Hypertensive disease

«Hypertensive disease»

Plan:

• What is hypertensive disease?
• Dividing blood pressure into categories
• Risk factors
• Symptoms
• Complications
• Diagnosis and Tests
• Treatment
• Prevention
• References

Hypertensive heart disease is a condition with damage to your heart from years of unmanaged or undermanaged high blood pressure. You may have thick and weak heart muscle (left ventricular hypertrophyor LVH) from strain on your heart. This can lead to heart failure. This happens because long-term high blood pressure (hypertension) makes it harder for your heart to pump blood. And it often makes it more difficult for your heart muscle to relax.

The American College of Cardiology and the American Heart Association divide blood pressure into four general categories:

• Normal blood pressure. Blood pressure is lower than 120/80 mm Hg.
• Elevated blood pressure. The top number ranges from 120 to 129 mm Hg and the bottom number is below, not above, 80 mm Hg.
• Stage 1 hypertension. The top number ranges from 130 to 139 mm Hg or the bottom number is between 80 and 89 mm Hg.
• Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom number is 90 mm Hg or higher.

Risk factors

High blood pressure has many risk factors, including:

• Age
• Race
• Family history
• Obesity or being overweight
• Lack of exercise
• Tobacco use or vaping
• Too much salt
• Low potassium levels
• Drinking too much alcohol
• Stress
• Pregnancy

Symptoms

Hypertensive heart disease symptoms include:

• Chest pain
• Shortness of breath
• Fatigue
• Heart palpitations
• Dizziness
• Fainting
• Swelling in your legs (from heart failure)

Complications

Complications of hypertensive heart disease include:

• Heart failure
• Arrhythmia
• Stroke
• Sudden cardiac death
• Atherosclerosis
• Retinal disease
• Peripheral arterial disease
• Chronic kidney disease
• Aortic aneurysm
• Cerebrovascular disease

Diagnosis and Tests

Since high blood pressure doesn’t have symptoms, your healthcare provider needs to check for it. They’ll also do a physical exam and look at your personal and family history.

Tests include:

• Blood tests
• Urine test
• Electrocardiogram (EKG)
• Echocardiogram (echo)
• Cardiac MRI

Treatment

Treatment may include:

• Taking medicines daily: These may include a mix of ACE inhibitors or ARBs, diuretics, calcium channel blockers and beta-blockers.
• Treating other medical problems: These may include diabetes, obesity, lung disease, sleep apnea, chronic kidney disease or high cholesterol.
• Making changes to your daily life: It’s helpful to avoid addictive substances like tobacco, get more physical activity, eat less salt, avoid fried and highly processed foods, and get to a weight that’s healthy for you.
• Being proactive about cardiovascular exercise and diet: This may include a consultation with a dietitian/nutritionist and/or physical therapist.

Prevention

You can prevent hypertensive heart disease by managing your blood pressure. Get your blood pressure checked once a year if you’re older than 18. Get readings more often if your numbers are high. If your blood pressure is high, bring it down and keep it down. You can purchase a blood pressure monitor that you can use at home.

Any medicine can have side effects, but it’s important to keep taking your blood pressure medicines. If you’re having side effects, your provider may be able to switch you to a different medicine.

When managing your blood pressure, it’s also helpful to:

• Be physically active
• Stay at a weight that’s healthy for you
• Eat heart-healthy foods

REFERENCES

• Ahmad SN, Gul I, Sultan ST. Prevalence and associated factors of hypertension complications among hypertensive patients: a hospital-based study. Int Jorunal Acad Med Pharm. 2023;5(1):34–8.
• Armstrong C. JNC 8 guidelines for the management of hypertension in adults. Am Fam Physician. 2014;90(7):503–4.
• Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 international society of hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334–57.
• Kifle ZD, Adugna M, Chanie GS, Mohammed A. Prevalence and associated factors of hypertension complications among hypertensive patients at university of Gondar comprehensive specialized referral hospital. Clin Epidemiol Global Health. 2022;13.
• Whelton PK, Carey RM, Mancia G, Kreutz R, Bundy JD, Williams B. Harmonization of the American college of Cardiology/American heart association and European society of Cardiology/European society of hypertension blood pressure/hypertension guidelines: comparisons, reflections, and recommendations. Eur Heart J. 2022;43(35):3302–11.

THANK YOU FOR YOUR ATTENTION