Hypertension

1. 160/95mmHg

1. 140/90mmHg

Nota:

• No definitive cause Managed by drugs and modification fo lifestyle factors

Nota:

• Due to a pathology. Causes: - renal disease - renal artery stenosis - endocrine disease - tumour of the adrenal medulla - hypersecretion of catecholamines -drugs/food - e.g corticosteroids, steroids, liquorice

Nota:

• Increased smooth muscle content leads to a thickened tunica media, causing narrowing of the lumen therefore increasing TPR and increasing risk of obstruction which would lead to tissue ischaemia.

Nota:

• Endothelial damage Atheroma formation Risk of vessel becoming weak and rupturing Risk of organ damage Premature death

Nota:

• ACE inhibitors - to decrease TPR and blood volumeBeta blockers - decrease work of the heartCa2+ antagonsists - VD and decrease work of the heartArterial dilators - decrease TPRDiuretics - decrease blood volume Modification of lifestyle Regular exercise

1. Exercise regs

   Nota:

   • Mod intensity 60-75% HR max. Aerobic exercise 5x per week for 30 mins at a time Strength training 2-3 times per week 1-3 sets of 12-15 reps.
   1. Exercise benefits
      1. Short term

         Nota:

         • Resets BP regulatory mechanisms - up to 12 hour decrease in BP in those with hypertension
      2. Long term

         Nota:

         • Prevents/treats obesity Decreases insulin resistance Promotes adaptations to sk muscles to increase pumping efficiency
   2. Exercise considerations

      Nota:

      • Do not exercise if systolic BP >200mmHg or diastolic >110mmHg Avoid overgripping Hypotensive episodes are common secondary to hypertensive meds so avoid posutral changes and keep the feet moving.