Hypertension KLP 10

HYPERTENSION
KELOMPOK I0
Ni Made Tri Ardiyani (223221320)

Luh Putu Merta Tejayanti (223221317)
Ida Ayu Puspayani (223221324)
Program Studi Ilmu Keperawatan

Stikes Wira Medika Bali
2022
1.DEFINITION
Hypertension is defined as abnormally high blood pressure (more

than 120/80 mm Hg) in the arteries. Persistent increase in
systemic arterial blood pressure is known as hypertension.
Usually a mean arterial pressure greater than in 110mm Hg
under resting conditions is considered to be hypertensive; this
level normally occurs when the diastolic blood pressure is greater
than 90 mm Hg and the systolic pressure is greater than about
135-140 mm Hg. Hypertension is generally symptom less, but
increases the risk of various other cardiovascular diseases like
stroke, heart attack and non-cardiovascular diseases like renal
damage, end stage of renal failure.
1.DEFINITION
The human heartbeat has two distinct phases, i.e., (i) the Systole, when
the heart beats and gives higher reading on sphygmomanometer, and
(ii) the Diastole, when the heart is at rest and gives lower reading on
sphygmomanometer. The normal values of systolic and diastolic blood
pressures are up to 120 mm Hg and 80 mm Hg respectively. The eighth
report of Joint National Committee of United States of America on
prevention, detection, evaluation and treatment of high blood pressure
and World Health Organization and International Society of
Hypertension (WHO and ISH, 2003) guidelines have defined
hypertension to be 140 mm Hg systolic and 90 mm Hg diastolic, though
risk appears to increase even above 120/80 mm Hg
2.SYMPTOMS
The clinical features may be due to the elevated BP
itself, target organ involvement or due to underlying
diseases, as in secondary hypertension
1)Symptoms due to hypertension:
a)Head ache: This occurs usually in morning hours. It
is throbbing and usually frontal.

b)Dizziness: The patients feel unsteadly.
c)Epistaxis: This occurs due to increased pressure,
causing repture of the capillaries of the nose. The

bleeding reduces circulating volume, and lowers the
BP
2.SYMPTOMS
2)Symptoms due to affection of organs
a) Dyspnea on exertion (insipient LVF)
b)Anginal chest pain (IHD)
c) Palpitation
d)Kidneys: Hematuria, nocturia, polyuris
e)Transient ischemic attacks (TIA or strocke) with focal
neurological deficit.
f)Hypertensive encephalopathy (head ache, vomiting, convulsion,
unconciousness, focal neurological deficit).
g) Dizziness, tinnitus and syncope.
h)Retina: Blurred vision or sudden blindness.
3)Symptoms due to underlying diseases
a)Edema and puffy face- Acute nephritis.
b) Weight gain, hirsutism and stira- Cushing’s syndrome.
c) Weight loss, tremors, palpitation and sweating.
d)Hyperthyroidism/ pheochromocytoma.
e)Weakness- hyperaldosteronism.
f)Joint pain, bronchospasm and peripheral vascular disease.
g) Symptoms- polyarteritis nodosa.
3.CLINICAL MANAGEMENT
1. Antihypertensive Drugs
The simultaneous use of drug with similar mechanism of
action and hemodynamic effects often produces little
additional benefit. However, concurrent use of drug from
different classes is strategy for achieving effective control
of blood pressure while minimising the dose related
adverse effects.
2. Non-Pharmacological Management Of Hypertension
Non pharmacological methods to lower blood pressure allow the
patient to participate actively in the management of his or her
disease. Reduction of weight, restriction of salt, and moderation in
the use of alcohol may be reduced blood pressure and improve the
effect of drug treatment. In addition, regular isotonic exercise also
lowers blood pressure in hypertensive patients.
Smoking per se does not cause hypertension. However, smokers
do have a higher incidence of malignant hypertension, and
smoking is major risk factor for coronary heart disease.
Hypertensive patients have an exceptionally great incentive to stop
smoking. Consumption of caffeine can raise blood pressure and
elevate plasma concentrations of nor epinephrine, but long term
consumption of caffeine causes tolerance to these effects and has
not been associated with the development of hypertension.
3.Reduction of Body Weight
Obesity and hypertension are closely associated, and the
degree of obesity is positively correlated with the incidence
of hypertension. Obese hypertensives may lower their
blood pressure by losing weight regardless of a change in
salt consumption
Obesity is also associated with increased activity of the

