Some limitations of hypertension, namely:
According to the WHO blood pressure equal to or above 160/95 mmHg
WHO / ISH (International Society of Hypertension)
Kaplan
Age <45 years : blood pressure above 130/90 mmHg
Age >45 years : blood pressure above 145/95 mmHg
Etiology
Based on the causes of hypertension were divided into two groups, namely:
Essential hypertension or primary hypertension of unknown cause, there are
about 95% of cases. Many factors can influence such as genetic, environmental,
metabolic disorders and factors that increase risk, such as obesity, alcohol,
smoking and polycythemia.
Secondary hypertension or renal hypertension. There are about 5% of cases.
Known specific cause, such as the use of estrogen, kidney disease,
pregnancy-related hypertension and others.
Clinical Manifestations
Elevation of blood pressure is sometimes the only symptom. If so, new
symptoms appear after complications in the kidneys, eyes, brain or heart. Another
common symptom is headache, epistaxis, angry, buzzing ears, heaviness in the nape
of the neck, difficulty sleeping, dizzy eyes, and dizziness.
Laboratory Test
Laboratory test are routinely performed prior to initiating therapy aims to
determine the presence of organ damage and other risk factors or find the cause
of hypertension. Usually examined urinalysis, complete peripheral blood, blood
chemistry (potassium, sodium, creatinie, fasting blood sugar, total
cholesterol, HDL cholesterol and ECG.
Diagnosis
The diagnosis of hypertension can not be enforced in one-time measurement,
can be determined only after two or more measurements at different visits,
unless there is a high rise or clinical symptoms. Blood pressure measurements
performed in the patient sat back, after leaning for 5 minutes, with
appropriate cuff size (covering 80% of the arm). With mercury sphygmomanometers
are still considered the best gauge.
Management
The purpose of the detection and management of hypertension is to lower the
risk of cardiovascular disease and related mortality and morbidity. The goal of
therapy is to achieve and maintain a systolic pressure below 140 mmHg and
diastolic blood pressure below 90 mmHg and
controlling risk factors. This can be achieved through lifestyle
modification and diet, or with hypertension medications.
The sixth report of the join National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure.
Note; The patient is not being sick or taking antihypertensive medication. If
the systolic and diastolic pressures are in different categories, enter in the
higher category.
Quite effective lifestyle modification, may lower cardiovasculer risk with
little cost and minimal risk. Governance is still advisable though to be
accompanied by hypertension drugs because it can decrease the number and
dosages of drugs. The steps are recommended for:
- Loss weight if there is excess (body mass index ≥27)
- Limiting alcohol
- Increase aerobic physical activity (30-45 minutes/day)
- Reduce your intake of sodium (<100 mmol Na/Na 2.4g/6g NaCl/day)
- Maintain adequate intake of potassium (90mmol/day)
- Maintain intake of adequate calcium and magnesium
- Stop smoking and reduce intake of saturated fats and cholesterol in the diet
Treatment with antihypertensive drugs for most patients starting with a low
dose and increase in titration in accordance with the age, needs and age. Optimal
therapy to be effective for 24 hours, and preferably in a single dose due to
better compliance, less expensive, can take control of hypertension continually
and smoothly, and protect patients against the risk of sudden death, heart
attack, or stroke due to increased pressure blood suddenly waking.
0 comments:
Post a Comment