By
Santhiya B, B.Sc., operation theatre and anaesthesia technology
Introduction
The force of circulating blood on the walls of the arteries is known as blood pressure and another name is hypertension. High blood pressure causes heart attack, heart failure and stroke, most of the adults have suffered from hypertension. The normal blood pressure value is 120/80mm Hg.
Blood pressure
Blood pressure can be measured by a sphygmomanometer
1. The rate and contraction of the heart is known as cardiac output
2. Peripheral resistance to the blood flow of the smaller arteries
Blood pressure increases due to contraction of the arteries. Normal BP is 120/80mmhg. 120mmhg is systolic blood pressure and 80 mmHg in diastolic blood pressure. In older people, the artery wall becomes thicker and the artery loses its elasticity. This is known as arteriosclerosis which hypertension is an age-related disease. If the pressure is below 100/60 mmHg is known as hypotension, whereas the above 130/90 is known as hypertension.
Causes of hypertension
In the majority of patients, there are no exact and obvious causes. But it can be caused by obesity, lack of physical activity, alcohol intake, deficiency of vitamin, calcium, magnesium and endocrine disorder can cause hypertension. Cushing syndrome increased cortisone retention of salt and fluids.
Pathophysiology
There are four factors, they are
1. Baroreceptor
2. Fluid quantity in the body
3. Renin-angiotensin
4. Vascular autoregulation
Fear and anxiety that stimulate the vasomotor and the impulses can travel through the sympathetic nervous system to the sympathetic ganglion, and reach the ganglion. At this point the preganglionic neurons release acetylcholine. This acetylcholine which stimulates the post-ganglion nerve fibres in the blood vessels. Where this is the point, there is release of norepinephrine. The norepinephrine will construct the blood vessels and cause hypertension. Our emotions like fear, anxiety can cause tension and which leads to contracting the blood vessels. In this vasoconstriction can stimulate the adrenal gland which results in additional vasoconstriction activity. These are the pathophysiological factors that lead to an increase in hypertension.
Symptoms
The symptoms may differ from moderate to a high level. Moderate level means it is present for many fears. Nearly about 10-15 years. In this period, it may cause symptoms like headache, giddiness, ringing in ears and bleeding in the nose. There are usually symptoms when BP is high. Mild symptoms extortions lead to breathlessness and cardiac asthma. In some cases hypertension leads to coronary thrombosis, it may lead to stroke caused by cerebral haemorrhage. In severe cases of hypertension, it causes hypertensive encephalopathy.
Hypertension encephalopathy is abnormal dysfunction in the brain. Severe headache, vomiting, convulsions, paralysis are usually present. This attack also leads to malignant hypertension. Usually, kidneys are affected in malignant hypertension, kidney failure is frequently happening.
Treatment
Now there are many treatments available to treat the blood pressure. Many drugs have been used to treat blood pressure. Hypotension drugs are the most frequently used for these patients. These drugs are
1. Beta-blockers
2. Oral diuretics
3. Calcium antagonists
4. Angiotensin-converting enzyme.
Beta-blockers
This is one of the drugs that block the constructing of the effect of the adrenaline on the vessels and reduces the heart rate. These drugs are not only reducing the blood pressure and also effective in relieving angina. For example, beta-blocker is atenolol.
Oral diuretics
These drugs are giving addition to beta-blockers. These drugs can help to release more amount of sodium in the urine. This sodium will absorb water from the blood. This will cause the level of fluid flowing through the blood vessels to be decreased. For example, diuretics are chlorothiazide, hydrochlorothiazide.
Calcium antagonists
These work by relaxing the muscles in the blood vessels, calcium antagonists work by the movement of calcium into the cells, which have been entered into the heart. It will help to pump the heart easier and result in reduced blood pressure. Examples of calcium antagonists are nifedipine, amlodipine.
Angiotensin-converting enzyme
It is used for the treatment of blood pressure and heart failure. These drugs relieve the blood vessels and decrease the blood volume, which leads to reducing the blood pressure.
Angiotensin-II is a potent constrictor of peripheral arterioles. The examples of the angiotensin-converting enzymes are Fosinopril, Benazepril, Captopril.
During the initial period of hypertension, the patients have to take the drugs in orally. While very mild, there are some habits to stage. These are some habits to control hypertension. Those habits are exercise regularly 150 min bodies and heart health.
Reduced sodium intake in their food we have to reduce the intake of salt and restriction of alcohol. It can cause 16% of people to lead to BP. Potassium-rich foods. Potassium foods like vegetables, sweet potatoes, tomatoes, bananas, oranges, avocados, nuts, seeds, beans and milk. These foods can reduce BP to avoid taking chocolates, smoking, caffeine and obesity. losing weight can also reduce hypertension.
Conclusion
In this session we will clearly explain the hypertension treatment, management is disused. Regular food habits and proper exercise will maintain our body health.