sympathetic nervous system. A combination of aerobic
physical exercise and dietary counseling may enhance
compliance.
4. Sodium Restriction
Severe restriction of salt will lower the blood pressure in
most hospitalised hypertensive patients; this treatment
method was advocated prior to the development of
effective antihypertensive drugs
Several studies have shown that moderate restriction of salt

intake to approximately 5 g per day (2 g Na+ ) will, on
average, lower blood pressure by 12 mm Hg systolic and 6
mm Hg diastolic. An additional benefit of salt restriction is
improved responsiveness to some antihypertensive drugs.
3.CLINICAL MANAGEMEN
5. Alcohol Restriction
Consumption of alcohol can raise blood pressure,
but it is unclear how much alcohol must be
consumed to observe this effect. Heavy consumption
of alcohol increases the risk of cerebrovascular
accidents but not coronary heart disease
Excessive intake of alcohol also may result in poor

compliance with antihypertensive regimens. All
hypertensive patients should be advised to restrict
consumption of ethanol to more than 30 ml per day.
6. Physical Exercise
Increased physical activity lowers rates of
cardiovascular disease in men. It is not known if this
beneficial effect is secondary to an antihypertensive
response to exercise. Lake of physical activity is associated
with a higher incidence of hypertension. Regular isotonic
exercise reduces blood volume and plasma catecholamines
and elevates plasma concentration of atrial natriuretic
factor. The beneficial effect of exercise can occur in
subjects who demonstrate no change in body weight or
salt intake during the training period.
7. Relaxation and Biofeedback therapy
The fact that long term stressful stimuli can cause
sustained hypertension in animals has given credence to
the possibility that relaxation therapy will lower blood
pressure in some hypertensive patients. Only those few
patients with mild hypertension who wish to use this
method should be encouraged to try, and these patients
should be closely followed and receive pharmacological
treatment if necessary.
8. Lacto vegetarian diet and
high intake of
polyunsaturated fish oils
lower BP due to high
content of potassium and
vegetable diet high
content of fiber. Natural
vegetables containing high
levels of potassium, which
lower the BP
9.Diet For A Hypertension In Pregnant Women
Hypertension in pregnant women is known as pre-eclampsia.
• Maintain a healthy weight

• Exercise regularly
• Follow a healthy eating plan and limit the amount of salt in your food.
• Avoid smoking. If you already smoke, try to stop
• If you drink alcohol, try to limit the amount the you drink
• Avoid bush medicines as these could affect the treatment you are
taking.
• Read food labels to see how much sodium or salts is in the food
• Check your blood pressure regularly,Take the medications that your
doctor prescribes regularly Take time to relax
and learn, how to manage stress
4.REFERENCE
Siyad.A.R. Hypertension, H.J.D.Med.vol.3 (1), HYGEIA:
JOURNAL FOR DRUGS AND MEDICINES April-October 2011,
pp.1-16
Mohd. Tariq Salman, Hypertension and its Management,

Department of Pharmacology, Era's Lucknow Medical
College, Sarfarazganj, Hardoi Road, Lucknow- 226003,
Uttar Pradesh
Cyndya Shibao etal ‘Management of hypertension in the

setting of autonomic failure: a pathophysiological
approach’, HypertensionJournal of American Heart
Association; Volume-45, February 2005; 469-476.
THANKYOU

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HYPERTENSION

Ni Made Tri Ardiyani (223221320)

Program Studi Ilmu Keperawatan

Hypertension is defined as abnormally high blood pressure (more

is throbbing and usually frontal.

causing repture of the capillaries of the nose. The

Obesity is also associated with increased activity of the

Several studies have shown that moderate restriction of salt

Excessive intake of alcohol also may result in poor

• Maintain a healthy weight

Mohd. Tariq Salman, Hypertension and its Management,

Cyndya Shibao etal ‘Management of hypertension in the

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