked every 3 to 4 years.  TRUE FALSE

39 Hypertension questions 9. If you are being treated for high blood pressure you will need to stay on treatment the rest of your life.  TRUE FALSE