Hypertension

2.  High blood pressure is a common condition
in which the long-term force of the blood
against your artery walls is high enough that
it may eventually cause health problems,
such as heart disease.
 Usually hypertension is defined as blood
pressure above 140/90, and is considered
severe if the pressure is above 180/120.

3.  Affects ~50 million people in the US
 Types:
› 1. Primary
 Chronic high blood pressure without a source or
associated with any other disease
 Most common form of hypertension
› 2. Secondary
 Elevation of blood pressure associated with
another disease such as kidney disease

4.  Genetics-some people are prone to hypertension simply based
off of their genetic makeup
 Family History- your risk for high blood pressure/hypertension
increases if it is in your family history
 Environment
 Inactivity
 Stress
 Obesity
 Alcohol
 High Sodium Diet
 Tobacco Use
 Age
 Menopausal Medications

5.  Thickening of the heart muscle
 Increased workload of the heart
 May lead to other conditions such as:
› Heart attack
› Stroke
› Renal (Kidney) Failure
› Loss of vision

6.  Diagnosed through repeat blood pressure
readings
 Primary Hypertension does not have
symptoms other than high blood pressure
 Secondary Hypertension
› Most likely caused by Renal Disorders,
symptoms you will see:
 Decreased urine formation
 Increased sodium and water retention

7.  Step 1:
› Lifestyle modifications
 Diet and exercise
 Limit alcohol and tobacco use
 Reduce stress factors
 Step 2:
› If lifestyle changes are not enough, drug therapy
will be introduced

8.  Lisinopril
 Captopril
 Enalapril
 Ramipril
 Perindopril
 Angiotensin II is a very potent chemical produced
by the body that primarily circulates in the blood. It
causes the muscles surrounding blood vessels to
contract, thereby narrowing the vessels. The
narrowing of the vessels increases the pressure
within the vessels causing increases in HTN.
Angiotensin II is formed from angiotensin I in the
blood by the enzyme angiotensin converting enzyme
(ACE). (Angiotensin I in the blood is itself formed
from angiotensinogen, a protein produced by
the liver and released into the blood..) angiotensin
converting enzyme inhibitors (ACE inhibitors) are
medications that slow (inhibit) the activity of the
enzyme ACE, which decreases the production of
angiotensin II. As a result, blood vessels enlarge or
dilate, and blood pressure is reduced

9.  Atenolol
 Bisoprolol
 propranolol
 Beta blockers prevent the stimulation
of the adrenergic receptors responsible
for increased cardiac action. Beta
blockers are used to control heart
rhythm, treat angina, and reduce high
blood pressure.
 Ex.) only certain receptors are affected
due to nonselct antagonist that block
beta 1 and beta 2 causing “
bronchconstriction and inhibited
glycogenolysis

10.  Angiotensin II is a very
potent chemical formed in the
blood that causes muscles
surrounding blood vessels to
contract, thereby narrowing
the vessels. This narrowing
increases the pressure within
the vessels and can cause
high blood pressure
(hypertension)
 Candestran
 Irbesartan
 lorsartan
 Angiotensin II receptor
blockers (ARBs) are
medications that block the
action ofangiotensin II by
preventing angiotensin
II from binding to angiotensin
II receptors on the muscles
surrounding blood vessels. As
a result, blood vessels
enlarge (dilate) and blood
pressure is reduced

11.  Veraparnil
 Diltiazem
 Amlodipine
 Felodipine
 nifedipine
 Calcium channel
blockers are
prescription
medications that relax
blood vessels and
increase the supply of
blood and oxygen to
the heart while also
reducing the heart's
workload

12.  Chlortalidone
 indapamide
 decrease reabsorption
of sodium by the
kidney and thereby
increase loss of water
and sodium. They also
increase urinary
secretion of chloride,
potassium, and
bicarbonate ions. Ex:
Loop diuretics.

13.  Doxazosin
 Prazosin
 terazosin
 Alpha blockers relax
certain muscles and help
small blood vessels
remain open.
 NE tightens the muscles
in the walls of smaller
arteries and veins. The
tightening of the vessels
keeps them opened and
relaxed.Resulting in
increased blood flow
and lowers blood
pressure