Detect Hypertension in time, before any serious arises. Hypertension means systolic >140mm and Diastolic > 80mm (>84mm in younger patients).

Check B.P. routinely in every patient of risk group.

In every patient above 40 years age (once a year).

In every diabetec and obese patient.

In every case with Headache, Giddiness, Chest pain, epistaxis,

In direct relatives of Hypertension patients (son, brother, uncle etc.).

Mild Hypertension (Diattolic <90mm)

Salt restricted diet. Avoid extra salt and pickles. Salt in cooking may be lowed. If possible, Low sodium salt should be used.

Low fat diet. Avoid Oil, Ghee, deep fried foods i.e less of saturated fats.

Reduce weight, if overweight, by regular exercise.

Regularise working hours and sleep for 8 hours. Yoga for relaxation of mind is helpful. Daily aerobic exercises.

Tab. ALPRAZOLAM 0.25mg HX x 10 days.

Check B.P. every week.

If not controlled.

Tab. ATEN 25mg 1daily.

Moderate Hypertension (Diastlolic >90mm)

Start with beta-blocker (or calcium channel blocker or ACE inhibitors) e.g

Tab. ATENol 50mg. 1-2 daily (avoid if bronchospasm)

Tab. Lopressor (beta blocker) 50 to 100mg. daily

Cap. DEPIN (NifeDEPIN) 10mg. OD to tds.

Tab. ENVAS (ACE Inhibitor) 2.5mg to 10mg. OD. Drug of choice.

If not controlled

Combine 2 drugs e.g beta blocker + ca blocker or ACE inhibitor + betablocker etc. or add Nepresol 1 bd (Dihydrallazin) or add ARKAMIN 1 tds.

Add a Diuretic (6B)

Tab. Dytide ½ 1 OD. Or

Tab. LASILACTONE ½ -1 OD.

Tab. ESIDREX 1 OD.

Stop salt intake completely even the salt in cooking.

Bed rest if necessary, hospitalize.

Refer to aphysician for advise and investigations if above measures fail to control the B.P.

Check the following regularly

B.P every month. (more frequently if fluctuating)

S. Cholestrol and Blood sugar – every year.

X-ray chest and ECG – for baseline readings.

If severe, uncontrolled Hypertension is seen in younger patients (below 30 years). Refer the patient to a physicion or nephrologists to investigate for Renal hypertension.

It is the general practioner’s duty to see that the patient takes th drugs regularly and keep B.P under control. Many patients believe that if they have no headache, then BP is under control, and take tablets only when symptomatic! Urge to take tablets regularly.

If the patient is asthamatic, do not give Beta-blockers. And if a patient on anti-hypertensives, complains of chronic mild cough, check whether he is receiving Beta-blocker.

Keep sublingual NifeDEPIN at hand for Hypertensive emergencies.

If BP is above 200mm systolic or 120mm diastolic:

Give DEPIN 10mg. Sublingually.

Bed rest.

If not lowered with 10 to 15 minutes repeat DEPIN Sublingual and refer to a physician.

Diet for Hypertnesion

Low salt diet

Total salt intake should not exceed 2 ½ gms per day.

No extra salt should be taken during meals.

Use Losalt, where salt is essential.

Avoid salt rich foods-pickels, papads, sauce, cheese, salted butter, salted biscuits, wafers, popcorns, salted peanuts/ cashews, salted butter milk.

Take potassium rich foods like grapes/ mosumbi.

Low Fat diet.

Avoid saturated oils – coconut oil, dalda, butter, ghee, cream.

Use monosaturated oils like- olive oil, mohair oil or polyunsaturated oils like- sunflower, corn, karadi (safflower oil)

Avoid all deep fried foods, unskimmed milk, meat.

Increase fibre intake i.e leafy vegetacles, salads, fruits, pulses and legumes.

Use skimmed or double tonned low fat milk.

Be very strict about low fat diet, if S. cholesterol is high, or lipid profile is abnormal , or if I.H.D, is associated.

Tab. Nepresol

Tab. Dytide