When is blood pressure high enough to go to the hospital.
High blood pressure is present in many people walking around with this disease without any symptoms or sing that nothing is wrong. The hypertension is called the Century XXI silent Plaque.
High blood pressure is a chronic disease characterized by the continued increase of the blood pressure amount above the limits of cardiovascular risk. Regarding International studies, cardiovascular morbidity and mortality have a direct relationship with the rise of the numbers in the systolic pressure above the 139 mmHg. Or a diastolic pressure keep high of 89 mmHg. for complications of coronaries disease and renal insufficiency.
Close to the third part of the adult population from developing countries suffer from HAS is the principal cause of the hypertensive crisis and medical attention. The risk of one cardiovascular event can be duplicate. When measure of 115.75 of arterial pressure for every increment of 20 mmHg of the systolic pressure or 10 mmHg of the diastolic pressure.
Statistics show the man has more predisposition to develop Arterial hypertension changes that woman get the menopause. A woman has protection with the hormonal balance, which changes when the woman gets the menopause.
That means menopause woman has more predisposition to get a vascular disease and stroke The Arterial pressure expressed in two sizes, the Arterial systolic pressure and diastolic, for example, 120/80 mmHg.
The systolic arterial pressure (first count) is arteries’ blood pressure around the ventricular systole when the blood is expulsed from the heart to the arteries.
The arterial diastolic pressure (the inferior) is the diastolic pressure when the heart is relaxed the pressure falls. Hypertension is a cardiovascular risk factor; the anti-hypertensive treatment is focused on reducing the cardiovascular risk. However, the instance of treatment has account, of the arterial pressure, and another cardiovascular risk, kidney disease, diabetes, or metabolic syndrome.
High blood Pressure causes
Some of the environmental factors that contribute to the development of Arterial Hypertension include obesity,alcohol consumption, genetic issues, and stress. There is a connection between the economically stable societies and the increase of hypertension with age.
The excessive consumption of salt induces and keeps Arterial hypertension. Hypertension sensitive to salt consists of the exaggerated increase of the pressure and osmotic pressure; that keeps water and increases the blood pressure.
The observation that renin, excreted from the kidney, is associated with Aldosterone. However, Arterial hypertension associated with a low level of renin is frequent in black people.
In ordinary people, the stimulation of Insulin in the Sympathetic Nervous System without the elevation of Arterial pressure. However, in people with pathological conditions like metabolic syndrome. Insulin resistance is proposed like the cause in the increase of Arterial pressure in such patients with metabolic diseases.
Diabetic patients have higher Arterial pressure than the rest of the population.
There exist a massive correlation between the corporal mass index and the pressure. It’s convenient a hypo-caloric diet plan in patients with obesity and hypertension who conduce to lower the pressure.
It’s a common disorder and a possible cause of Arterial Hypertension. The treatment of this pathology through arterial positive pressure.
Arterial hypertension is one of the complex genetic disorders associated with more than 50 genes. Recent 12 new genes found in relation to diverse phenotype. It found 35 SNPs associated with Obesity, Diabetes Mellitus type II, Coronary disease, and kidney function, given evidence that those genes connect with Arterial pressure with cardiovascular activity.
With age the numbers of collagen fiber increase, produce rigidly in the blood vessels, and reduce the elastic created blood flow resistance and consequence compensatory increase in the Arterial pressure.
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Arterial pressure is cardiac waste and vascular resistance product. However, the factors affect determined cardiac waste and the physiology and structure of the little arteries. When high viscosity of the blood has significant affects on the necessary work for bumping the amount of blood and can give persistence in the Arterial pressure.
The malleability of the wall from blood vessels (pulse components) affects the velocity of the blood flow, and has an important relationship in regulating the the Arterial pressure.
The changes in the wall thickness affect the amplification of the peripheral vascular resistance in the hypertensive patient, conduce to the relaxing waves in the direction of Aorta artery and opposite to the blood flow, with the increase in the systolic arterial pressure.
The volume of the circulating blood is regulated for the sodium (Na) from the Kidney system and the management of water. This phenomenon plays an important role in moderate hypertension in response to sodium concentration in blood. The associated mechanism to secondary hypertension is evident.
However, such related to essential hypertension. The cardiac waste is elevated initially, in the natural curse with a resistance periphery total (RPT) average, but an increase in the total peripheral resistance.
This theory explains the process.
1. The kidney capacity to excrete sodium result in the apparition of sodium excretion factors, like the secretion of atrial natriuretic peptide that promotes the excretion of salt with the side effect of the increase of the total peripheral resistance.
2. Renin-Angiotensin-Aldosterone hyperactive system that conduces vasoconstriction and the consequence retention of sodio and water. The reflex increases the blood volume that conduces to Arterial hypertension.
