【高血压英文ppt课件】高血压Hypertension
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英文疾病介绍-Hypertension(高血压病) PPT课件
cold medications, Migraine([ˈmaɪˌgreɪn])
Medications.
renal artery stenosis
甲状旁腺功能亢进症
([stɪ'nəʊsɪs])
肾动脉狭窄
Causes Of Hypertension
Genes（遗传因素） Diet（膳食因素） Social And Mental
Pathological Changes(病变)
Left ventricle in hypertensive heart disease. 左心室壁明显增厚
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 vessels, brain, and kidneys if left untreated. It’s a major risk factor for strokes(中风/脑卒中) and heart attacks(心脏 病).
sad in a long time
Hypertension Symptoms
High blood pressure is sometimes called a silent killer(无症状杀 伤者) because it may have no outward symptoms for years (可能没 有外在症状长达数年).
sign
but below 140/90
It is called
Pre-hypertension 高血压前期
Medications.
renal artery stenosis
甲状旁腺功能亢进症
([stɪ'nəʊsɪs])
肾动脉狭窄
Causes Of Hypertension
Genes（遗传因素） Diet（膳食因素） Social And Mental
Pathological Changes(病变)
Left ventricle in hypertensive heart disease. 左心室壁明显增厚
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 vessels, brain, and kidneys if left untreated. It’s a major risk factor for strokes(中风/脑卒中) and heart attacks(心脏 病).
sad in a long time
Hypertension Symptoms
High blood pressure is sometimes called a silent killer(无症状杀 伤者) because it may have no outward symptoms for years (可能没 有外在症状长达数年).
sign
but below 140/90
It is called
Pre-hypertension 高血压前期
【高血压英文ppt课件】高血压急症Hypertensive-emergencies
– Prevalence of cerebrovascular disease and coronary artery disease ( Stenotic lesions)
– Altered cerebral autoregulation – Impaired baroreflexes – Blood viscosity – Ability to increase oxygen extractmortality
5
Hypertensive Emergencies : Definition
. A rapid decompensation of vital organ function secondary to an inapropriately elevated BP
6
Hypertensive Emergencies
. CNS - Hypertensive encephalopathy . CVS
– Acute myocardial ischemia – Acute cardiogenic pulmonary edema – Acute aortic dissection – Post-op vascular surgery
• HTN as an associated symptom rather than as a cause of disease
• “Essential hypertension” (i.e., FDR)
4
Chronic Hypertension
. Increases risk of
– atherosclerosis ( CAD, MI)
. Vascular stenosis
9
Cerebral Autoregulation
– Altered cerebral autoregulation – Impaired baroreflexes – Blood viscosity – Ability to increase oxygen extractmortality
5
Hypertensive Emergencies : Definition
. A rapid decompensation of vital organ function secondary to an inapropriately elevated BP
6
Hypertensive Emergencies
. CNS - Hypertensive encephalopathy . CVS
– Acute myocardial ischemia – Acute cardiogenic pulmonary edema – Acute aortic dissection – Post-op vascular surgery
• HTN as an associated symptom rather than as a cause of disease
• “Essential hypertension” (i.e., FDR)
4
Chronic Hypertension
. Increases risk of
– atherosclerosis ( CAD, MI)
. Vascular stenosis
9
Cerebral Autoregulation
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
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Hypertensive Urgency
DBP > 120 that requires control in BP over 24 to 48 hours
No end organ damage
Malignant Hypertension is no longer used
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
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
Treatment
Hypertensive Urgency
No end-organ damage—NOT emergent Look for reactive HTN and treat this first
Drugs, pain, anxiety, cocaine, withdrawal Use oral medications to lower BP gradually
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
Epidemiology
Hypertensive Emergency
Definitions
Hypertensive Emergency
Acute, rapidly evolving end-organ damage associated with HTN (usu. DBP > 120)
BP should be controlled within hours and requires admission to a critical care setting
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
Physical
Confirm BP in more than one extremity Ensure appropriate cuff size Pulses in all extremities Lung exam—look for pulmonary edema Cardiac—murmurs or gallops, angina, EKG Renal—renal artery bruit, hematuria Neurologic—focal deficits, HA, altered MS Fundoscopic exam—retinopathy, hemorrhage
vasoactive substances Further loss of autoregulatory mechanism Exposes organs to increased pressure
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
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
Diagnosis and Recognition
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
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
