What is hypertension?

Before we discussed the hypertension first of all everybody wants to know who introduced this.How it affects the body and our brain? 

 

Historical perspectives of hypertension.

• Hypertension is a chronic form of illness that requires life long medication. Development of heart and Brain distress was percribed by ancient Egyptian physician in Ebers papyrus.
• In 1733, English clergyman Stephen Hales invented a manometer and also made the first measurement of arterial Blood pressure in horse.

Who invented the sphygmomanometer?

Mostly people are suspicious to know who was the person who introduced the blood pressure measuring apparatus. 

In 1896,cuff based mercury sphygmomanometer was invented by Italian physician Scipione Riva Rocci. He was also known by the title of” Father of blood pressure”.

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Korotkoff sounds 

These are the sounds that are Heard when we apply the pressure by the cuff based mercury sphygmomanometer on the antecubital fossa of the arm. They can be heard when the cuff is gradually deflated.

 

 How was hypertension first discovered?

In 1870, Frederick Mahomed was a medical resident at Guys Hospital in London measuring the Blood pressure in the general population. 

 

Who was the Person suffering from high Blood pressure? 

Everyone wants to know who is the first person who is suffering with that disease. Should he or she recover or not?

Franklin D. Roosevelt was an American politician documented as having hypertension at the age of 54,he did not receive the treatment for another 4 years when he prescribed phenobarbital and massage therapy for the BP of 188/105 in 1941.on April 12, 1945, Roosevelt reported a severe occipital headache when his BP was at 300/190 is recorded. He subsequently lost consciousness and died. 

 

Few words on the perspective of drugs.

• On drug fonts, hexamethonium hydralazine and reserpine were used after world war 2. 
• In 1950, diuretic chlorothiazide were well tolerated.
• In 1960, British physician James black developed beta-blockers.
• Discovery of renin angiotensin system lead to development of angiotensin converting enzyme inhibitors which leads to renin inhibitors .

Definition of hypertension.

After the historical perspectives know we should know about hypertension, what is it and how it occurred in our body?Normal blood pressure is 120/80. 

As we know that hyper means more and tension means pressure. So hypertension is a condition in which the Blood vessels have continuously raised pressure.Systolic pressure greater than 140 and diastolic pressure is more than 90 mm Hg. 

Classification of hypertension 

Hypertension can be classified as:

 

1. Normal :when the systolic blood pressure is less than 120 and diastolic blood pressure is less than 80mmHg it is called Normal blood pressure. 
2. Prehypertensive stage: prehypertensive means just before the hypertension or may be nearer to hypertension. Systolic is 120-129,and diastolic is less than 80.
3. Stage 1 hypertension:This stage start when the systolic blood pressure is 130-139 and diastolic blood pressure is 80-89mmHg.
4. Stage 2 hypertension :This stage is more sever stage this occurs when the systolic blood pressure is more than or equal to 140 and diastolic blood pressure is more than or equal to 90mmHg.

What are the causes of hypertension?

Causes are the sources or events in our body that lead to hypertension. We want to know what are the main causes of hypertension and how we can prevent ourselves from suffering from this condition. Now we know the different causes of hypertension . 

• High salt intake 
• Obesity
• Vascular disorders
• Genetics
• Low potassium diet
• Smoking
• Lack of physical activity 
• Renal problems
• Endocrine disorders
• Unhealthy diet
• Physical inactivity 

Pathophysiology of hypertension.

Pathophysiology means how the disease processes in our body.

As we know that hypertension is caused due to multiple factors.

• When we take a sodium rich diet then the renal sodium retention occurs which increases the fluid volume resulting in increased preload and then the contractility of heart also increases that leads to hypertension. The kidney takes part in urine formation and also helps the body in preventing dehydration when we take excessive sodium then it is retained in our body by the kidney.

 

• Obesity is also the main risk factor of many diseases. It is also the main cause of hypertension because hyperinsulinemia develops that causes the structural hypertrophy that leads to increased peripheral vascular resistance.

 

• Genetics variation is also the leading cause of hypertension. Any change in the cell structure and function leads to the changes in Normal functioning of the cell . Disturbing the normal function leads to the development of peripheral vascular resistance that causes hypertension. 

Clinical manifestations of hypertension.

Many people who have hypertension are asymptomatic; they are physically fit and have no active complaints of hypertension . But measurements of the BP are only the indicator of high blood pressure. It’s very important to detect hypertension earlier before it damages our Vital organs in the body just like the kidney.Sign and symptoms of the hypertension are: 

• Headache  occurs due to the constricted Blood vessels due to which the RBCs have difficulty in reaching the brain. 
• Dizziness due to the low concentration of oxygen in the blood reaches the brain.
• Chest pain due to decreased oxygen level in the body. 
• Blurred vision due to much more construction in the blood vessels of eyes.

All are the most common signs and symptoms of hypertension. If someone feels that they must visit and be concerned with their Doctor as early as possible. 

Prevention from hypertension.

As all want to know how we can prevent and protect from suffering in that condition. 

As we hear that “prevention is better than cure.”following are the preventions of hypertension:

• Weight reduction can prevent hypertension.
• Improve your physical activity take aerobic exercises at least for 30 minutes
• Take a sodium restriction diet.
• Eat a healthy diet that includes vegetables, fruits,low fat  and potassium rich diet because potassium helps to reduce the Blood pressure.
• Avoid smoking.
• Avoid alcohol consumption.

Complications of hypertension.

If the hypertension is untreated It can lead to organ damage and be harmful for the health of individuals. 

• Heart failure due to the weakness of heart muscles from too much exertion 
• Myocardial infarction due to the decreased level of oxygen reaches the heart muscles.
• Impaired vision due to decreased oxygen.
• Renal failure due to the constriction of the blood vessels supplying nutrition and blood to the kidneys. 

Diagnosis of hypertension

Hypertension can be diagnosed by performing several tests.

• Urine analysis to detect the sodium level.
• Blood analysis this test is performed to detect the sodium and fat in the body.
• ECG is performed to detect the normal functioning of the heart.
• Renal test to assess how the RAAS is performing his Function in regulating the blood.
• Echocardiogram performanced to assess the Left ventricular hypertrophy.
• Serum potassium analysis.

Medical management of hypertension.

Medical management is necessary to cure hypertension and save the person’s life and also prevent further complications. 

Pharmacological management of hypertension.

Stage 1:This type of hypertension is treated by thaizid diuretics for most angiotensin converting enzyme inhibitors, aldosterone receptor blockers ,beta blockers and  calcium channel blockers are considered.

Stage 2:two drug are given in combination form like beta blockers or calcium channel blockers or thaizid diuretics and angiotensin converting enzyme inhibitors. 

Nursing management.

The main purpose of the nurses is to maintain the BP of the patient within normal range and also help the patient to achieve the normal Blood pressure through the dependent or independent interventions. 

• Encourage the patient to consult with the dietician for a healthy diet plan.
• Encourage the patient to restrict the sodium rich diet.
• Implement the regular physical activities.
• Advise the patient to limit the alcohol.
• Educate the patient to avoid smoking. 
• Encourage the patient to take potassium rich diet.