--高血压英文PPT精品课件Renovascular
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【高血压英文PPT精品课件】 cardiovascular disease (CVD)
Adhesion Molecules
Monocyte
Vessel Lumen LDL
Endothelium
LDL
ห้องสมุดไป่ตู้
Cytokines
Oxidized LDL
Macrophage
Intima
Macrophages take up modified LDL
Monocyte
Adhesion Molecules
Different from arteriosclerosis (hardening of the arteries), which is due to calcification of the arterial wall.
Oxidized LDL Induces leukocyte “homing”
Etiology
• Mutations in the gene coding for LDL receptors
Protein synthesis, expost and import
Ways to get proteins into organelles or membranes
Co-translational import
Genetic factors are prevalent (like in familial hypercholesterolemia)
Familial Hypercholesterolemia
Incidence: 1 in 500 The most common known form of genetic disease Results in
Atherosclerosis: A disease of large and mediumsized arteries that results in progressive accumulation of smooth muscle cells and lipids within the intima. Typically kills by inducing myocardial infarction
高血压英文PPT精品课件Antihypertensive
• Diagnosis is generally based on repeated, reproducible measurements of elevated blood pressure and not on patient symptoms. Patient compliance is a major obstacle to therapy
Kidney
Na loss
Thiazides
Summary of Long Term Renal Control of BP
Regulates BP by Changing:
1.
Directly – by allowing more or less fluid to enter kidney tubules
• Pakistan (NHSP):the prevalence of hypertension is 17.9%
• 24% of the USA adult population representing 43,186,000 persons had hypertension.
Diagnosis
CNS
BV
Na retention Clonidine
CO
Venous tone
NE release
Sympathetic tone
TPR
Arteriolar tone
dry mouth sexual dysfunction
The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy.
Kidney
Na loss
Thiazides
Summary of Long Term Renal Control of BP
Regulates BP by Changing:
1.
Directly – by allowing more or less fluid to enter kidney tubules
• Pakistan (NHSP):the prevalence of hypertension is 17.9%
• 24% of the USA adult population representing 43,186,000 persons had hypertension.
Diagnosis
CNS
BV
Na retention Clonidine
CO
Venous tone
NE release
Sympathetic tone
TPR
Arteriolar tone
dry mouth sexual dysfunction
The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy.
--高血压英文PPT精品课件CORONARY
Effects of coronary artery disease: •Fatal cardiac arrhythmia. •Myocardial infarction. •Myocardial fibrosis.
Postmortem findings: •coronary atheroma. •areas of myocardial fibrosis. •rarely, areas of recent infarcts.
dissections is a rare condition,
mostly occurring in females particularly in the peripartum period. Usually presenting as
Cross photograph of ruptured aneurysm of right coronary artery and
Sites of coronary artery occlusion: •First 2 cm of the left anterior descending coronary artery. •Right coronary artery. •Circumflex coronary artery.
with atheroma. • Coronary artery spasm. • Dissecting coronary aneurysm. • Myocardial bridging.
ATHEROMA
• A fatty deposit in the intima (inner lining) of an artery, resulting from atherosclerosis.
surபைடு நூலகம்ounding hemorrhage.
Postmortem findings: •coronary atheroma. •areas of myocardial fibrosis. •rarely, areas of recent infarcts.
dissections is a rare condition,
mostly occurring in females particularly in the peripartum period. Usually presenting as
Cross photograph of ruptured aneurysm of right coronary artery and
Sites of coronary artery occlusion: •First 2 cm of the left anterior descending coronary artery. •Right coronary artery. •Circumflex coronary artery.
with atheroma. • Coronary artery spasm. • Dissecting coronary aneurysm. • Myocardial bridging.
ATHEROMA
• A fatty deposit in the intima (inner lining) of an artery, resulting from atherosclerosis.
surபைடு நூலகம்ounding hemorrhage.
