Hypertension (High Blood Pressure)

 

Definition

Hypertension ek chronic condition hai jisme blood pressure normal limit se continuously zyada hota hai — usually systolic ≥140 mmHg aur diastolic ≥90 mmHg. Ye heart, brain, kidney, aur blood vessels ko damage kar sakta hai agar control na ho.

Epidemiology

● Worldwide common chronic disease.

● Mostly adults >40 years me hoti hai.

● Major risk factor for stroke, heart failure, and kidney disease.

Causes & Risk Factors

1. Primary (Essential) Hypertension:

Exact cause unknown (90–95% cases).

Risk factors:

● Family history

● Obesity

● High salt intake

● Stress, smoking, alcohol

● Sedentary lifestyle

● Ageing

2. Secondary Hypertension:

Due to underlying cause like:

● Kidney disease

● Endocrine disorders (Cushing’s, hyperthyroidism)

● Drugs (oral contraceptives, steroids)

Pathophysiology

● Increased peripheral vascular resistance due to arterial constriction.

● Overactivity of sympathetic nervous system & renin-angiotensin-aldosterone system (RAAS).

● Sodium & water retention → increased blood volume.

● Long-term pressure damages endothelium → atherosclerosis & organ damage.

Symptoms

● Often asymptomatic ("silent killer").

● Headache (especially morning occipital).

● Dizziness, blurred vision.

● Palpitations.

● Fatigue, shortness of breath.

● Nosebleeds (rare).

Complications

● Stroke (CVA)

● Myocardial infarction (heart attack)

● Heart failure

● Kidney failure (nephrosclerosis)

● Retinopathy (vision loss)

● Aneurysm

Diagnosis

● BP measurement (multiple readings on different days).

● ECG (LV hypertrophy).

● Blood tests (lipid profile, renal function, electrolytes).

● Urine test (proteinuria).

● Fundoscopy (retinal changes).

Treatment

Non-Pharmacological (Lifestyle Modifications)

● Low-salt, low-fat diet.

● Regular exercise (30 mins/day).

● Maintain healthy weight.

● Avoid alcohol & smoking.

● Stress reduction (yoga, meditation).

Pharmacological (Medications)

● Diuretics (Hydrochlorothiazide).

● ACE inhibitors (Enalapril).

● ARBs (Losartan).

● Calcium channel blockers (Amlodipine).

● Beta blockers (Metoprolol).

● Combination therapy if needed.

Nursing Management

● Monitor BP regularly & record trends.

● Educate about lifestyle modification & medication adherence.

● Assess for side effects of antihypertensives (dizziness, hypotension).

● Encourage low-salt diet & exercise routine.

● Teach relaxation techniques.

● Prevent complications by early detection of symptoms (chest pain, blurred vision).

● Support emotional health — stress management is key.

Prevention

● Regular BP screening after age 30.

● Healthy diet & exercise habits.

● Avoid junk food, smoking & alcohol.

● Stress control & adequate sleep.

Prognosis

● Well-controlled BP → normal life expectancy.

● Uncontrolled hypertension → high risk of stroke, heart attack, kidney failure.