3. The hyperactivity of the Sympathetic Nervous System produces high levels of stress. Hypertension is highly heritage and polygenic (causes for more than one gen). The endothelial changes produced for the persistent elevated arterial pressure.
High Blood Pressure Affected Organs for Co-lateral Effects
The organs such structure and function alternated like a consequence of the Arterial hypertension is called “Diana organs”. For example; a individual between the ages of 40 and 70 when Arterial pressure between 115/75 to 185/115 mmHg. Exist duplicate risk in the apparition of increase of 20 mmHg in the systolic pressure or 10 mmHg in the diastolic pressure.
-Hypertensive retinopathy, vasospasm, increase of arterial brightness, arteriovenous pathologic cross, hemorrhages, exudates, papilledema, and venous retina thrombosis.
-Central Nervous System.
Is affected when systolic pressure in more of 160 mmHg. One increased amount of systolic of diastolic is harmful, or one diastolic pressure of more than 100 mmHg. In the Central Nervous System; other hypertensive crisis are manifestation that conduce to cerebrovascular disease (stroke), hypertensive encephalopathy, cerebral microvascular damage and dementia of vascular origin consequent to multiples infarctions in the Central Nervous System.
Chronic endothelial dysfunction, arteriosclerosis progressive, atherosclerosis of great vessel, in special cerebral vessels aorta, coronaries, and low limb arteries. The complicated aneurysm eventually with the dissection or rupture at the level of the thoracic aorta. In the beginning left ventricular hypertrophy is parietal think without and increase in the muscle ventricular that progress to concentric hypertrophy which develops the dilate phase (eccentric hypertrophy).
Develop of hypertrophic process on deteriorating of the parietal distensible and the viscoelastic properties of the myocardial contractibility.
-Coronary microvascular ischemic principally for rarefaction of the capillary red and endothelial dysfunction of the remnants vessels.
-Acute coronary syndrome.
Unstable angina or infarct without Q wave called too like infarction without elevation of the segment S-T. Acute Myocardial infarction. The left ventricular diastolic dysfunction the consequence of ischemic, hypertrophy and ventricular fibrosis. The left ventricular systolic dysfunction with the drop of the ejection fraction from the left ventricular (the percentage of the blood that fills up the ventricle in diastole is effectively pumped out of the cavity).
-Congestive Cardiac Insufficiency (ICC)
Global consequently of the fail left ventricular there a secondary compromise from right hemi-Cardium with dilatation of the chambers the secondary pulmonary arterial hypertension. What does Pulmonary Arterial Hypertension means is a complication of the insufficiency Cardiac Congestive global, consequently failling from the left ventricular and secondary compromise from right ventricular a total cardiac failure.
The PAH (Pulmonary Arterial Hypertension is a cause of total fail from the heart can be ischemic Cardiopathy (75%) infarction of myocardium and hypertensive valvulopathy (severe hypertension).
-Ventricular arrhythmia, like c consequence o metro-centric for fibrosis damage or ischemic.
Early marks of nephropathy and an independent factor of risk of cardiovascular morbidity. Focal and diffuse glomerulosclerosis win-loss of nephrons, like the consequence of hypertension intraglomerular chronic.
-Chronic renal ischemic due to atherosclerosis accelerate of the kidney
-Reduction of the glomerular
Filter rate, for the loss of the number of functional nephrons, progressive process that it’s accelerated in hypertension and more much in the presence of the diabetes mellitus.
-Chronic Kidney insufficiency is a complicated and terminal event.
The early detection with the correct take of Arterial Pressure. The take of the arterial pressure in patients with high risk, takes the right measure incorrectly to avoid false results. With the use of sphygmomanometers and stethoscope.
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The clinical records from hypertension patients are detailed and enrich with the provision of information from close parents, or other medical or paramedical staff from the pass.
La hypertension is the asymptomatic disease for excellency, it is called “silent killer” don wonder not record of so much symptomatology in the medical records, or less specific symptoms (a headache, dizzies, visual disorder, red flash).It is defining the motive from the visit.
Some of the cardiovascular symptoms are; (dyspnea, orthopnea, dyspnea paroxistic, palpitation, symcope, edema, intermittent claudication) or in speciffic mood state, erectile dysfuction, etc.
Complex Cardiovascular symptoms: ischemic cerebral transitory, cerebrovacular accidents, chest angina, myocardial infarct, congestive cardiac insufficiency, chronic kidney insufficiency.
Eearly Detention From Arterial Hypertension
Steps for check blood pressure; sit a person with the back reclined in the chair, and the upper limb should rest over the superfas from the desk, and the forearm in pronation, to the high of the heart. The soles are over the floor without cross the legs. After some minutes of res (about 5 minutes, after the interrogatories), put the wrist BP monitor or aneroid sfingmanometer appropriated in right conditions in the middle of forearm portion take the two thirds from the arm.
