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Q.1) What does Hypertension mean?

Ans :  Hypertension means persistent high blood pressure that may damage the arteries and the heart. A person is considered to have hypertension when his or her blood pressure is persistently higher than 140/90 mmHg, even at rest.

Normal : A blood pressure of 120/80 at rest is considered normal in  young healthy adults.

The standard method of measuring BP is by calculating two values in units of millimeters of mercury. In our daily life blood pressure varies depending on: Age, weight, while exercising, and stress.

The types of Hypertension are
  • Primary or essential as there is no obvious precipitating cause. 
  • Secondary Hypertension as some identifiable cause is present.
 

Q.2) Whom does it affect the most?

Ans: It usually affects adults and elderly both males as well as females.

  

Q.3) How does Hypertension progress?
Ans: The condition puts strain on the heart and arteries, damaging delicate tissues. If it is left untreated, it may eventually affect the eyes and kidneys.
Complications that occur are Heart attack, coronary artery disease, and stroke.
 
Q.4) What are the causes of Hypertension?
Ans: Genetic factors
  • Hereditary
  • Race - Essential hypertension is more common in blacks
Environmental factors
  • Stress- Chronic psychological stress
  • Excessive salt intake.
  • Obesity-especially high cholesterol intake.
  • Smoking
  • Excessive alcohol intake.
  • Lack of Physical exercise
Renal Disease
  • Parenchymal renal disease.
  • Stenosis or aberrant renal artery,
  • Polycystic disease of kidney,
 
Endrocrine
  • Adrenocortical disease-  Adrenal carcinoma, Cushing's syndrome.
  • Pheochromocytoma.
  • Acromegaly
  • Hyperparathyroidism
Cardiovascular
  • Coarctation of aorta.
Toxic
Pregnancy toxemia,. 
  
Q.5)What are the symptoms of Hypertension?
Ans : The symptoms are
  • Headache-. Usually occipital and on waking
  • Dizziness.
  • Visual problems
  • Sweating
  • Tremours
  • Breathlessness
  • Numbness or weakness of limbs
  
Q.6) What are the related signs?
Ans: The related signs are
Blood pressure
Diastolic is very important and is grouped as 
  • mild- less than 100 
  • moderate- 100-120 
  • severe-120-140
  • Gross-more than 140.
Peripheral arterial vessels
  • Bounding Pulse, 
  • Radial artery hard (whip cord).
  • Locomotor brachials may be seen. 
Optic fundi
Retinal changes. 
  • Grade-I: Mild arteriolar narrowing.
  • Grade-II: More marked narrowing and arteriovenous kinking or compression.
  • Grade-III: Flame-shaped or circular hemorrhages and cotton wool exudates.
  • Grade-IV: Any of the above plus edema of the disc.
Physical Examination
  • Repeated B.P. examination 
  • Examination of heart
  • Pulse
  • Abdomen, for presence of kidney lump
  • Signs of Cushing's syndrome: Abdominal striae, truncal obesity, moon face.
  • Fundus examination
 
Q.7)What investigations are done?
Ans:  Routine Tests conducted are
  • Urine for:
    • Proteinuria.
    • Microscopic haematuria
    • Leucocytes
    • Glycosuria
  • X-Ray chest
  • ECG
  • Glucose tolerance test.
  • Serum biochemistry
    • Serum creatinine and BUN.
    • Serum potassium
    • Uric acid
    • Serum calcium
    • Serum lipids
  • Liver function test
Special tests
1. Investigation of reno-vascular hypertension
  • Plain X-ray of kidneys
  • Imaging method
          Ultrasound, Intravenous urography (IVU)
          Micturiting cystourethrogram
          Intravenous Digital subtraction angiography- IV DSA 
          
  •  CT Scan
2.  Investigation of endocrine hypertension
  • Serum biochemistry 
  • CT scan of adrenal gland 
Q.8) What are the treatment measures?
Ans: The treatment measures are
1.Correction of known risk factors
  •  Smoking- should be stopped.
  •  Obesity- calorie restricted diet.
  •  Alcohol- intake should be moderate.
  •  Salt- Moderate restriction (less than 5 gm/day).
  •  Regular physical exercise.
2. Generally used drugs are 
A. Initial (first line) drug therapy
  • Diuretics- If renal function is normal 
  • ACE inhibitors        
  • Calcium Channel Blockers  

B. Second line drugs

  • Beta-blockers
  • Alpha adrenergic agonist
  
Q.9) How can Hypertension be prevented?
Ans: Hypertension can be prevented by avoiding all the risk factors.
 

 

 

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