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PART I
ANTECEDENT
1.1 Background
Blood Pressure
Before discussing about high blood pressure or hypertension, you'll
want to know beforehand about the blood pressure. When you perform a
physical examination or clinical examination to the doctor, there is usually a
special tool used by doctors to check blood pressure. Tool to check the blood
pressure is also known as sphygmomanometer tensimeter. There are digital
and there is also tensimeter mercury that is still commonly used for clinical
examinations.
Checking Blood Pressure
When checking blood pressure, there are two numbers that are usually
referred to as 120/80. What are these numbers?
Systolic: The first number (120), is systolic blood pressure, the pressure when
the heart beats or beats (systole). Often called the pressure on.
Diastolic: The first number (90) is diastolic blood pressure, the pressure when
the heart is resting between when pumping. Often referred to under the
pressure.
The doctor will perform blood pressure checks to tell you to sit or lie
down, because it was the best position to measure blood pressure. Then the
doctor will usually be binding on the air bag on his right arm on the arm
unless there are injuries. After that, blood pressure measurement. The
difference between systolic and diastolic pressure is called pulse pressure.
Blood pressure is the pressure experienced by the blood in the arteries
when the heart pumps blood to all members of the human body. Blood
pressure is created by taking two measurements and usually there are two
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numbers that will be referred by a physician. For example doctors call 140-
90, it means it is 140/90 mmHg. The first number (140) showed upward
pressure due to pulsation of the arteries when the heart or heart beat or beats,
and is called the systolic pressure or pressure is often called upon. The
second number (90) shows the pressure when your heart rest in between
pumping, and is called diastolic pressure, or often also referred under
pressure.
Once you know your blood pressure, you definitely want to know whether
your blood pressure low, normal or high.
1.2 Purpose
1.2.1 Generally Purpose
Generally purpose from this handing out is to know cause
incidence of hypertension.
1.2.2 Specially Purpose
Specially purpose from this handing out is:
1. For to know definition of hypertension
2. For to know sign and symptom of hypertension
3. For to know caused incidence of hypertension
4. For to know prevention of hypertension
1.3 Problem
1. what definition of hypertension?
2. what sign and symptom of hypertension?
3. what is caused incidence of hypertension?
4. what is prevention of hypertension?
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PART II
SOLUTION
A. High Blood Pressure
1. Definition
High blood pressure or hypertension is a condition medically where
there was an increase in blood pressure are chronic (long term). Patients
who have at least three blood pressure readings exceeding 140/90 mm Hg at
rest is estimated to have high blood condition. 's blood pressure is always
high which is one risk factor for stroke , heart attack , heart failure and
aneurysms arterial, and a major cause failing heart chronic.
On examination the blood pressure will get two numbers. Higher rates
obtained when the heart contracts (systolic), lower number obtained when
the heart relaxes (diastolic). Blood pressure less than 120/80 mmHg is
defined as "normal." In high blood pressure, usually there is an increase
systolic and diastolic pressure. Hypertension usually occurs in the blood
pressure of 140/90 mmHg or above, measured in both arms three times in a
period of several weeks.
2. Symptoms
In most patients, hypertension does not cause symptoms, although
some symptoms inadvertently occur together and trust associated with high
blood pressure (when in fact it is not). Symptoms referred to are headache,
bleeding from the nose , dizziness, facial redness and fatigue, which could
have occurred either in patients with hypertension, as well as to a person
with normal blood pressure.
If hypertension is severe or chronic and untreated, can develop the following
symptoms:
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headache
fatigue
nausea
puke / vomiting
asphyxiate
nervous
blurred vision that occurs because of damage on the brain, eyes, heart
and kidney.
Sometimes patients with severe hypertension has decreased
consciousness and even coma because of swelling of the brain . This is
called encephalopathy hypertensive which requires immediate treatment.
Why Blood Pressure Rising?
What causes blood pressure to rise? As an illustration, if you're flush
with the garden hose. If you press the end of the hose, the water that comes
out will be faster and faster. That's because water pressure increases when
the hose is pressed. Also, if you zoom in tap water, the flow of water
through the hose going faster and faster because of increased water
discharge. The same thing happens with your blood. If you narrowed blood
vessels, so blood pressure in the blood vessels will increase. In addition, if
the amount of blood that flows increases, blood pressure will also increase.