Expose the area, preferred to use physical exam gown, in persons with heart problems. Try to use a healthy arm without any compromise to avoid the false result. Precaution in some patients doesn’t take the pressure in of compromise arm with amputation, radical upper surgery history, or the presence of an arteriovenous fistula.
Exist diverse diagnostic ways (aneroid sphygmomanometer, writs BP) It’s recommended the use of the Tensiometer or mercury that need it to calibrated regularly. The procedure from a take of pressure measurement. This procedure it doesn’t need to be discomfort and pain. The inflow from the inflation bulb needs be less 20-10 mmHg high of the necessary pressure for disappearing the wrist or elbow pulse, which separated the pressure of 220 mmHg.
The stethoscope over the arterial deflates slowly until hear audible the first time the Korotkoff sounds (systolic pressure). The early disappear of the sounds and you’re ulterior reappear, called the auscultatory gag breach is frequent in elderly people, that which deflate the inflation bulb slowly until disappearing all sounds (phase of Korotkoff diastolic pressure) arm be immobilized.
The measure of the arterial pressure in stand up the patient is recommended in an older adult, leave the standing person around five minutes before to make the measure.
In the first appointment or early detection of the arterial pressure, it’s ideal toke in two arms and clarify in which of the limb it found higher and consequently take the same arm for the arterial pressure.
The doctor needs teach to the patient the importance of taking the right measure of Arterial pressure (with heart disease of HA-like complication). The use of these machines in a home is a confinable measure for the control and avoid strokes and sudden death. The me pressure in the house is around 5 mmHg less than in a medical office for both pressures systolic and diastolic.
Clinic Sings For the Diagnostic of Arterial Hypertension
Count with the Keith Wagener classification of hypertensive retinopathy (shying arterial cross pathologic arteriovenous (Gunn sing), lose relationship venous arterial, exude, hemorrhages, and anomalies of the optic disc and periphery retina. Remember, the incipient hypertensiv retinopathy (relation arteriovenous changes) are specific to the hemorrhages and exude.
Neck inspection of Jugular veins.
In the neck evaluation check the palpation, and auscultation of carotid arteries and thyroid glandules. Exhauster exploration cardiopulmonary describe aspect and expansion of thorax, lung ventilation, impulse max point of heart, fremitus and cardiac sound, the normal, accessories and Pathologic.
Adipose, visible pulsation presence venous circulation complementary, visceromegaly and tumor. Explored the peripheral pulses (amplitude, pulse wave and symmetry) of the capillary fill, acres zones temperature, venous peripheric nets.
Basic neurologic exploration.
In preview lesion or actual show signs of damage from the peripheric and central nervous system) pupils, oculars movements, facial symmetry, equilibrium, coordination tongue and force a sensibility, reflex osteotendinous and musculocutaneous normal and pathologic.
For cardiac evaluatin these tests are necessary; Creatinine (Ureic nitrogen is necessary in case of acute cardia insufficiency).
Potassium serum, glycemia, lipid profile; Cholesterol total / HDL and triglycerides, uric acid, EGO we look for microalbuminuria (proteinuria the possible kidney lesion for the type of risk present risk factor (diabetes mellitus).
For confirmation of the diagnostic to dismiss secondary causes and determine the lesion of Diana organs and the severity.
The use for the diagnostic of left ventricular hypertrophy, arrhythmia evaluation, the presence of X-ray of poster anterior from the thorax, and lateral radiography is necessary. To check the cardiac shape, aorta, lungs, Helios, mediastinal, bone thorax and the lung parenchyma and show up evidence of damage.
Effort test with an electrocardiogram.
Help to value the physical condition, the pressure answer to the exercises in the patient in treatment and the presence or absence of ischemic lesion or inducible arrhythmias.
Doppler color echocardiogram.
It’s a not invasive study with great diagnostic value. It’s recommended only if the persons with a patient with hypertension without symptoms or clinical evidence or damage in the cardiac organ. Another procedure
Kidney arteries Doppler.
Holter monitorization is use in case of suspicious results, autonomic function studies, vascular mechanic probe, studies of nuclear medicine, computerized axial tomography, nuclear magnetic resonance. In the treatment, diuretic aKd beta-blocker reduces the apparition of site adverse for hypertension arterial related to the cerebrovascular disease.
However, diuretics are more effective in the reduction of event-related coronary heart disease. The hypertensive patient with the treatment has fewer possibilities for developing risk hypertension or insufficiency congestive heart disease. An older adult patient with aisle systolic hypertension utilized alternative one inhibitor of a channel of calcium.
The preventive measures are important in developing of severe diseases, sharing the content with somebody can be beneficial to it.