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高血压英文PPT精品课件AddressingDisparityinHealthandHealthCa
• must be eliminated!
Columbus Health Department
The journey to eliminate disparities …
Is an ongoing process – not a discrete event
Requires collaboration from many partners
ongoing basis ➢ Identifying and addressing problem areas
➢ Ongoing evaluation – process & outcomes
Columbus Health Department
Addressing the problem – Our Efforts …
Must be evaluated regularly to
– assure progress – assess impact – identify gaps, strengths & opportunities – celebrate successes
Columbus Health Department
Columbus Health Department
The Context and . . . the Mandate
Disparities in health status, health care and health outcomes:
• exist
• are unacceptable, and
sectors
》 Many sources may contribute:
- health systems - health care providers - patients - utilization managers
Columbus Health Department
The journey to eliminate disparities …
Is an ongoing process – not a discrete event
Requires collaboration from many partners
ongoing basis ➢ Identifying and addressing problem areas
➢ Ongoing evaluation – process & outcomes
Columbus Health Department
Addressing the problem – Our Efforts …
Must be evaluated regularly to
– assure progress – assess impact – identify gaps, strengths & opportunities – celebrate successes
Columbus Health Department
Columbus Health Department
The Context and . . . the Mandate
Disparities in health status, health care and health outcomes:
• exist
• are unacceptable, and
sectors
》 Many sources may contribute:
- health systems - health care providers - patients - utilization managers
--高血压英文PPT精品课件Renovascular
– 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
– 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
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ChronicDisease
216.6
145.4 HP 2010 Goal: 159.9 105.7
Black
Hispanic
Race/Ethnicity
Asian/Other
Note: All rates are adjusted to 2000 Standard U.S. Population. Source: California Death Statistical Master File; SANDAG January 1, Population Estimates.
Nutrition by Gender
Women
Healthcare Cost in California and San Diego
• $130 Billion spent (treatment and lost productivity) by California in 2003
• $4.3 Billion in SD County (not including
Year San Diego
*2006 U.S. data are preliminary
2004 U.S.
2005
2006*
San Diego County Population
by Race/Ethnicity, 2007
• 3 million people
• Racial/Ethnic groups from around the world.
What Is Chronic Disease?
• According the U.S. National Center for Health Statistics, is a disease that lasts 3 months or more.
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PPT精品课件HYPERTENSIONANDVASCULAR
Moderation of alcohol consumption
Hale Waihona Puke Limit consumption to no more than 2 drinks (1 oz or 30 mL ethanol; eg, 24 2–4 mm Hg oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day in most men and to no more than 1 drink per day in women and lighter-weight persons.
(elevated serum creatinine,
▪(2) Renovascular disease
abnormal urinalysis),
(abdominal bruits)
▪(3) APKD-autosomal dominant
polycystic kidney disease (abdominal or flank masses)
Prehypertension:
recheck in 1 year
2. Stage 1 hypertension: SBP 140–159 or DBP 90–99
Stage 1 hypertension:
confirm within 2 months
2 separate office visits)
▪(5) Primary hyperaldosteronism
(hypokalemia)
7
JNC VII 2003 recommendations
Normal: recheck in 2 years (see Comments)
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HYPERTENSIVE
GRADE 2 HTR
SEVERE GENERALIZED AND FOCAL ARTERIOLAR CONSTRICTION
A-V CROSSING CHANGES (SALUS SIGN)
GRADE 3 HTR
Copper wiring of arterioles Venous banking distal to A-V
the arterial & venous circulation
Green et al – Thrombus formation in the region of lamina cribrosa is the primary event
GRADE 4 HTR
All changes of grade 3
Silver wiring of arterioles
Disc edema
Ocular associations of hypertension
Retinal vein occlusion
• CRVO (Central Retinal Vein Occlusion)
crossing (bonnet’s sn) Venous tapering on either
side of crossing (gunn’s sn) Right angle deflection of
veins. Flame shaped hemorrhages
cotton wool spots, hard exudates.
