The document discusses hypertension (high blood pressure) as a major public health problem and risk factor for cardiovascular disease. Some key points:
- Hypertension affects over 50 million Americans and 1 billion people worldwide. It is the leading cause of preventable death.
- Even small reductions in blood pressure of 2-5 mmHg can significantly reduce the risk of cardiovascular events like stroke and heart disease.
- Lifestyle modifications like diet, exercise, weight control and limiting alcohol/sodium can help prevent and control hypertension. The DASH diet in particular has been shown to lower blood pressure.
- Guidelines recommend treating hypertension based on risk factors and blood pressure levels, starting with lifestyle changes and adding drug therapy as needed.
This presentation focus on the accurate method of BP measurement as well as the presentation of the latest clinical trials of hypertension management and their impact on recent guidelies
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
This presentation focus on the accurate method of BP measurement as well as the presentation of the latest clinical trials of hypertension management and their impact on recent guidelies
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
JNC 8 guideline to Management of HypertensionPranav Sopory
JNC - 8 guidelines to management of Hypertension.
Rencent developments in CKD (Chronic Kidney Disease) and DM (Daibetes Mellitus) management.
Drugs discussed along with doses and side effects.
Compelling indiactions.
2017 AHA/ACC criteria for Hypertension management in brief.
>> Contains animation. Download and view.
Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
this presentation have various hypertension management guidelines used in the Indian context, hypertension management algorithm, medication used and AYUSH interventions
This lecture shows the recently updated guidelines for the management of hypertension in primary health care clinics. Moreover, it talks about secondary and resistant hypertension.
This session will help pharmacists enhance their expertise in managing patients with hypertension through updates on the latest hypertension guidelines, discussion on the role that pharmacists can and should play in the detection and ongoing management of hypertension and hands-on experience with blood pressure measurement devices.
JNC 8 guideline to Management of HypertensionPranav Sopory
JNC - 8 guidelines to management of Hypertension.
Rencent developments in CKD (Chronic Kidney Disease) and DM (Daibetes Mellitus) management.
Drugs discussed along with doses and side effects.
Compelling indiactions.
2017 AHA/ACC criteria for Hypertension management in brief.
>> Contains animation. Download and view.
Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
this presentation have various hypertension management guidelines used in the Indian context, hypertension management algorithm, medication used and AYUSH interventions
This lecture shows the recently updated guidelines for the management of hypertension in primary health care clinics. Moreover, it talks about secondary and resistant hypertension.
This session will help pharmacists enhance their expertise in managing patients with hypertension through updates on the latest hypertension guidelines, discussion on the role that pharmacists can and should play in the detection and ongoing management of hypertension and hands-on experience with blood pressure measurement devices.
Recommendation 1
In the general population aged ≥60 years, initiate pharmacologic treatment to lower blood pressure (BP) at systolic blood pressure (SBP) ≥150 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg and treat to a goal SBP <150><90><140><60><90><60><140><140><90><140><90 mm Hg. (Expert Opinion – Grade E)
Recommendation 6
In the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB). (Moderate Recommendation – Grade B)
Recommendation 7
In the general black population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or CCB. (For general black population: Moderate Recommendation – Grade B; for black patients with diabetes: Weak Recommendation – Grade C)
Recommendation 8
In the population aged ≥18 years with CKD, initial (or add-on) antihypertensive treatment should include an ACEI or ARB to improve kidney outcomes. This applies to all CKD patients with hypertension regardless of race or diabetes status. (Moderate Recommendation – Grade B)
Recommendation 9
The main objective of hypertension treatment is to attain and maintain goal BP. If goal BP is not reached within a month of treatment, increase the dose of the initial drug or add a second drug from one of the classes in recommendation 6 (thiazide-type diuretic, CCB, ACEI, or ARB). The clinician should continue to assess BP and adjust the treatment regimen until goal BP is reached. If goal BP cannot be reached with 2 drugs, add and titrate a third drug from the list provided. Do not use an ACEI and an ARB together in the same patient. If goal BP cannot be reached using only the drugs in recommendation 6 because of a contraindication or the need to use more than 3 drugs to reach goal BP, antihypertensive drugs from other classes can be used. Referral to a hypertension specialist may be indicated for patients in whom goal BP cannot be attained using the above strategy or for the management of complicated patients for whom additional clinical consultation is needed. (Expert Opinion – Grade E)
This lecture presents the 1-Updated recommendations regarding definition and proper diagnosis of HTN. 2-Updated guidelines for threshold of BP to start treatment and targets of treatment. 3- Updated recommendations on CV risk assessment and management. 4-Hypertension and comorbidities: updated guidelines
Essential Hypertension By Raheef Alatassi
Definition & classifications
Prevention & detection & importance
Causes
HTN in pregnancy
Management
Goals of treatment
Classes of drugs & side effects
Specific management in e.g. IHD,DM
HTN emergency & urgency with management
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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7. Hypertension: A Significant CV and Renal Disease Risk Factor National High Blood Pressure Education Program Working Group. Arch Intern Med. 1993;153:186-208.
