38 Hypertension
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38 Hypertension

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    38 Hypertension 38 Hypertension Document Transcript

    • Hypertension
      = Htn, Essential Hypertension
      See Also
      Hypertension in Children
      Hypertension in Infants
      Hypertension in Pregnancy
      Hypertension in Athletes
      Hypertension in the Elderly
      Epidemiology
      Demographics
      White Adults in US: 20% are hypertensive
      Black Adults in US: 30% are hypertensive
      Of all hypertensives, >50% are over age 65 years
      Outcomes
      BEST PREDICTOR TO OUTCOME VARIES BY AGE
      Diastolic Blood Pressure best predictor <50 years
      SBP and DBP predict outcomes equally ages 50-59
      Pulse Pressure best predictor age >60 years
      Coronary Artery Disease
      Hypertension Causes 35-45% morbidity and mortality
      Cerebrovascular Accident
      Relative Risk increases 1.84 for each 10 mmHg DBP
      Midlife hypertension raises longterm CVA risk
      Seshadri (2001) Arch Intern Med 161:2343
      Alzheimer's Disease
      Increased SBP in middle age is predisposing factor
      Reference
      (1995) Lancet 346(8991):1647
      Kivipelto (2001) BMJ 322:1447
      Hypertension Definition
      See Hypertension Criteria
      Types
      Essential Hypertension (Primary Hypertension)
      Stage 1-2 (DBP 90-104) in 80% of cases
      ACCELERATED MALIGNANT HYPERTENSION
      Recent substantial Blood Pressure increase
      Associated with retinal vessel damage
      Retinal Hemorrhages
      Retinal exudates
      Papilledema
      Diastolic Blood Pressure over 140
      ISOLATED SYSTOLIC HYPERTENSION
      Systolic Blood Pressure: >160 mmHg
      Diastolic Blood Pressure: <90 mmHg
      Risks
      Coronary Artery Disease
      Cerebrovascular Accident
      Onset: 5th decade
      Affects 11% of those over age 75 years
      Results from progressive fall in vessel compliance
      Causes of secondary Hypertension
      See Hypertension Causes
      Diagnosis
      See Hypertension Criteria
      Hypertension Evaluation
      Hypertension Evaluation History
      Hypertension Evaluation Exam
      Hypertension Evaluation Labs
      Management
      See Hypertension Management