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Summary treatment of hypertension

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Summary of the treatment of hypertension

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Treatment of Hypertension

 Control of blood pressure
 Definition and importance of hypertension
 Treatment of hypertension
 Lifestyle modifications
 Pharmacological treatment
 Drug selection for hypertension


What is Blood Pressure?

Blood pressure is pressure exerted by blood on blood vessels. It is controlled by
cardiac output and total peripheral resistance (resistance in the peripheral arteries):
BP = CO x TPR
BP is essential for organ perfusion as we know from Darcy’s law: Flow = Art. BP/TPR
Too little BP and you won’t have perfusion, too much and you’ll start damaging things.

Blood pressure has a short term regulation mechanisms and long term regulation
mechanisms.
Short-term regulation is neural via baroreceptors etc.
Long-term regulation is hormonal (through Na+ balance, RAAS and ANP) and to do
with controlling extracellular fluid volume and the general degree of vasoconstriction
(people with long term hypertension often have a greater degree of vasoconstriction
in their CVS).

High blood pressure can arise from an increase in the ECFV, an increase in
vasoconstrictor agents (e.g. endothelins, leukotrines) or a reduction in vasodilator
agents (e.g. ANP).

What is High Blood Pressure or Hypertension?

, If you measured a group of middle age people’s BP, the results would end up similar to
above. Majority will have a normal BP, while some will have very low BP and some
very high BP.
There is quite a large distribution, so there are many risk factors involved.

Hypertension is defined according to increased risk and this is accepted as having a BP
140/90 or over if you’re less than 50yrs old or 160/95 for older individuals.
The cut off point changes depending on how old you are.

Hypertension is set at 140/90 because of studies done which found a very strong
relationship between diastolic BP and stroke/CAD.
We set it at this value, because when your BP starts raising above this level, the risk
(relative risk) of having stroke, CAD etc. begins to increase significantly.

Hypertension is a strong risk factor for many things including: stroke ischemic heart
disease, renal failure, retinopathy, left ventricular hypertrophy, cardiac failure.

We also classify BP—

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