Lifestyles, Fitness and Rehabilitation Hypertension

Hypertension What is Blood Pressure? Lifestyles, fitness and rehabilitation What is Blood Pressure? Pressure created by the heart as it pumps blood through the arteries and the circulatory system What do Blood Pressure Numbers Mean? Top number (Systolic)= Pressure while heart is beating Bottom number (Diastolic)= Pressure while heart is resting between beats

Hypertension Normal Blood Pressure High Blood Pressure Lifestyles, Fitness and Rehabilitation Normal Blood Pressure Blood Pressure of < 140/ 90 Blood Pressure of 130 to 139/ 85 to 89 should be closely watched High Blood Pressure Blood Pressure > 140/ 90

Hypertension How can I tell if I have High Blood Pressure? Lifestyles, Fitness and Rehabilitation How can I tell if I have High Blood Pressure? Usually NO SYMPTOMS! “The Silent Killer” May have: Headache Blurry vision Chest Pain Frequent urination at night

Hypertension Blood Pressure Measurement Blood Pressure Cuff Size Lifestyles, Fitness and Rehabilitation Blood Pressure Measurement Sphygmomanometer Systolic pressure= pressure when 1st sound is heard “Diastolic pressure= pressure when last sound is heard Blood Pressure Cuff Size Small – children and small adults Average Large – overweight and large adults

American Heart Association Recommended Blood Pressure Levels Lifestyles, fitness And Rehabilitation BP Category Systolic (mmHg) Diastolic (mmHg) Follow-up Optimal < 120 and < 80 Recheck 2 years Normal < 130 < 85 Recheck 2 years High Normal 130-139 or 85-89 Recheck 1 year

American Heart Association Recommended Blood Pressure Levels Lifestyles, fitness And Rehabilitation BP Category Systolic (mmHg) Diastolic (mmHg) Follow-up Stage 1 (mild HTN) 140-159 or 90-99 Confirm within months Stage 2 (moderate HTN) 160-179 100-109 Evaluate within 1 month Stage 3 (severe HTN) 180 or > 110 or > Evaluate immediately

Hypertension What Causes High Blood Pressure? Lifestyles, Fitness and Rehabilitation What Causes High Blood Pressure? Cause unknown in 90 to 95% of cases = Primary Hypertension Secondary Hypertension = 5 to 10% Kidney Abnormalities Narrowing of certain arteries Rare tumors Adrenal gland abnormalities Pregnancy

Hypertension What Causes High Blood Pressure? Lifestyles, Fitness and Rehabilitation What Causes High Blood Pressure? Controllable Risk Factors Increased salt intake Obesity Alcohol Stress Lack of exercise

Hypertension What Causes High Blood Pressure? Lifestyles, Fitness and Rehabilitation What Causes High Blood Pressure? Uncontrollable Risk Factors Heredity Age Men between age 35 and 50 Women after menopause Race 1 out of every 3 African Americans Higher incidence in non-Hispanic blacks and Mexican Americans

Hypertension Women and High Blood Pressure Birth Control Pill Lifestyles, Fitness and Rehabilitation Women and High Blood Pressure Birth Control Pill Pregnancy Overweight After Menopause African Americans Birth control pill: linked with HTN in some women. Greater risk if overweight and hx of HTN during pregnancy, or predisposing condition ie. Kidney disease or family hx of HTN. Pregnancy induced HTN most common in last trimester and poses a danger to mother and baby if not treated. HTN usually disappears after pregnancy. If it does not it should be treated. In women who are hypertensive before pregnancy, HTN may become more severe. Obesity increases the risk of HTN. After menopause the risk of developing HTN becomes greater than a mans. Incidence of HTN is much greater in African American women(even very young women) than whites. Disease is also more severe.

