No definitive cause
Managed by drugs and modification fo lifestyle factors
Secondary
Annotations:
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
Hypertensive vessel wall changes
Annotations:
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.
Consequences of hypertension
Annotations:
Endothelial damage
Atheroma formation
Risk of vessel becoming weak and rupturing
Risk of organ damage
Premature death
Doubles the risk of heart attack
Management
Annotations:
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
Exercise regs
Annotations:
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.
Exercise benefits
Short term
Annotations:
Resets BP regulatory mechanisms - up to 12 hour decrease in BP in those with hypertension
Long term
Annotations:
Prevents/treats obesity
Decreases insulin resistance
Promotes adaptations to sk muscles to increase pumping efficiency
Exercise considerations
Annotations:
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.