--高血压英文PPT精品课件_5
Hypertension is often symptom less, so screening is vital - before damage is done. Many surveys continue to show that hypertension remains under diagnosed, undertreated and poorly controlled in the UK
Approximately 25% are due to Reno vascular disease - most frequently atheromatous (e.g. elderly cigarette smokers with peripheral vascular disease) or fibromuscular dysplasia (more common in younger females). Endocrine disease
Secondary hypertension 5% Underlying cause
Causes of Secondary Hypertension
Renal disease
Approximately 75% are from intrinsic renal disease: glomerulonephritis, polyarteritis nodosa, systemic sclerosis, chronic pyelonephritis, or polycystic kidneys.
Hypertension, Introduction.
Hypertension is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for stroke (ischemic and haemorrhagic), myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension may result in vascular and renal damage that can culminate in a treatment-resistant state.
Approximately 25% are due to Reno vascular disease - most frequently atheromatous (e.g. elderly cigarette smokers with peripheral vascular disease) or fibromuscular dysplasia (more common in younger females). Endocrine disease
Secondary hypertension 5% Underlying cause
Causes of Secondary Hypertension
Renal disease
Approximately 75% are from intrinsic renal disease: glomerulonephritis, polyarteritis nodosa, systemic sclerosis, chronic pyelonephritis, or polycystic kidneys.
Hypertension, Introduction.
Hypertension is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for stroke (ischemic and haemorrhagic), myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension may result in vascular and renal damage that can culminate in a treatment-resistant state.
高血压(英文版) ppt课件
Hypertension
Introduction
Hypertension is a major public health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular disease.
<90
130140-159 140-149
Epidemiology
Prevalence rate ( 患 病 率 ) China: In 1959, In 1979, 5.11% 7.73% of hypertension in
In 1991,
11.88%
The prevalence of high BP increases with age. Hypertension is more common in men than in women up to age 50, after that age, hypertension is more common in women. Hypertension is more common in northern China than in southern China.
For instance:
21/3 1st visit: 146/98mmHg, 150/98mmHg 23/3 2nd visit: 128/84, 126/80
27/3 3rd visit: 130/80, 130/82
Notes(continue)
4. Optimal BP with respect to cardiovascular risk is less than 120/80 mmHg. However, unusually low readings should be evaluated for clinical significance. For example, 70/50 mmHg is less than 120/80 mmHg, but it is not optimal.
Introduction
Hypertension is a major public health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular disease.
<90
130140-159 140-149
Epidemiology
Prevalence rate ( 患 病 率 ) China: In 1959, In 1979, 5.11% 7.73% of hypertension in
In 1991,
11.88%
The prevalence of high BP increases with age. Hypertension is more common in men than in women up to age 50, after that age, hypertension is more common in women. Hypertension is more common in northern China than in southern China.
For instance:
21/3 1st visit: 146/98mmHg, 150/98mmHg 23/3 2nd visit: 128/84, 126/80
27/3 3rd visit: 130/80, 130/82
Notes(continue)
4. Optimal BP with respect to cardiovascular risk is less than 120/80 mmHg. However, unusually low readings should be evaluated for clinical significance. For example, 70/50 mmHg is less than 120/80 mmHg, but it is not optimal.
高血压英文PPT精品课件Cerebrovascular
deficit that has a sudden onset, lasts more than 24 hours, and results from cerebrovascular disease.
A stroke occurs when there is a disruption
of blood flow to a region of the brain.
Dysphasia: difficulty in speaking and putting words into the correTATIONS
A stroke is usually characterized by the sudden onset of focal neurological impairment.
About one-fourth of strokes are hemorrhagic, resulting from hypertensive vascular disease (which causes an intracerebral hemorrhage), a ruptured aneurysm, or an arteriovenous malformation.
Risk factors for stroke include smoking, hypertension, obesity, cardiac disease, hypercholesterolemia, diabetes, and use of birth control pills.
Prevention efforts focus on lifestyle changes that can modify risk factors.
PATHOPHYSIOLOGY
A stroke occurs when there is a disruption
of blood flow to a region of the brain.
Dysphasia: difficulty in speaking and putting words into the correTATIONS
A stroke is usually characterized by the sudden onset of focal neurological impairment.
About one-fourth of strokes are hemorrhagic, resulting from hypertensive vascular disease (which causes an intracerebral hemorrhage), a ruptured aneurysm, or an arteriovenous malformation.
