Management Of Hypertension Or Blood Pressure.
hypertension, also called high blood pressure, condition that arises when the blood pressure is abnormally high. Hypertension occurs when the body’s smaller blood vessels narrow, causing the blood to exert excessive pressure against the vessel walls and forcing the heart to work harder to maintain the pressure.
Although the heart and blood vessels can tolerate increased blood pressure for months and even years, eventually the heart may enlarge (a condition called hypertrophy) and be weakened to the point of failure. Injury to blood vessels in the kidneys, brain, and eyes also may occur.
Blood pressure is actually a measure of two pressures, the systolic and the diastolic. The systolic pressure (the higher pressure and the first number recorded) is the force that blood exerts on the artery walls as the heart contracts to pump the blood to the peripheral organs and tissues. The diastolic pressure (the lower pressure and the second number recorded) is residual pressure exerted on the arteries as the heart relaxes between beats. A diagnosis of hypertension is made when blood pressure reaches or exceeds 140/90 mmHg .
Classification
When there is no demonstrable underlying cause of hypertension, the condition is classified as essential hypertension. (Essential hypertension is also called primary or idiopathic hypertension.) This is by far the most common type of high blood pressure, occurring in 90 to 95 percent of patients. Genetic factors appear to play a major role in the occurrence of essential hypertension. Secondary hypertension is associated with an underlying disease, which may be renal, neurologic, or endocrine in origin; examples of such diseases include Bright disease (glomerulonephritis; inflammation of the urine-producing structures in the kidney), atherosclerosis of blood vessels in the brain, and Cushing syndrome (hyperactivity of the adrenal glands). In cases of secondary hypertension, correction of the underlying cause may cure the hypertension. Various external agents also can raise blood pressure. These include cocaine, amphetamines, cold remedies, thyroid supplements, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and oral contraceptives.
Medication for High Blood Pressure
Several types of medicine can be used to help control high blood pressure.Many people need to take a combination of different medicine.If you're under 55 years of age – you'll usually be offered an ACE inhibitor or an angiotensin-2 receptor blocker (AR
if you're aged 55 or older, or you're any age and of African or Caribbean origin – you'll usually be offered a calcium channel blocke
You may need to take blood pressure medicine for the rest of your life. But your doctor might be able to reduce or stop your treatment if your blood pressure stays under control for several years. its really important to take your medicine as directed. If you miss doses, it will not work as well.
Treatment .
Effective treatment will reduce overall cardiovascular morbidity and mortality. Nondrug therapy consists of: (1) relief of stress, (2) dietary management (restricted intake of salt, calories, cholesterol, and saturated fats; sufficient intake of potassium, magnesium, calcium, and vitamin C), (3) regular aerobic exercise, (4) weight reduction, (5) smoking cessation, and (6) reduced intake of alcohol and caffeine.
Mild to moderate hypertension may be controlled by a single-drug regimen, although more severe cases often require a combination of two or more drugs. Diuretics are a common medication; these agents lower blood pressure primarily by reducing body fluids and thereby reducing peripheral resistance to blood flow. However, they deplete the body’s supply of potassium, so it is recommended that potassium supplements be added or that potassium-sparing diuretics be used. Beta-adrenergic blockers (beta-blockers) block the effects of epinephrine (adrenaline), thus easing the heart’s pumping action and widening blood vessels. Vasodilators act by relaxing smooth muscle in the walls of blood vessels, allowing small arteries to dilate and thereby decreasing total peripheral resistance. Calcium channel blockers promote peripheral vasodilation and reduce vascular resistance. Angiotensin-converting enzyme (ACE) inhibitors inhibit the generation of a potent vasoconstriction agent (angiotensin II), and they also may retard the degradation of a potent vasodilator (bradykinin) and involve the synthesis of vasodilatory prostaglandins. Angiotensin receptor antagonists are similar to ACE inhibitors in utility and tolerability, but instead of blocking the production of angiotensin II, they completely inhibit its binding to the angiotensin II receptor.
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