61.systemic hypertension

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61.systemic hypertension

  1. 1. Systemic Hypertension Paleerat Jariyakanjana, MD Faculty of Medicine Naresuan University 28 Mar 2014
  2. 2. Definition of Terms
  3. 3. Definition of Terms Hypertensive crises hypertensive urgency hypertensive emergency
  4. 4. Definition of Terms Hypertensive emergency acute elevation of blood pressure (≥180/120 mm Hg) associated with end-organ damage
  5. 5. Definition of Terms
  6. 6. Definition of Terms
  7. 7. Definition of Terms Hypertensive urgency severe elevations in blood pressure without progressive target organ dysfunction
  8. 8. Diagnosis Validity of ED-Identified Hypertension few blood pressure changes occurred after 20 minutes from ED arrival blood pressure measurements at 60- 80 minutes after arrival may be the most predictive of chronic hypertension
  9. 9. Treatment Emergency:  MAP by 25% in mins-2 h w/ IV agents; goal DBP <110 w/in 2–6 h, as tolerated Urgency:  BP in hours using PO agents; goal normal BP in 1–2 d Pocket medicine, 4th edition
  10. 10. Treatment
  11. 11. Treatment
  12. 12. Treatment
  13. 13. Treatment Pocket medicine, 4th edition
  14. 14. Disposition and Follow-Up
  15. 15. Disposition and Follow-Up Recommendations for initial therapy  thiazide diuretic: HCTZ (25) 1x1  ACEIs: lisinopril (10) 1x1
  16. 16. Disposition and Follow-Up
  17. 17. Disposition and Follow-Up
  18. 18. Reference Tintinalli's Emergency Medicine, 7th edition Pocket medicine, 4th edition
  19. 19. ANY QUESTIONS?

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