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Hypertension

Learn about hypertension, its types (essential and secondary), prevalence, complications, and treatment options such as diet, exercise, and medications. Explore why hypertension is more prevalent in African Americans and how it can be controlled.

blake-chang
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Hypertension

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  1. Hypertension

  2. Blood Flow www.sdm.scot.nhs.uk/images/pfo.jpg

  3. Blood Pressure • Measure of pressure exerted on the wall of the blood vessels • Measure of the pressure exerted when heart contracts • Normal: • Contraction = systole = 105-139mmHg • Relaxation = disystole = 70-90 mmHg • Hypertension greater than 140/90 mmHg • Symptoms --- often none

  4. How controlled • Controlled by mechanism in kidney • Blood flow through kidney • Cells sense the decreased volume, pressure and sodium • Produce a enzyme call “renin” • Renin breaks down protein to form angiotensin I • Angiotension I converted to Angiotensin II by another enzyme called “Angiotension Converting Enzyme” or ACE • Angiotension II increase BP and bring water and sodium into blood

  5. Types of Hypertension • Essential • No identifiable cause • Both systolic reading and disystolic readings are high • Systolic • Fewer cases/ more often in elderly • Systolic reading elevated • Secondary • Kidney disease • Cushings disease • Diabetes • Pre-eclampsia

  6. Prevalence • Less in more physically active group • When controlled for activity, income, smoking, smoking, weight, Black had odds ratio of 1.77 compared to whites (0.73) (Bassett et.al, 2002) • Higher percentage of hypertension in the Southeast- (Hall et.al, 1997) (Glover et.al, 2002) • Black men 35%; Black women 37.7% (40.5%) • White men 36.5%; White women 21.5% (27.4%) • Why? • Obesity– 25% • Diet high in sodium and fat • Lack of education • Access and utilization of health care

  7. Complications • Earlier onset • Stroke- 80% higher stroke mortality • Heart Disease– 50% higher heart disease mortality • Kidney Failure—320% greater End Stage Kidney Disease

  8. Treatment • Diet • Exercise • Drugs • Diuretics– AKA “water pills” • Beta Blockers—block receptors on heart to reduce the contractions • ACE inhibitors • Ca channel blockers • Angiotension II inhibitors

  9. Why more prevalent in African Americans? • Decreased renin • Stress • Genetics • Adaptation • Food • Lack of exercise

  10. Centers for Disease Control

  11. References • Hall, et. al. (1997) Hypertension-related morbidity and mortality in the southeatern United States • Glover et al. (2005) Racial/ethnic disparities in prevalence, treatment, and control of hypertension, MMWR weekly, January 14, 54, 7-9 • National Institutes of Health, Joint National Committee on Prevention , Detection, Evaluation and Treatment of High Blood Pressure (1999), http:// www.ncbi.nlm.nih.gov.

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