Hypertension 2002 An Overview 1 Leading Risks For

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Hypertension 2002: An Overview 1

Hypertension 2002: An Overview 1

Leading Risks For Death (World Health Organization 1995) 2

Leading Risks For Death (World Health Organization 1995) 2

What Is Blood Pressure? Ø Blood pressure is the amount of force on the

What Is Blood Pressure? Ø Blood pressure is the amount of force on the walls of the arteries as the blood circulates around the body. 3

What Do The Numbers Mean? Ø The upper number is when the heart beats

What Do The Numbers Mean? Ø The upper number is when the heart beats (Systolic Blood Pressure SBP) Ø The lower number is when the heart relaxes (Diastolic Blood Pressure DBP) 4

Measured in mm Hg (millimeters of mercury) e. g. 124/82 mm Hg § Systolic=124

Measured in mm Hg (millimeters of mercury) e. g. 124/82 mm Hg § Systolic=124 mm Hg § Diastolic= 82 mm Hg 5

What is Hypertension ? It is also called High Blood Pressure (HBP) 140 Hypertension

What is Hypertension ? It is also called High Blood Pressure (HBP) 140 Hypertension is a blood pressure of 140/90 mm Hg or greater 6 90

Classification of Blood Pressure for Adults Blood pressure category 7 Blood pressure (mm. Hg)

Classification of Blood Pressure for Adults Blood pressure category 7 Blood pressure (mm. Hg) Diastolic Systolic Optimal <120 and <80 Normal High normal <130 130– 139 and or <85 85– 89 Hypertension Stage 1 Stage 2 Stage 3 140– 159 160– 179 >180 or or or 90– 99 100– 109 >110

What Causes HYPERTENSION ? Ø 95% ‘not known’ § Genetics 40% § Environment 60%

What Causes HYPERTENSION ? Ø 95% ‘not known’ § Genetics 40% § Environment 60% (lifestyle) Ø 5% underlying disease 8

Your Lifestyle is Related to Hypertension Ø Sedentary lifestyle Ø Unhealthy diet § To

Your Lifestyle is Related to Hypertension Ø Sedentary lifestyle Ø Unhealthy diet § To little fresh fruit, fresh vegetables and low fat dairy products § To much salt (sodium) and saturated fats Ø Being overweight Ø Alcohol Ø Stress 9

Hypertension Is More Common in Older People 10

Hypertension Is More Common in Older People 10

22% of Adult Canadians Have Hypertension Treated and controlled Unaware of their hypertension 16%

22% of Adult Canadians Have Hypertension Treated and controlled Unaware of their hypertension 16% 42% 19% Not treated and not controlled 23% Treated and not controlled 11

Untreated Hypertension Cause Atherosclerosis Strokes Dementia Heart failure Kidney failure Poor circulation – impotence,

Untreated Hypertension Cause Atherosclerosis Strokes Dementia Heart failure Kidney failure Poor circulation – impotence, leg cramps when walking Ø Premature death Ø Ø Ø Re 12 Pressure related damage Ø Strokes Ø Heart failure Ø Kidney failure Ø Confusion Ø Premature death

Why Do Some Develop Heart Disease or Stroke and Others Don’t? Ø There are

Why Do Some Develop Heart Disease or Stroke and Others Don’t? Ø There are several risks that cause heart attacks and strokes Ø The more risks and the higher the risks, the greater the chance of developing heart disease or stroke Ø More than 9 in 10 Canadians with hypertension have other risks of developing heart disease and stroke 13

Cardiovascular Risks Ø High blood pressure Ø Smoking Ø High cholesterol Ø Diabetes Ø

Cardiovascular Risks Ø High blood pressure Ø Smoking Ø High cholesterol Ø Diabetes Ø Low physical activity Ø Stress Ø Obesity Ø Diet Ø Excess alcohol consumption 14

What Are the Benefits of Treating Hypertension? For a decrease of 10/5 mm Hg:

What Are the Benefits of Treating Hypertension? For a decrease of 10/5 mm Hg: Ø Heart attack by 15% Ø Heart failure by 50% Ø Stroke by 38% 15 Ø Death by 10%

Who Can Help You Control & Treat Your Hypertension ? Ø Your family Ø

Who Can Help You Control & Treat Your Hypertension ? Ø Your family Ø Family doctor Ø Nurse, dietitian, pharmacist, psychologist, exercise physiologist Ø Medical specialist 16

How Low Should Your Blood Pressure Be Lowered to? Ø Most people: § Less

How Low Should Your Blood Pressure Be Lowered to? Ø Most people: § Less than 140/90 mm Hg when measured at the doctors office § Less than 135/85 mm Hg when measured at home Ø Diabetes or kidney disease § Less than 130/80 mm Hg when measured at the doctor’s office 17

9 Ways to Help Control Hypertension 18 Ø Eat a healthy diet Ø Be

9 Ways to Help Control Hypertension 18 Ø Eat a healthy diet Ø Be active for at least 45 -60 minutes 4 -5 times / week Ø Control your weight Ø Limit daily alcohol to 2 drinks/day or less

