# data[].attributes.body
> High blood pressure associated with genetic, physiological, and lifestyle factors

> May be primary or secondary

> Related to water and sodium retention, altered renin-angiotensin-aldosterone mechanism, stress and increased sympathetic nervous system activity, insulin resistance and hyperinsulinemia, and endothelium dysfunction

# data[].attributes.body
Ambulatory Monitoring: A longer blood pressure monitoring test may be done to check blood pressure at regular times over six or 24 hours.

Lab Tests: Routine urinalysis

BUN

Creatinine / creatinine clearance

Basic metabolic panel/ CBC

Lipid profile

Electrocardiogram (ECG/EKG): This quick and painless test measures the heart's electrical activity. It can tell how fast or how slow the heart is beating.

Echocardiogram: A noninvasive test using sound waves to create detailed images of the heart and blood flow.

# data[].attributes.body
Diuretics

Act on kidneys to help eliminate water and sodium, reducing blood volume

Calcium Channel Blockers

Help relax the muscles of the blood vessels

Angiotensin-converting enzyme inhibitors

Dilates blood vessels by blocking the formation of angiotensin II

Angiotensin II receptor blockers (ARBs)

Dilates blood vessels by blocking the formation of angiotensin II

Beta Blockers

Reduces the afterload on the heart and dilate blood vessels, causing the heart to beat more slowly

Combined alpha and beta blockers

Reduces nerve impulses that promote vasoconstriction

Vasodilators

Relaxes the muscle tissues in the blood vessel walls

Central agonist

Decrease blood vessels' ability to contract and cause vasocontraction

# data[].attributes.body
-heart failure

(increased overload causes diastolic dysfunction)

-renal failure

(high pressure in the walls causes thickening & bloodflow is reduced)

-stroke

(prolonged high BP can cause vessel rupture, leading to hemorrhage & disrupted bloodflow to part of the brain)

-aneurysm

(dilation of cerebral artery walls presses on nerves & brain tissue causing damage/ruptures which causes hemorrhage or stroke)

-hypertensive crisis

(acute, severe elevations in BP)

# data[].attributes.body
Assessments

Neurological assessment

Blood pressure

Heart rate

Examination of the optic fundi

Auscultation for carotid, abdominal, and femoral bruits

Palpation of the lower extremities for edema and pulses

Serum creatinine, BUN, estimated glomerular filtration rate, and 24-hr urine collection for creatine clearance

Albumin excretion rate

Calculation of BMI and waist circumference

Actions

Administer antihypertensive medications as ordered

# data[].attributes.body
Non-modifiable:

~Race (x4 in African Americans)

~Gender (Men)

~Renin elevation

~Genetics

Modifiable:

~Obesity

~Vitamin D deficiency

~Cigarette smoking

~Salt sensitivity

~Insulin resistance

# data[].attributes.body
> Watch for orthostatic hypotension and risk for falls

> Monitoring of blood pressure with phone apps, home monitoring

> Life-long treatment, adherence to medication regimen, and lifestyle changes

DASH diet: diet rich in fruits, vegetables, and low-fat dairy products, and reduced in saturated fat and cholesterol

Sodium restriction: less than or equal to 1,600 mg sodium per day is recommended

Moderate exercise: at least 150mins of moderate aerobic exercise each week

Limit alcohol: no more than one drink per day for women, two drinks per day for men

Stress reduction

Smoking cessation

> Explore use of fish oils and Omega-3 fatty acids

> Contact HCP before using OTC medications