1. Hypertension: A Risk Factor For Stroke
Shannon Harris, DNP, FNP

2. Objectives Causes of hypertension Classifications of hypertension
Risk factors
Diagnosis
Complications
Management
Final thoughts

3. Hypertension The #1 modifiable risk factor for stroke
Know your patients’ numbers
Medications
BP Classification using ACC/AHA 2017 guidelines

4. Affected By Hypertension
Heart
Brain
Kidneys
Blood vessels
Eyes

5. Causes Renin-Angiotensin-Aldosterone System
Angiotensin constricts blood vessels and over time can cause a stiffening of arteries
Aldosterone controls how the kidney manages sodium uptake which increases blood volumes
Chronic kidney disease
The sympathetic nervous system plays a role in blood pressure control
Unhealthy lifestyle
Medications- HRT, asthma meds
NIH 2017

6. Hypertension Classifications
Normal: Less than 120/80 mm Hg
Elevated: Systolic between  and diastolic less than 80
Stage 1: Systolic between  or diastolic between 80-89
Stage 2: Systolic at least 140 or diastolic at least 90
Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
2017 ACC/AHA hypertension guideline

7. Risk Factors Anyone can develop hypertension
About 65 percent of Americans age 60 or older have high blood pressure
More common in African Americans
Overweight
Lifestyle habits
Family history

8. Diagnosis
To assist your provider in diagnosing you as having hypertension:
2–3 readings at several medical appointments
Monitor BP on different days and at different times to obtain your true BP reading
Home BP checks and keep a diary

9. Arterial Changes Platelet “Party” Aggregation
Occurs with damage to any artery
Smoking and DM increase

10. Complications of Hypertension

11. Common Classes of Drugs
Calcium Channel Blockers
Beta Blockers
Diuretics
ARBS
Ace-Inhibitors

12. Angiotensin-Renin Pathway

13. ARBS Angiotensin II receptor blockers
Displaces Angiotensin II from the Angiotensin I receptor.
Blocks the vasoconstrictive properties
Decreases water uptake by reducing the secretion of vasopressin (ADH)
Decreases Aldosterone production and release
Mayo Clinic 2018

14. Ace-I Angiotensin-converting enzyme inhibitors
Prevents the production of angiotensin II
Also help to relax blood vessels, decrease water re-uptake, and decreases Aldosterone
Angioedema
Chronic dry cough
Mayo Clinic 2018

15. Questions