Which is a first line recommendation in the treatment of hypertension?
Feb 24, 2020 · Eat a Healthy Diet. Choose healthy meal and snack options to help you avoid high blood pressure and its complications. Be sure to eat plenty of fresh fruits and vegetables. Talk with your health care team about eating a variety of foods rich in potassium, fiber, and protein and lower in salt (sodium) and saturated fat.
What is the initial treatment strategy for hypertension (high blood pressure)?
Mar 22, 2018 · Treatment with the low-dose chlorthalidone and amiloride combination resulted in both a decrement in BP and prevention of hypertension and a reduction in left ventricular mass. A drug intervention is easier to implement and maintain than a lifestyle change intervention but there is a natural reluctance to recommend a lifetime of pharmaceutical ...
What are the Recommended lifestyle modifications for a patient with hypertension?
Lifestyle modifications for patients with prehypertension or hypertension include: 1. Diet and increase exercise to achieve a BMI greater than 25. 2. Drink 4 ounces of red wine at least once per week. 3. Adopt the dietary approaches to stop hypertension (DASH) diet. 4. Increase potassium intake.
How can hypotension be prevented in patients with hypertension?
Jul 08, 2015 · Explanation: Lifestyle changes are a first line recommendation in the treatment of hypertension. Systolic blood pressure reduces 1 mm Hg for every pound of weight loss, reducing sodium intake to 1,500 – 2,300 mg/day decreases blood pressure by as much as 8 mm Hg, and 30 minutes of activity five days a week reduces systolic blood pressure by as much as 9 mm …
How to control high blood pressure?
Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and trans fat.
Why do doctors take blood pressure readings?
Because blood pressure normally varies during the day and may increase during a doctor visit (white coat hypertension), your doctor will likely take several blood pressure readings at three or more separate appointments before diagnosing you with high blood pressure.
What is elevated blood pressure?
Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below (not above) 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure. Elevated blood pressure may also be called prehypertension. Stage 1 hypertension.
What to do if you have chest pain?
If you also have chest pain, vision problems, numbness or weakness, breathing difficulty, or any other signs and symptoms of a stroke or heart attack, call 911 or your local emergency medical number. Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more important.
What does blood pressure measure?
A blood pressure reading, as shown in the blood pressure monitor in the image, measures the pressure in your arteries when your heart beats (systolic pressure) in the first number, and the pressure in your arteries between heartbeats (diastolic pressure) in the second number.
Why do doctors ask you to record your blood pressure?
Your doctor may ask you to record your blood pressure at home to provide additional information and confirm if you have high blood pressure.
What happens if your blood pressure is high?
If your blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, one of which usually should be a diuretic, you may have resistant hypertension.
How to keep blood pressure low?
Talk with your health care team about eating a variety of foods rich in potassium, fiber, and protein and lower in salt (sodium) and saturated fat. For many people, making these healthy changes can help keep blood pressure low and protect against heart disease and stroke.
What is the best way to lower your risk of heart disease?
Preventing high blood pressure, which is also called hypertension, can lower your risk for heart disease and stroke. Practice the following healthy living habits:
Does obesity increase blood pressure?
Having overweight or obesity increases your risk for high blood pressure. To determine whether your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight website.
What is the primer of hypertension?
This Primer will discuss the epidemiology and pathophysiology of primary hypertension, prevention strategies for slowing the progression of BP elevation, management strategies (including optimal BP targets) for lowering BP and preventing CVD outcomes in patients with established hypertension and the effects of antihypertensive treatment on quality of life; finally, we will explore knowledge gaps, future trends and the outlook for hypertension research and treatment over the next decade.
What is the most important modifiable risk factor for all-cause morbidity and mortality worldwide?
Systemic arterial hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and is associated with increased risk of cardiovascular disease (CVD).
What is the role of angiotensin II in hypertension?
Angiotensin II is tightly linked to target organ damage in hypertension via these mechanisms22.. Angiotensin-converting enzyme 2 (ACE2) has emerged as an important modulator in the pathophysiology of hypertension, CVD and renal disease, owing to its role in metabolizing angiotensin II into angiotensin-(1–7)33.
What is the normal BP for humans?
In pre-industrial societies, BP levels had narrow distributions with mean values that changed little with age and averaged around 115/75 mmHg12, a value that probably represents the normal (or ideal) BP for humans. However, in most contemporary societies, systolic BP levels rise steadily and continuously with age in both men and women. This ubiquitous finding could be explained because age is a proxy for the probability and duration of exposure to the numerous environmental factors that increase BP gradually over time, such as excessive sodium consumption, insufficient intake of dietary potassium, overweight and obesity, alcohol intake and physical inactivity. Other factors, such as genetic predisposition or adverse intrauterine environment (such as gestational hypertension or pre-eclampsia), have small but definite associations with high BP levels in adulthood13. Even modest rises in mean population BP lead to large increases in the absolute number of people with hypertension14.
