Download Hypertension

‫‪Hypertension‬‬
‫مرض ارتفاع ضغط الدم‬
‫كرار كريم جعين الحيدري‬
‫بكالوريوس طب وجراحة عامة‬
‫ماجستير ادوية وعالجيات‬
‫كلية الطب‪ -‬جامعة الكوفة‬
‫‪3102‬‬
Hypertension
Blood pressure
It is the force that produced by blood on the surface area of blood vessels and it
is measured by mmHg.
The normal level of blood pressure is 100-145/60-85 mmHg . The upper No.
represents the systolic blood pressure which is defined as the blood pressure during
the contractions of ventricles of heart. While, the lower No. is represent the
diastolic blood pressure which is defined as the blood pressure during the
relaxation of ventricles1.
Hypertension
Hypertension is defined as an increase in blood pressure more than 145 mmHg for
systole and more than 85 mmHg for diastole1 .
Types of hypertension
According to the cause the hypertension classified into:
1-Primary hypertension. 2- secondary hypertension
Primary hypertension
It is the most common type and it is called primary because it has no clear etiology
but there are many genetic and environmental factors that play an important in
pathogenesis of hypertension, these factors include2:
1-Genetic factors
Genetic factors play an important role in the etiology of hypertension. Some of
families have an tendency to develop hypertension in offspring . the individual
itself may has predisposing genetic base so that when exposed to certain
environmental factor develop hypertension.
2- enviromental factors
A-Obesity
Its play a role in pathology of hypertension , so that high increase in body weight is
associated with increase incidence of hypertension . also obesity is usually
associated with hypercholesterolemia that regarded as one of major predisposing
factor to hypertension.
B- Dietary habit
The food type is a strong effecting factor in etiology of hypertension so the high
calorie diet and fatty food is usually regarded as a risk factor to disease.
C- sedentary life and decrease exercise lead to increase incidence of hypertension
D- smoking and alcoholism: nicotine and alcohol is one of major predisposing
factor to hypertension.
E- emotional stress: life stress, anxiety and jobs associated with tension is one of
predisposing factor to hypertension.
Secondary hypertension
Means that the disease occurs secondary to other known cause such as other
disease or certain drug intake2.
A- Pheochromocytoma: which is an tumor of adrenal gland associated with
increase in adrenaline secretion that in turn cause excessive vascular
contraction that lead to increase blood pressure.
B- Hypertension secondary to diabetes : diabetes is one of causes of
cardiovascular system disorders including hypertension.
C- Valve heart disease.
D- Increase of blood pressure due to chronic intake of certain drugs like
steroids .
Complications of hypertension4
1- Central nervous system complications: high blood pressure may lead to
stroke.
2- Hypertension increase the occurrence of angina and myocardial infarction
3- Renal complications: hypertension is so dangerous to kidney and may lead
to various renal parenchymal disorders.
4- Eye complications: it may cause an increase in intra ocular pressure that may
lead to retinal damage and bleedings.
Management of hypertension5
Treatment of secondary hypertension is by treatment of underlying cause while
the treatment of primary hypertension is by:
Non pharmacological treatment
1- Change the dietary habit: by decrease salt intake, decrease fatty diet ,
enhance eating of fruit and vegetables also advice the patient to increase the
intake of fish oil.
2- Quit smoking and alcohol intake.
3- Decrease body weight to ideal one.
4- Enhance controlled exercise.
5- Avoid stress sources.
Pharmacological treatment3
1-diuratics (Lasix, thiazide)
2- calcium channel blockers.( amlodipine, nifidipine)
3- angiotensin converting enzyme inhibitors.(captopril, enalapril)
4-Beta blockers (atenolol, propranolol).
 At end I hope the good health for all patients
Thank you
References
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Laurence in clinical pharmacology
Davidson in medicine
BNF
Goodman and Gilman, pharmacology and toxicology
Lipincode , pharmacology and theraputics