HYPERTENSION

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KELOMPOK 11

ASEP 081901000

INTAN KURNIAWATI 081901000

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ROJABNA SAPUTRA 081901000

S1 KEPERAWATAN EKSTENSI

SEKOLAH TINGGI ILMU KESEHATAN INDONESIA MAJU

JAKARTA
A. DEFINITION
Hypertension is high blood pressure is, a repeatedly elevated blood pressure
exceeding 140 over 90 mmHg. A systolic pressure above 140 or a diastolic
pressure above 90.

B. ETIOLOGY
Smoking, Overweight or obesity, Lack of physical activity, Too much salt
consumption, Too much alcohol consumption (more than 1 to 2 drinks per day),
Stress, Older age, Genetics, Family history of high blood pressure, Chronic
kidney disease, Adrenal and thyroid disorders, Sleep apnea.

C. CLASSIFICATION
1. Stage 1 hypertension: The systolic number is between 130 and 139 mm Hg,
or the diastolic number is between 80 and 89 mm Hg.
2. Stage 2 hypertension: The systolic number is 140 mm Hg or higher, or the
diastolic number is 90 mm Hg or higher.
3. Hypertensive crisis: The systolic number is over 180 mm Hg, or the diastolic
number is over 120 mm Hg. Blood pressure in this range requires urgent
medical attention. If any symptoms such as chest pain, headache, shortness
of breath, or visual changes occur when blood pressure is this high, medical
care in the emergency room is needed.

D. SYMPTOMS AND SIGNS

Most people with high blood pressure have no signs or symptoms, even if
blood pressure readings reach dangerously high levels.
A few people with high blood pressure may have headaches, shortness of breath
or nosebleeds, but these signs and symptoms aren't specific and usually don't
occur until high blood pressure has reached a severe or life-threatening stage.
E. PATHOPHYSIOLOGY
Because blood pressure equals cardiac output (CO) × total peripheral
vascular resistance (TPR), pathogenic mechanisms must involve
1. Increased CO
2. Increased TPR
3. Both
In most patients, CO is normal or slightly increased, and TPR is increased.
This pattern is typical of primary hypertension and hypertension due to primary
aldosteronism, pheochromocytoma, renovascular disease, and renal
parenchymal disease.
In other patients, CO is increased (possibly because of venoconstriction in
large veins), and TPR is inappropriately normal for the level of CO. Later in the
disorder, TPR increases and CO returns to normal, probably because of
autoregulation. Some disorders that increase CO (thyrotoxicosis, arteriovenous
fistula, aortic regurgitation), particularly when stroke volume is increased,
cause isolated systolic hypertension. Some elderly patients have isolated
systolic hypertension with normal or low CO, probably due to inelasticity of the
aorta and its major branches. Patients with high, fixed diastolic pressures often
have decreased CO.
Plasma volume tends to decrease as BP increases; rarely, plasma volume
remains normal or increases. Plasma volume tends to be high in hypertension
due to primary aldosteronism or renal parenchymal disease and may be quite
low in hypertension due to pheochromocytoma. Renal blood flow gradually
decreases as diastolic BP increases and arteriolar sclerosis begins. Glomerular
filtration rate (GFR) remains normal until late in the disorder; as a result, the
filtration fraction is increased. Coronary, cerebral, and muscle blood flow is
maintained unless severe atherosclerosis coexists in these vascular beds.
F. Diagnostic examination
1. urine test
2. cholesterol screening and other blood tests
3. test of your heart’s electrical activity with an electrocardiogram (EKG,
sometimes referred to as an ECG)
4. ultrasound of your heart or kidneys

G. TREATMENT
1. Weight loss and exercise
2. Smoking cessation
3. Diet: Increased fruits and vegetables, decreased salt, limited alcohol
4. Drugs: Depending on BP and presence of cardiovascular disease or risk
factors

H. COMPLICATIONS
Coronary artery disease (CAD) and myocardial infarction (MI), Heart
failure, Stroke (particularly hemorrhagic), Renal failure, Death.