1. Lifestyles, Fitness
and Rehabilitation
Hypertension

2. 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

3. 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

4. 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

5. 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

6. 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 or
85-89
Recheck 1 year

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

8. 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

9. 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

10. 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

11. 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.

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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)

22. 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

23. 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

24. 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

25. 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