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Transcript: Hypertension Hypertension is high blood pressure and it affects your arteries by increasing the force of the blood on the artery walls. This causes your heart to have to work harder to pump the blood to your body. Effects on your body Most of the time there are no symptoms and people don't know they have high blood pressure. Severe symptoms are bad headaches and nosebleeds. Hypertension is more common in African Americans, obese people, people who are often stressed, drinkers, and people with diabetes. Hypertension can be inherited. The main causes of hypertension are too much sodium in your body and the condition that your kidneys and blood vessels are in. After diagnosed you should reduce stress in your life, start exercising regularly, limit alchohol, quit smoking if you do, and start eating healthy which means less salt and cholesterol. The doctor may give you prescription medicine to take as well. Prevention To reduce the risk of high blood pressure you should eat a healthy and well balanced diet , exercise regularly, and try not to smoke or drink. Most people find out they have hypertension when they go to the doctor and have a blood pressure test. Many doctors recommend home tests so you can find out quicker and efficiently. I learned that hypertension is very common and you can have it without knowing. Also that that high blood pressure can reduce your life expectancy. Also that you really have to be careful with your lifestyle and diet. What is hypertension? Nathan Smiley 3rd period After diagnosed Common with certain groups? how common overall? What I learned How to detect Hypertension Hypertension is very common.


Transcript: Dental Related Side effects of HTN Medications Exercise DASH diet Reduce alcohol consumption Reduce salt intake Weight loss of 3%-9% of body weight -2.5 Systolic vs. Diastolic Four Determinants in Blood Pressure Cardiac Output= HR x SV, CO increases, higher BP Overall compliance= More compliance, lower BP Peripheral Resistance= More resistance, higher BP Blood Volume= Higher the volume, higher BP Body Guidelines of HTN Diet Usually asymptomatic at first. Early symptoms: Occipital headache Fatigue Vision changes Tinnitus Dizziness Alcohol moderation Dental Management of the Hypertensive Patient, Continued SBP mmHg Navy Guidelines for BP During Treatment -11 -5.5 Common Characteristics: Increasing age Male Family history of HTN African Americans Overweight Stress Tobacco use Certain medical conditions Excessive alcohol consumption Identify patient and take thorough medical hx If BP is WNL, no contraindications to tx If BP is not WNL: Defer elective care and provide only urgent with BP 180/110 mmHg Use caution with vasoconstrictors in local anesthetics (0.036-0.054mg of Epi =2-3 carpules of Lidocaine/visit) Take BP before and after injections Caution: Non-selective Beta blockers and Epinephrine Avoid epinephrine impregnated cords Immediate physician referrals Avoid long, stressful appointments Be mindful of coadministration of antihypertensive meds with NSAIDS Pharmacologic Therapy Harvard Health Publications. Aug 2009 Medications for treating hypertension. Little, Falace, Miller, Rhodus. 2007. Dental Management of the Medically Compromised Patient. 7th Ed. Iaizzo, P. 2009. Handbook of Cardiac Anatomy, Physiology, and Devices. Greenlund, Daviglus, Croft. 2009. Differences in healthy lifestyle characteristics between adults with prehypertension and normal blood pressure. Journal of Hypertension. Weight loss <140/<90 WNL check annually 140-160/90-100 recheck at 3 visits if no change seek medical consult 160-200/100-115 recheck in 5 minutes, no dental treatment, medical consult >200/>115 recheck in 5 minutes, no dental treatment, medical consult immediately -3 Identify the types of Hypertension Know the guidelines of Hypertension Understand the treatment options for Hypertension Understand how to manage a patient with Hypertension in the dental setting -3 What is Hypertension? Blood Pressure Screening Guidelines Common Characteristics: Female Caucasian/Mexican American Normal BMI Under 40 years of age Physically active Moderate to no alcohol consumption Low daily sodium intake -3 Prevention of orthostatic hypotension Alleviate/manage anxiety Nitrous oxide can control anxiety but rebound hypertension is a risk if hypoxia occurs -4 Dental Management of the Hypertensive Patient, Continued Robyn C Neal LT DC USN Walter Reed National Military Medical Center General Practice Residency Blood pressure: Force applied on arterial walls in the systemic circulation Dental Management of the Hypertensive Patient "An abnormal elevation of arterial pressure that, if sustained and untreated, is associated with a significant increase in morbidity and mortality" Little, Falace, Miller, Rhodus Diuretics-(HTZ, furosemide)inhibit ion reuptake in kidney Anti-Adrenergics-(-olol, -zosin) Direct-acting vasodilators-(Hydralazine)- relax smooth muscle Ca+ channel blockers-(-dipine, verapamil)- reduces PR ACE inhibitors-(-pril)- block synthesis of angiotensin II Angiotensin receptor blockers-(sartan)-inhibit effects of angiotensin II Essential Hypertension Secondary Hypertension -5 Physiology Exercise Hypertension Is Your Patient Having a Hypertensive Crisis? -4 References The Hypertensive Patient Lifestyle Changes: Decrease in BP 200/120 mmHG Stop procedure Alert medical professionals Administer O2 6-10L Position in 45 degree angle Monitor ABCs and reassess every 5 minutes JNC 7 Recommendations Salt Reduction How Do I recognize a hypertensive patient? 5+7= Lifestyle Changes (cc) image by anemoneprojectors on Flickr -5 Learning Objectives Diuretics Xerostomia, postural hypotension, lichenoid reactions ACE inhibitors Xerostomia, dysgeusia Calcium channel blockers Gingival enlargement, postural hypotension Vasodilators Postural hypotension Alpha-blockers Xerostomia, postural hypotension Life threatening condition which involves acute, severe increase in BP that causes end-organ loss of function At every annual examination Before and after invasive surgery At every appointment with a hypertensive patient Refer for medical eval if 180/110 or above DBP mmHg The Normotensive Patient


