Hypertension (Hindi) Care Plan

<div><font face="arial" size="2">Early diagnosis of hypertension leads to avoidance or delaying the effects of hypertension on the body.&nbsp;</font></div><div><font face="arial" size="2"><br></font></div><div><font face="arial" size="2">Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time like yours. Having high blood pressure raises your risk for heart disease and stroke, leading causes of death in the world.<a href="http://www.cdc.gov/bloodpressure/about.htm" target="" title="">⁽¹⁾</a></font></div><div><font face="arial" size="2"><br></font></div><div><font face="arial" size="2">For your information blood pressure readings are usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure. Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.</font></div><div><font face="arial" size="2"><br></font></div><div><font face="arial" size="2">High blood pressure (hypertension) is when your blood pressure is <b>140/90 mmHg</b> <b>or above</b> most of the time. If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension. If you have pre-hypertension, you are more likely to develop high blood pressure.^{<a href="http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm" target="" title="">(2)</a>}However, for diabetic and chronic kidney disease patients, the normal blood pressure should not cross 130/80 mmHg.</font><br><br></div><div>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <img src="https://i.imgur.com/h0NsKzu.png" width="200"><img src="https://i.imgur.com/jzOKsC2.png" style="font-size: 1.1em; font-family: Arial;" width="200"></div><div><div>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (A)<span class="Apple-tab-span" style="white-space:pre">    </span> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(B)</div><div>&nbsp;<font face="arial" size="2"> Fig.1. Diagram of (A) Blood Pressure (B) Measurement</font></div><div><font face="arial" size="2">&nbsp; <b>Photo Credit: </b>(A): <a target="" title="" href="http://www.cdc.gov">www.cdc.gov</a> (B): <a target="" title="" href="http://www.nlm.nih.gov">www.nlm.nih.gov</a></font></div></div><div><br></div><div><br></div><font size="2"><br><b>To learn more, check out these video-</b></font><br><a <br=""><br>
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<div align="justify"><b><font face="arial"><span class="Apple-tab-span" style="white-space:pre"></span><font size="3">Signs and Symptoms:</font><br></font></b><font size="2"><span style="font-family: arial; font-size: small;">Hypertension itself usually has no signs or symptoms. Rarely, headaches may occur.</span></font></div><div align="justify"><font size="2"><span style="font-family: arial; font-size: small;">You can have hypertension for years without knowing it. During this time, the condition can damage your heart, blood vessels,&nbsp; kidneys, and other parts of your body.</span></font></div><div align="justify"><font face="arial" size="2">Some people only learn that they have hypertension after the damage has caused problems, such as coronary heart disease, stroke, or kidney failure.<a target="" title="" href="http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/signs.html">⁽³⁾</a></font></div><div align="justify"><b><font face="arial"><span class="Apple-tab-span" style="font-size: small; white-space: pre;"><br></span><font size="3">Self-care instructions</font><font size="2">:</font></font></b></div><div align="justify"><font face="arial" size="2">You can do many things to help control your blood pressure, including:<a href="http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm" target="" title="">⁽²⁾</a></font></div><div align="justify"><ul><li><font face="arial" size="2"><span class="Apple-tab-span" style="white-space:pre"></span>Eat a heart-healthy diet, including fibres, and drink plenty of water.<span class="Apple-tab-span" style="white-space:pre"></span></font></li><li><font face="arial" size="2">Hypertension is a chronic life-long condition. Do not forget to take medicines if your doctor has prescribed medicines to control the blood pressure. Ask your doctor for the side effects of the medicines and signs and symptoms to look out for.&nbsp;</font></li></ul></div><div align="justify"><ul><li><font face="arial" size="2"><span class="Apple-tab-span" style="white-space:pre"></span><b>Exercise regularly</b> - at least 30 minutes of aerobic exercise a day. Find an exercise buddy.&nbsp;<span class="Apple-tab-span" style="white-space:pre"></span></font></li><li><font face="arial" size="2">If you smoke, <b>quit</b> - find a program that will help you stop.</font></li></ul></div><div align="justify"><ul><li><font face="arial" size="2"><span class="Apple-tab-span" style="white-space:pre"></span>Limit how much alcohol you drink. Try to stop it altogether.</font></li></ul><font face="arial" size="2"><br></font></div><div><font face="arial" size="2">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;<img src="https://i.imgur.com/1y4frsc.png" width="163">&nbsp;</font></div><div><ul><li><font face="arial" size="2"><span class="Apple-tab-span" style="white-space: pre;"></span>Limit the amount of sodium (salt) you eat -aim for less than 1,500 mg per day. (&lt; 1 tbsp/ day)</font></li></ul></div><div><font face="arial" size="2">&nbsp;</font></div><div><font face="arial" size="2">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<img src="https://i.imgur.com/wbkQ36x.png" width="192">&nbsp;</font></div><div><div><ul><li><font face="arial" size="2"><span class="Apple-tab-span" style="white-space:pre"></span><b>Reduce stress</b> - try to avoid things that cause you stress. You can also try meditation or yoga.<span class="Apple-tab-span" style="white-space:pre"></span></font></li><li><font face="arial" size="2">Stay at a healthy body weight -find a weight-loss program to help you, if you need it. Keep a track on your weight</font></li></ul></div></div><div><br></div><font size="3">&nbsp;</font>...more

Typical follow-up schedule:

You should consult with your doctor after 1, 3, 6, 9 and 12 months once your hypertension is detected. An ECG should be done every time you visit your doctor. After 6 and 12 months, along with ECG, some more tests like 2D Echo, fasting blood sugar, serum creatinine, lipid profile, and micro-albumin needs to be done.



