INTRODUCTION
In lay man language, its only high level of blood pressure and
unfortunately high blood pressure is invariably not accompanied by
symptoms and therefore its detection and management is a
challenge. This is fact, why it has been described as a "Silent Killer".
Definition:-
According to WHO, a person having systolic blood pressure
≥160mmHg and/or diastolic blood pressure ≥95mmHg is said to
have hypertension.
According to Joint National Committee V and International
Society of hypertension, “Blood pressure ≥140mmHg systolic and
≥90mmHg diastolic is called hypertension.”
Classification:-
Hypertension can be classified in various ways,
A. According to causation.
1. Essential Hypertension, in which causes are
generally unknown & are responsible for
90% of all causes.
2. Secondary hypertension, in which some
other disease or abnormality is responsible
in its causation, like, diabetes mellitus,
Cushing syndrome, kidney diseases, etc.
B. According to Blood pressure measurement: - According to level of
blood pressure, category of hypertension is decided. Most
commonly we are considering WHO criteria for diagnosis,
which we will discus later in Methodology.
C. Classification by JNV-VII :-
Category Systolic BP(mmHg) Diastolic
BP(mmHg)
Normal ≤120 ≤80
Pre- hypertension 120-139 80-89
Hypertension- 140-159 90-99
Stage -1
Hypertension- ≥160 ≥100
Stage -2
Diagnosis:-
It is done by measuring the blood pressure with the help of
mercury manometer. But due to subjective variations, anxiety, fear,
inexperienced interpretation of korotkow sound, faulty instrument
etc, errors occur. So, WHO study group has mentioned standard
method of measuring BP.
Standard method of measuring BP-
1. Position of patient – sitting position.
2. Position of mercury manometer – at the level of patient’s
heart.
3. Arm to be used – In any arm, but clinic policy must be
uniform.
4. It should be measured at least 3 times over a period of 3
minutes & lowest reading is recorded.
From total number of cases of HT, only 50% are aware of this
condition & 25% are taking treatment regularly & only 12.5% cases
are controlled successfully. These figures vary from country to
country.
According to American Heart Association,
One in 3 US adults has high Bp.
28% of people with high BP don’t know that they have it.
Among other who knows, 64.9% do not have it controlled.
Statistics:-
Hypertension is a major health problem in world. To reveal it
incidence has limited value because of variability in reading of an
individual.
Prevalence:-
In industrialized countries 25% of adults and in developing &
European countries 20% of adults are affected.
Prevalence is high in U.S. blacks, Russia, Finland (30-40%),
usual in Europe, Japan, U.S. whites (15-30%), low in rural Africa,
south china (7-15%).
And absent in Yanomani, Paeitic Island.
In India, urban areas prevalence rate is 164.18/1000 & in rural
areas prevalence rate is 157.44/1000. More incidences are found in
males than in females.
METHOD OF STUDY
Case study is a good tool for understanding a disease in
community medicine. It not only guides us for scientific methods
of prevention but also tells about social, economical, cultural,
moral factors which might interfere in control measures.
Case selection:-
This study was conducted in group & we were allotted
subject of hypertension. We selected one patient who had
essential hypertension. We got her from our hospital.
We conformed that she’s living within limits of Baroda city
as we had given limitation of travel expenditure from
department & she is co-operative.
Processes in study:-
We visited patient’s house, met her family & following steps were
taken.
History taking & examination of patient to confirm
diagnosis.
Family health checks up.
Detailed study of diet of patient & her family.
Study of housing, environment & sanitation.
Socio-economic states of patient.
Advised her for controlling the disease.
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