Hypertension
Hypertension
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Content
0 ->
1.01 -> Hello, my name is Crystal Tyson,
3.39 -> and this module will cover
4.53 -> hypertension.
5.071 ->
8.252 -> The learning objectives
9.21 -> for this module
10.13 -> is to one, understand the health
11.8 -> care burden of hypertension,
13.66 -> two,
14.27 -> learn
14.57 -> the different classifications
15.79 -> of blood pressure, three,
17.96 -> distinguish
18.52 -> between primary and secondary
20.11 -> hypertension, four,
22.14 -> identify complications
23.55 -> of hypertension, and five,
25.98 -> learn treatment strategies
27.252 -> for hypertension.
27.96 ->
31.38 -> Hypertension is a major health
32.63 -> care burden that affects
33.7 -> approximately 40%
34.99 -> of the global population.
37.11 -> Diagnosing and properly treating
38.65 -> hypertension
39.27 -> is a great public health
40.32 -> concern, because it is
41.4 -> the largest risk factor
42.54 -> for cardiovascular disease,
44.357 -> the leading cause of death
45.44 -> worldwide.
45.94 ->
49.31 -> Hypertension exists when blood
50.88 -> pressure
51.5 -> within the arterial walls
52.96 -> is abnormally elevated.
54.63 -> Blood pressure has been
55.68 -> classified into the following
57.07 -> categories, normal tension,
59.75 -> a systolic blood pressure less
61.13 -> than 120
62.11 -> and a diastolic blood pressure
63.77 -> less than 80,
65.23 -> pre-hypertension, systolic blood
67.3 -> pressure between 120 and 139
69.87 -> or a diastolic blood pressure
71.97 -> between 80 and 89,
74.08 -> stage one hypertension,
76.42 -> a systolic blood pressure
77.56 -> between 140 and 159
80.04 -> or a diastolic blood pressure
81.95 -> between 90 and 99, and stage two
85.09 -> hypertension, a systolic blood
87.13 -> pressure equal to or greater
88.34 -> than 160 or a diastolic blood
90.94 -> pressure equal to or less
92.14 -> than 100.
93.54 -> Cardiovascular risk increases
95.754 -> as blood pressure increases.
96.92 ->
100.51 -> The most common form
101.37 -> of hypertension
102.2 -> is primary hypertension, which
104.15 -> is also referred to as essential
105.91 -> hypertension.
107.12 -> This form of hypertension
108.28 -> accounts for 90% to 95%
110.29 -> of all cases.
111.71 -> Risk factors
112.44 -> for primary hypertension
113.85 -> include advanced age, race,
116.76 -> gender, above normal body
118.63 -> weight, family history,
120.77 -> and lifestyle factors,
121.99 -> such as excess salt,
123.3 -> excess alcohol, stress,
125.26 -> or physical inactivity.
126.3 ->
129.87 -> Secondary hypertension is caused
132.15 -> by an identifiable underlying
134.69 -> source.
135.86 -> Secondary hypertension accounts
137.49 -> for 5% to 10% of cases.
139.85 -> Examples
140.57 -> of secondary hypertension
142.31 -> are outlined in this slide,
144.23 -> but the most common forms are
145.47 -> kidney disease
146.27 -> and primary aldosteronism.
147.37 ->
151.31 -> To diagnose hypertension,
152.537 -> it is important that blood
153.62 -> pressure is measured correctly.
155.46 -> Patients should refrain
156.69 -> from ingesting food or caffeine,
159.08 -> smoking, and exercising at least
161.6 -> 30 minutes prior to the planned
163.19 -> measurement.
164.187 -> Patients should be allowed
165.27 -> to rest for at least five
166.69 -> minutes in a quiet environment.
168.85 -> Their back should be supported
170.1 -> and feet should be
170.849 -> flat on the ground.
171.996 -> The patient's arm should be
173.12 -> supported at heart level,
174.42 -> and measurement should be taken
176.15 -> with an appropriate size cuff.
178.31 -> Failure to use
179.12 -> the correct cuff size
180.56 -> will lead
181.06 -> to inaccurate measurements.
182.587 -> Two measurements should be taken
183.92 -> in average.
