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38 Hypertension


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38 Hypertension

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