【高血压精品英文课件】Hypertension in CKD
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英文疾病介绍——Hypertension(高血压病)ppt课件
② Secondary Hypertension: High blood pressure that is caused by another medical condition(医疗条件) or medication(药物).
➢Primary or Essential Hypertension
Benign Hypertension
Prevention
➢ Adults over 18 should have their blood pressure checked regularly. ➢ Lifestyle changes may help control your blood pressure. • Exercise often. • Eat foods low in salt. • Lose weight or keep weight at a healthy level. • Do not smoke. • Limit alcohol.
sign
but below 140/90
It is called
Pre-hypertension 高血压前期
Danger Zone
systolic blood pressure≥140 diastolic blood pressure ≥90
Lead to Either of them
英文疾病介绍——Hypertension(高血压病)
In fact, one in five people with the condition don‘t know they have it. Internally([ɪnˈtɜ:nəlɪ],在体内地), it can quietly damage the heart, lungs, blood ve英ss文e疾l病s,介b绍r—a—inH,ypaerntednsiokni(d高n血e压y病s) if left untreated. It’s a major risk factor for strokes(中风/脑卒中) and heart attacks(心脏病).
【高血压精品英文课件】Hypertension and Kidney
RENAL SCARRING
MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE
HYPERTENSION HYPERLIPIDEMIA SMOKING FAMILY HISTORY
Байду номын сангаас
OBESITY
DIABETES
CHRONIC KIDNEY DISEASE
PHYSICAL INACTIVITY
of endovascular health
Miettinen H et al, Stroke 27:2033, 1996
Prevalence of HTN in CKD
80% of patients with glomerulonephritis and 30% of patients with chronic interstitial disease are hypertensive.
Hypertension and renal function
%
90 80 70 60 50 40 30 20 10
0 stage 1
stage 2
normal hypertension
stage 3 stage 4
1 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1
0
stage 1
Hypertension in CKD
Pathophysiology thought to be both pressor- and volumerelated, thus CKD patients respond to both vasodilators as well as diuretics/sodium restriction.
【高血压精品英文课件】高血压 Hypertension_
Pathophysiology
Hypertensive Emergency
Failure of normal autoregulatory function Leads to a sharp increase in systemic
vascular resistance Endovascular injury with arteriole necrosis Ischemia, platelet deposition and release of
Epidemiology
Hypertensive Emergency
Estimates are that about 1% of those with hypertension will present with hypertensive emergency each year
That is >500,000 Americans per year Correct and quick diagnosis and
Risk Factors
If >50, systolic BP > 140 is a more concerning risk factor for cardiovascular disease than diastolic BP.
The risk of cardiovascular disease doubles for every increase in BP of 20/10 over 115/75.
140-159/90-99
Stage II HTN
>160/>100
(Severe HTN
>180/>110)
Severe HTN is not a JNC VII defined entityDefinitions
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.
英文疾病介绍——Hypertension(高血压病)PPT课件
Who is at risk?
➢Your chances of having high blood pressure are higher if you:
• Are overweight • Eat foods high in salt • Do not get regular exercise • Smoke • Drink alcohol heavily • Under Stress,anger,frightened or
Diagnosis
systolic blood
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Classification Of Hypertension
➢Hypertension
Essential Secondary Hypertension Hypertensio ①pr原im发ar性y o高r e血s压sennt继ial发性高血 hype（rte高n血sio压n:病h）igh blood压 pressu➢9rPer0im–war9yito5hr %Esnseontiaol bHyvpei5orte–un1ssio0n % underlying(潜在的,根本的) meBdeicnailgcnause. Malignant ②HSyepceorntednasriyoHn ypHeyrpteenrtseionnsi:on
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
【高血压精品英文课件】高血压 Hypertension
Pathophysiology
Hypertensive Emergency
Failure of normal autoregulatory function Leads to a sharp increase in systemic
vascular resistance Endovascular injury with arteriole necrosis Ischemia, platelet deposition and release of
Epidemiology
Why should we care about hypertension?
One of the most common chronic medical concerns in the US
Affects >30% of the population > age 20 Risk factor for
vasoactive substances Further loss of autoregulatory mechanism Exposes organs to increased pressure
Diagnosis and Recognition
Presentation
Always present with a new onset symptom
Take a good history
History of HTN and previous control Medications with dosage and compliance Illicit drug use, OTC drugs
Diagnosis and Recognition
Normal BP
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
英文疾病介绍——Hypertension(高血压病)ppt课件
Hypertension
英文疾病介绍——Hypertension(高血压病)
What Is Hypertension?
➢Hypertension (HTN) is a chronic medical condition in which the blood pressure in the arteries is elevated(提高的).
