اريد مساعدة اذا ممكن

    • اريد مساعدة اذا ممكن

      السلام عليكم ورحمة الله وبركاته

      تحياتي للجميع

      كل عام والجميع بألف خير

      بس اريد معلومات تتعلق
      بمرض الضغط
      وباللغة الانجليزية
      ودور الممرض في علاج مرضى الضغط
      وبمعنى اخر
      nurssing managment


      اذا يمكن بأسرع وقت
      ولكم مني جزيل الشكر والله ولي التوفيق

    • وعليكم السلام ورحمة الله وبركاته


      What is blood pressure?
      The heart pumps blood around the body and the brain. In order for the blood to reach the muscles and organs, it is pumped away from the heart through the arteries. When blood has permeated the body's tissues it travels back, through the veins, to the right side of the heart. From there, it is pumped into the lungs, where carbon dioxide (CO2) is exchanged for fresh oxygen. The blood then returns to the left side of the heart to be pumped via the arteries to the tissues once again.

      The blood pressure depends on how forcefully the heart pumps the blood around the body and how narrowed or relaxed your arteries are. Hypertension occurs when blood is forced through the arteries at an increased pressure.

      Blood pressure is measured using two numbers. An example of this could be 'the blood pressure is 120 over 80', which is written as '120/80'. The first figure is the systolic blood pressure - the pressure in the arteries when the heart contracts and pushes the blood out into the body. The second figure is the diastolic blood pressure. This is the pressure in the arteries when the heart is filled with blood as it relaxes between two beats.



      What is hypertension?

      There is a natural tendency for blood pressure to rise with age due to the reduced elasticity of the arterial system. The definition of hypertension is thus dependent on the age of the patient.

      For example, in a 60-year-old patient, hypertension occurs when the blood pressure is higher than 160/90 while the patient is at rest.

      Some patients have lower thresholds for the diagnosis of hypertension, in particular diabetic patients, for whom any persisting pressure above 130/80 causes problems.

      Even though hypertension itself rarely has any symptoms, it can cause many serious problems.



      What causes hypertension?

      In more than 90 per cent of cases, the cause is unknown. This is called 'primary' or 'essential hypertension'.

      In the remaining minority of cases, there is an underlying cause. This is called 'secondary hypertension'.

      Some of the main causes for secondary hypertension are: chronic kidney diseases, diseases in the arteries supplying the kidneys, chronic alcohol abuse, hormonal disturbances and endocrine tumours.



      How is blood pressure measured?

      To take a blood pressure measurement, a blood pressure cuff is placed around the upper part of the arm. The cuff is inflated and the doctor listens to the artery just below the cuff as the air is then released. When the doctor can hear the heart beat, he or she will note the systolic pressure. When the sound disappears, the doctor will record the diastolic pressure.

      Blood pressure can be measured in other ways, such as using an automatic blood pressure gauge, which can also be used at home.

      When the doctor measures blood pressure, it sometimes increases slightly because the patient is nervous. This reaction is called 'white coat hypertension' and the doctor will usually perform several blood pressure readings to get a better idea of what your average level tends to be.

      Blood pressure can also be measured evenly over the course of a day using an automatic day and night pressure gauge, which the patient carries for 24 hours.



      What are the symptoms?

      Hypertension hardly ever causes symptoms and may not be noticed at all. However, serious and rare manifestations of severe hypertension can be:



      headache, sleepiness, confusion or coma


      serious breathing difficulties


      nosebleeds.



      What factors increase the risk of hypertension?

      Anyone can suffer from hypertension but certain factors can seriously aggravate hypertension and increase the risk of complications:



      a tendency in the family to suffer hypertension


      obesity


      smoking


      diabetes Type 1 or Type 2


      kidney diseases


      high alcohol intake


      excessive salt intake


      lack of exercise


      certain medicines, such as steroids and certain kinds of diet pills.



      What can I do?



      Have regular blood pressure tests if there is a family tendency for hypertension. In this way, treatment can be started before any complications arise.


      Change your lifestyle: stop smoking, lose weight and exercise regularly. Cut down on alcohol, eat a varied diet, try to avoid stressful situations and experiment with different relaxation techniques.


      If you suffer from hypertension, your blood pressure should be measured regularly so that any necessary treatment can be arranged.


      If your blood pressure requires medical treatment, you will probably have to take medicine on a regular basis. If so, never stop taking it without consulting your GP, even if you feel fine. Hypertension can lead to serious complications if left untreated.



      What can your doctor do?



      Pinpoint risk factors and help change your lifestyle in order to reduce blood pressure.


      If necessary, offer medication for the reduction of blood pressure and arrange regular monitoring.



      Possible complications



      Atherosclerosis (narrowing of the arteries).


      Strokes (CVAs) - cerebral haemmorrhage or cerebral thrombosis.


      Thoracic aortic aneurysm - expansion of the main artery in the chest.


      Abdominal aortic aneurysms - expansion of the main artery in the abdomen.


      Heart attack.


      Heart failure (reduced pumping ability).


      Kidney failure.


      Eye damage.



      Probable developments

      By treating the hypertension, complications can be avoided and average life expectancy will remain almost normal.

      Without treatment, life expectancy may well be reduced due to the risk of developing any number of the complications listed above.



      What medicines are used?



      Diuretics help the body excrete superfluous fluids and salt through the kidneys and, in certain cases, relax blood vessels thus reducing the strain on the circulation. Diuretics can have different effects on your kidneys and can be divided into thiazides, loop diuretics, potassium-sparing diuretics or a combination of these.


      Beta-blockers block the effect of the hormone adrenaline and the sympathetic nervous system on the body. This relaxes the heart so that it beats more slowly, lowering the blood pressure.


      Alpha-blockers cause the blood vessels to relax and widen. Combining them with beta-blockers has a greater effect on the resistance in the circulation.


      Calcium-channel blockers reduce the muscle tension in the arteries, expanding them and creating more room for the blood flow. In addition, they slightly relax the heart muscle so that it beats more slowly, thus reducing the blood pressure.


      ACE inhibitors interrupt the formation of a hormone (called angiotensin II) that makes the blood vessels contract. As a result, the vessels expand. The tension in the circulation is also lowered by more fluid being filtered from the vessels into the urine by the kidneys. Both mechanisms help reduce blood pressure. These are very useful medicines for the treatment of high blood pressure and, if your blood pressure is not easily controlled on simple medication, your doctor will probably use a medicine of this type.


      Angiotensin-II receptor antagonists work in a similar way to ACE inhibitors, however, instead of interrupting the formation of angiotensin II, they block the receptors that it acts on. This reduces blood pressure in the same way as above.



      The following medicines are used less frequently.



      Indapamide is a mildly diuretic preparation which also relaxes the peripheral arteries.


      Hydralazine relaxes the vascular walls in the peripheral arteries thereby reducing the blood pressure.


      Methyldopa stimulates the alpha receptors in the brain that relax the blood vessels, causing the blood pressure to drop.


      Moxonidine is another medicine that acts on receptors in the involuntary part of the brain, causing blood pressure to decrease.


      Minoxidil relaxes the small arteries so that blood pressure drops. It must be used in combination with other antihypertensive medicines.

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