Download Free Medical Hypertension PowerPoint Presentation

Hypertension PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Antihypertensive, which is titled "Hypertension", to know about hypertension, sustained elevation of BP.

Tags : Antihypertensive, Hypertension, elevation of BP, blood pressure

Published on : May 25, 2021 | Views : 1307 | Downloads : 7

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Hypertension
Slide 2-

Factors Influencing Blood Pressure Blood Pressure = Cardiac Output x Systemic Vascular Resistance
Slide 3-

Factors Influencing BP HR SNS/PNS Vasoconstriction/vasodilation Fluid volume Renin-angiotensin Aldosterone ADH
Slide 4-

Hypertension Definition Hypertension is sustained elevation of BP Systolic blood pressure  140 mm Hg Diastolic blood pressure  90 mm Hg
Slide 5-

Blood Pressure Classification
Slide 6-

Hypertension For persons over age 50, SBP is more important than DBP as a CVD risk factor Starting at 115/75 mmHg, CVD risk doubles with each increment of 20/10 mmHg throughout the BP range
Slide 7-

Classification of Hypertension Primary (Essential) Hypertension - Elevated BP with unknown cause - 90% to 95% of all cases Secondary Hypertension - Elevated BP with a specific cause - 5% to 10% in adults
Slide 8-

Classification of Hypertension Primary Hypertension - Contributing factors: •  SNS activity • Diabetes mellitus •  Sodium intake • Excessive alcohol intake
Slide 9-

Classification of Hypertension • Secondary Hypertension - Contributing factors: • Coarctation of aorta • Renal disease • Endocrine disorders • Neurologic disorders - Rx: Treat underlying cause
Slide 10-

Risk Factors for Primary Hypertension Age (> 55 for men; > 65 for women) Alcohol Cigarette smoking Diabetes mellitus Elevated serum lipids Excess dietary sodium Gender
Slide 11-

Risk Factors for Primary Hypertension Family history Obesity (BMI > 30) Ethnicity (African Americans) Sedentary lifestyle Socioeconomic status Stress
Slide 12-

Hypertension Clinical Manifestations • Frequently asymptomatic until severe and target organ disease has occurred Fatigue, reduced activity tolerance Dizziness Palpitations, angina Dyspnea
Slide 13-

Hypertension: Complications Complications are primarily related to development of atherosclerosis (“hardening of arteries”), or fatty deposits that harden with age
Slide 14-

Hypertension Complications The common complications are target organ diseases occurring in the Heart Brain Kidney Eyes
Slide 15-

Hypertension Complications Hypertensive Heart Disease Coronary artery disease Left ventricular hypertrophy Heart failure
Slide 16-

Left Ventricular Hypertrophy Fig. 32-3
Slide 17-

Hypertension Complications Cerebrovascular Disease Stroke Peripheral Vascular Disease Nephrosclerosis Retinal Damage
Slide 18-

Hypertension Diagnosis • Diagnosis requires several elevated readings over several weeks (unless > 180/110) • BP measurement in both arms - Use arm with higher reading for subsequent measurements
Slide 19-

Hypertension Diagnosis Ambulatory BP Monitoring For “white coat” phenomenon, hypotensive or hypertensive episodes, apparent drug resistance
Slide 20-

Hypertension BP Measurement See Table 32-12 (p. 794)
Slide 21-

Treatment Goals Goal is to reduce overall cardiovascular risk factors and control BP by the least intrusive means possible BP < 140/90 In patients with diabetes or renal disease, goal is < 130/80
Slide 22-

Benefits of Lowering BP Average Percent Reduction Stroke incidence 35–40% Myocardial infarction 20–25% Heart failure 50%
Slide 23-