In fact, one in five people with the condition don‘t know they have it. Internally([ɪnˈtɜ:nəlɪ],在体内地), it can quietly damage the heart, lungs, blood ve英ss文e疾l病s,介b绍r—a—inH,ypaerntednsiokni(d高n血e压y病s) if left untreated. It’s a major risk factor for strokes(中风/脑卒中) and heart attacks(心脏病).
Who is at risk?
➢ Anyone can have high blood pressure. Some people are more likeressure including:
• African Americans(more sensitive to salt) • People over age 55 • People with a family history of high blood pressure
Malignant Hypertension
(Chronic Hypertension)
(Accelerated Hypertension)
英文疾病介绍——Hypertension(高血压病)
What Is Hypertension?
➢Hypertension (HTN) is a chronic medical condition in which the blood pressure in the arteries is elevated(提高的).
In fact, one in five people with the condition don‘t know they have it. Internally([ɪnˈtɜ:nəlɪ],在体内地), it can quietly damage the heart, lungs, blood ve英ss文e疾l病s,介b绍r—a—inH,ypaerntednsiokni(d高n血e压y病s) if left untreated. It’s a major risk factor for strokes(中风/脑卒中) and heart attacks(心脏病).
Who is at risk?
➢ Anyone can have high blood pressure. Some people are more likeressure including:
• African Americans(more sensitive to salt) • People over age 55 • People with a family history of high blood pressure
Malignant Hypertension
(Chronic Hypertension)
(Accelerated Hypertension)
hypertension高血压 全英语版 -ppt课件
hypertensio n高血压 全英 语版 -
What is Hypertension?
Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated.
Precaution
---Lifestyle
8.Be physically active.
Precaution
--- Check our blood pressure
>90 >130 Be careful!
Thanks
Signs And Symptoms
Most of the time, there are no symptoms. About one out of every 100 (1%) people with hypertension is diagnosed with severe high blood pressure (accelerated or malignant hypertension) at their first visit to the doctor.
Cause and Pathogenesis
Cause and Pathogenesis
Cause and Pathogenesis
---Inherited genetic factors
About half of patients have family history of hypertension, they were born to have higher risk to suffer hypertension.
What is Hypertension?
Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated.
Precaution
---Lifestyle
8.Be physically active.
Precaution
--- Check our blood pressure
>90 >130 Be careful!
Thanks
Signs And Symptoms
Most of the time, there are no symptoms. About one out of every 100 (1%) people with hypertension is diagnosed with severe high blood pressure (accelerated or malignant hypertension) at their first visit to the doctor.
Cause and Pathogenesis
Cause and Pathogenesis
Cause and Pathogenesis
---Inherited genetic factors
About half of patients have family history of hypertension, they were born to have higher risk to suffer hypertension.
高血压英文PPT精品课件HYPERTENSIVE
In Young ...
Protein C levels Protein S levels Platelet Analysis Sr. & Urine for Homocysteine levels
Others ...
Hb Electrophoresis PT / PTT Anti-Phospholipid antibody Complete Cardiovascular evaluation
Microaneurysyms Optociliary vessels – collaterals between retinal & ciliary
vessels
Cilioretinal artery occlusion
Combined with CRVO
Cilioretinal artery occlusion
• HRVO (Hemi Retinal Vein Occlusion)
• BRVO (Branch Retinal Vein Occlusion) Constitutes 69.5 % of all RVO cases
CRVO ...
Classic Appearance
Mildest Form
CRVO
Combined with anterior ischaemic optic neuropathy
HRVO ...
HRVO ...
Superior & Inferior vein do not merge into Central Vein before entering into lamina cribrosa
Traditional Rx Options ...
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Hypertensioninthe
Clinical Findings
• Of Complications/TOD
– Brain: H/A, N/V, meningism, FND, delirium, decreased LOC, seizures, coma
– Retina: blurred vision, papilledema (IV) +/- cotton wool exudate, flame shape hg, AV nipping and silver wiring (G I-III in chronic Htn)
Definitions: Hypertensive
Crisis (Severe Htn)
• Hypertensive Urgency:
– SBP >180 or DBP>110 w/o TOD
• Hypertensive Emergency (Malignant Htn):
– SBP >180 or DBP>110 (esp >120) or accelerated htn wt TOD – TODs: 1. Brain: Hypertensive encephalopathy/edema, ICH, ischemic
• In the last week, the headaches have become much more severe and frequent, occurring almost daily, and are accompanied by throbbing chest pain, sweating, dizziness and palpitations.
