High Blood Pressure Hypertension

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High Blood Pressure (Hypertension)

• Joint National Committee on Prevention,
• Detection, Evaluation, and Treatment of
• High Blood Pressure
• Beginning at 115/75 mmHG, cardiovascular disease
  risk doubles for each increment of 20/10 mmHg.
• In those older than age 50, a systolic blood
  pressure greater than 140 mmHg is a more
  important risk factor for cardiovascular disease
  than diastolic blood pressure.
• Men and women with normal blood pressure at age
  55 have a 90 percent lifetime risk of developing
  hypertension.

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Blood Pressure
Definition A measure of the force exerted
against the walls of the vessels by the blood
flowing through them.

• Systolic Blood
• Pressure
• Highest blood pressure
• when the heart contracts.
• Diastolic Blood
• Pressure
• Lowest blood pressure between contractions of
• the heart.

Sphygmomanometer Stethoscope
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Eye damage Prolonged high blood pressure can
damage delicate blood vessels on the retina, the
layer of cells at the back of the eye. If the
damage, known as retinopathy, remains untreated,
it can lead to blindness.
Stroke High blood pressure can damage vessels
that supply blood to the brain, eventually
causing them to rupture or clog. The interruption
in the blood flow to the brain is known as a
stroke.
Damage to artery walls Artery walls are normally
smooth, allowing blood pressure to flow easily.
Over time, high blood pressure can wear rough
spots in artery walls. Fatty deposits can collect
in the rough spots, clogging arteries and
raising the risk of a heart attack or stroke.
Heart attack High blood pressure makes the heart
work harder to pump sufficient blood through
narrowed aterioles (small blood vessels). This
extra effort can enlarge and weaken the heart,
leading to heart failure. High blood pressure
also damages the coronary arteries that supply
blood to the heart, sometimes leading to
blockages that can cause a heart attack.
Rough artery walls
Clogged artery
Kidney failure Prolonged high blood pressure can
damage blood vessels in the kidney, where wastes
are filtered from the bloodstream. In severe
cases, this damage can lead to kidney failure and
even death.
Consequences of High Blood Pressure
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Preventing Hypertension

• Lifestyle Changes
• Lose weight
• Exercise regularly
• Consume adequate amounts of folate
• Follow the DASH Diet
• Dietary Approaches to Stop Hypertension
• Restrict daily sodium intake
• Factors That Have Not Proven Effective
• Dietary supplements such as calcium, magnesium,
  potassium, and fish oil.

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Making Heart Healthy ChangesChanges You Can Make
Today

• Eat a good breakfast whole-grain cereal, juice,
  yogurt, and so forth.
• Take a walk after lunch.
• Skip desert at dinner.
• Eat one more serving of vegetables.
• Eat one more piece of fruit.Drink one more glass
  of water.
• Take the stairs for one or two flights rather
  than riding the elevator to your dorm room or
  classroom building.
• Get seven to eight hours of sleep a night.

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Making Heart Healthy ChangesChanges You Can Make
This Week

• Block out time for exercise on your calendar.
• If you havent had your lipoproteins checked
  within the last year, schedule a test.
• If you dont know your blood pressure, find out
  what it is.
• Make a list of stress-reducing activities.
• Get in touch with an old friend.

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Making Heart Healthy ChangesChanges You Can Make
This Term

• Look for new ways to meet your goal.
• Be patient.
• If you slip up and smoke again or blow your diet,
  dont give up.
• Develop and use a support system of friends and
  family members.

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Making Heart Healthy ChangesGetting Physical

• Benefits
• Reduction in body weight
• Reduction in blood pressure
• Reduction of harmful LDL cholesterol
• Increase in beneficial HDL cholesterol
• Increase in insulin sensitivity
• American Heart Association, American
• College of Sports Medicine and the Center for
  Disease Control
• 30 to 60 minutes or more of moderate-intensity
  physical activity on most, if not all, days of
  the week to reduce heart disease risk by 30-40

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Making Heart Healthy ChangesChoosing
Heart-Healthy Foods

• Plenty of fruits and vegetables.
• Cholesterol lowering foods such as oats, barley,
  soy protein, and nuts.
• Fish 2 times a week (AHA).
• Insufficient evidence exists to recommend for or
  against the use of
• Supplements of vitamin A, C, or E.
• Multivitamins with folic acid.
• Antioxidant combinations.