Risk factors for stroke include smoking, hypertension, obesity, cardiac disease, hypercholesterolemia, diabetes, and use of birth control pills.
Prevention efforts focus on lifestyle changes that can modify risk factors.
PATHOPHYSIOLOGY
《高血压英语》课件
了解高血压可能导致的一些严重健康问题,如心脏病、中风和肾脏问题。
预防与治疗
饮食
了解如何通过健康的饮食来预防和管理高血压。
减肥
了解如何通过控制体重来降低高血压的风险。
运动
探索适合高血压患者的运动方式,以维持健康。
药物治疗
介绍高血压的常用药物和治疗选项。
与高血压相关的英语词汇
1 血压
了解血压的定义和测量方 式。
2 心脏
探索心脏的结构和功能, 以及它与高血压之间的关 系。
ห้องสมุดไป่ตู้
3 动脉
了解动脉的作用和与高血 压的相关性。
4 血管
了解血管的结构和功能,以及其在高血压中 的角色。
5 测量血压的工具
介绍用于测量血压的不同工具和设备。
医生的面诊
了解在与医生交流时使用的常见英语表达,如病症描述和治疗方案。
处理心理问题
1
《高血压英语》PPT课件
# 高血压英语PPT课件 探索高血压的定义,症状和风险。了解如何预防和治疗高血压以及相关的英 语词汇。
什么是高血压?
高血压是一种常见的健康问题,也称为高血压。了解什么是高血压以及它对 身体的影响。
高血压的症状
探索高血压可能引起的一些常见症状,如头痛、头晕和呼吸困难。
高血压的风险
被诊断出患有高血压的心理反应
了解当你被诊断出患有高血压时可能出现的心理反应。
2
减轻心理负担的方法
探索如何通过积极的心理策略来减轻与高血压相关的心理负担。
3
支持小组
介绍参加支持小组的好处,并了解如何加入。
总结
高血压的关键知识点
简要回顾高血压的关键知识点, 以加强理解。
处理高血压的英语技能
预防与治疗
饮食
了解如何通过健康的饮食来预防和管理高血压。
减肥
了解如何通过控制体重来降低高血压的风险。
运动
探索适合高血压患者的运动方式,以维持健康。
药物治疗
介绍高血压的常用药物和治疗选项。
与高血压相关的英语词汇
1 血压
了解血压的定义和测量方 式。
2 心脏
探索心脏的结构和功能, 以及它与高血压之间的关 系。
ห้องสมุดไป่ตู้
3 动脉
了解动脉的作用和与高血 压的相关性。
4 血管
了解血管的结构和功能,以及其在高血压中 的角色。
5 测量血压的工具
介绍用于测量血压的不同工具和设备。
医生的面诊
了解在与医生交流时使用的常见英语表达,如病症描述和治疗方案。
处理心理问题
1
《高血压英语》PPT课件
# 高血压英语PPT课件 探索高血压的定义,症状和风险。了解如何预防和治疗高血压以及相关的英 语词汇。
什么是高血压?