3. Classification
Blood Pressure Classification by JNC VII In Adults
Category Systolic Blood Pressure Diastolic blood pressure
Normal < 120 mmHg (And) <80 mmHg
Pre-
120-139 mmHg (Or) 80-89 mmHg
hypertension
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Stage 1 140-159 mmHg (Or) 90-99 mmHg
Stadium 2 > = 160 mmHg (Or)> = 100 mmHg
In isolated systolic hypertension, systolic blood pressure reached 140
mmHg or more, but less than diastolic pressure of 90 mmHg and diastolic
blood pressure were within normal range. Hypertension is often found in
elderly.
Along with increasing age, almost everyone experienced an increase
in blood pressure, systolic pressure continued to increase until the age of 80
years and diastolic pressures continue to increase until age 55-60 years, then
decreases slowly or even decreased.
In patients with diabetes mellitus or renal disease , research has shown
that the blood pressure of 130/80 mmHg above should be considered as a
risk factor and should be given proper treatment.
4. Causes of High Blood
There are several things that can cause a person has high blood
pressure. There are factors causing high blood pressure that you can’t
control. There is also that you can control so that it can cope with high
blood diseases. Those factors include:
Offspring
This factor can’t you control. If someone has a parent or relative who
has high blood pressure, then it is likely he suffered from high blood
pressure is greater. Statistics show that the problem of high blood pressure is
higher in identical twins than identical twins are not. A study shows that
there is evidence that genes derived for high blood pressure problems.
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Age
These factors you can’t control. Research shows that as age increases
a person, blood pressure will rise You can’t expect that your blood pressure
when the young will be the same when you get older. But you can control to
avoid over the limit of normal.
Salt
This factor you have control. Salt may increase blood pressure quickly
in some people, especially for people with diabetes , hypertensive mild,
people with old age, and those who were black.
Cholesterol
These factors can you control. Gynecology excess fat in your blood,
can cause accumulation of cholesterol in the blood vessel walls. This can
make blood vessels narrow and blood pressure consequently increases.
Control your cholesterol as early as possible.
Obesity / Overweight
These factors can you control. People who have a weight above the 30
percent ideal body weight, are more likely to suffer hypertension.
Stress
These factors can you control. Stress and unstable emotional condition
can also trigger high blood pressure.
Cigarette
These factors can you control. Smoking also can increase blood
pressure becomes high. Habit of smoking can increase the risk of diabetes,
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heart attack and stroke. Therefore, the continued habit of smoking while
having high blood pressure, is a very dangerous combination that will
trigger diseases related to heart and blood.
Caffeine
These factors can you control. Caffeine contained in coffee , tea or
cola drinks can cause increased blood pressure.
Alcohol
These factors can you control. Excessive alcohol consumption also
causes high blood pressure.
Poor Sports
These factors can you control. Lack of exercise and move can cause
increased blood pressure in the body. Regular exercise can lower your high
blood pressure but do not do heavy exercise if you suffer from high blood
pressure.
Based on the cause of hypertension is divided into two types:
1. Primary or essential hypertension is hypertension that is not / not yet
known cause (found in approximately 90% of all hypertension).
2. Secondary hypertension is hypertension caused by / as a result of other
diseases.
Possibility of primary hypertension has many causes, some changes on
the heart and blood vessels together with the possibility of causing
increased blood pressure.
If the cause is unknown, it is called secondary hypertension. At
approximately 50-10% of hypertensive patients, the cause is kidney disease.
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In about 1-2%, the cause is a hormonal disorder or the use of certain
medications.
Another rare cause of hypertension is Phaeochromocytoma, namely
tumor on the adrenal glands that produce hormones epinephrine (adrenaline)
or nor epinephrine (nor adrenaline).
Overweight (obesity), an inactive lifestyle (lazy to exercise ), stress ,
alcohol or salt in food can trigger the occurrence of hypertension in those
who have inherited susceptibility. Stress tends to cause an increase in blood
pressure for a while, if the stress has passed, then the blood pressure usually
returns to normal.
