High blood pressure is generally defined as a level exceeding 140/90 mm Hg on multiple occasions. The systolic blood pressure, which is the first number, represents the pressure in the arteries as the heart contracts and pumps blood throughout the circulatory system
High blood pressure is not an illness in itself, but it can lead to some organ damage. People with high blood pressure are very prone to strokes, heart attacks, problems with the eyes retinas and kidney disease. Pregnant women can certainly not afford to ignore hypertension because it often leads to many complications.
Some Serious Causes of Hypertension
Alcohol and Cocaine:
Both alcohol and cocaine cause hypertension. Excessive ingestion of alcohol can cause a patient to exacerbate his preexisting hypertension, or it can induce hypertension. And cocaine produces devastating effects on blood pressure by increasing the release of norepinephrine, a powerful vasopressor produced by the body in response to hypotension and stress. This can result in acute hypertension, tachycardia, tremor, and seizures as well as coronary artery vasoconstriction from a CVA or Ml.
Many poisons can elevate blood pressure and cause hypertension. Some common poisons include cyanide, phencyclidine, and black widow spider venom. Treatment varies depending on the poison, and it usually relieves poison-induced hypertension.
Pregnancy-induced hypertension can threaten the lives of both the mother and infant. It causes elevated blood pressure, proteinuria, and edema and may lead to abnormalities in the mothers coagulation system and liver function. The only treatment for pregnancy-induced hypertension is delivery of the infant.
For some patients, even mild stress can cause a rise in blood pressure. In response to a stressful event, the patient perceives a stressor, and his body initiates a fight-or-flight reaction. Physical signs and symptoms of stress-induced hypertension include decreased gastrointestinal motility, pupil dilation, and increased perspiration, all of which result from sympathetic nervous system stimulation that causes increased blood pressure and increased heart and respiratory rates.
With the white-coat phenomenon, a patient has elevated blood pressure readings in his physicians office or the hospital but normal readings elsewhere. To determine if a patient has true hypertension, a physician may order repeated measurements over time or ambulatory measurements.
In postoperative patients, stress-related hypertension commonly results from sympathetic stimulation caused by pain, bladder distention, hypothermia, or respiratory compromise.
Sleep apnea can contribute to the development of hypertension. During apnea, the tongue and soft palate relax and fall back, obstructing the airway either partially or completely. As a result, the patient cant breathe. His oxygen levels fall, and carbon dioxide levels rise, resulting in acidosis and vasoconstriction of the pulmonary arterioles. Eventually, the patient partially awakens, gasps, and reopens his airway. Episodes of apnea may last from 15 to 90 seconds and occur repeatedly during the night.
Diseases Causing Vasculitis:
Scleroderma, polyarteritis nodosa, lupus erythematosus, rheumatoid arthritis, and nonspecific arthritis may cause vasculitis in some patients. About one-half of these patients subsequently develop hypertension because of the effect the diseases have on the arterioles and major arteries.
Benefits of Exercise for Hypertension Patients
When your hypertensive patient begins an exercise program, teach him about the prescribed exercise. Monitor his exercise tolerance and continue to regularly measure his blood pressure.During your patient teaching, tell him to exercise at the same time every day. Instruct him to wear loose-fitting clothing and to wear shoes that properly support his feet. If his exercise consists of walking, tell him to walk at a comfortable pace on level ground. Also, urge him to carry identification and a list of the drugs he is taking.
Hypertensive patients with other health problems may need special devices, such as braces or splints, to assist them in an exercise program. Assess your patient’s overall physical status and consult with a physical therapist or cardiac rehabilitation specialist for exercise suggestions.
To help your patient adapt his exercise program to his needs and tolerance level, advise him to measure his pulse rate before and immediately after the exercises. He can use his pulse as a guide to increasing or decreasing his activity. Also, tell him to assess himself after 5 minutes of exercise. He should feel warm, not hot and sweat.
Until the patient knows his exercise tolerance, he should exercise with someone else. Instruct him to stop exercising if he becomes extremely tired, short of breath, dizzy, or light-headed. If he develops chest pain, palpitations, or tingling, numbness, or pain in his arms or legs, he should stop exercising and contact his physician. Tell him to seek emergency care if any of these symptoms persists for more than 15 minutes after the exercise activity is stopped.
Review the key elements of the exercise program with your patient. Provide suggestions to help him comply with the plan and stress the importance of exercise for managing his hypertension. Encourage him to do exercises that he enjoys so that hell be more likely to do them regularly.
Advise your patient to set realistic goals and advance his exercise program at his own pace. To ensure compliance, suggest that he join a walking group such as one that walks in malls.
Monitor the success of your patients exercise program by checking his blood pressure and resting heart rate weekly. If his blood pressure decreases, emphasize the success of the exercise program to encourage continued compliance.