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<font face="arial" size="2"><b>Being active and taking regular exercise</b> lowers blood pressure by keeping your heart and blood vessels in good condition. Regular exercise can also help you lose weight, which will also help lower your blood pressure.<br><br>Maintain a healthy BMI (a measure of body fat) of less of 23. This will aid maintaining weight and stable blood pressure levels. BMI is calculated by<br><br>BMI = Weight in Kg <b>/</b> (Height in meter)²<br><br>Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (i.e. <b>cycling or fast walking</b>) every week. For it to count, the activity should make you feel warm and slightly out of breath. The normal heart rate range 60-100 beats per minute. Aim to stay within a target heart rate zone that is 55 to 70 percent of your maximum heart rate to exercise moderately. Calculate your max heart rate by subtracting your age from 220.<br>Someone who is overweight may only have to <b>walk up a slope</b> to get this feeling. Physical activity can include anything from sport to <b>walking and gardening</b>.<a target="" title="" href="4.    http://www.nhs.uk/Conditions/Blood-pressure-%28high%29/Pages/Prevention.aspx">⁽⁴⁾</a><br></font><br><b>Exercises which can be followed:</b><br><br><b>A.&nbsp;&nbsp; &nbsp;<font size="2">Marching on the spot with dumbbells</font></b><br><br><ul><li><font size="2"><span style="font-family: Arial;">Stand upright and carry lightweight dumbbells by your sides.</span></font></li></ul><br><img src="https://i.imgur.com/dyU7DSw.png" width="454"><br><br><ul><li><font size="2"><span style="font-family: Arial;">March continuously on the spot, keeping your knees low and avoid swinging your arms.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Do this continuously for 30 to 60 seconds before taking a short break.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Do the exercise four to six times.</span></font></li></ul><br><img src="https://i.imgur.com/dDTbo4j.png" width="276"><br><b><br>B.&nbsp;&nbsp;&nbsp; <font size="2">Marching on the spot with hammer curl</font></b><div><font size="2"><b><br></b></font><div><ul><li><font size="2"><span style="font-family: Arial; font-size: small;">Stand upright and carry lightweight dumbbells by your sides.</span></font></li><li><font size="2"><span style="font-family: Arial; font-size: small;">March on the spot, with your knees lifted high. To do so, flex your right hip and left arm at the same time till the knee and elbow are each bent at 90 degrees. Return to the starting position and repeat with the left hip and right arm. Do this continuously. Breathe normally and do not hold your breath when lifting the weights.</span></font></li><li><font size="2"><span style="font-family: Arial; font-size: small;">Depending on your fitness level, start with 30 to 60 seconds for each set of marching. Then, slow down by marching on the spot with dumbbells by your side for another 30 to 60 seconds.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial; font-size: small;">Do the exercise four to six times.</span></font></li></ul></div><div><br><img src="https://i.imgur.com/Lt15kSv.png" width="236"><br><b><br>C.&nbsp;&nbsp;<font size="2">&nbsp; Squat with bicep curl</font></b><br><br><ul><li><font size="2"><span style="font-family: Arial;">Carrying dumbbells at your sides, march continuously on the spot for 30 to 60 seconds.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Then stop and do a quarter squat, with your legs shoulder-width apart and your arms by the side.</span></font></li></ul><br><img src="https://i.imgur.com/oA9E09z.png" width="236"><br><br><ul><li><font size="2"><span style="font-family: Arial;">Stand upright again and flex both arms upwards to perform bicep curls. Breathe normally while doing this exercise and do not hold your breath when lifting the weights. Then return both arms to your sides.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Depending on your fitness level, start with 10 repetitions and progress to 20.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Then march on the spot, holding the dumbbells by your sides, for 30 to 60 seconds.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Do the exercise four to six times</span></font></li></ul><br><img src="https://i.imgur.com/80VINcH.png" width="217"><br><br><br><b>D.&nbsp;&nbsp;<font size="2">&nbsp; Walking lunge</font></b><br><font size="2"><br></font><ul><li><font size="2"><span style="font-family: Arial;">Carrying dumbbells at your sides, march continuously on the spot for 30 to 60 seconds.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Take one step forward with your right leg and lower your body slightly. At the same time, flex the left elbow upwards fully till the dumbbell is parallel to the floor. Return to the starting position, lowering the left arm back to the side. Repeat with the other leg and arm. Breathe normally while doing the exercise. Do not hold your breath when lifting the weights.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Depending on your fitness level, start with 10 repetitions and progress to 20 repetitions on each leg.</span></font></li></ul><font face="Arial" size="2"><br></font><img src="https://i.imgur.com/52rDFGU.png" width="276"><br><br><ul><li><font size="2"><span style="font-family: Arial;">Then march on the spot, holding the dumbbells by your sides, for 30 to 60 seconds.&nbsp;</span></font></li><li><font size="2"><span style="font-family: Arial;">Do the whole sequence of 10 to 20 repetitions on each leg and marching on the spot four to six times.</span></font></li></ul><br><img src="https://i.imgur.com/j7EryvS.png" width="276"><br><br><img src="https://i.imgur.com/niT68o1.png" width="407"><br></div></div>...more

To avoid the state of hypertension and high BP, it is necessary to combine positive dietary and lifestyle changes with the recommended medications.
Typically, food items can be classified into six major groups as shown in the Healthy Heart pyramid.