Some causes of secondary hypertension:
1. Kidney Disease
o Renal artery steno sis
o Pyelonephritis
o Glomerulonephritis
o Renal tumors
o Polikista kidney disease (usually decreased)
o Trauma to the kidney (renal injury related)
o Radiation therapy is related to kidney
2. Hormonal disorders
o Hyperaldosteronism
o Cushing's syndrome
o Phaeochromocytoma
3. Drugs
o Pill
o Corticosteroids
o Cyclosporine
o Erythropoietin
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o Cocaine
o Alcohol abuse
o Cinnamon (in a very large amount)
4. Other Causes
o Aortic Koartasio
o Preeclampsia in pregnancy
o Acute intermittent Porphyries
o Toxicity of lead exposure.
5. Setting Blood Pressure
Increased blood pressure in the arteries can occur in several ways:
Stronger heart pumps that drain more fluid in each second
Large arteries lose elasticity and become rigid, so that they can’t inflate
when the heart pumps blood through the arteries. Hence the blood at
each heart beat was forced to go through narrow vessels than usual and
causes increased pressure. Here's what happens in old age, where the
wall has been thickened and stiff arteries due to arteriosclerosis. In the
same way, blood pressure also increased in the event of
"vasoconstriction", if the small arteries ( arterioles ) to temporarily
shrink due to stimulation of nerves or hormones in the blood.
Increased fluid in the circulation can cause increased blood pressure.
This occurs when there is abnormal function of kidneys that are not able
to throw some salt and water from the body. Blood volume in the body
increases, so the blood pressure also increases.
Conversely, if:
Reduced cardiac pumping activity
Experienced widening arteries
Plenty of fluids out of circulation
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Then the blood pressure will decrease or become smaller.
Adjustments to these factors is carried out by the changes in renal
function and autonomic nervous system (part of the nervous system that
regulates many body functions automatically).
6. Changes In Kidney Function
Renal control of blood pressure in several ways:
If the increase in blood pressure, kidney will add salt and water
expenditure, which will lead to reduced blood volume and restore blood
pressure to normal.
If blood pressure decreases, the kidneys will reduce the disposal of salt
and water, thus increasing blood volume and blood pressure returned to
normal.
Kidneys can also increase blood pressure by producing an enzyme
called rennin , which triggers the formation of the hormone angiotensin ,
which in turn will trigger the release of the hormone aldosterone.
Kidney is an important organ in controlling blood pressure and
therefore a variety of diseases and disorders can lead to kidney pad high
blood pressure. For example narrowing of arteries that leads to one of the
kidneys (renal artery steno sis) can cause hypertension. Inflammation and
injury to one or both kidneys can also cause increased blood pressure.
The Autonomic Nervous System
Sympathetic nervous system is part of the autonomic nervous system, which
will temporarily:
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increase the blood pressure response during the fight-or-flight (the
physical reaction the body against external threats)
improve the speed and power of heart rate; too narrow majority of the
arterioles, but widens the arterioles in certain areas (ex, skeletal muscle,
which require more blood supply)
reduce the disposal of water and salt by the kidneys, thereby increasing
blood volume in the body
release the hormone epinephrine (adrenaline) and nor epinephrine (nor
adrenaline), which stimulates the heart and blood vessels .
7. Prevention Of Hypertension
The degree to which hypertension can be prevented depends on a
number of features including: current blood pressure level,
sodium/potassium balance, detection and omission of environmental toxins,
changes in end/target organs (retina, kidney, heart - among others), risk
factors for cardiovascular diseases and the age at the time of diagnosis of
pre hypertension or at risk for hypertension. A prolonged assessment period
within which repeated measurements of blood pressure are taken provides
the most accurate assessment of blood pressure levels. Following this,
lifestyle changes are recommended to lower blood pressure, before the
initiation of prescription drug therapy. The process of managing pre
hypertension according the guidelines of the British Hypertension Society
suggest the following lifestyle changes;
Weight reduction and regular aerobic exercise (e.g., walking): Regular
exercise improves blood flow and helps to reduce the resting heart rate
and blood pressure.
Reducing dietary sugar intake
Reducing sodium (salt) in the diet: This step decreases blood pressure
in about 33% of people (see above). Many people use a salt substitute
to reduce their salt intake.
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Additional dietary changes beneficial to reducing blood pressure
include the DASH diet (dietary approaches to stop hypertension)
which is rich in fruits and vegetables and low-fat or fat-free dairy
products. This diet has been shown to be effective based on research
sponsored by the National Heart, Lung, and Blood Institute.[45] In
addition, an increase in dietary potassium, which offsets the effect of
sodium has been shown to be highly effective in reducing blood
pressure.
