HYPERTENSIONDEFENITION:Hypertension is defined as the high blood pressure as the systolic blood pressure (SBP) is >140 mm hg and the diastolic blood pressure (DBP) is >100 mm hg.INCIDENCE:The prevalence of the hypertension is increases with the age above 55 yrs. The mens are more affected than women.STAGES:STAGESSBPDBP

Pre HTN120 139 mm hg80 89 mm hg

Stage 1 HTN140 159 mm hg90-99 mm hg

Stage 2 HTN>160 mm hg> 100 mm hg

ETIOLOGY:PRIMARY CAUSES: Unknown or idiopathic. Contributing factors are increased SNS activity. Alcohol consumption. Diabetes mellitus. Greater body weight. Increased sodium intake. Overproduction of the sodium retaining hormones.SECONDARY CAUSES: Congenital narrowing of the aorta. Endocrine disorders( Cushing syndrome ) Medications( estrogen therapies and NSAIDs ) Neurologic disorders( brain tumor ) Pregnancy, sleep apnea. Renal diseases( renal artery stenosis )PATHOPHYSIOLOGY:Due to the etiological factorsDecreased cardiac outputDecreased renal blood flowIncreases the CNS stimulation on the renalStimulate rennin secretion from the kidneyActivates the AngiotensinAngiotensin - IAngiotensin - IIVasoconstrictionIncreased the blood pressureCLINICAL MANIFESTATIONS: Called as silent killer. Angina. Dizziness. Dyspnea. Fatigue. Giddiness. Head ache. Nose bleeds. Palpitations. Reduced activity intolerance.ASSESSMENT AND DIAGNOSIS: History collection. Physical examination. 12 lead ECG. Blood urea nitrogen. Complete blood count. Liver function tests. Routine urine analysis. Serum glucose, potassium, chloride, carbon dioxide, calcium. Serum lipid profile (total lipids, LDL, VLDL,LDL) Serum ureic acid. TSH hormone levels.MANAGEMENT:LIFE STYLE MODIFICATIONS: Reduce the body weight by increases the physical activity. Moderation of the alcohol consumption. Avoidance of the smoking and the tobacco chewing. DASH (Dietary Approaches to Stop Hypertension) should be followed eating plan.NUTRITIONAL THERAPY: Restriction of the sodium contained diets. Restrict the cholesterol and the saturated fats. Maintain the adequate intake of the potassium. Maintain the adequate intake of the calcium and magnesium.PHARMACOLOGICAL THERAPY: Administration of the mentioned drugs. ACE inhibitors caprtopril, enalopril, lisinopril. Alpha 1 adrenergic blockers terazosin, parzosin, doxazosin Angiotensin II inhibitors losartan, vaslartan. Beta 1 adrenergic blockers propanolol, esmolol. Metroprolol. Ca channel blockers nifidipine, felodipine, amlodipine. Direct vasodilators felodipine, minoxidil, nitroglycride. Diuretics - furosemide, torsemide, chlorothiazide.COMPLICATIONS: Coronary artery diseases. Left ventricular hypertrophy. Cardiac failure. Ischemic stroke. Retinal damage. Nephrosclerosis. Renal damage.