So, what's the big deal if my
blood pressure is a little high?
Well, I want you to write down
6 very important things.
Now, we've got them on the slide there.
So if you'll just number them as we go through,
put some type of marking for yourself,
because these are really important.
These are things that you should be
educating patients about all the time.
You want to do it in a kind way.
But see, when your blood pressure
is high, you don't always know it.
Some people think they can always tell
when their blood pressure is high.
But really, we call it "the
silent killer" for a reason.
Now, let's start at the top
and work our way down.
High blood pressure can put you at increased
risk for events like strokes and heart attacks.
It can also severely damage your eyes.
So there's the first 3 reasons:
stroke, vision loss, or heart attack.
Sometimes, you see the word for heart
attack as myocardial infarction,
but they mean the same thing.
Now, the heart can also be
thrown into heart failure,
and I want to walk you through
that just a little bit.
The reason heart failure becomes
a problem, let's think back;
what are the 2 components of blood pressure?
Right, cardiac output and
systemic vascular resistance.
So, why…how does high blood
pressure cause heart failure?
Well, remember what SVR is?
The force that heart has to push against
the blood back out to the body, right?
So we're talking right after that left ventricle.
The higher that SVR is over a period of
time, the harder that heart has to work.
So, initially, what the heart
does is like, "Oh, I'll show you.
I'm gonna get bigger and stronger, and bigger
and stronger, and bigger and stronger."
And finally…we call that cardiac remodeling…
the bigger and stronger part
gets way out of control,
and the heart becomes kind of floppy and mushy.
And that's what causes…1 of the
causes of congestive heart failure.
When someone has prolonged hypertension,
prolonged high blood pressure,
that heart has had to work so very
hard, that it just gets overworked.
That muscle gets big and floppy and
mushy and not effective anymore.
So that's why high blood pressure
can cause heart failure.
Now, I already talked about
heart attack and stroke.
And remember, we talked about people with high
blood pressure often already have plaque, too.
So, that's another issue where that plaque
can break off and it can land in your heart,
the blood supply of your heart, cause a
heart attack, or a myocardial infarction.
It can land in your head and cause a stroke.
Now, the other 2 things aren't any fun, either.
But high blood pressure just really
beats up on your kidneys, right?
They weren't made to just be boom,
boom, boom, boom, boom, boom, boom,
to just be beat with a really high blood pressure.
So, high blood pressure damages your kidneys.
You'll start to see protein
showing up in their urine,
and some early signs of the kidneys are
really struggling as that first begins.
And the last one is no fun either, because
it usually deals with sexual dysfunction.
So we've got 6 things here.
I want you to stop and pause and think,
"What's going to be the best way for
you to keep in mind these 6 things?"
I like to go from head to toe, but you
can group them however you want.
But I want you to keep in mind
that you should be able to
quickly and easily recall these 6
main risks of high blood pressure.
Please be sure that you can explain how heart
failure is caused by high blood pressure,
why kidneys fail because of high blood pressure,
what role does plaque play in high blood
pressure, and stroke, and heart attack?
Now, let's talk about the actual numbers, the
nitty gritty of how we define blood pressure.
It may surprise you how we
now define blood pressure.
Normal used to be 120/80, but now
they're making it even stricter.
So, now they want normal to be < 120 and < 80,
so that's considered a normal blood pressure.
Elevated blood pressure…and I'm going to give
you 5 different categories of blood pressure.
So normal, < 120; elevated, 122-129,
but your diastolic is still < 80.
High blood pressure, that we call
stage 1 hypertension, a systolic…
a systolic blood pressure of 130/139,
or diastolic blood pressure that's
now higher…look at that, it's 80-89.
So, if a patient meets these criteria, we
consider them to have stage 1 hypertension.
High blood pressure or hypertension stage 2
is a systolic blood pressure 140 or higher.
See, that used to be the number that people…
if they hit 140, they're like, "I don't
really have high blood pressure."
Yeah, you're at stage 2 now with
these different categories.
And if you're a diastolic, pressure is 90 or higher,
you're definitely at stage 2 hypertension.
Now, this one is considered
a hypertensive crisis,
and you would be amazed at how
many people experience this.
That's a systolic pressure higher than 180,
and the diastolic pressure higher than 120.
And have I seen this?
And did it get my attention?
I was so afraid my patient was gonna
have some major type event.
So, normal, you don't need any more follow up
except just to kind of consistently
check it to make sure it's okay.
Elevated, it's time to start doing some things.
It's time for lifestyle changes
and to let your physician know.
Talk to your healthcare provider
and look what you can do.
At hypertension stage 1, you definitely have
a problem now, so this really is serious.
Stage 2, for sure you're on medications,
but for the hypertensive crisis,
circle that, underline it,
do whatever you need to do because those numbers
say your patient is in danger right now.
They need to get to the hospital
immediately for treatment.