【高血压精品英文课件】Hypertension in CKD

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).

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.

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

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.