ASUHAN KEPERAWATAN

Pathophysiology of Hypertension

The pathophysiology of hypertension is an area of active research, attempting to explain causes of hypertension, which is a chronic disease characterized by elevation of blood pressure. Hypertension can be classified as either essential or secondary. Essential hypertension indicates that no specific medical cause can be found to explain a patient's condition. About 90-95% of hypertension is essential hypertension. Secondary hypertension indicates that the high blood pressure is a result of another underlying condition, such as kidney disease or tumours (adrenal adenoma or pheochromocytoma). Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure.

Most mechanisms leading to secondary hypertension are well understood. The pathophysiology of essential hypertension remains an area of active research, with many theories and different links to many risk factors.

Cardiac output and peripheral resistance are the two determinants of arterial pressure. Cardiac output is determined by stroke volume and heart rate; stroke volume is related to myocardial contractility and to the size of the vascular compartment. Peripheral resistance is determined by functional and anatomic changes in small arteries and arterioles.

Pathophysiology of Hypertension
Source : wikipedia

Hypertension

Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated. In current usage, the word "hypertension" without a qualifier normally refers to systemic, arterial hypertension.

Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure. Even moderate elevation of arterial blood pressure leads to shortened life expectancy.(Wikipedia)

The most effective treatment plan for hypertension uses a multifaceted approach. Treatment plans are also individualized to best address the specific cause and the patient's age, medical history, and severity of hypertension. Hypertension is highly treatable and in most people, prompt and ongoing treatment will result in a normalization of blood pressure and in minimizing the risk of serious complications.

Treatment begins with prevention. This includes maintaining a healthy weight, not drinking alcohol excessively, not smoking, eating a healthy-healthy diet, and getting regular exercise. These preventive measures are also generally recommended as treatment measures as well.

Not all people can effectively manage their blood pressure by these lifestyle measures alone. For these people oral medications, known as anti-hypertensive drugs, may be prescribed. Individual medications may be used alone or in combination with other medications.

Anti-hypertensive medications include diuretics, also known as "water pills", which lower blood pressure by stimulating the kidneys to flush extra fluid and salt from the body. ACE inhibitors lower blood pressure by preventing the body from making a hormone called angiotensin II, which narrows and tightens blood vessels. Angiotensin II receptor blockers protect blood vessels from the narrowing effects of angiotensin. Beta blockers help the heart to beat slower and less forcefully. Calcium channel blockers block calcium from entering the cells of the heart and blood vessels, resulting in relaxation of the vessels. Alpha blockers decrease nerve impulses that tighten blood vessels. Vasodilators relax and widen the blood vessels walls. Nervous system inhibitors work in the brain to increase messages to the blood vessels to relax and widen them.

Treatment of hypertension also includes addressing underlying causes such as thyroid disease, obesity, and kidney disease. If hypertension is caused by a certain medication, then a dosage adjustment or different medication may be needed.

Complications of hypertension are also treated as appropriate.

Source : http://www.wrongdiagnosis.com

Most people are not aware that they have hypertension because of a general lack of symptoms until major complications arise. In rare cases, some people with hypertension may have headaches or nosebleeds.

Despite a general lack of symptoms, uncontrolled hypertension damages the kidney and heart and large and small blood vessels throughout the body. This due to the excessive and ongoing pressure that the blood is putting on the walls of the arteries as it is pumped from the heart throughout the body.

Untreated hypertension can lead to and/or complicate many health problems, including coronary heart disease, stroke, kidney failure and heart failure. Uncontrolled hypertension can also result in a dangerous, even fatal aneurysms, an abnormal "ballooning" of arteries that can rupture. Hypertension can also lead to vision changes and blindness due to bursting of arteries in the eyes.....more about Hypertension »

Blood pressure measurements are the result of the force of the blood produced by the heart and the size and condition of the arteries.

Many factors can affect blood pressure, including :

• How much water and salt you have in your body
• The condition of your kidneys, nervous system, or blood vessels
• The levels of different body hormones

High blood pressure can affect all types of people. You have a higher risk of high blood pressure if you have a family history of the disease. High blood pressure is more common in African Americans than Caucasians. Smoking, obesity, and diabetes are all risk factors for hypertension.

Most of the time, no cause is identified. This is called essential hypertension.

High blood pressure that results from a specific condition, habit, or medication is called secondary hypertension. Too much salt in your diet can lead to high blood pressure. Secondary hypertension may also be due to:

• Adrenal gland tumor
• Alcohol abuse
• Anxiety and stress
• Arteriosclerosis
• Birth control pills
• Coarctation of the aorta
• Cocaine use
• Cushing syndrome
• Diabetes
• Kidney disease, including :
  • Glomerulonephritis (inflammation of kidneys)
  • Kidney failure
  • Renal artery stenosis
  • Renal vascular obstruction or narrowing
• Medications
  • Appetite suppressants
  • Certain cold medications
  • Corticosteroids
  • Migraine medications
• Hemolytic-uremic syndrome
• Henoch-Schonlein purpura
• Obesity
• Pain
• Periarteritis nodosa
• Pheochromocytoma
• Pregnancy (called gestational hypertension)
• Primary hyperaldosteronism
• Renal artery stenosis
• Retroperitoneal fibrosis
• Wilms' tumor

Source : http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm

By Cory Brusseau

Although there are new blood pressure treatments coming out ever day, exercise is still one of the best remedies around. Studies have shown that sedentary lifestyles tend to elevate blood pressure, while regular exercise can reduce it. A single workout can reduce blood pressure for an entire day, and regular exercise can keep the pressure down for the long run.

Hypertension or high blood pressure is often a precursor to heart disease and if left undetected or isn't properly controlled can lead to heart attack, kidney failure, stroke and death. Because it has few early symptoms, many people aren't aware they have it, leading to the statistic that one out of every two Americans die of heart disease. The risk generally increases with age due to the high fat-high cholesterol diets that most modern societies consume throughout their lives.

The good news is that the right kind of fitness program can make a big difference. A balanced fitness plan is always the best way to achieve the results you desire. Stretching, strength training, aerobic activity, and anaerobic activity all play a part in a total fitness plan. Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure. Regular exercise is also a great way to maintain your proper bodyweight, another important way to control blood pressure. To keep your blood pressure low, you need to keep exercising. Depending on your condition, it can take from one to three months for regular exercise to have the desired effect you aim for. The benefits last only as long as you continue your fitness routine, so as long as you exercise on a regular basis, you will see marked benefits all your life.

If your blood pressure is already at normal levels, a good fitness plan will keep it from rising as you age. Remember to begin your fitness routine slowly. If your condition is bad, do not overwork yourself! Find an fitness plan that will allow you to go at your own pace. Remember to incorporate a good warm up and cool down plan. Build up the intensity of your workouts gradually. Yes, it is important to simply get out there and get moving. However, to achieve the maximum benefit from exercise, it is important to strive for a full, balanced, ongoing workout plan that grows in intensity.

Based on the mountains of evidence that now exists, there is one message for all couch potatoes out there: Get moving. Whether you are overweight or slim, have hypertension or normal blood pressure, engaging in regular exercise can help reduce, risk of heart attack, stroke, and premature death.