– Including microvascular thrombosis
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• Confirm 2 readings 5 minutes apart in both arms for initial diagnosis
• If taken in wrist or legs, the cuff must be at the level of the heart
BP Measurement
Home BP Monitoring
• Self readings or continuous ambulatory monitoring • Helpful adjunct to office readings • More readings in patients usual environment • Better correlated with cardiovascular outcomes • Improves patient compliance • Helps clarify symptoms • Defines masked and white coat hypertension
Home BP Monitoring
• Patients need to be taught proper methods
– No wrist cuffs – Semi-automated electronic cuffs
• Cuff needs to be checked against office readings
Hypertension in CKD
Michael J Casey, MD Wake Nephrology Associates
Hypertension Stats
• HTN affects approximately 1 billion worldwide • $500 billion in direct costs • Continuous, consistent and independent relationship
Prevalencen CKD
• 80% of patients with CKD have HBP • Most start with essential hypertension • As GFR decreases it is more dependent on
Ambulatory BP Monitoring
• More reproducible than office measurements
• Helpful in early diagnosis • Unexplained microalbuminuria or LVH • White Coat Hypertension • Resistant Hypertension • No long term studies yet
• Frequency of monitoring can vary • All current outcome data/guidelines/trails
are from office readings
Ambulatory BP Monitoring
Ambulatory BP Monitoring
Hypertension as Defined by JNC VII
• 120/80 - normal; “optimal” • 121-139/80-89 - “pre-hypertension”
– Controversial – More a health policy statement
• 140-160/90-100 - Stage 1 Hypertension • >160/100 - Stage 2 Hypertension
between BP and Cads • For those age 40-70, each increased increment of
20/10 mmHg in BP doubles the risk of CVD across the entire BP range of 115/75 to 185/115. • Only 35% of hypertensive patients on treatment are under control.
salt/water retention from decreased GFR • CKD patients also have derangements in the
Renin/Angiotensin/Aldosterone system
Treatment of Hypertension
• Goal depends on disease state
– <130/80 if DM, CKD, CVDz – <125/75 if CKD with proteinuria
• SBP is the issue in the old • Diastolic HBP is a problem of the young • Reaching the target is more important than
how you get there • Multiple interventions are necessary in most
Hypertensive Emergencies
• Hypertension is a chronic outpatient disease with rare acute side effects
Measurement of Blood Pressure
• Seated position with arm supported ideal • Allow patient to settle for several minutes • Proper sized cuff
– Bladder to encircle 80 – 100% arm – Bladder width 40-50% of arm
• If taken in wrist or legs, the cuff must be at the level of the heart
BP Measurement
Home BP Monitoring
• Self readings or continuous ambulatory monitoring • Helpful adjunct to office readings • More readings in patients usual environment • Better correlated with cardiovascular outcomes • Improves patient compliance • Helps clarify symptoms • Defines masked and white coat hypertension
Home BP Monitoring
• Patients need to be taught proper methods
– No wrist cuffs – Semi-automated electronic cuffs
• Cuff needs to be checked against office readings
Hypertension in CKD
Michael J Casey, MD Wake Nephrology Associates
Hypertension Stats
• HTN affects approximately 1 billion worldwide • $500 billion in direct costs • Continuous, consistent and independent relationship
Prevalencen CKD
• 80% of patients with CKD have HBP • Most start with essential hypertension • As GFR decreases it is more dependent on
Ambulatory BP Monitoring
• More reproducible than office measurements
• Helpful in early diagnosis • Unexplained microalbuminuria or LVH • White Coat Hypertension • Resistant Hypertension • No long term studies yet
• Frequency of monitoring can vary • All current outcome data/guidelines/trails
are from office readings
Ambulatory BP Monitoring
Ambulatory BP Monitoring
Hypertension as Defined by JNC VII
• 120/80 - normal; “optimal” • 121-139/80-89 - “pre-hypertension”
– Controversial – More a health policy statement
• 140-160/90-100 - Stage 1 Hypertension • >160/100 - Stage 2 Hypertension
between BP and Cads • For those age 40-70, each increased increment of
20/10 mmHg in BP doubles the risk of CVD across the entire BP range of 115/75 to 185/115. • Only 35% of hypertensive patients on treatment are under control.
salt/water retention from decreased GFR • CKD patients also have derangements in the
Renin/Angiotensin/Aldosterone system
Treatment of Hypertension
• Goal depends on disease state
– <130/80 if DM, CKD, CVDz – <125/75 if CKD with proteinuria
• SBP is the issue in the old • Diastolic HBP is a problem of the young • Reaching the target is more important than
how you get there • Multiple interventions are necessary in most
Hypertensive Emergencies
• Hypertension is a chronic outpatient disease with rare acute side effects
Measurement of Blood Pressure
• Seated position with arm supported ideal • Allow patient to settle for several minutes • Proper sized cuff
– Bladder to encircle 80 – 100% arm – Bladder width 40-50% of arm