【高血压精品英文课件】hypertension

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1、HypertensionKieranMcGladeNov2001DepartmentofGeneralPracticeQUBAetiologyofHypertensionPrimary–90-95%ofcases–alsotermed“essential”of“idiopathic”Secondary–about5%ofcasesRenalorrenovasculardiseaseEndocrinediseasePhaeochomocytomaCusingssyndromeConn’ssyndromeAcromegalyandhypothyroidismCo

2、arctationoftheaortaIatrogenicHormonal/oralcontraceptiveNSAIDsKieranMcGladeNov2001DepartmentofGeneralPracticeQUBThisleftventricleisverythickened(slightlyover2cminthickness),buttherestoftheheartisnotgreatlyenlarged.Thisistypicalforhypertensiveheartdisease.Thehypertensioncreatesagreat

3、erpressureloadonthehearttoinducethehypertrophy.KieranMcGladeNov2001DepartmentofGeneralPracticeQUBTheleftventricleismarkedlythickenedinthispatientwithseverehypertensionthatwasuntreatedformanyyears.Themyocardialfibershaveundergonehypertrophy.KieranMcGladeNov2001DepartmentofGeneralPra

4、cticeQUBHOTHypertensionOptimalTreatmentLargestinterventiontrialinhypertension.Publishedin1998ConductedinGeneralPractice.18,790patientsin26countriesFollowedupforanaverageof3.8yearsKieranMcGladeNov2001DepartmentofGeneralPracticeQUBHOTFindingsLowestincidenceofmajorCVeventsoccurredatam

5、eanachievedDBPof83mmhg.Thistarget(comparedtomeanachievedof105mmHgwasassociatedwitha30%reductioninmainCVevents.Indiabetes–Diastolic

6、ofdiabetesisthreateningtoreversethereductionindeathsfromheartdiseaseinmanywesterncountries,includingtheUnitedKingdom.TocoincidewithWorldDiabetesDayon14November,DiabetesUKiscallingforactiontobetakentoreducethe20,000deathsperyearfromcoronaryheartdisease(CHD)amongpeoplewithdiabetesint

7、heUK.KieranMcGladeNov2001DepartmentofGeneralPracticeQUBHypertensionandDiabetesHypertensionco-existswithtypeIIinabout40%atage45risingto60%atage75.70%oftypeIIpatientsdiefromcardio-vasculardisease.Atleast60%ofpatientswillrequire2or3antihypertensiveagentstoachievetightcontrol.KieranMcG

8、ladeNov2001DepartmentofGen