Car
, ANTI HYPERTENSION 1-3
LECTURE
guidelines)
Hypertension (NICE
·
Hypertension:high blood pressure (bp)
2nd largest global risk factor for disease 30% of all strokes
-
·
and ischemic heart disease
·
Patient diagnosis:
1) Normotensive:120180mmH4
2) stage / hypertension:patient (80 yrs. With clinical by
(24n)
>
140190mmHg vs. ambulatory pp. 135/85MMHG
↳ can have organ damage. IV disease, renal disease, diabetes
3) stage 2 hypertension:patient of any age with clinical bp.
>160/100mmHg vs. ambulatory by.150/95mmHg
4) Resistant hypertension:pp. 140/90 mmHg after treatment
with at least 3 antihypertensive drugs
BD. 180/110:patient at risk-start antihypertensive drug
=
·
treatment without ambulatory by monitoring (ABPM) or home pp.
monitoring (HBPM)
·
cardiovascular risk factors:
1) Age+seX
2) Cholesterol/HDL ratIO
3) BD
4) SMOKING StatUS
5) Ethnicity:family history (CHD in 1st degree relative (60)
6) Deprivation (Townsend scores income, employment, housing
-
7) BM 1
8) Disease:diabetes, rheumatoid arthritis, chronic kidney disease,
atrial fibrilation (rapid irregular heartbeat)
·
Essential/primary hypertension:bp>140/90mmHg with no
identifiable cause -
develop gradually over many yrs. occurs after
early adulthood (prevalence 4 with ages
·Patients 140:high cardiac output with normal peripheral
resistance
older patients:normal/I cardiac outputwith a peripheral
resistance
,·
secondary hypertension:high by caused by underlying condition
that tends to appear suddenly
x linked to:obstructive sleep apnoed. Kidney problems, advenal
gland tumours, thyroid problems, congenital defect of blood
vessels, medicines (birth control, cold, decongestant. OTC pain
relief, prescrip, arugs), cocaine, amphetamine
·
Lifestyle changes to control DD:
·
Eat healthy.I salt intake (<2300mg/day)
Healthy weight
↑ physical activity:1bp, stress, health problems
Limit alcohol:no smoking
control by during pregnancy
·
Treating high by may fail due to:
1) Lifestyle problems
2) COMD11Ance
3) White coat/masked hypertension
4) Drug-drug interactions (sympathomimetics + bp)
3) volume overload:No "intale:renal problems
6) unsuspected secondary cause:renal/endocrine disease
RAAS system
sympathetic nerves
ctions
A of Angiotensin II that 4 bp:
1) Stir. advenal cortexto release aldo.
2) Release of ADH from pithatary which 4
(inactives water reabsorption in kidney:4 D.D.
4
(actives 3) Stimulates thirst
I
4) causes vasoconstriction:4 b.p.
5) cardiac,vascular hypertrophy-- muscle
mass:4 cardiac output
, ↑ athophysiologies of hypertension
Atherosclerosis:development of fatty plaques,cholesterol in
·
wall of arteries as part of inflammatory response - over yrs.
↳ laque gets bigger eventually causing vessel occlusion and
thrombus formation
·
other pathophysiologies:
1) Trouble with memory/understanding:due to uncontrolled
high up affecting ability to think, remember, learn
2) Dementia:narrowed/blocked arteries can limit blood flow to
brain):vascular demential or stroke that interrups blood to
brain
·
A abdominal
:
aorta
B c Kidney in artery
bulge
=
+
D:aortic aneurysm: clinical significance as may
rupture with massive blood,likely death
E F +
COMMON
=
iliac artery
Mechanisms controlling DD
BD CO resistance
-
=
, ANTI HYPERTENSION 1-3
LECTURE
guidelines)
Hypertension (NICE
·
Hypertension:high blood pressure (bp)
2nd largest global risk factor for disease 30% of all strokes
-
·
and ischemic heart disease
·
Patient diagnosis:
1) Normotensive:120180mmH4
2) stage / hypertension:patient (80 yrs. With clinical by
(24n)
>
140190mmHg vs. ambulatory pp. 135/85MMHG
↳ can have organ damage. IV disease, renal disease, diabetes
3) stage 2 hypertension:patient of any age with clinical bp.
>160/100mmHg vs. ambulatory by.150/95mmHg
4) Resistant hypertension:pp. 140/90 mmHg after treatment
with at least 3 antihypertensive drugs
BD. 180/110:patient at risk-start antihypertensive drug
=
·
treatment without ambulatory by monitoring (ABPM) or home pp.
monitoring (HBPM)
·
cardiovascular risk factors:
1) Age+seX
2) Cholesterol/HDL ratIO
3) BD
4) SMOKING StatUS
5) Ethnicity:family history (CHD in 1st degree relative (60)
6) Deprivation (Townsend scores income, employment, housing
-
7) BM 1
8) Disease:diabetes, rheumatoid arthritis, chronic kidney disease,
atrial fibrilation (rapid irregular heartbeat)
·
Essential/primary hypertension:bp>140/90mmHg with no
identifiable cause -
develop gradually over many yrs. occurs after
early adulthood (prevalence 4 with ages
·Patients 140:high cardiac output with normal peripheral
resistance
older patients:normal/I cardiac outputwith a peripheral
resistance
,·
secondary hypertension:high by caused by underlying condition
that tends to appear suddenly
x linked to:obstructive sleep apnoed. Kidney problems, advenal
gland tumours, thyroid problems, congenital defect of blood
vessels, medicines (birth control, cold, decongestant. OTC pain
relief, prescrip, arugs), cocaine, amphetamine
·
Lifestyle changes to control DD:
·
Eat healthy.I salt intake (<2300mg/day)
Healthy weight
↑ physical activity:1bp, stress, health problems
Limit alcohol:no smoking
control by during pregnancy
·
Treating high by may fail due to:
1) Lifestyle problems
2) COMD11Ance
3) White coat/masked hypertension
4) Drug-drug interactions (sympathomimetics + bp)
3) volume overload:No "intale:renal problems
6) unsuspected secondary cause:renal/endocrine disease
RAAS system
sympathetic nerves
ctions
A of Angiotensin II that 4 bp:
1) Stir. advenal cortexto release aldo.
2) Release of ADH from pithatary which 4
(inactives water reabsorption in kidney:4 D.D.
4
(actives 3) Stimulates thirst
I
4) causes vasoconstriction:4 b.p.
5) cardiac,vascular hypertrophy-- muscle
mass:4 cardiac output
, ↑ athophysiologies of hypertension
Atherosclerosis:development of fatty plaques,cholesterol in
·
wall of arteries as part of inflammatory response - over yrs.
↳ laque gets bigger eventually causing vessel occlusion and
thrombus formation
·
other pathophysiologies:
1) Trouble with memory/understanding:due to uncontrolled
high up affecting ability to think, remember, learn
2) Dementia:narrowed/blocked arteries can limit blood flow to
brain):vascular demential or stroke that interrups blood to
brain
·
A abdominal
:
aorta
B c Kidney in artery
bulge
=
+
D:aortic aneurysm: clinical significance as may
rupture with massive blood,likely death
E F +
COMMON
=
iliac artery
Mechanisms controlling DD
BD CO resistance
-
=
