1. AN INSIGHT INTO SOME COMMON DISEASES HYPERTENSION DIABETES
Dr (Mrs) Grace Asante-Duah
MB ChB, BSc Human Biology

2. HYPERTENTION Definition: Generally means high blood pressure (high BP)
BP 140/90mmHg on 3 or more occasions (Patient at rest) OR
Diastolic BP persistently  100mmHg

3. The Heart- the body’s pump

4. Components of Blood Pressure
BP = Heart Rate x Peripheral resistance
Systolic pressure: the pressure of the blood when your heart beats to pump blood out – designated by the top number/value
Diastolic pressure: the pressure of the blood when your heart rests in between beats - designated by the bottom number/value

5. EPIDEMIOLOGY
Known as the 'silent killer', high blood pressure rarely has obvious symptoms.
Around 30% ( that is 1 in 3 adults) of people in England have high blood pressure but many don't know it.
If left untreated, high blood pressure increases your risk of a heart attack or stroke.

6. TYPES Two main types: Essential Hypertension Secondary Hypertension
Early onset
Usually no underlying cause
1st degree relative with HPT
Secondary Hypertension
Late onset
Usually has an underlying cause e.g. lifestyle, diabetes, kidney disease, adrenal gland tumours etc
Uncontrolled/Malignant HPT
White Coat HPT

7. SYMPTOMS
Headaches - chronic headaches that last for days (rather than hours)
Dizziness or Vertigo
Blurry or double vision.
Drowsiness
Nausea
Fatigue - general tiredness
Nosebleeds
A strong need to urinate often (especially during the night)
Tinnitus (a ringing or buzzing in the ears)

8. SYMPTOMS -2
Shortness of breath - Usually when this occurs people start to get a little concerned. Often by this time though the blood pressure has probably reached high enough levels to be dangerous as this is one of the last symptoms of hypertension you'll experience.
NB// If you have any combination of these symptoms, then you should get your blood pressure checked by a doctor.

9. RISK FACTORS You are at risk of developing HPT if you: are a man
are overweight / obese
have a relative with high blood pressure (GENETICS)
are of African or Caribbean descent - salt sensitivity
eat a lot of salt/ high sodium meals
don't eat many fruit and vegetables
don't do enough exercise
drink a lot of coffee (or other caffeine-based drinks)
drink a lot of alcohol
are aged over 65
Have excessive levels of stress
Other medical conditions e.g. diabetes, high cholesterol, kidney dx

10. Multi-organ dysfunction
COMPLICATIONS
Multi-organ dysfunction
Stroke/paralysis
Retinal detachment – loss of sight
Pulmonary oedema
Hypertensive heart disease – chronic heart failure
Renal failure
Myocardial Infarction (Heart attack)
death

11. Prevention and treatment
You can take effective steps to prevent high blood pressure by:
Modifying one’s lifestyle e.g.
losing weight if you need to
exercising regularly
eating a healthy diet
cutting back if you drink a lot of alcohol
stopping smoking
cutting down on salt and caffeine
seeking prompt help for medical conditions

12. Health MOT !!
All people between 40 and 74 should be offered a health check once every five years to look for things like high blood pressure.
Uptake is poor
Between April 2011 and March 2012 only 2% of those eligible in England actually had a health check.
Out of nearly 16 million people eligible, about 425,000 were offered a check and 211,000 took up the offer.

13. Prevention and treatment - 2
Antihypertensive medication
Usually for life
Different modes of action
Diuretics
Calcium channel blockers
Angiotensin Converting Enzyme inhibitors
Beta- blockers
Angiotensin Receptor Blockers
Side effects

14. Thank you ANY QUESTIONS???

15. DIABETES
Definition:
A metabolic disease in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.
Sugar- glucose
Insulin- hormone

16. TYPES
Two main types
Type 1:results from the body's failure to produce insulin, and requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.)
Type 2: results from body cells failing to use insulin properly, (insulin resistance). Also referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.)

17. OTHER
Gestational Diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.

18. SYMPTOMS Classic triad:
Polyuria – frequent urination, more pronounced at night (nocturia)
Polydipsia – increased thirst
Polyphagia – increased hunger

19. RISK FACTORS Genetic predisposition (family history) Obesity
Lack of exercise
Eating badly
Aging
High BP
High cholesterol
Gestational diabetes (increased risk of developing type 2 DM)

20. COMPLICATIONS Acute complications hypoglycemia, hyperglycaemia
diabetic ketoacidosis,
Non-ketotic hyperosmolar coma.
Serious/Long-term complications:
cardiovascular disease,
chronic renal failure,
retinal damage.
diabetic neuropathy
Poor wound healing - amputations

21. TREATMENT/PREVENTION
Adequate treatment of diabetes is very important.
Insulin
Hyperglycaemic drugs e.g. metformin, glibenclamide etc
blood pressure control
lifestyle modification such as:
Smoking cessation
Eating a healthy/balanced diet
Adequate exercise
Keeping a healthy body weight.

22. ANY QUESTIONS?????