Algorithm for Treatment of Hypertension Not at Goal Blood Pressure (<140/90 mmHg) (<130/80 mmHg for those with diabetes or chronic kidney disease) Initial Drug Choices Drug(s) for the compelling indications Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed. With Compelling Indications Lifestyle Modifications Stage 2 Hypertension (SBP >160 or DBP >100 mmHg) 2-drug combination for most (usually thiazide-type diuretic and ACEI, or ARB, or BB, or CCB) Stage 1 Hypertension (SBP 140–159 or DBP 90–99 mmHg) Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination. Without Compelling Indications Not at Goal Blood Pressure Optimize dosages or add additional drugs until goal blood pressure is achieved. Consider consultation with hypertension specialist.
Slide 24-

Hypertension Collaborative Care • Lifestyle Modifications - Weight reduction - Dietary changes (DASH diet) - Limitation of alcohol intake (< 2 drinks/day for men; < 1/day for women) - Regular physical activity - Avoidance of tobacco use - Stress management
Slide 25-

Hypertension Collaborative Care • Nutritional Therapy: DASH Diet = Dietary Approahes to Stop HTN - Sodium restriction - Rich in vegetables, fruit, and nonfat dairy products - Calorie restriction if overweight
Slide 26-

Hypertension Collaborative Care • Drug Therapy - Reduce SVR - Decrease volume of circulating blood
Slide 27-

Hypertension Collaborative Care • Drug Therapy Diuretics Adrenergic inhibitors β - Adrenergic blockers ACE Inhibitors Calcium channel blockers
Slide 28-

Hypertension: Drug Therapy Thiazide-type Diuretics Inhibit NaCl reabsorption Side effects: Electrolyte imbalances: ↓ Na, ↓ Cl, ↓ K** (advise K rich foods) Fluid volume depletion (monitor for orthostatic hypotension) Impotence, decreased libido
Slide 29-

Hypertension: Drug Therapy Adrenergic Inhibitors Reduce sympathetic effects that cause HTN by: Reducing sympathetic outflow Blocking effects of sympathetic activity on vessels Side effects Hypotension Varied, depending on specific drug
Slide 30-

Hypertension: Drug Therapy β – adrenergic blockers (suffix “olol”) (metoprolol, propranolol) Block β – adrenergic receptors ↓ HR, ↓ inotropy, reduces sympathetic vasoconstriction) Side effects Bradycardia, hypotension, heart failure, impotence
Slide 31-

Hypertension: Drug Therapy ACE Inhibitors (suffix “pril) Enalapril, captopril Prevents conversion of angiotensin I to angiotensin II, thereby preventing the vasoconstriction associate with A II. Side effects Hypotension, cough
Slide 32-

Hypertension: Drug Therapy Calcium Channel Blockers Block movement of calcium into cells, causing vasodilation Side effects Brdaycardia, heart block
Slide 33-

Hypertension Collaborative Care • Drug Therapy and Patient Teaching - Identify, report, and minimize side effects • Orthostatic hypotension • Sexual dysfunction • Dry mouth • Frequent urination
Slide 34-

Primary Hypertension Nursing Management Nursing Diagnoses - Ineffective health maintenance - Anxiety - Sexual dysfunction - Ineffective therapeutic regimen management r/t - lack of S/S of HTN, side effects of Rx, cost of Rx, etc.
Slide 35-

Primary Hypertension Nursing Management Nursing Implementation Health Promotion • Individual patient evaluation • Screening programs • Cardiovascular risk factor modification
Slide 36-

Hypertensive Crisis • Severe, abrupt elevation in BP • The rate of  in BP is more important than the absolute value • Most common in patients with a history of HTN who have failed to comply with medications or who have been under-medicated
Slide 37-

Hypertensive Crisis Clinical Manifestations - Hypertensive encephalopathy (H/A, N & V, seizures, confusion, coma) - Renal insufficiency - Heart failure - Pulmonary edema
Slide 38-

Hypertensive Crisis Nursing and Collaborative Management Hospitalization - IV drug therapy - Monitor cardiac and renal function - Neurologic checks - Determine cause - Education to avoid future crises
Slide 39-

Supporting Materials Website www.nhlbi.nih.gov For patients and the general public Facts About the DASH Eating Plan Your Guide to Lowering Blood Pressure For health professionals Reference Card