Hypertension (HPN) or high blood pressure is a chronic medical condition in which the blood pressure in the arteries is elevated. It is classified as either primary (essential) or secondary. Primary hypertension which refers to high blood pressure for which no medical cause can be found. The Secondary hypertension are caused by another conditions that affect the kidneys, arteries, heart, or endocrine system.
People can live with hypertension for many years without having any symptoms. That's why high blood pressure is frequently known as "The Silent Killer". High blood pressure is a condition in which the patient has higher than normal blood pressure. It's currently defined as a BP of above 140/90 mmHg. Basically there are three types of hypertension namely Primary, Secondary & White Coat Hypertension.
Primary Hypertension, may lead to worse conditions. It's not easy to find the cause of the primary hypertension. some say that primary hypertension is linked to genetic, poor diet, overweight, etc.
Secondary Hypertension, is an effect of other medical conditions. It means there are several conditions that may cause high blood pressure. the disorder of an organ in the body may lead high pressure. Kidneys disorder is an example of the condition that may cause the secondary hypertension.
Tension & Anxiety are known to cause temporary increases in blood pressure, which is known as White Coat Hypertension. If a person is having white coat hypertension, he is asked to monitor his blood pressure by wearing a device called an ambulatory blood pressure device. This device is usually worn for 24 hours& can take blood pressure every 30 minutes.
It is very important to know the type of hypertension one is having. The treatment is also essential because if it's not treated it causes the heart to work very hard & ultimately damages it. The American Medical Association notifies that serene cases of untreated hypertension can double the chance of a heart attack & a temperate case triples it.
Stages of Hypertension
Pre-hypertension – Systolic blood pressure (SBP) 120-139 or diastolic blood pressure(DBP) 80-89
Stage I HTN – SBP 140-159 or DBP 90-99
Stage II HTN – SBP >160 or DBP >100
Signs and Symptoms
- Tiredness
- Irregular Heartbeat
- Blurred Vision
- Confusion
- Headache
- High blood pressure
- Diabetes Mellitus
- Family History
- Advance age
- Obesity
- Sedentary Lifestyle
- Stress
- Smoking
- High intake of Na, saturated fats
- Alcohol
- One can control hypertension or blood pressure by adopting healthy lifestyle options like quit smoking, healthy eating habits like little salt, ample of fruits & vegetables & an active lifestyle involving daily cycling or walking.
- Exercise is an important treatment for hypertension.
- Practices like yoga, meditation also help in reducing high blood pressure.
- Only people with severe uncontrolled hypertension, which is very rare, need to be careful about exercise.
Nursing Care Plan of Hypertension
Medications and Treatment
Thiazide diuretics. Diuretics, sometimes called "water pills," are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. If you're not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic.
Beta blockers. These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don't work as well in blacks or in the elderly — but they're effective when combined with a thiazide diuretic.
Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.
Angiotensin II receptor blockers. These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels.
Calcium channel blockers. These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks and older adults than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Talk to your doctor or pharmacist if you're concerned about interactions.
Renin inhibitors. Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Due to a risk of serious complications, including stroke, you shouldn't take aliskiren with ACE inhibitors or ARBs.
If you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:
Alpha blockers. These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.
Alpha-beta blockers. In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.
Central-acting agents. These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.
Vasodilators. These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
Once your blood pressure is under control, your doctor may have you take a daily aspirin to reduce your risk of cardiovascular disorders.
To reduce the number of daily medication doses you need, your doctor may prescribe a combination of low-dose medications rather than larger doses of one single drug. In fact, two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication — or combination of drugs — is a matter of trial and error.
Lifestyle changes to treat high blood pressure
No matter what medications your doctor prescribes to treat your high blood pressure, you'll need to make lifestyle changes to lower your blood pressure. These changes usually include eating a healthier diet with less salt (the Dietary Approaches to Stop Hypertension, or DASH, diet), exercising more, quitting smoking and losing weight.
