Study on Essential Hypertension

Systolic heart failure is characterized by enlarged ventricles that are unable to fully contract to pump enough blood into circulation to adequately perfuse tissues. The enlargement in ventricles is due to an increased end-systolic volume. If the heart is not able to sufficiently pump the expected volume of blood with each contraction, which in a normal healthy heart is 50-60%, there will be a residual volume left in the heart after every pump (Heart Healthy Women, 2012). With the next period of filling, the heart will receive the same amount of blood volume from the atria combined with that residual volume from the previous contraction. This causes the ventricles to have to dilate to accommodate this increase in volume. The dilation causes the walls of the ventricles to stretch and become thin and weak. Also the myocardium, the muscle layer of the heart, will stretch and not be able to adequately make a full and forceful enough contraction to push blood from the ventricles (Lehne, 2010).

Injury to the glomerulus and the tubules presents the onset of Intra-renal failure (Matzke, 2011). Some of the frequent causes for Intra-renal failure are glomerulonephritis; pyelonephritis; and tubular injury. Post-renal failure develops from things like ureteroliths, tumors, or anatomic impediments. Opposite of the acute form, the chronic form has a slow onset that has no early stage symptoms. It is important to know that following an acute episode a chronic renal episode often follows, and at this juncture the damage is irreversible. Glomerulonephritis and pyelonephritis combined, has been reported to be the forerunner in as much as half the cases from acute to chronic renal failure. Diabetes mellitus, renal vascular disease, such as atherosclerosis, hypertension, polycystic kidney disease, drug damage, and nephrolith are all examples of other causes of CKD (Pradeep, 2014). Biopsies of kidneys that suffered with CKD reveal smaller kidneys with scarring on the tubules.

Primary hypertension can be linked to several risk factors, some in which are evident in K.H.’s history and

Hypertension, also known as high blood pressure, has become a major risk factor for several types of heart disease across the globe. In the United States alone, nearly 70 million adults have been diagnosed with this condition [1]. Hypertension is a condition in which arterial walls experience extreme force from blood flowing through; long-term force against artery walls will lead to more serious health problems such as stroke, renal failure, and other cardiovascular diseases [2]. If the proper steps to treat hypertension are not taken, patients have a high risk of developing atherosclerosis, a condition that causes arteries to harden significantly. Smoking, obesity, lack of physical activity, high alcohol consumption, and high sodium intake are factors that may cause an individual to be diagnosed with hypertension [3] Detection of hypertension is crucial in order to reduce the incidence of death by cardiovascular disease [1].

High blood pressure has many damaging effects on the heart. High blood pressure is known as a silent killer and if left untreated can cause serious damage to the heart. What causes high blood can differ from person to person. What causes this for some may be different with another. Genetics, diet, family history, weight, and use of salt are just some of the causes of high blood pressure. Some of the ways that high blood pressure damages the heart is through narrowing of the arteries in the heart, called arteriosclerosis, left ventricular hypertrophy, and restricted blood flow that can lead to strokes and heart attacks. High blood pressure can have damaging effects on the heart if left untreated, and can cause arteriosclerosis, left ventricular hypertrophy, and restricted blood flow that leads to strokes and heart attacks.

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

Hypertension is characterized as an elevation in blood pressure. A blood pressure reading consistently of 140/90 mm Hg or higher is classified as high blood pressure (Appel & Linas, 2012). Hypertension is classified as two forms and they are Essential hypertension and Secondary hypertension. Essential hypertension mainly develops through lifestyle factors such as diets high in salt or low in potassium, lack of exercise, and obesity (Appel & Linas, 2012). Secondary hypertension

As mentioned above, strokes are pathophysiological changes. Ischemia which accounts for 87% of all strokes is a decrease or absent circulating blood which deprives neurons of necessary substrates. As there is no storage of glucose in the brain it leaves no opportunity for the chief ingredient for energy substrate and is incapable of anaerobic metabolism (Shah, MD, n.d.). Ischemia is a medical condition diagnosed when tissues do not have a sufficient oxygen supply, therefor resulting in a decrease in ATP energy, leading to necrosis of tissue. Decreased oxygen supply to tissue (ischemia) is caused by a blockage in an artery mainly from an embolism. An embolism is the breakage of an atherosclerosis formed in any coronary arteries. This floats freely in the blood stream, which eventually may plug a major artery in the brain (stroke), heart (MI) or lungs (lung failure). A thrombus occurs when an already