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Superior vena cava
Aorta
Right pulmonary artery
Left pulmonary artery
Right pulmonary veins
Left pulmonary veins
Right atrium
Left atrium
Right coronary artery
Left coronary artery
Right ventricle
Left ventricle
Inferior vena cava
Pericardium
The Healthy Heart
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Left atrium
Right atrium
Left ventricle
Right ventricle
Myocardium
Pericardium
The Healthy Heart
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Capillary beds of lungs, where gas exchange occurs
The Path of Blood Flow
Pulmonary arteries
Pulmonary veins
Venae cavae
Aorta and branches
Left atrium
Left ventricle
Right atrium
Right ventricle
Oxygen-poor CO2-rich blood
Oxygen-rich CO2-poor blood
Capillary beds of all body tissues, where gas
exchange occurs
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Tobacco and Heart Disease

• Smoking is the single most significant risk
  factor for CV disease and peripheral vascular
  disease.
• Each year smoking causes 250,000 deaths from
  cardiovascular disease.
• Active vs. passive smoking.
• How Smoking Damages The Heart
• Nicotine over-stimulates the heart.
• Carbon monoxide reduce the oxygen supply to the
  heart.
• Tars and other smoke residues increase the risk
  of cholesterol build-up in the arteries.
• Smoking increases blood clotting.
• Smoking causes irreversible damage to the
  arteries.

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Your Lipoprotein Profile
Low Density Lipoprotein (LDL)
Fatty substances produced by the liver that
carry cholesterol to arterial walls bad
cholesterol.
High Density Lipoprotein (HDL)
Fatty substance that picks up cholesterol
in the blood-stream and returns it to the
liver good cholesterol.
Very Low Density Lipoprotein (VLDL)
The largest of the lipoproteins which allow
cholesterol to circulate in the bloodstream.
Triglycerides
Fats that flow through the blood after
meals and have been linked to increased
risk of coronary artery disease.
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What Is A Healthy Cholesterol Reading?
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Lowering Cholesterol

• Therapeutic Life
• Changes (TLC)
• Dietary changes
• Weight management
• Physical activity

• Medications
• Statins
• Nicotinic acid (niacin)
• Fibrates
• Aspirin

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Crises of the Heart
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How Atherosclerosis Happens
Hard fibrous cap
Red blood cell
LDL
Plaque
Macrophage
Foam cells
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Unclogging Arteries
Low Fat, Vegetarian Diet
Yoga, Meditation, Breathing
Moderate Exercise
Stress Counseling
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Angina Pectoris

• Definition a severe, suffocating chest pain
  caused by brief lack of oxygen to the heart.
• Often more pronounced during exercise or when
  under stress.

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Factors That Trigger Coronary Artery Spasms
Clumping of Platelets
Smoking
Increased Calcium Flow
Stress
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How Do I Know Its a Heart Attack?
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Heart Attack (Myocardial Infarction)
Blood flow
Aorta
Plaque breaks loose
Blood clot
Left coronary artery
Blood flow
Blockage
Artery spasm can block blood flow
Right coronary artery
Area of myocardial cell death
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Treatments That Save Hearts

• Clot-dissolving drugs
• Thrombolytic agents
• Clot-thinning drugs
• Thrombolytic
• Platelet receptor blocker
• Early administration of appropriate medications
  to dissolve clots.
• Intravenous nitroglycerin
• Beta-blockers
• Angioplasty

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Other Heart Disorders
Arrythmias
Mitral-Valve Prolapse
Congenital Defects
Congestive Heart Failure
Rheumatic Fever
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Heart Savers

• Diagnostic Tests
• Electrocardiogram (ECG, EKG)
• Thallium scintigraphy
• Coronary angiography
• Treatments
• Aspirin therapy
• Medications
• Diuretics, beta-blockers, calcium channel
  blockers, angiotensin-converting enzyme
  inhibitors (ACE).
• Surgical Procedures and Mechanical Aids
• Coronary bypass, percutaneous transluminal
  coronary angioplasty, heart transplant, and
  left-ventricular-assist devices (LVADs).

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Stroke

• Definition
• When the blood supply to a portion of the brain
  is blocked. Also called a cerebrovascular
  incident.
• Statistics
• Strokes are the 3rd leading cause of death in the
  U.S.
• Worldwide, strokes are the second leading cause
  of death.
• Types
• Ischemic stroke The result of a blockage that
  disrupts blood flow to the brain.
• Hemorrhagic stroke Occurs when blood vessels
  rupture.
• Causes
• Cerebral thrombosis, cerebral embolism, head
  injury and bursting of an aneurysm.

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How to Recognize a Stroke
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Risk Factors for Strokes
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Prevention and Treatment for Strokes

• A baby aspirin a day keeps strokes away.
• Surgery
• Carotid endartectomy
• Brain angioplasty
• Medications
• Thrombolytic drugs
• Tissue-type plasminogen activator (tPa)
• Heparinoids
• Nimodipine

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Protecting Your Heart

• Dont smoke.
• Watch your weight.
• Cut down on saturated fats and cholesterol.
• Get moving.
• Lower your stress levels.
• Know your family history.
• Get your blood pressure checked regularly.
• Tame your temper.
• Get a lipoprotein profile.
• Take appropriate medications.