LECTURE PRESENTED BY MRS. MARIAN ONOTU OKWUAZUN AT EWERE OKONTA BLOGS (EOB)THURSDAY LECTURE SERIES HELD ON 14TH JANUARY, 2021TOPIC: HIGH BLOOD PRESSURE (HYPERTENSION)

MRS. MARIAN ONOTU OKWUAZUN

Hypertension, often called high blood pressure, occurs when blood moving through the arteries places too much force against the artery walls. What that means is that the heart is working harder than it should to pump the blood around the body through the arteries.Hypertension is also called a silent killer/disease due to the fact that it is a disease that could persist without signs and symptoms and thus could remain undetected for a long time with gradual damaging effect on various system of the body from which death could result.DEFINITION: Hypertension simply means the persistent elevation of blood pressure above the normal range of 100-140 for systolic pressure and 60-90 mmHg for diastolic pressure.Blood pressures reading are given in two numbers (120/80mmHg).

1. Systolic Blood Pressure(SBP):This is the top number, it is the maximum pressure the heart exerts while beating.

2.Diastolic Blood Pressure(DBP): This is the bottom number, it is the amount of pressure in the arteries between beats.

PREVALENCE RATE:From the random-effects meta-analysis, an overall hypertension prevalence of 28.9% with a prevalence of 29.5% among men and 25.0% among women. Then 30.6% and 26.4% among urban and rural dwellers, respectively.

TYPES:There are two main types of high blood pressure.

1. Primary or Essential High Blood Pressure:This is most common type of high blood pressure and the cause is unknown.2. Secondary High Blood Pressure: This is caused by another medical condition (e.g Diabetes, Kidney disease) or use of certain medicines or drugs.

CLASSIFICATION:Hypertension can be classified according to the degree of rise of systolic or diastolic pressure.Under the classification of Hypertension, we have Normal, Pre-hypertension, Stage 1 & 2 hypertension.Normal systolic blood pressure ranges from 90-119mmHg for systolic and 60-79mmHg for diastolic pressure.Pre-hypertension:Systolic pressure ranges from 120-139mmHg while diastolic pressure is 80-99mmHg.Stage I hypertension: Systolic pressure ranges from 140-159mmHg while diastolic is from 90-99mmHg.Stage II hypertension: Systolic pressure ranges from above 160mmHg while diastolic pressure is from above 100mmHg.RISK /PREDISPOSING FACTORS1.Atherosclerosis (A build up of fat/cholesterol plaque in the walls of arteries, causing obstruction of blood flow).

Cigarette smokingExcessive sodium (Salt) intakeStress and tensionObesityFamily history of hypertensionAge (high blood pressure is common among the elderly).Sex (start early in males from age 35 and females from age 45)CLINICAL MANIFESTATION (SIGNS AND SYMPTOM)Hypertension can remain asymptomatic for years except for the high blood pressure, it can manifest in the following symptoms:Headache (especially early morning frontal or occipital headache)WeaknessDizzinessPalpitationBlood pressure is consistently above 140mmHg systolic and 90mmHg diastolicNausea and vomitingEpistaxis (Bleeding from the nose) memory disturbanceVisual disturbanceTREATMENT/PREVENTIONDrugs: for example anti hypertensive drugs e.g methyldopa(ie Aldomet) hydralazine (appresolone) etc. to reduce blood pressure2.Diuretics: for example frusemide (laxis)Diet: sodium(salt), calories, fat and cholesterol restrictionExercise/weight reduction: this must be medically regulated to prevent obesity and help burn off fat. Patient should avoid strenuous exercise which can increase blood pressure, simple aerobic exercise (e.g walking) should be encouraged.Treat the cause if it is secondary hypertensionRegular blood pressure check, say daily, weekly or monthly depending on the diastolic pressure, the diastolic of ≥ 120mmHg needs immediate treatment.Discontinuing tobacco use and alcohol consumption has been shown to lower blood pressure.Reducing stress, for example with relaxation therapy, such as meditation and other mindbody relaxation techniques.Increasing omega 3 fatty acids can help lower hypertension. Fish oil has shown to lower blood pressure in hypertensive individuals. The fish oil may increase sodium and water excretion.COMPLICATION OF HYPERTENSIONRupture of arteries (or blood vessels) that could lead toa. Epistaxis (bleeding from the nose)b. CVA (Cerebro Vascular Accident) and other cerebro vascular diseases)Hypertensive encephalopathy marked by nausea, vomiting and severe headache.Kidney complication e.g nephrosclerosis(hardening of the walls of the small arteries and arterioles).Eye complication e.g retina damage.Left ventricular hypertrophy: caused by cardiac compensation over a long time can lead to heart failure.Death.However, the causes, treatment and management of High Blood Pressure may not be limited to only just what we have listed above, there are many more emerging and contemporary factors underling HBP as it relates to human health.Thus, proper and adequate attention and care must be given to issue of our health. No sacrifice is too much for your health.Thank you.
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