高血压是一种常见的健康问题,也称为高血压。了解什么是高血压以及它对 身体的影响。
高血压的症状
探索高血压可能引起的一些常见症状,如头痛、头晕和呼吸困难。
高血压的风险
被诊断出患有高血压的心理反应
了解当你被诊断出患有高血压时可能出现的心理反应。
2
减轻心理负担的方法
探索如何通过积极的心理策略来减轻与高血压相关的心理负担。
3
支持小组
介绍参加支持小组的好处,并了解如何加入。
总结
高血压的关键知识点
简要回顾高血压的关键知识点, 以加强理解。
处理高血压的英语技能
高血压(英文版) ppt课件
arteriole structure Compliance of Vessel wall
ppt课件 6
Psychological factors Renin –angiotensin aldosterone system(RAAS) Sodium and hypertension Abnormality of vascular endothelium(ET,NO, AngII, PGI2, etc) Insulin resistance revascularization other(obesity,smoking,drinking,hypocalcium, hypomagnesium, hypopotassium)
Heart failure Systolic hypertension 长效) Diabetes, proteinuria Renal insufficiency(mild) Myocardial infarction ACEI Stable angina Disorder of lipid pregnancy Prostate proliferation
ppt课件
12
Risk factor of cardiovascular disease
male > 55, female> 65 smoking Total cholesterol> 5.72mmol/L (250mg/dl) diabetes Early cardiovascular family history(early onset of CV disease male<55;female <65)
Diuretics ß–blocker a-blocker Calcium channel blocker ACE inhibitor Angiotensin II receptor blocker compound anti-hypertensive agents
高血压(英文版) ppt课件
Etiology and pathogenesis of EH
No
cause can be established Possible mechanisms Genetic tendency
Spontaneous hypertension rat EH tends to cluster in families
Classification of Blood Pressure Levels (mmHg)
Category Systolic Diastolic Hypotension??? <60 Optimal <120 <80 Normal <130 <85 High-normal 139 85-89 Grade 1 hypertension(mild) 90-99 Subgroup: borderline 90-94
Optional investigations
Plasma renin( 肾 素 ) activity & aldosterone (醛固酮), urinary VMA(香草杏仁酸),to identify secondary hypertension Echocardiography, to detect ventricular hypertrophy Vascular ultrasonography should be performed if arterial disease is suspected. Renal ultrasonography should be performed if renal disease is suspected.
perhaps by catecholamines儿茶酚胺
高血压英文PPT精品课件HYPERTENSIONDIABETESADANGEROUS
IL- 6, TNF- @, and RAS
liver(NASH)
(↑CRP) (Endothelial
Dysfunction)
• ↑Small, dense LDL • ↑triglyceridemia
Atherosclosis
Activation • ↓HDL
Reduced • Hypertension
Renal Na+ Reabsorption
Hypertension
Cardiometabolic Syndrome:
Large
(Insulin resistant) ( ↑Central Fat)
Fat Cells
(Fatty
Visceral Obesity
Enhanced
Lipolysis > FreeFA
Millions of Cases
60 50 40 30 20 10
0
India
China
1995 2025
US
Data from King H et al. Diabetes Care. 1998;21:1414-1431.
CV Mortality Risk Doubles with Each 20/10 mm Hg BP Increment*
<200 mg/dL (5.18 mmol/L)
Vascular Disease Risk Factors
Saydah SH et al. JAMA. 2004;291:335-342.
Metabolic Syndrome: NCEP/ATP III Definition
Presence of at least 3 of 5 risk factors: Abdominal obesity Elevated blood pressure Elevated fasting glucose Elevated triglycerides Low HDL-C
liver(NASH)
(↑CRP) (Endothelial
Dysfunction)
• ↑Small, dense LDL • ↑triglyceridemia
Atherosclosis
Activation • ↓HDL
Reduced • Hypertension
Renal Na+ Reabsorption
Hypertension
Cardiometabolic Syndrome:
Large
(Insulin resistant) ( ↑Central Fat)
Fat Cells
(Fatty
Visceral Obesity
Enhanced
Lipolysis > FreeFA
Millions of Cases
60 50 40 30 20 10
0
India
China
1995 2025
US
Data from King H et al. Diabetes Care. 1998;21:1414-1431.
CV Mortality Risk Doubles with Each 20/10 mm Hg BP Increment*
<200 mg/dL (5.18 mmol/L)
Vascular Disease Risk Factors
Saydah SH et al. JAMA. 2004;291:335-342.