What is systemic arterial hypertension?
Systemic arterial hypertension (hereafter referred to as hypertension) is characterized by persistently high blood pressure (BP) in the systemic arteries. BP is commonly expressed as the ratio of the systolic BP (that is, the pressure that the blood exerts on the arterial walls when the heart contracts) and the diastolic BP (the pressure when the heart relaxes). The BP thresholds that define hypertension depend on the measurement method (Table 1). Several aetiologies can underlie hypertension. The majority (90–95%) of patients have a highly heterogeneous ‘essential’ or primary hypertension with a multifactorial gene-environment aetiology. A positive family history is a frequent occurrence in patients with hypertension, with the heritability (a measure of how much of the variation in a trait is due to variation in genetic factors) estimated between 35% and 50% in the majority of studies1,2. Genome-wide association studies (GWAS) have identified ~120 loci that are associated with BP regulation and together explain 3.5% of the trait variance3,4,5. These findings are becoming increasingly important as we search for new pathways and new biomarkers to develop more-modern ‘omics’-driven diagnostic and therapeutic modalities for hypertension in the era of precision medicine6.
What are the genetic factors that contribute to hypertension?
Primary hypertension involves multiple types of genes; some allelic variants of several genes are associated with an increased risk of developing primary hypertension and are linked in almost all cases to a positive family history (Box 1) This genetic predisposition, along with a host of environmental factors, such as high Na+intake, poor sleep quality or sleep apnoea, excess alcohol intake and high mental stress, contribute to the development of hypertension22,23,24. Finally, the probability of developing hypertension increases with aging, owing to progressive stiffening of the arterial vasculature caused by, among other factors, slowly developing changes in vascular collagen and increases in atherosclerosis25,26,27. Immunological factors can also play a major part, especially on the background of infectious or rheumatological diseases such as rheumatoid arthritis. The mosaic theory of hypertension describes its multifaceted pathophysiology28,29.
Where is the Vascular Biology and Hypertension Program located?
1Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, School of Medicine, The University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, Birmingham, Alabama, USA 35294-0007
What is a chronic disease where patients may be taking drugs for a long time?
Hypertension is a chronic disease where patients may be taking drugs for a long time.
Does beta blockade affect hypertension?
Both might worsen. 4. Beta blockade does not affect these disorders. 3. Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: 1. Heart failure. 2. Angina.
Do antihypertensive drugs come in generic form?
Few antihypertensive drugs come in generic formulations.
What medications are considered first line therapy for hypertension?
Explanation: The JNC 8 guidelines expanded the number of medications that can be considered as first line therapy to include calcium channel blockers, ACE inhibitors and ARBs.
When a patient does not meet the target, treatment needs modification by increasing dosages, adding another medication or both until
When a patient does not meet the target, treatment needs modification by increasing dosages, adding another medication or both until the goal is achieved (Townsend & Anderson 2015, Mahajan 2014). The interval between provider visits can be increased once the goal is achieved. Treatment adherence can be compromised by the patients’ experience of drug side effects, lack of motivation and insufficient knowledge. Nurse led clinics to coach and monitor adherence is a keystone in managing inmate/patients who are being treated for hypertension (Voermans 2013, Arries & Maposa 2013).
What is the main purpose of JNC 8?
Explanation: An important feature of the JNC recommendations are the target goals for blood pressure. A significant change in the JNC 8 was to ease the target goals for patients with diabetes and chronic kidney disease (James, Oparil, Carter et al 2014). The main purpose of hypertension treatment is to achieve and maintain blood pressure within the target range listed in the table below.
What is the target blood pressure for a 60 year old?
Explanation: The patient in the case example has a blood pressure of 148/90 mm Hg. A previous blood pressure reading was 154/92 mm Hg. According to the JNC 8 guidelines a target blood pressure of 150/90 mm Hg is recommended for persons 60 and older, without diabetes or chronic kidney disease (James, Oparil, Carter et al 2014). If he is 60 years of age or older he should still be followed so that he can be referred for drug treatment when his blood pressure exceeds 150/90 mm Hg. In the meantime continued assessment and coaching about lifestyle changes is recommended.
What foods do inmates have the least control over?
What inmates have the least control over are meals, both the calories and sodium content. Foods high in sodium which are frequently on the menu in correctional facilities are processed meat, baked goods, and processed cheese.
When are men more likely to have high blood pressure?
Men are more likely than women to have high blood pressure until about age 45. The rates of disease are similar between men and women from age 45 to 64 but after that women are at much higher risk (American Heart Association).
Is Lisinopril an ACE inhibitor?