• HRVO (Hemi Retinal Vein Occlusion)
• BRVO (Branch Retinal Vein Occlusion) Constitutes 69.5 % of all RVO cases
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
【高血压英文ppt课件】ValvularStenosis
代理报关委托书委托报关协议关于审 理城镇 房屋租 赁合同 纠纷案 件司法 解释有 关劳务 派遣制 度设计 及对劳 务派遣 行业的 影响分 析糖皮 质激素 在呼吸 系统疾 病中的 合理应 用严重 脓毒症 导致急 性肺损 伤病人 自发利 尿现象 的观察 分析
Question
Physical examination: BP 150/110 mmHg, pulse 120/min, respirations 24/min. Neck veins 10cm. Lungs have rales 3/4 the way up posteriorly bilaterally. Carotids are difficult to feel. PMI is in the 5th intercostal space just outside the midclavicular line and sustained. There is a grade II/VI systolic ejection murmur at the base and a grade II/VI diastolic blowing murmur at the 3rd left intercostal space. There is an S4 and an S3 gallop. There is no hepatomegaly and no pedal edema.
The pulses and BP are against severe aortic regurgitation. Although the patient probably has angina, and even may have coronary artery disease, the presence of the systolic murmur, the poor arterial pulses, the severe LVH on ECG make aortic stenosis the likely diagnosis. Although the BP was elevated when she was in severe failure due to the excessive sympathetic stimulation and activated renin angiotensin system, when the patient was treated the BP returned to normal, inconsistent with acute heart failure due to hypertensive disease.
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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.
Cushing’s syndrome, Conn's syndrome, pheochromocytoma, acromegaly, Hyperparathyroidism Others
The risk associated with increasing blood pressure is continuous, with each 2 mmHg rise in systolic blood pressure associated with a 7% increased risk of mortality from ischemic heart disease and a 10% increased risk of mortality from stroke.
The clinical management of hypertension is one of the most common 22 interventions in primary care, accounting for approximately £1 billion in drug costs alone in 2006.
Hypertension, Introduction
In many countries, 50% of the population older than 60 years has hypertension. Overall, approximately 20% of the world’s adults are estimated to have hypertension.
UK, 1 in every 4th person has Hypertension and this increases to 1 in every second person aged over 60.
Types of hypertension
Essential hypertension (Primary) 90% No underlying cause
Hypertension-Overview
Hypertension itself-Introduction Types Classification Risk Factors Sequels Hypertension in special circumstances Management Follow Up Guidelines Referral to Secondary care
Hypertension, Introduction.
Diastolic pressure is more commonly elevatelic hypertension becomes a more significant problem.
Hypertension
Dr Zaka Haq, MBBS, MRCP Cardiology Registrar Queens Hospital Romford
Hypertension
Prevalence (UK) NICE Beta Blockers
Challenges Primary Care
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.
Cushing’s syndrome, Conn's syndrome, pheochromocytoma, acromegaly, Hyperparathyroidism Others
The risk associated with increasing blood pressure is continuous, with each 2 mmHg rise in systolic blood pressure associated with a 7% increased risk of mortality from ischemic heart disease and a 10% increased risk of mortality from stroke.
The clinical management of hypertension is one of the most common 22 interventions in primary care, accounting for approximately £1 billion in drug costs alone in 2006.
Hypertension, Introduction
In many countries, 50% of the population older than 60 years has hypertension. Overall, approximately 20% of the world’s adults are estimated to have hypertension.
UK, 1 in every 4th person has Hypertension and this increases to 1 in every second person aged over 60.
Types of hypertension
Essential hypertension (Primary) 90% No underlying cause
Hypertension-Overview
Hypertension itself-Introduction Types Classification Risk Factors Sequels Hypertension in special circumstances Management Follow Up Guidelines Referral to Secondary care
Hypertension, Introduction.
Diastolic pressure is more commonly elevatelic hypertension becomes a more significant problem.
Hypertension
Dr Zaka Haq, MBBS, MRCP Cardiology Registrar Queens Hospital Romford
Hypertension
Prevalence (UK) NICE Beta Blockers
Challenges Primary Care