HIPERTENSION ARTERIA ACTUALIZACION JNC 8 - ESH/ESC - 4003

1. SNAYDER JOSE PEREZ GOELKEL
MEDICO CIRUJANO
UNIVERSIDAD DEL NORTE
¿HIPERTENSION ATERIAL?

2. CONCEPTO DE TENSIÓN ARTERIAL
PA = GC · RVS
VS · FC
Precarga Postcarga Contractilidad

3. Md Med J. 1988 Sep; 37 (9):698-701
JNC 4

4. Arch Inter Med. 1993;154-183
JNC 5

5. Arch Inter Med. 1997 Nov 24; 157(21): 2413-46
JNC 6

6. JAMA 2003 May 21; 289 (19): 2560-72
JNC 7

7. JAMA 2014; 311 (5):507-20

8. CASE
A 58 year old African-American woman with
diabetes and dyslipidemia has a BP of 158/94
confirmed on several office visits. Other than
obesity, the exam is normal. Labs show normal
renal function, well-controlled lipids on
atorvastatin and well-controlled diabetes on
metformin. Urine micro-albumin is mildly
elevated.

9. CASE QUESTION 1
What goal BP is most appropriate for this patient?
1. <150/90 mmHg
2. <130/80 mmHg
3. <140/90 mmHg
4. <140/80 mmHg
5. <140/85 mmHg

10. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

11. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

12. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

13. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

14. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

15. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

16. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

17. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

18. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

19. RECOMENDACIONES PARA EL
MANEJO DE LA HIPERTENSIÓN
JAMA 2014; 311 (5):507-20

20. JAMA 2014; 311 (5):507-20

21. JAMA 2014; 311 (5):507-20

22. ANEXO TÉCNICO 4003

24. Medical Education & Information – for all Media, all Disciplines, from all over the World
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2013 ESH/ESC Guidelines for the management of arterial hypertension
The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) - J Hypertension 2013;31:1281-1357
Definitions and classification of office BP levels (mmHg)*
Category Systolic Diastolic
Optimal <120 and <80
Normal 120–129 and/or 80–84
High normal 130–139 and/or 85–89
Grade 1 hypertension 140–159 and/or 90–99
Grade 2 hypertension 160–179 and/or 100–109
Grade 3 hypertension ≥180 and/or ≥110
Isolated systolic hypertension ≥140 and <90
* The blood pressure (BP) category is defined by the highest level of BP, whether systolic or diastolic. Isolated systolic hypertension should be graded 1, 2, or
3 according to systolic BP values in the ranges indicated.
Hypertension:
SBP >140 mmHg ± DBP >90 mmHg

25. Medical Education & Information – for all Media, all Disciplines, from all over the World
Powered by
2013 ESH/ESC Guidelines for the management of arterial hypertension
The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) - J Hypertension 2013;31:1281-1357
Blood pressure goals in hypertensive patients
SBP, systolic blood pressure; CV, cardiovascular; TIA, transient ischaemic attack; CHD, coronary heart disease; CKD, chronic kidney disease;
DBP, diastolic blood pressure.
Recommendations
SBP goal for “most”
•Patients at low–moderate CV risk
•Patients with diabetes
•Consider with previous stroke or TIA
•Consider with CHD
•Consider with diabetic or non-diabetic CKD
<140 mmHg
SBP goal for elderly
•Ages <80 years
•Initial SBP ≥160 mmHg
140-150 mmHg
SBP goal for fit elderly
Aged <80 years
<140 mmHg
SBP goal for elderly >80 years with SBP
•≥160 mmHg
140-150 mmHg
DBP goal for “most” <90 mmHg
DB goal for patients with diabetes <85 mmHg

31. ¡MUCHAS GRACIAS!