Hypertension, types, causes, symptoms, investigation, treatment


 A systolic (pressure measured when heart contracts)  >139 mm Hg, and / or a Diastolic BP ( pressure when heart relaxes) >89 mmHg. 

Criteria for classification of BP:-
Category                    Systolic       Diastolic
Normal  -                   <120             <80
Pre- hypertension   120-139        80-89
Hypertension
Stage -1                      140-159        90-99
Stage -2                      >=160           >=100

Hypertension (Crisis) :-
  1. Hypertension Emergencies (Malignant hypertension) are characterized by severe elevations in BP (>180/120mm hg) with progressive end- organ dysfunction. 
  2. Hypertension Urgencies (Accelerated Hypertension) are associated with severe elevation s in BP but no progressive target organ dysfunction. 
Types of Hypertension:-
  1. Primary Hypertension:- also known as Essential Hypertension Accounts for 95% causes of hypertension, No universally established cause known
  2. Secondary Hypertension:- less common causes of hypertension 5% , by use of certain medicine, or secondary to other potentially rectifiable causes. 
Causes:- 
  1. Essential hypertension
  2. Renal - Acute Nephritis, pyelonephritis, Polycystic Kidneys, Diabetic Neuropathy
  3. Endocrine - Pheochromocytoma, Cushing's syndrome, Thyrotoxicosis, Myxedema. 
  4. Pregnancy induced hypertension
  5. Cardiovascular - Coarctation of Aorta
  6. Neurological - Raised Intra cranial pressure
  7. Drugs - Cocaine
  8. Miscellaneous - Polycythemia, Hypercalcaemia 
Effects of Hypertension:- the common organs damaged by long standing Hypertension are Heart, kidney, Blood vessels, Retina and CNS. 

Symptoms due to hypertension:-
  • Headache
  • Dizziness
  • Epistaxis ( bleeding through nose) 
  • CVS - Dyspnea on exertion, Angina
  • Kidneys - Haematuria, Polyuria, Nocturia
  • CNS - stroke, Convulsions, Unconscious ness, Dizziness
  • Retina - Blurred Vision / Sudden  blindness
  • Edema
  • Weakness
  • Joint pains. 
Investigation:- 
  • Pressure measuring gauge check bp 
  • Chest X- ray, 
  • Imaging of Abdomen ( Sonography, CT scan, MRI) 
  • ECG for LV hypertrophy
  • Urinalysis
Treatment
Lifestyle Modification:-
  • Salt restrictions
  • Weight reduction
  • Stop Smoking
  • Diet control
  • Limit of Alcohol Intake
  • Relaxation
  • Regular exercise
Pharmacological treatment:-
  • Diuretics
  • Beta blockers
  • Calcium channel blockers
  • ACE inhibitors
  • Angiotensin 2 blockers
  • Alpha Blockers
  • Vasodilators. 



Comments

Post a Comment

Popular posts from this blog

Head injuries,symptoms, causes, pathology, types, examination, treatment, physio

 It is the insult to the brain caused by external physical force leading to altered conscious levels, cognitive problems as well as motor & sensory deficits.  Commonly called traumatic brain injuries.  Head injuries have increased due to increased traffic and decreased traffic sense. Most of the cases are proved to be fatal death.  Incidence:-  High Head injuries from road traffic accidents are most common in young males.  RTA's although constituting only about 25% of all patients with head injury, are the cause of more severe injuries.  RTA's contribute to 60%of deaths from head injury, of these half die before reaching hospital.  Causes of head injuries:- Road traffic accidents (RTA's)  Gunshot Riots  Blow or hit on the head Fall from heights.  Pathology:- Primary brain damage - Occuring at impact Secondary brain damage - Occuring due to ongoing neuronal damage, haematoma, brain swelling, Ischaemia Or infection.  Types of...
Read more

Muscular dystrophy, types, pathophysiology, symptoms, investigation, physiotherapy management

 Muscular dystrophy is a group of rare hereditary progressive disease in which muscle fibers are usually susceptible to damage.  Muscular dystrophies are genetically determined myopathies in which progressive degeneration & wasting of muscles occur.  Dystrophies can be of 3 types  Congenital muscular dystrophy Genetic muscular dystrophy Metabolic muscular dystrophy Epidemiology :- Commonly seen in males.  Pathophysiology :- Deficiency of dystrophin protein (due to defect in the XP21 gene which codes dystrophin)  Loss of properties of skeletal muscle cells membrane ( Dystrophin is essential to maintain the properties of skeletal muscle cells membrane)  Cell break down Release of all contents of cell into the serum Death of cell i.e necrosis of muscle cells Fatigue, weak & dystrophin muscles Elevated serum creatinine phosphokinase levels.  Classification :- based on inheritance & clinical picture X-linked recessive - Duchenne muscular dy...
Read more

Humidification, types, methods, supplies, indications.

Image
 Air is moistened because it is passed through the water vapour, Patient is asked to inspire the air by face mask or by the mouth piece.  • Normally air passing through nose& pharynx is continuously moistening the respiratory mucous, if this is inefficient cilial action is impaired & secretions are viscid so need of humidifier to loosen viscid & thick secretions.  • Humidification is moistening of air & gases, this is normal function of upper respiratory tract if this is inefficient then artificial humidifier is required Indications - 1) Patient with tracheostomy/ endotracheal tube   2) patient with oxygen mask       3) when thick secretions Choice of humidifier Ultrasonic type - patient with dry gas Disposal type - patient with respiratory failure like in chronic bronchitis, asthma, emphysema  Method Humidification given by wide boring tube,,,,, short period given before chest clearance done for patient who is not intu...
Read more