9 Ways to Help Control Hypertension(Cont. . ) 19 Ø Cut back on salt

9 Ways to Help Control Hypertension(Cont. . ) 19 Ø Cut back on salt Ø Don’t smoke Ø Take time to relax Ø Take medications as prescribed Ø Check your BP at home

Drugs for Hypertension 20

Drugs for Hypertension 20

Antihypertensive Drugs (Drugs Used to Treat Hypertension) Ø risk of death and disability Ø

Antihypertensive Drugs (Drugs Used to Treat Hypertension) Ø risk of death and disability Ø Usually do not make you feel better Ø Usually do not make you feel worse Ø Usually need to be combined to normalize blood pressure 21

Antihypertensive Drugs (Cont. ) Ø Are taken for life unless your doctor stops the

Antihypertensive Drugs (Cont. ) Ø Are taken for life unless your doctor stops the medication Ø Need to be continued, even though you feel well Ø Can interact with alcohol 22

Classes of Drugs ØDiuretics ØBeta-Blockers ØACE inhibitors ØCalcium channel blockers ØAngiotensin receptor blockers (ARB’s)

Classes of Drugs ØDiuretics ØBeta-Blockers ØACE inhibitors ØCalcium channel blockers ØAngiotensin receptor blockers (ARB’s) ØAlpha blockers ØMiscellaneous 23

Antihypertensive Medications Compliance Adherence Concordance

Antihypertensive Medications Compliance Adherence Concordance

If Medication Is Not Taken As Directed Ø BP may not be controlled Ø

If Medication Is Not Taken As Directed Ø BP may not be controlled Ø When you don’t take your medication, your doctor may prescribe another drug since they might think the first one didn’t work or increase dosage of drugs Ø Side effects may be more troublesome Ø An adverse reaction or event may result 25

Tips To Help You Take Your Medication Ø Develop a practical medication schedule (timetable)

Tips To Help You Take Your Medication Ø Develop a practical medication schedule (timetable) with your doctor or pharmacist Ø Keep an up-to-date medication record listing all medical conditions and drugs you take Ø Keep this record in your wallet Ø Show your medication record to your doctor and pharmacist at each visit 26

Hints For Using Medication Wisely Ø Tailor your medication taking to fit your daily

Hints For Using Medication Wisely Ø Tailor your medication taking to fit your daily schedule (e. g. when you brush your teeth) Ø Monitor your BP to see how well your medications are working 27

Hints For Using Medication Wisely (Cont. ) If you are having problems remembering your

Hints For Using Medication Wisely (Cont. ) If you are having problems remembering your pills § Count your tablets to see how often you are forgetting them § Use a dosette (medication box) 28

Self measurement of BP AND® UA-767 Omron® HEM-747 29

Self measurement of BP AND® UA-767 Omron® HEM-747 29

Summary Ø Hypertension is a common cause of disability and death Ø Hypertension can

Summary Ø Hypertension is a common cause of disability and death Ø Hypertension can be prevented and treated by changes in lifestyle Ø The problems caused by hypertension can be largely prevented by drug therapy if treatment goals are reached 30

Hypertension questions 1. Blood pressure measures the amount of pressure in your arteries. Ø

Hypertension questions 1. Blood pressure measures the amount of pressure in your arteries. Ø TRUE FALSE 31

Hypertension questions 2. A blood pressure greater than 140 over 90 (140/90 mm. Hg)

Hypertension questions 2. A blood pressure greater than 140 over 90 (140/90 mm. Hg) is generally considered too high. Ø TRUE FALSE 32

Hypertension questions 3. You can usually tell if your blood pressure is too high

Hypertension questions 3. You can usually tell if your blood pressure is too high by the way you feel. Ø TRUE FALSE 33

Hypertension questions 4. Having one elevated blood pressure reading means than you have high

Hypertension questions 4. Having one elevated blood pressure reading means than you have high blood pressure. Ø TRUE FALSE 34

Hypertension questions 5. High blood pressure (sometimes called hypertension) is a major risk factor

Hypertension questions 5. High blood pressure (sometimes called hypertension) is a major risk factor for heart disease. Ø TRUE FALSE 35

Hypertension questions 6. The following lifestyle factors can help to treat and control high

Hypertension questions 6. The following lifestyle factors can help to treat and control high blood pressure: · Weight control or having a healthy weight · Regular exercise · Eating a healthy diet · Restricting alcohol intake Ø TRUE FALSE 36

Hypertension questions 7. Smoking can cause high blood pressure. Ø TRUE FALSE 37

Hypertension questions 7. Smoking can cause high blood pressure. Ø TRUE FALSE 37

Hypertension questions 8. Generally, people who do not have high blood pressure should have

Hypertension questions 8. Generally, people who do not have high blood pressure should have their blood pressure checked every 3 to 4 years. Ø TRUE FALSE 38

Hypertension questions 9. If you are being treated for high blood pressure you will

Hypertension questions 9. If you are being treated for high blood pressure you will need to stay on treatment the rest of your life. Ø TRUE FALSE 39