➤ Blood pressure is the force exerted by blood on blood vessels.
➤ Prevalence of hypertension in India is around 25% in urban population,10% in rural population.
➤ Worldwide around 7.5 million people die yearly because of hypertension, which is about 12.5% of total deaths.
➤ Blood pressure is interpreted as systolic blood pressure over diastolic blood pressure.
➤ Systolic pressure is exerted as the heart pumps blood around body and diastolic blood pressure is exerted when the heart relaxes and refills with blood.
➤ Normally systolic blood pressure is 100-120mm of Hg and diastolic blood pressure is 70-80mm of Hg.
➤ And it is written as 120/80,110/70, etc.
Hypertensionis defined as sustained increase in blood pressure more than 140/90.
It is one of the most common and complicated condition affecting people.
➤ Stress, exercise, anxiety can increase BP for short duration.
➤ Main causes of hypertension are lifestyle changes like..
» -decreased physical activity,
» -increased salt intake,
» -high intake of fats (junk food) leading to obesity,
» -alcohol and tobacco abuse,etc.
➤ Kidney disorders.
➤ Old age
➤ Usually hypertension is asymptomatic (although sometimes it may present as occipital headache) and it appears as an accidental finding. Hence it is called as a silent killer.
➤ Prolonged hypertension may cause narrowing of the blood vessels which can affect heart, kidneys, eyes, etc
➤ Narrowing of blood vessels supplying heart may lead to heart attack.
➤ Chronic kidney disease
➤ Maintain normal body weight and avoid obesity.
➤ Restrict salt intake.
➤ Avoid excessive alcohol consumption.
➤ Regular aerobic physical exercises like jogging, running, aerobics, etc.
➤ Regular health checkups.
➤ Diabetes mellitus (DM) commonly called as diabetes is the metabolic disorder causing high blood sugar level for prolonged period.
➤ Normal fasting blood sugar level should be less than 100mg/dl and post meal(postprandial) blood sugar level should be less than 140mg/dl.
➤ Sugar levels in our body are maintained by hormone called insulin.
➤ When there is decreased secretion of insulin or increase in production/consumption of sugar, there is increase in blood sugar levels.
Around 69.2 million Indians are suffering from diabetes. The prevalence has been doubled in last 15 years.
Types of diabetes
1. Type 1 DM: It is because of failure of secretion of insulin from pancreatic cells. It generally presents in childhood.
2. Type 2 DM: It is because of the development of resistance to insulin by the body cells. Hence,although there is normal secretion of insulin but as cells are unable to respond to insulin the sugar levels are high.
This generally presents in adults.
3. Gestational DM: It is development of high sugar levels in pregnancy in previously non-diabetic women.
➤ Polyurea (increased frequency of urination)
➤ Poludypsia (increased thirst)
➤ Polyphagia (increased hunger)
➤ Sudden weight loss.
➤ As Type 1 DM is congenital failure it can not be prevented
➤ Type 2 DM can be prevented by lifestyle changes like
➤ Eating healthy food with high fibers, good saturated fatty acids, low sugar.
➤ Regular exercise.
➤ Avoid obesity.
➤ Avoid eating food with high glycaemic index like-sugar, sweets, cookies, cakes, rice, banan,etc.
➤ Type 1 DM is treated with insulin.
➤ Type 2 DM can be treated with oral hypoglycemic agents.
Oral hypoglycemic agents
➤ They either reduce production/absorption (from gut) of sugar or increase sugar consumption.
➤ Prolonged high sugar levels can cause damage to blood vessels leading to peripheral vascular diseases.
➤ Damaging the kidneys leading to chronic kidney disease.
➤ Damaging the retina in eyes causing diabetic retinopathy.
➤ Diabetic foot ulcer.
➤ Damage to nerves leading to neuropathies causing loss of sensation, tingling, etc.
➤ Diabetes makes patient prone for infections, especially fungal infections.
➤ Bronchial asthma commonly known as asthma is a disease of respiratory system resulting from obstruction of airway mainly small airway.It is generally reversible.
➤ Around 300 million people are suffering from asthma worldwide, one tenth of those are Indians.
➤ Asthama is more common in developing countries.
➤ Shortness of breath,
➤ Tightness in chest,
Symptoms are generally exaggerated by exercise,triggers or during night/early morning.
It is due to chronic inflammation of respiratory airways due to…
1. Environmental factors
Pollen grains, dust, smoking, pollution, volatile chemical agents, etc.
2. Genetic factor-
Positive family history is a risk factor for asthma.
3. Medical conditions-
History of atopic diseases like eczema, atopic rhinitis is a strong risk factor for development of asthma.
4. Exercise induced asthma
Exercise causes broncho-constriction even in 20% of normal population. In asthmatic patients exercise can cause severe broncho-constriction which needs prompt treatment.
Types of asthma
1. Allergic (atopic)
It is due to the allergic response to triggers like dust, pollen grains, etc.
It occurs early in life.
2. Non allergic asthma (intrinsic or nonatopic asthma)
In this type, skin test is negative for allergy.
It generally presents later in life and women are more commonly affected than men.
➤ Acute exacerbation of asthama can lead to status asthamaticus. It is a dreadful condition which causes severe broncho-constriction leading to decrease in oxygen saturation,if not treated promptly it can cause death of the patient.
Avoidence of the allergent is the only way to prevent asthama.
➤ Control of pollution,
➤ Avoid active as well as passive smoking,
➤ Maintain hygiene, etc
1. Bronchodilators are the treatment of choice in asthma.
2. For severe or acute cases steroids are given.
4. Anti-inflammatory and antiallergic agents.