【高血压英文PPT精品课件】 Target Organ Damage
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【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
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Hypertensive Emergencies : Definition
. A rapid decompensation of vital organ function secondary to an inapropriately elevated BP
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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)
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Chronic Hypertension
. Increases risk of
– atherosclerosis ( CAD, MI)
. Vascular stenosis
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Cerebral Autoregulation
– Altered cerebral autoregulation – Impaired baroreflexes – Blood viscosity – Ability to increase oxygen extractmortality
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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)
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Chronic Hypertension
. Increases risk of
– atherosclerosis ( CAD, MI)
. Vascular stenosis
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Cerebral Autoregulation
高血压危象-PPT课件
Hypertensive Urgencies and Emergencies
§ Patients with marked BP elevations and acute TOD (e.g., encephalopathy, myocardial infarction, unstable angina, pulmonary edema, eclampsia, stroke, head trauma, life-threatening arterial bleeding, or aortic dissection) require hospitalization and parenteral drug therapy. § Patients with markedly elevated BP but without acute TOD usually do not require hospitalization, but should receive immediate combination oral antihypertensive therapy.
ACCELERATED HYPERTENSION
VASOCONSTRIVE
SUBSTANCES
SVR
BP
END-ORGAN DAMAGE (Brain, heart, kidney)
ARTERIOLAR FIBRINOUS NECROSIS
LOSS OF AUTOREGULATION
高血压危象的发生机理
急性脏器损害伴高血压 许多情况不一定是先有血压急剧升高造 成靶器官损害，而是脏器损害使高血压成 为极其危险的临床因素之一；或者是脏器 损害引起应激反应，交感神经张力增高而 出现血压的急剧上升，从而造成恶性循环。 然而，诸如心肌梗死、主动脉夹层、左心 衰等脏器损害，其基础病变都常常与高血 压有关。
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】高心病 Hypertensive Heart Disease
Hypertensive Heart Disease
2- Dimension/ M-mode Concentric LVH Increased wall thickness (> 11 mm) Non-dilated chamber Increased LV mass
Hypertensive Heart Disease
Aortic valve leaflet shows calcification – aortic regurgitation.
Mitral annular calcification – mitral regurgitation.
LA dilation – due to MR and the chronically elevated LV-EDP.
Hypertensive Heart Disease
Results in LVH to maintain normal wall stress Initially impaired diastolic function Normal systoensive Heart Disease
Hypertensive Heart Disease
Increased irregular echogenicity of the aortic walls – atherosclerosis
Aortic annulus is not dilated
Hypertensive Heart Disease
Other Findings Aortic root dilation Aortic valve sclerosis
Hypertensive Heart Disease
Mitral annular calcification Left atrial enlargment Atrial fibrillation
【高血压精品英文课件】老年性高血压 HYPERTENSION IN ELDERLY
Management
Primary goal is to reduce cardiovascular and renal morbidity and mortality.
Other keys to management are: Prevention Patient education Life-style modification Medication
DOES ELDERLY HYPERTENSION HAVE SPECIFIC CHARACTERISTICS?
CHARACTERISTICS OF HYPERTENSION IN THE ELDERLY
Increased Systolic blood pressure and pulse pressure Left ventricular mass and wall thickness Arterial stiffness Calculated total peripheral resistance
140/90
White Coat Hypertension
True Normotension
Sustained Hypertension
Masked Hypertension
135/85 Ambulatory Pressure
Pseudo Hypertension
Recording of high B.P. but do not have
Category
Systolic
Diastolic
Normal
<120 and
<80
Pre-hypertension 120-139 or
85-89
Stage 1 hypertension 140-159 or
【高血压精品英文课件】高血压 Hypertension
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
Take a good history
History of HTN and previous control Medications with dosage and compliance Illicit drug use, OTC drugs
Diagnosis and Recognition
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
That is >500,000 Americans per year Correct and quick diagnosis and
management is critical
Mortality rate of up to 90%
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
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)
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