Metabolic Syndrome: NCEP/ATP III Definition
Presence of at least 3 of 5 risk factors: Abdominal obesity Elevated blood pressure Elevated fasting glucose Elevated triglycerides Low HDL-C
高血压英语PPTPPT课件
Blood pressure readings of 180/110 mmHg or higher
Headache
Vision changes
Shortness of Breath
Fatigue
Dizziness
Chest pain or discomfort
01
02
03
04
05
06
Symptoms of Hypertension
Mental stress
Sleep quality
Chronic stress
03
The HAZARDS of Hypertension
Increased risk of heart disease
High blood pressure can damage the heart muscle, leading to heart disease
Hypertension English PPT courseware
contents
目录
Introduction to Hypertension The causes of hypertension The HAZARDS of Hypertension Diagnosis and prevention of hypertension
Diagnostic method
ቤተ መጻሕፍቲ ባይዱ
Preventive measure
Healthy die: A balanced die rich in fruits, vegetables, whole grains, and lean protein can help reduce blood pressure Limiting salt and reducing intake of saturated fat and trans fat are also important
Headache
Vision changes
Shortness of Breath
Fatigue
Dizziness
Chest pain or discomfort
01
02
03
04
05
06
Symptoms of Hypertension
Mental stress
Sleep quality
Chronic stress
03
The HAZARDS of Hypertension
Increased risk of heart disease
High blood pressure can damage the heart muscle, leading to heart disease
Hypertension English PPT courseware
contents
目录
Introduction to Hypertension The causes of hypertension The HAZARDS of Hypertension Diagnosis and prevention of hypertension
Diagnostic method
ቤተ መጻሕፍቲ ባይዱ
Preventive measure
Healthy die: A balanced die rich in fruits, vegetables, whole grains, and lean protein can help reduce blood pressure Limiting salt and reducing intake of saturated fat and trans fat are also important
高血压英文PPT精品课件Diseasesofthe
• CAD • Almost all from atherosclerotic narrowing
or complete obstruction • Depending on the degree & character of
the obstruction
– angina pectoris – MI – sudden cardiac death – chronic ischemic heart disease with CHF
Diseases of the Heart
Major Determinants of Disease
• Most heart disease is the result of atherosclerotic obstruction of the coronary arteries
• Congestive heart failure is mechanical failure of the heart to eject blood delivered to it
• Premature ventricular contractions
– occur in healthy people – chest palpitations & anxiety
• Ventricular tachycardia
– spontaneous, regular beating at > 120 beats/min
• Each year heart disease accounts for about 1/3 of deaths in the US, most of which are associated with coronary artery atherosclerosis. If cerebrovascular disease, vascular complications of diabetes, & other vascular diseases are included, the figure is over 40%. After age 40 the lifetime risk for developing symptomatic coronary artery disease is 50% in men & 40% in women.
or complete obstruction • Depending on the degree & character of
the obstruction
– angina pectoris – MI – sudden cardiac death – chronic ischemic heart disease with CHF
Diseases of the Heart
Major Determinants of Disease
• Most heart disease is the result of atherosclerotic obstruction of the coronary arteries
• Congestive heart failure is mechanical failure of the heart to eject blood delivered to it
• Premature ventricular contractions
– occur in healthy people – chest palpitations & anxiety
• Ventricular tachycardia
– spontaneous, regular beating at > 120 beats/min
• Each year heart disease accounts for about 1/3 of deaths in the US, most of which are associated with coronary artery atherosclerosis. If cerebrovascular disease, vascular complications of diabetes, & other vascular diseases are included, the figure is over 40%. After age 40 the lifetime risk for developing symptomatic coronary artery disease is 50% in men & 40% in women.
【高血压英文PPT精品课件】 Hypertension and Peripheral Vascular Disease
Small number curable with surgery
Hypertension Pathology
Increased BP inflammation, sclerosis of arteriolar walls narrowing of vessels decreased blood flow to major organs Left ventricular overwork hypertrophy, CHF Nephrosclerosis renal insufficiency, failure
20% of adult population • ~35,000,000 people 25% do not know they are hypertensive Twice as frequent in blacks than in whites 25% of whites and 50% of blacks > 65 y/o
Types
Primary (essential) hypertension Secondary hypertension
Primary Hypertension
85 - 90% of hypertensives Idiopathic More common in blacks or with positive family history Worsened by increased sodium intake, stress, obesity, oral contraceptive use, or tobacco use Cannot be cured
• Commonly used prehospital when targeting BP lowering only especially in AMI
Hypertension Pathology
Increased BP inflammation, sclerosis of arteriolar walls narrowing of vessels decreased blood flow to major organs Left ventricular overwork hypertrophy, CHF Nephrosclerosis renal insufficiency, failure
20% of adult population • ~35,000,000 people 25% do not know they are hypertensive Twice as frequent in blacks than in whites 25% of whites and 50% of blacks > 65 y/o
Types
Primary (essential) hypertension Secondary hypertension
Primary Hypertension
85 - 90% of hypertensives Idiopathic More common in blacks or with positive family history Worsened by increased sodium intake, stress, obesity, oral contraceptive use, or tobacco use Cannot be cured
• Commonly used prehospital when targeting BP lowering only especially in AMI
高血压英文PPT精品课件_3
BPLTTC Meta-analysis: Stroke and CHD
Relative Risk of Stroke Relative Risk of CHD
Stroke
1.50
CHD
1.50
1.25
1.25
1.00
1.00
0.75
0.75
0.50
0.50
0.25
0.25
-10 -8 -6 -4 -2 0 2 4
2 mm Hg decrease in mean SBP
7% reduction in risk of CHD mortality
10% reduction in risk of stroke mortality
Prospective Studies Collaboration. Lancet. 2002;360:1903-1913.
