hypertension by dr. nagwa eid saad prof. of internal medicine & family medicine in cairo...
TRANSCRIPT
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HypertensionBy
Dr. Nagwa Eid SaadProf. Of Internal Medicine
&
Family Medicine
In
Cairo University
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Objectives:by the end of this session the family doctor should
know:
•Prevalence of hypertension in Egypt & other countries .
•Diagnosis, proper medical history, examination & investigations of hypertension.
•Risk & TOD in hypertensive patients.•Secondary hypertension.•Referrals.•Cost minimization.
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What is Blood Pressure?
BP = CO x TPR (CO = HR x SV)–Stroke volume – affected by contractility
and venous return–TPR is regulated by
•Norepinephrine, Epinephrine, Angiotensin II
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JNC-7 Classification
NormalNormal
PrehypertensionPrehypertension
Stage I hypertensionStage I hypertension
Stage II hypertensionStage II hypertension
SBP (mmHg)SBP (mmHg) DBP (mmHg)DBP (mmHg)BP ClassificationBP Classification
< <120120
120-139120-139
140-159140-159
>> 160160
< <8080
80-8980-89
90-9990-99
>> 100100
andand
oror
oror
oror
http://hin.nhlbi.nih.gov/nhbpep_slds/menu.htmhttp://hin.nhlbi.nih.gov/nhbpep_slds/menu.htm
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Isolated systolic hypertension•ISH:
Grade1 SBP 140-159 & DBP < 80mmHg Grade2 SBP > 160 & DBP< 80mmHg
•Strong predictor of CV complications•Lowering SBP is associated with significant reduction
in: –CV mortality–Stroke–HF –MI –Dementia
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•Prevalence rate is of 26.3% among
adult Egyptians population ≥ 25 years.
•Its prevalence increases with age ,
50% of Egyptians above the age of
6o years are hypertension.
•Only 8% of hypertensive Egyptians
have their blood pressure controlled .
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Epidemiology and CVD Risk
•Over 50 million Americans have HTN–30% are unaware they have HTN–Only 60% receive treatment–Only 34% of those treated, achieve goal
•Prevalence increases with age
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Epidemiology and CVD Risk
•The relationship between BP and CVD is continuous, consistent and independent of
other risk factors–MI–Heart failure–Stroke–Kidney disease
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Prehypertension:
Signals a need for increased education
to reduce BP in order to prevent HTN
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Historical Trends in HTN
National Health and Nutrition Examination SurveyNational Health and Nutrition Examination Survey
AwarenessAwareness
TreatmentTreatment
ControlControl
1991-19941991-1994
68%68%
54%54%
27%27%
1976-19801976-1980
51%51%
31%31%
10%10%
1988-19911988-1991
73%73%
55%55%
29%29%
1994-20001994-2000
70%70%
59%59%
34%34%
SBP > 140 mmHg and DBP > 90 mmHgSBP > 140 mmHg and DBP > 90 mmHg
Trends in awareness, treatment, and control of high blood Trends in awareness, treatment, and control of high blood pressure in adults ages 18-74pressure in adults ages 18-74
http://hin.nhlbi.nih.gov/nhbpep_slds/menu.htmhttp://hin.nhlbi.nih.gov/nhbpep_slds/menu.htm