Diagnosis and Recognition
Cardiovascular disease and mortality Cerebrovascular disease and mortality End stage renal disease Other end organ damage
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
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
Outline
Epidemiology Definitions Pathophysiology Diagnosis and Recognition Treatment Special Circumstances
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
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
Pathophysiology
Hypertensive Emergency
Definitions
Hypertension (according to JNC VII)
Normal BP
<120/<80
Prehypertension
121-139/80-89
Stage I HTN
140-159/90-99
Stage II HTN
>160/>100
(Severe HTN
mediastinum to look for aortic dissection
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
management is critical
Mortality raபைடு நூலகம்e of up to 90%
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
Definitions
End-Organ Damage (% of cases)
Cerebral infarction…………………………………… 24% Hypertensive encephalopathy……………………16% Intracranial hemorrhage……………………………4.5% Acute aortic dissection………………………………2% Acute coronary syndrome/myocardial infarction…12% Pulmonary edema with respiratory failure…………22% Severe eclampsia/HELLP syndrome………………2% Acute congestive heart failure……………………14% Acute renal failure……………………………………9%
Epidemiology
Why should we care about hypertension?
30% of the population is unaware they have hypertension
Control rates for known cases is about 50% (we don’t do a great job at controlling BP)
DBP > 120 that requires control in BP over 24 to 48 hours
No end organ damage
Malignant Hypertension is no longer used
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
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
Treatment
Hypertensive Urgency
No end-organ damage—NOT emergent Look for reactive HTN and treat this first
Drugs, pain, anxiety, cocaine, withdrawal Use oral medications to lower BP gradually
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
Epidemiology
Hypertensive Emergency
Definitions
Hypertensive Emergency
Acute, rapidly evolving end-organ damage associated with HTN (usu. DBP > 120)
BP should be controlled within hours and requires admission to a critical care setting
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
Physical
Confirm BP in more than one extremity Ensure appropriate cuff size Pulses in all extremities Lung exam—look for pulmonary edema Cardiac—murmurs or gallops, angina, EKG Renal—renal artery bruit, hematuria Neurologic—focal deficits, HA, altered MS Fundoscopic exam—retinopathy, hemorrhage
vasoactive substances Further loss of autoregulatory mechanism Exposes organs to increased pressure
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
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
Diagnosis and Recognition
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
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
Diagnosis and Recognition
Cardiovascular disease and mortality Cerebrovascular disease and mortality End stage renal disease Other end organ damage
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
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
Outline
Epidemiology Definitions Pathophysiology Diagnosis and Recognition Treatment Special Circumstances
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
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
Pathophysiology
Hypertensive Emergency
Definitions
Hypertension (according to JNC VII)
Normal BP
<120/<80
Prehypertension
121-139/80-89
Stage I HTN
140-159/90-99
Stage II HTN
>160/>100
(Severe HTN
mediastinum to look for aortic dissection
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
management is critical
Mortality raபைடு நூலகம்e of up to 90%
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
Definitions
End-Organ Damage (% of cases)
Cerebral infarction…………………………………… 24% Hypertensive encephalopathy……………………16% Intracranial hemorrhage……………………………4.5% Acute aortic dissection………………………………2% Acute coronary syndrome/myocardial infarction…12% Pulmonary edema with respiratory failure…………22% Severe eclampsia/HELLP syndrome………………2% Acute congestive heart failure……………………14% Acute renal failure……………………………………9%
Epidemiology
Why should we care about hypertension?
30% of the population is unaware they have hypertension
Control rates for known cases is about 50% (we don’t do a great job at controlling BP)