No Compelling Indications
Stage 1 140-159/90-99 Diuretics for most;
consider ACEI, ARB, B, CCB
Stage 2 BP 160/100 2-drug combo for
most (diuretic + ACEI, or ARB, or BB, or CCB)
What Is Hypertension?
JNC 7 Definitions
Blood Pressure (mm Hg)
Systolic
Diastolic
<120
and <80
120-139
or 80-89
140-159
or 90-99
≥160
高血压英文PPT精品课件Cardiovascular
Myocarditis Morphology
• Gross –dilated, flabby heart, pale patches with hemorrhage
• Microscopic – interstitial inflammatory infiltrate with myocyte necrosis, fibrosis
– Dilated Cardiomyopathy – Hypertrophic Cardiomyopathy – Restrictive Cardiomyopathy
Congestive Heart Failure
• Cardiac output insufficient for metabolic requirements of the body
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy – myofiber dysarray – not all fibers are pulling the same direction. Thus the contraction is ineffective. However, the cardiac conduction system can have these same problems, which might cause the arrhythmias and sudden death these patients tend to die of.
Cardiomyopathies
Dilated Cardiomyopathy
高血压英文PPT精品课件CardiovascularDiseasePreventive
Acceptable methods of treatment must be available for the condition (YES).
The condition must have an asymptomatic period during which detection and treatment significantly reduce morbidity or mortality (YES).
CAD screening and EKG (4)
Stress testing (EKG only) more sensitive and specific than resting EKG, but many false + (not specific enough Still, only 1-11% w/ abnormalities suffered
Atherosclerotic Vascular Disease
Risk Factors, Screening to Prevent
Athertery disease (CAD) Cerebrovascular disease CVD) Peripheral vascular disease (PVD) Reno-vascular dis. and renal failure (CRF) >> hypertension
Obesity, diabetes, hypertension and dyslipidemia
80%-90% of type II diabetics are obese Prevalence of obesity and of diabetes type II have risen in parallel since 1980. 33% increase in prevalence of D/M between 1990 and 1998
The condition must have an asymptomatic period during which detection and treatment significantly reduce morbidity or mortality (YES).
CAD screening and EKG (4)
Stress testing (EKG only) more sensitive and specific than resting EKG, but many false + (not specific enough Still, only 1-11% w/ abnormalities suffered
Atherosclerotic Vascular Disease
Risk Factors, Screening to Prevent
Athertery disease (CAD) Cerebrovascular disease CVD) Peripheral vascular disease (PVD) Reno-vascular dis. and renal failure (CRF) >> hypertension
Obesity, diabetes, hypertension and dyslipidemia
80%-90% of type II diabetics are obese Prevalence of obesity and of diabetes type II have risen in parallel since 1980. 33% increase in prevalence of D/M between 1990 and 1998
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– The overall prevalence rate of RVD (>60% stenosis) was 6.8%, which would represent 2.4 million affected individuals in the U.S.
– Those variables independently associated with the presence of RVD were increasing age (OR 1.87), increasing systolic blood pressure (OR 1.44) and HDL <40 (OR 2.63).
Etiology
Atherosclerosis (ARAS) – 70-90% of cases
– Usually involves the ostium and/or proximal third of the main renal artery, with non-ostial lesions comprising only 15-20% of cases
– 834 patients consecutive patients who were participants in the Forsyth county cohort of the Cardiovascular Health Study underwent RAD. The Cardiovascular Health Study is a longitudinal cohort study of cardiovascular disease risk factors among adults >65 y/o.
