SUPERVISED BY Dr . Essmat Gemeay

Outline: Outline:

InterdictionDefinitionCauses

ComplicationRisk factureSings and symptomsDiagnostic studymanagementNursing diagnosisDash diet

Introduction

•When blood pressure is high, it starts to damage the blood vessels, heart, and kidneys. This can lead to heart attack, stroke, and other problems. High blood pressure is called a "silent killer,'' because it doesn't usually cause symptoms while it is

causing this damage .

definition

•Hypertension: High blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above

140 with a diastolic pressure above 90 .

causes cause. But several things are known to

raise blood pressure, including1-being very overweight ,

2 -drinking too much alcohol,3 -having a family history of high blood

pressure ,4-eating too much salt, and getting older .

5-strees6-decreased vasodilatation of arterioles

related dysfunction of the vascular endothelium.

7-chronic kidney disease8-thyroid or parathyroid disease

•Your blood pressure may also rise if you are not very active, you don't eat enough potassium and calcium

Sings &symptoms•High blood pressure doesn't usually cause symptoms. Most people

don't know they have it until they go to the doctor for some other reason.

•Without treatment, high blood pressure can damage the heart, brain, kidneys, or eyes. This damage causes problems like coronary artery disease, stroke, and kidney failure.

•Very high blood pressure can cause•1 -headaches ,

•2-vision problems,•3 -nausea, and vomiting. Malignant high blood pressure

(hypertensive crisis), which is blood pressure that rises very fast, can also cause these symptoms. Malignant high blood pressure is a medical emergency.

Diagnostic tests

•Routine Investigations of Hypertensive Patient should always include.

•Chest X-Ray •ECG

•Echocardiography •Urinalysis

•Fasting Blood Lipids •Urea Creatinine and

Electrolytes

Risk facture•High blood pressure has many risk factors. Some you can't

control. High blood pressure risk factors include :•Age. The risk of high blood pressure increases as you age.

Through early middle age, high blood pressure is more common in men. Women are more likely to develop high

blood pressure after menopause .•Race. High blood pressure is particularly common among

blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart

attack, also are more common in blacks .•Family history .

•Being overweight or obese .•Not being physically active .

•Using tobacco .•Too much salt (sodium) in your diet .

•Too little potassium in your diet .•Too little vitamin D in your diet .

•Drinking too much alcohol .•Stress.

•Certain chronic conditions . .

Complications

•Uncontrolled high blood pressure can lead to :

•Damage to your arteries .•Aneurysm.

• Weakened and narrowed blood vessels in your kidneys

•Heart failure .•A blocked or ruptured blood vessel in your

brain .•Weakened and narrowed blood vessels in

your kidneys .•Thickened, narrowed or torn blood vessels in

the eyes This can result in vision loss .•Metabolic syndrome .

•Trouble with memory or understanding

How is it treated??

•1-Treatment depends on how high your blood pressure is, whether you have other health problems such as diabetes, and whether any organs have already been damaged.

• Your doctor will also consider how likely you are to develop other diseases, especially heart disease.

•You can help lower your blood pressure by making healthy changes in your lifestyle. If those lifestyle changes don't work, you may also need to take pills. Either way, you will need to control your high blood pressure throughout your life.

•If you have prehypertension, your doctor will likely recommend lifestyle changes .

•If you have high blood pressure without any organ damage or other risk factors for heart disease, your doctor may recommend that you take medicine in addition to making

lifestyle changes .•If you have high blood pressure and have

some organ damage or other risk factors for heart disease, you may need to try various combinations of medicines in addition to

making big lifestyle changes .

•Most people take more than one pill for high blood pressure. Work with your doctor to find the right pill or combination of pills that

will cause the fewest side effects .•It can be hard to remember to take pills when

you have no symptoms. But your blood pressure will go back up if you don't take your medicine. Make your pill schedule as simple as you can. Plan times to take them when you are doing other things, like eating a meal or getting ready for bed.

Management •Reducing morbidity and mortality is the main

goal in hypertension management. Blood pressure reduction is done in a step-wise approach, often beginning with non-pharmacologic methods that include weight

loss, and dietary and lifestyle modifications .•Should non-pharmacological methods prove

unsuccessful ,

•There are four families of drugs from which to choose :

•1 .Diuretics (reduce blood volume by inhibiting sodium and water retention)

•2 .Beta blockers (decrease cardiac output)•3 .Calcium antagonists (induce vasodilation)

•4 .ACE inhibitors (decrease peripheral vascular resistance)

•Medications from each family may be combined in order to achieve the desired pressure reduction

What can you do to prevent high blood pressure?

•There are six lifestyle changes you can make to help prevent high blood pressure:

•Lose extra weight .•Eat less salt .

•Exercise .•Manage stress

•Don't smoke •Practice relaxation or slow, deep breathing

.•Get 3,500 mg of potassium in your diet every day. Fresh, unprocessed

whole foods have the most potassium. These foods include meat, fish, nonfat and low-fat dairy products, and many fruits and vegetables .

•Follow the DASH eating plan (Dietary Approaches to Stop Hypertension). This diet is rich in fruits, vegetables, and low-fat dairy

products and is low in fat

DASH Diet •The DASH diet focuses on lowering your

blood pressure and keeping it under control. DASH, which stands for Dietary

Approaches to Stop Hypertension, could lower your blood pressure by a few

points in just two weeks. Over time, your blood pressure could drop by eight to 14

points .•The DASH diet offers other health

benefits, too, such as protection against osteoporosis, cancer, heart disease, stroke and diabetes. The DASH diet is especially effective in reducing blood pressure in older adults. If adopted early and combined with other lifestyle changes such as exercising more and quitting smoking, the DASH diet can prevent high blood pressure (hypertension) .

DASH diet

Nursing diagnosis

• Deficient knowledge regarding the relation between the treatment regimen and control of the disease process

• risk to complication

•Paling and goal

Increase knowledge

protective to patient from any complication

•Nursing intervention: •The patient needs to

understand the disease process and how lifestyle changes and medications can control hypertension.

• encouraged to patient for follow up care, all body systems must be assessed to detect any evidence of vascular damage.