Transcript: What is it? Hypertension affects your whole body, whether by increasing the risks of other diseases or by putting more strain on your heart. A poor diet and sedentary lifestyle enhances the effects of hypertension by bringing other possible causes into play. These things can put strain on your heart by making it beat harder and more often to try and combat the negative effects they have on the body. Sphygmomanometer Factors such as obesity, lack of exercise, heavy drinking, kidney disease and a diet high in salt can all contribute to the development of hypertension. High Blood Pressure As people age, their arteries become more rigid and this causes 'isolated systolic hypertension' which is when only the systolic blood pressure increases. Even though aging is natural, this state is still not good and needs to be treated accordingly. Hypertension The effects of hypertension on the arteries can also be worsened by the smoking of cigarettes, diabetes, high blood cholesterol and high levels of saturated fat in a diet. Hypertension can be caused by lifestyle choices, but may also be hereditary. Some pharmacy drugs may also cause hypertension. Blood pressure is measured by a Sphygmomanometer which is known colloquially as a 'Blood Pressure Cuff'. This device is placed on the upper arm, where it inflates to block the artery. The doctor then listens to the artery further along its path while they release the pressure on the artery. The sudden burst of blood flow makes a sound and the pressure on the cuff is recorded. The cuff is then loosened further and when the sound stops, the pressure on the cuff is again recorded. This gives you the systolic and diastolic blood pressures, respectively. Other Factors Treatments for Hypertension There are various ways to treat hypertension. The easiest way is to commit to certain lifestyle changes such as cutting out saturated fat and salt, getting regular exercise and limiting alcohol consumption. It is advisable to also quit smoking and have a high-fibre diet. Treatments for Hypertension (Cont.) Hypertension is essentially high blood pressure. You can also get antihypertensive medication from your doctor or pharmacist. These drugs will not cure the condition, and those who take them will probably have to for the rest of their life. Systolic blood pressure is usually between 110 and 130mmHg and Diastolic blood pressure is usually between 70 and 80mmHg, anything above these numbers is classified as high blood pressure. There are no notable symptoms of hypertension, but it increases the risk of many other diseases. Causes Bibliography Measuring Blood Pressure Effects on your Body Hypertension is when blood is pumped through the arteries with more force. This can be caused by many factors; both controllable and set.

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