As discussed by Dr. Fink, hypertension is a multifactorial phenomenon. The hereditability based on twin studies suggests levels as high as 30-60%, but a familial correlation may also originate from environmental factors or lifestyle habits. Specific genetic polymorphisms that may contribute include mutations in controllers of vascular smooth muscle tone and the regulators of blood volume (Mitchell, 262). It is important to note that the genetic contribution is most often polygenic in nature and not the result of a single gene mutation. This can complicate the overall picture and prevention/treatment

Hypertension can be identified as either primary or secondary hypertension. Primary hypertension is the most common and is typically due to factors like age, race, level of stress, obesity, diet, tobacco use, and/or alcohol consumption in

Correspondingly, there are two pathways that transports blood to the brain called internal carotid artery and vertebral artery. The internal carotid artery has three layers call the tunica adventitia, tunica media, and tunica intima. Tunica intima is made up of smooth muscle cells and elastin. The basilar artery forms and it branches out to the posterior cerebral arteries. The posterior cerebral arteries form the internal carotid arteries and when they connect they make cerebral arterial circle ( circle of willis). The middle cerebral arteries branch out two separate arteries called the anterior cerebral arteries. Each of these arteries are the force that direct the blood flow to the brain. There are three tiny vascular systems that work together to profuse the deep brain. Which are the pial, subependymal, and lenticulostriate arteries. The small area of white matter that depends on blood flow is called the subcortical “shed water” area. The subcortical is more prone than other areas of the brain to have ischemia. The leading cause of ischemia is the fibrin builds up and this cause a narrowing of the lumen. Which does not allow the flow of red blood cells and deprives the white matter of tissue of oxygen. The tissue then losses density and produces white matter lesions. The neurons become demyelinated which leads to loss of cognitive ability.

Fluids have gone from the body, causing a decreased quantity of Volume in the blood vessels. Venous return is decreased because of the diminishing Fluid in the vascular space, leading to decreased Ventricular filling. The decrease of Ventricle filling leads to reduced stroke

Hypertension is widely considered to be one of the most important risk factors of cardiovascular diseases (angina, arrhythmia, etc.). It is the second leading disease that causes mortality in the world. Hypertension is the condition when there is an increase in the force of blood on the walls of vessels. It can also be defined as an arterial blood pressure that is raised above 140/90 mm Hg (systolic/ diastolic BP). Hypertension can be classified into Secondary hypertension and Essential hypertension. When specific cause is evident but heredity, and various physiological parameters play a role in increasing blood pressure is known as Essential Hypertension. Secondary Hypertension is one where the cause is known. According to WHO guidelines between 2006 and 2015, deaths due to cardiovascular diseases are expected to increase by 17% while the deaths from infectious diseases, nutritional deficiencies, maternal and prenatal conditions are projected to decline by 3%. The main causes of hypertension includes the age ,hereditary, gender, extra weight, alcohol consumption, stress life, lazy life etc.

Approximately one in every three adult’s ages 20 years old and older are diagnosed with high blood pressure or hypertension. Hypertension affects 78 million people in the United States and is equally prevalent in both men and woman (Crabtree et al., 2013). Hypertension is a major risk factor for cardiovascular disease (Hajjar & Kotchen, 2003). It can lead to stroke, myocardial infarction, renal failure, heart failure, neurological issues, and death if not detected early and not treated properly (James, Oparil, Carter, & et al., 2014). Approximately 9.4 million deaths in 2010 were attributed to high blood pressure (Angell, De Cock, & Frieden, 2015). About 54% of strokes, 47% of coronary heart disease, and 25 % of other cardiovascular diseases are attributed to high blood pressure (Arima, Barzi, & Chalmers, 2011).

Hypertension is defined a consistent elevation of the systolic blood pressure above 140mmHg, a diastolic pressure above 90mmHg or a report of taking antihypertensive medication. Early diagnosis and effective management of hypertension is essential because it is a major modifiable risk factor to cerebrovascular, cardiac, vascular, and renal diseases. The higher the blood pressure, the greater the risk for heart attack, heart failure, stroke, and kidney disease.