184.419 ->
187.781 -> In addition to measuring
188.78 -> seated blood pressure,
189.696 -> it is also recommended
191.04 -> that a clinician assesses
192.28 -> standing blood pressure.
193.95 -> Orthostatic hypotension
195.4 -> is diagnosed when a person
196.65 -> experiences a 20 millimeter
198.16 -> reduction in systolic blood
199.44 -> pressure
200.21 -> or a 10 millimeter mercury
201.84 -> reduction in diastolic blood
203.35 -> pressure
204.26 -> two to three minutes
205.17 -> after standing.
206.56 -> This drop in blood pressure
208.1 -> may be associated
208.88 -> with light headedness
209.754 -> or dizziness.
211.23 -> At times, there is a discrepancy
213.7 -> between blood pressure
214.68 -> measurements
215.18 -> that are taken at home
216.8 -> versus those that are taken
217.93 -> in a clinic setting.
220.51 -> White coat hypertension occurs
221.947 -> when office blood pressure
223.03 -> measurements are elevated
224.7 -> but measurements performed
225.83 -> at home are normal.
227.44 -> On the contrary,
228.61 -> masked hypertension is blood
230.314 -> pressure that is found to be
231.48 -> normal in clinic, yet home blood
233.77 -> pressure measurements are
234.83 -> elevated.
235.329 ->
238.52 -> Goal blood pressure
239.37 -> for the general population
240.65 -> is less than 140
241.86 -> over 90 millimeters mercury.
244.07 -> Lower blood pressure targets
245.32 -> have been set for patients
246.45 -> with additional risk factors
247.74 -> for cardiovascular disease,
249.38 -> such as diabetics and patients
250.749 -> with chronic kidney disease.
251.915 ->
255.26 -> A mainstay of therapy
256.82 -> for patients with hypertension
258.6 -> is lifestyle modifications.
260.529 -> This includes weight loss,
262.52 -> adoption of the dietary
263.84 -> approaches to stop hypertension,
265.31 -> or DASH diet,
266.94 -> an increased physical activity,
269.15 -> sodium restriction,
270.6 -> limited alcohol intake,
272.27 -> and stress minimization.
274.49 -> Aside from lowering blood
275.71 -> pressure, these interventions
277.3 -> also contribute positively
278.91 -> to an individual's
279.72 -> overall health
280.444 -> and should be strongly
281.36 -> recommended.
281.86 ->
285.26 -> Most individuals
286.14 -> with hypertension will require
287.46 -> the addition of medications
288.69 -> to help achieve goal blood
289.85 -> pressure.
290.82 -> Several classes of medications
292.36 -> exist to treat hypertension.
294.56 -> They are summarized
295.56 -> in this slide.
296.32 ->
299.39 -> Failure to control hypertension
300.9 -> can lead to end organ damage,
302.93 -> for instance, eye disease,
304.45 -> stroke, heart disease, vascular
307.1 -> complications, and kidney
308.305 -> disease.
308.805 ->
312.377 -> There are some patients who fail
313.71 -> to reach blood pressure targets
315.02 -> despite typical medical
316.24 -> management.
317.28 -> These patients may have
318.32 -> resistant hypertension.
320.02 -> Resistant hypertension
321.1 -> is defined as blood pressure
322.37 -> that is not at goal
323.58 -> despite treatment
324.47 -> with optimal doses of three
326.12 -> or more
326.62 -> anti-hypertensives medications,
328.67 -> one of which is a diuretic.
330.69 -> Patients with resistant
331.72 -> hypertension should be evaluated
333.41 -> for secondary causes
334.349 -> of hypertension.
335.015 ->
338.49 -> To summarize, hypertension
340.52 -> is a chronic disease that
341.83 -> is highly prevalent worldwide.
344.43 -> Essential hypertension
345.71 -> is the most common cause
347.05 -> of hypertension.
348.51 -> Treating blood pressure
349.6 -> to appropriate targets
350.7 -> has proven benefits.
352.43 -> Both lifestyle modifications
354.21 -> and pharmacologic intervention
355.76 -> are beneficial.
357.43 ->
Source: https://www.youtube.com/watch?v=VLa1rC1dvRE