Discontinuing tobacco use and alcohol consumption has been shown to
lower blood pressure. The exact mechanisms are not fully understood,
but blood pressure (especially systolic) always transiently increases
following alcohol or nicotine consumption. Abstaining from cigarette
smoking reduces the risk of stroke and heart attack which are
associated with hypertension.
Reducing stress, for example with relaxation therapy, such as
meditation and other mind body relaxation techniques, by reducing
environmental stress such as high sound levels and over-illumination
can also lower blood pressure. Jacobson's Progressive Muscle
Relaxation and biofeedback are also beneficial, such as device-guided
paced breathing, although meta-analysis suggests it is not effective
unless combined with other relaxation techniques.
8. Medications
There are many classes of medications for treating hypertension,
together called antihypertensive, which — by varying means — act by
lowering blood pressure. Reduction of the blood pressure by 5–6 mmHg can
decrease the risk of stroke by 40%, decrease the risk of heart disease by 15–
20%, and reduce the likelihood of dementia, heart failure, and death.
The aim of treatment should be reduce blood pressure to
<140/90 mmHg for most individuals, and lower individuals with diabetes or
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kidney disease (some medical professionals recommend keeping levels
below 120/80 mmHg). Each drug reduces systolic blood pressure by about
5–10 mmHg, so often multiple drugs are combined to achieve the goal
blood pressure.
Commonly used prescription drugs include:
ACE inhibitors such as ramipril
Angiotensin II receptor antagonists may be used where ACE
inhibitors are not tolerated: e.g., candesartan
Calcium channel blockers such as nifedipine.
Diuretics: e.g. hydrochlorothiazide (aHCTZ).
Diuretics such a furosemide or low-dosages of spironolactone.
Alpha blockers such as terazosin. Doxazosin has been shown to the
increase risk of heart failure, and to be less effective than a diuretics.
Beta blockers such as metoprolol. Whilst once were first line agents,
now they are less commonly used because they increase the risk of
diabetes.
Direct rennin inhibitors such as aliskiren.
Common combined prescription drug treatments:
The diuretic HCTZ and one other drug combined in one pill.
A fixed combination of the ACE inhibitor perindopril and the calcium
channel blocker amlodipine, recently been proved to be very effective
even in individuals with glucose intolerance or metabolic syndrome.
Can Be Used In Traditional Medicine
mulberry
leaf cincau green
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celery (should not exceed 10-10 grams per day, because it can cause a
drastic decrease in blood pressure)
garlic (no more than 3-5 cloves a day)
Rosella
leaf cats whiskers
lemongrass tea, dry or wet lemongrass (fresher) drunk three times
daily. Within a week may seem high blood pressure decreasing.
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PART III
CLOSING
3.1 Conclusion
Hypertension (HTN) or high blood pressure is a chronic medical
condition in which the blood pressure in the arteries is elevated. It is
classified as either primary (essential) or secondary. About 90-95% of cases
are termed "primary hypertension", which refers to high blood pressure for
which no medical cause can be found.[1] The remaining 5-10% of cases
(Secondary hypertension) are caused by other conditions that affect the
kidneys, arteries, heart, or endocrine system.
Persistent hypertension is one of the risk factors for strokes, heart
attacks, heart failure and arterial aneurysm, and is a leading cause of chronic
kidney failure. Moderate elevation of arterial blood pressure leads to
shortened life expectancy. Both dietary and lifestyle changes as well as
medicines can improve blood pressure control and decrease the risk of
associated health complications.
3.2 Suggestion
The degree to which hypertension can be prevented depends on a
number of features including: current blood pressure level,
sodium/potassium balance, detection and omission of environmental toxins,
changes in end/target organs (retina, kidney, heart - among others), risk
factors for cardiovascular diseases and the age at the time of diagnosis of
pre hypertension or at risk for hypertension.
Lets we prevent hypertension with changes our life style that is by
arranging pattern to eat, and regular exercise so that hypertension doesn't
arise at us.
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REFERENS
Http//Wikipedia foundation. Hypertension. Posted By: 01 Juli 2010.
Bryg, Robert J, MD. Http//WebMD.Causes of Hypertension. Posted By: 02 Juli
2010
http://solusiherbal.blogspot.com. High Blood Pressure. Posted By: 29 Juni 2010
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