Hello, everyone. Welcome to cardiovascular disease.
Our specific topic here is hypertension. Dr. Raj. Let's start.
We'll begin with hypertension. 130/80 mmHg,
that is the cutoff point to define hypertension. 130 systole, 80 diastole.
Stage one hypertension extends until 139/89,
stage two hypertension is blood pressure higher than or equal to 140/90.
Now, what do you need to confirm hypertension?
At least two separate measurements over at least two separate office visits.
Once you have confirmed hypertension, you should understand
at what point you need to administer therapy immediately,
instead of proceeding with further laboratory testing.
Lifestyle changes or non-pharmacologic therapy.
Blood pressure higher than 180 systolic over 120 diastolic
accompanied by evidence of organ damage should be treated immediately.
Anything that we do moving forward, you need to make sure that you confirm your diagnosis always.
Those are types of questions that you should get from every single source.
Let it be rotations, let it be your residency, let it be any licensing exam.
Now, once you go beyond 130/80, what do you need to do?
You wanna make sure that you understand at what point you need to administer therapy immediately.
What does that mean? Well, as we proceed through hypertension,
we will take a look at the differences between primary and secondary.
We'll be spending a little bit more time on secondary
because the exact etiology and pathogenesis
become quite obvious to us in the journey towards secondary hypertension, it becomes very relevant.
Primary hypertension, for the most part, what are you thinking about telling your patient?
Hey, why don't you lose some weight?
Now, you're not gonna come out and say that. That wouldn't be very nice.
So, what do you say? What are you eating?
Would you wanna cut down on salt, perhaps? Salt, what is that? Sodium.
So, you start thinking about sodium and its effects on your blood pressure.
Whenever sodium is present in your plasma in your blood, guess what it's going to do.
It's gonna retain some of that fluid, huh?
So, all I'm doing here is giving you a better idea and more detailed, oriented patophys
so that you understand how to deal with something like primary hypertension.
As your blood pressure continues to rise, you wanna start thinking about,
wow, do I need to administer immediate therapy?
A diastole of 120, huh, what are you thinking about when you think diastole?
The resting phase. Everything that we do -- close your eyes.
Everything that we do in medicine, we should be able to conceptualize.
If you're just reading what is written here, if you just look at my mouth
and listen to what I have to say, so be it, but you have to be able to picture it.
So, that's your resting phase, isn't it? What resting? How about your blood vessels?
Well, if your blood vessels get constricted, what happens? What's that called, please? Good.
It's called TPR, total peripheral resistance.
And so therefore, if there's increase to vasoconstriction of your blood vessel,
what phase of your blood pressure is going to be affected?
The systole or diastole, please? The diastole.
So, as you move forward, or any question that you get in terms of dissecting your blood pressure further,
you wanna pay attention to what is the volume contributing to my systole
or is it the fact that my blood vessels and whether
or not it's vasoconstricting or dilating, affecting my diastole.