Hypertension How does High Blood Pressure develop? Lifestyles, Fitness and Rehabilitation How does High Blood Pressure develop? Certain nerve impulses cause arteries to become larger (dilate) or smaller (contract) If vessels wide open blood flows easily If vessel narrows pressure inside increases causing hypertension

Hypertension What does High Blood Pressure do to my Body? Stroke Lifestyles, Fitness and Rehabilitation What does High Blood Pressure do to my Body? Stroke Congestive heart failure Kidney failure Heart attack Heart rhythm problems Aneurysm High blood pressure adds to the workload of the heart The heart must pump harder If high blood pressure continues for a long time, the heart and arteries may not function appropriately. The heart may at first thicken and then dialate and weaken causing heart failure Other body organs may also be affected

Hypertension What Can I Do? High blood pressure is a lifelong disease Lifestyles, Fitness and Rehabilitation What Can I Do? High blood pressure is a lifelong disease Blood pressure can be controlled not cured Controlling blood pressure will reduce the risk of stroke, heart attack, heart failure and kidney disease

Hypertension What Can I Do? Loose weight if your overweight Lifestyles, Fitness and Rehabilitation What Can I Do? Loose weight if your overweight Get regular physical activity Avoid excessive alcohol Stop smoking Manage your stress

Hypertension What Can I Do? Decrease salt intake Eat for heart health Lifestyles, Fitness and Rehabilitation What Can I Do? Decrease salt intake Eat for heart health Discuss the use of oral contraceptives with your doctor Discuss the use of some medications with your doctor

Hypertension Ten Commandments for Blood Pressure Control Lifestyles, Fitness and Rehabilitation Ten Commandments for Blood Pressure Control Know your blood pressure Have it checked regularly Know what your weight should be Keep it at that level or below Don’t use excessive salt in cooking or at meals Avoid salty foods 1 2 3

Hypertension Ten Commandments for Blood Pressure Control Lifestyles, Fitness and Rehabilitation Ten Commandments for Blood Pressure Control Eat a low-fat diet According to AHA regulations Don’t smoke cigarettes Or use tobacco products Take your medicine exactly as prescribed Don’t run out of pills even for a single day 4 5 6

Hypertension Ten Commandments for Blood Pressure Control Lifestyles, Fitness and Rehabilitation Ten Commandments for Blood Pressure Control Keep your appointments with the doctor Follow your doctors advice about exercise Make certain family members have their blood pressure checked regularly Live a normal life in every other way! 7 8 9 10

Hypertension Medication for High Blood Pressure Diuretics Lifestyles, Fitness and Rehabilitation Medication for High Blood Pressure Diuretics Rid the body of excess fluids and salt Beta-blockers Reduce the heart rate and the work of the heart Calcium antagonists Reduce heart rate and relax blood vessels

Hypertension Medication for High Blood Pressure Lifestyles, Fitness and Rehabilitation Medication for High Blood Pressure Angiotensin II receptor blockers(ACE) Interfere with the bodies production of angiotensin, a chemical that causes the arteries to constrict (narrow) Vasodialators Cause the muscle in the wall of the blood vessels to relax, allowing the vessel to dialate (widen)

Hypertension Medication for High Blood Pressure Lifestyles, Fitness and Rehabilitation Medication for High Blood Pressure Sympathetic nerve inhibitors Sympathetic nerves go from the brain to all parts of the body, including the arteries Cause arteries to constrict raising blood pressure These drugs reduce blood pressure by inhibiting these nerves from constricting blood vessels

Hypertension Home Blood Pressure Monitoring Mercury sphygmomanometer Lifestyles, Fitness and Rehabilitation Home Blood Pressure Monitoring Mercury sphygmomanometer Standard for BP monitoring No calibration May be bulky Need a second person to use machine May be difficult for hearing impaired or patients with arthritis

Hypertension Home Blood Pressure Monitoring Aneroid equipment Lifestyles, Fitness and Rehabilitation Home Blood Pressure Monitoring Aneroid equipment Inexpensive, lightweight and portable Two person operation/need stethoscope Delicate mechanism, easily damaged Needs calibration with mercury sphygmomanometer

Hypertension Home Blood Pressure Monitoring Automatic equipment Lifestyles, Fitness and Rehabilitation Home Blood Pressure Monitoring Automatic equipment Contained in one unit Portable with easy-to-read digital display Expensive, fragile Must be calibrated Requires careful cuff placement