Explanation: Lisinopril is an ACE inhibitor. ACE inhibitors frequently cause an elevation in creatinine which can give rise to hyperkalemia. Both of these should monitored and dosage adjusted or drug regime changed if levels rise (Townsend & Anderson 2015). Nurses can counsel patients about what side effects to expect, how to care of various side effects and what conditions should cause the patient to request health care attention. Nurses should always consider the medications a patient is taking during a sick call encounter. The problem being experienced may be a side effect that can be addressed so that adherence with prescribed treatment continues or it may be an adverse effect that needs prompt medical attention (Smith 2013).
How many goals are there for managing hypertension?
Management of hypertension includes three of the following four goals, depending on the primary and secondary causes.
Do you have to change alcohol consumption for hypertension?
d) There is usually no need to change alcohol consumption for clients with hypertension.
Can an antihypertensive medication cause dizziness?
A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include?
What is the best way to reduce blood pressure?
Diuretics . Diuretics , sometimes called water pills, help the kidneys get rid of excess water and salt (sodium). This reduces the volume of blood that needs to pass through the blood vessels. As a result, blood pressure goes down. There are three major types of diuretics defined by how they work.
What is resistant hypertension?
Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medication. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
How does catecholamine affect blood pressure?
The muscles around some blood vessels have what are known as alpha-1 or alpha adrenergic receptors. When a catecholamine binds to an alpha-1 receptor, the muscle contracts, the blood vessel narrows, and blood pressure rises.
How many types of diuretics are there?
There are three major types of diuretics defined by how they work. They include:
What is the systolic pressure of a person with hypertension?
Hypertension (or high blood pressure) is present once the systolic pressure is 130 or higher, or the diastolic pressure is 80 or higher.
What is considered high blood pressure?
The goal is to get your blood pressure below the high range. If normal is less than 120/80 mm Hg, what’s high? When the systolic blood pressure — the top number — is between 120 and 129, and the diastolic blood pressure — the bottom number — is less than 80, this is considered elevated blood pressure.
How does ACE inhibitor work?
ACE inhibitors help the body produce less of a hormone called angiotensin II, which causes blood vessels to narrow. These medications decrease blood pressure by helping blood vessels expand and let more blood through.
How to detect hypertension?
The only way to detect hypertension is to have a health professional measure blood pressure. Having blood pressure measured is quick and painless. Although individuals can measure their own blood pressure using automated devices, an evaluation by a health professional is important for assessment of risk and associated conditions.
Which region has the highest prevalence of hypertension?
The prevalence of hypertension varies across regions and country income groups. The WHO African Region has the highest prevalence of hypertension (27%) while the WHO Region of the Americas has the lowest prevalence of hypertension (18%).
What is the systolic blood pressure reading on both days?
Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.
What is the target for noncommunicable diseases?
One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 25% between 2010 and 2025.
What happens when the heart cannot pump enough blood and oxygen to other vital body organs?
The longer the blood flow is blocked, the greater the damage to the heart. Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs. Irregular heart beat which can lead to a sudden death. Hypertension can also burst or block arteries that supply blood and oxygen to the brain, causing a stroke.
Why is it important to check blood pressure?
For this reason, it is essential that blood pressure is measured regularly. When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears.
What are the complications of hypertension?
What are the complications of uncontrolled hypertension? 1 Chest pain, also called angina. 2 Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart. 3 Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs. 4 Irregular heart beat which can lead to a sudden death.
Diagnosis
Treatment
- Changing your lifestyle can help control and manage high blood pressure. Your doctor may recommend that you make lifestyle changes including: 1. Eating a heart-healthy diet with less salt 2. Getting regular physical activity 3. Maintaining a healthy weight or losing weight if you're overweight or obese 4. Limiting the amount of alcohol you drink But sometimes lifestyle change…
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and Home Remedies
- Lifestyle changes can help you control and prevent high blood pressure, even if you're taking blood pressure medication. Here's what you can do: 1. Eat healthy foods.Eat a heart-healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get ple...
Alternative Medicine
- Although diet and exercise are the most appropriate tactics to lower your blood pressure, some supplements also may help lower it. However, more research is needed to determine the potential benefits. These supplements include: 1. Fiber, such as blond psyllium and wheat bran 2. Minerals, such as magnesium, calcium and potassium 3. Folic acid 4. Supplements or products that incre…
Coping and Support
- High blood pressure isn't a problem that you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control: 1. Take your medications properly.If side effects or costs pose problems, don't stop taking your medications. Ask your doctor about other options. 2. Schedule regular doctor visits.It takes a team effort to tr…
Preparing For Your Appointment
- If you think you may have high blood pressure, make an appointment with your doctor to have your blood pressure checked. No special preparations are necessary to have your blood pressure checked. You might want to wear a short-sleeved shirt to your appointment so that the blood pressure cuff can fit around your arm properly. Avoid eating, drinking caffeinated beverages an…