Fibromuscular dysplasia (FMD) – 10-20% Renal thromboembolic disease Renal atheroembolic disease Aortorenal dissection Vasculitis involving the renal artery (i.e. PAN) AVMs involving the renal artery Nephroangiosclerosis (hypertensive injury) Trauma Irradiation of the renal artery Scleroderma
Follow up serum creatinine level in patients with normal renal function at baseline, categorized according to progression of arterial stenosis
Prevalance of ARAS
An overlooked clinical entity?
Hansen et al in September 2002 published the first population based study estimating the prevalence of RAS:
Natural History
Crowley et al
Largest cohort of patients evaluating the progression of ARAS (1,189). Mean follow up was 2.6 yrs The incidence of significant stenosis (>50%) at baseline was 6.3%
Natural History
Crowley et al. cont.
Disease progression was associated with a decline in renal function.
– patients in whom stenosis progressed from normal to >75% showed a significant rise in serum creatinine compared with those with less significant progression.
Naturalቤተ መጻሕፍቲ ባይዱHistory
Major Points
ARAS is a progressive disease ARAS has been shown to be associated with renal insufficiency Patients with IRD that progress to ESRD has a dismal prognosis
Renovascular Disease
Michael Shomaker, MD January 7, 2003
Goals
Define those at risk for RAS and who should be screened Review the pathophysiology, clinical features, and natural history of RAS and how this effects therapeutic decisions Provide a brief overview of the different diagnostic tests and their performance profiles Critically review the literature as it pertains to the different treatment options Provide house staff with an evidence-based, practical algorithm for the evaluation and treatment of RAS at Wake Forest Attempt to persuade Al Hadley from inundating the housestaff with Duke basketball scores each day at morning report
– Those variables independently associated with the presence of RVD were increasing age (OR 1.87), increasing systolic blood pressure (OR 1.44) and HDL <40 (OR 2.63).
Etiology
Atherosclerosis (ARAS) – 70-90% of cases
– Usually involves the ostium and/or proximal third of the main renal artery, with non-ostial lesions comprising only 15-20% of cases
– 834 patients consecutive patients who were participants in the Forsyth county cohort of the Cardiovascular Health Study underwent RAD. The Cardiovascular Health Study is a longitudinal cohort study of cardiovascular disease risk factors among adults >65 y/o.
Fibromuscular dysplasia (FMD) – 10-20% Renal thromboembolic disease Renal atheroembolic disease Aortorenal dissection Vasculitis involving the renal artery (i.e. PAN) AVMs involving the renal artery Nephroangiosclerosis (hypertensive injury) Trauma Irradiation of the renal artery Scleroderma
Follow up serum creatinine level in patients with normal renal function at baseline, categorized according to progression of arterial stenosis
Prevalance of ARAS
An overlooked clinical entity?
Hansen et al in September 2002 published the first population based study estimating the prevalence of RAS:
Natural History
Crowley et al
Largest cohort of patients evaluating the progression of ARAS (1,189). Mean follow up was 2.6 yrs The incidence of significant stenosis (>50%) at baseline was 6.3%
Natural History
Crowley et al. cont.
Disease progression was associated with a decline in renal function.
– patients in whom stenosis progressed from normal to >75% showed a significant rise in serum creatinine compared with those with less significant progression.
Naturalቤተ መጻሕፍቲ ባይዱHistory
Major Points
ARAS is a progressive disease ARAS has been shown to be associated with renal insufficiency Patients with IRD that progress to ESRD has a dismal prognosis
Renovascular Disease
Michael Shomaker, MD January 7, 2003
Goals
Define those at risk for RAS and who should be screened Review the pathophysiology, clinical features, and natural history of RAS and how this effects therapeutic decisions Provide a brief overview of the different diagnostic tests and their performance profiles Critically review the literature as it pertains to the different treatment options Provide house staff with an evidence-based, practical algorithm for the evaluation and treatment of RAS at Wake Forest Attempt to persuade Al Hadley from inundating the housestaff with Duke basketball scores each day at morning report