8. CV Mortality Risk Doubles with Each 20/10 mm Hg BP Increment* *Individuals aged 40-69 years, starting at BP 115/75 mm Hg. CV, cardiovascular; SBP, systolic blood pressure; DBP, diastolic blood pressure Lewington S, et al. Lancet . 2002; 60:1903-1913. JNC VII. JAMA. 2003. CV mortality risk SBP/DBP (mm Hg) 0 1 2 3 4 5 6 7 8 115/75 135/85 155/95 175/105
9.
10.
11. BP Control Rates Trends in awareness, treatment, and control of high blood pressure in adults ages 18–74 Sources: Unpublished data for 1999–2000 computed by M. Wolz, National Heart, Lung, and Blood Institute; JNC 6. National Health and Nutrition Examination Survey, Percent II 1976–80 II (Phase 1) 1988–91 II (Phase 2) 1991–94 1999–2000 Awareness 51 73 68 70 Treatment 31 55 54 59 Control 10 29 27 34
12. Blood Pressure Classification JNC 7 Definition Hypertension 2003;42:1206-52 Blood Pressure (mm Hg) Category Systolic Diastolic <120 and <80 Normal 120-139 or 80-89 Prehypertension 140-159 or 90-99 Stage 1 hypertension ≥ 160 or ≥100 Stage 2 hypertension
13. "The Goal is to Get to Goal!” JNC VII recommended BP goals Hypertension -PLUS- Diabetes or Renal Disease < 140/90 mmHg < 130/80 mmHg
14.
15. 4-Year Progression To Hypertension: The Framingham Heart Study (<120/80 mm Hg) (130/85 mm Hg) (130-139/85-89 mm Hg) Vasan, et al. Lancet 2001;358:1682-86 Participants age 36 and older
16.
17. † CVD designation is determined by the constellation of risk factors, early disease markers, and target-organ disease. CVD, cardiovascular disease. ASH Writing Group Definition and Classification of Hypertension Classification Normal Stage 1 hypertension Stage 2 hypertension Stage 3 hypertension Descriptive Category Normal BP or rare blood pressure elevations AND No identifiable CVD † Occasional or intermittent BP elevations OR Early CVD † Sustained BP elevations OR Progressive CVD † Marked and sustained BP elevations OR Advanced CVD † Cardiovascular Risk Factors None or few Several Many Many Early Disease Markers None Usually present Overtly present Overtly present with progression Target-organ Disease None None Early signs present Overtly present with or without CVD events
20. BP Measurement Techniques http://hin.nhlbi.nih.gov/nhbpep_slds/menu.htm; Accessed October 20, 2003; 8:15AM Method Brief Description In-office Two readings, 5 minutes apart. Sitting in chair, not on exam table. Confirm elevated reading in contralateral arm. Self-measurement Provides information on response to therapy. May help improve adherence to therapy and evaluate “white-coat” HTN. Ambulatory BP monitoring Indicated for evaluation of “white-coat” HTN. Can be used to confirm self-measurement when inconsistent with in-office measurement. Reimbursable.
29. Classification and Management of BP for adults *Treatment determined by highest BP category. † Initial combined therapy should be used cautiously in those at risk for orthostatic hypotension. ‡ Treat patients with chronic kidney disease or diabetes to BP goal of <130/80 mmHg. BP classification SBP* mmHg DBP* mmHg Lifestyle modification Initial drug therapy Without compelling indication With compelling indications Normal <120 & <80 Encourage Prehypertension 120–139 or 80–89 Yes No antihypertensive drug indicated. Drug(s) for compelling indications. ‡ Stage 1 Hypertension 140–159 or 90–99 Yes Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination. Drug(s) for the compelling indications. ‡ Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed. Stage 2 Hypertension > 160 or > 100 Yes Two-drug combination for most † (usually thiazide-type diuretic and ACEI or ARB or BB or CCB).
32. AB/CD Rule – HT Treatment AGE Younger (< 55) ACEi, Beta-blocker Ca++-blocker, Diuretic) (AB/CD = Dickerson et al. Lancet 353:2008-11;1999 Older (> 55) ACEi / ARB BB A + B A + B + D Diuretic CCB D + C + A D + C I II III III II I Resistant HT / Intolerance Add / substitute alpha blocker Re-consider 2 0 causes trial of spironolactone IV: V:
33. Compelling Indications for Individual Drug Classes Compelling Indication Initial Therapy Clinical Trial Basis ACC/AHA Heart Failure Guideline, MERIT-HF, COPERNICUS, CIBIS, SOLVD, AIRE, TRACE, ValHEFT, RALES ACC/AHA Post-MI Guideline, BHAT, SAVE, Capricorn, EPHESUS ALLHAT, HOPE, ANBP2, LIFE, CONVINCE THIAZ, BB, ACEI, ARB, ALDO ANT BB, ACEI, ALDO ANT THIAZ, BB, ACE, CCB Heart failure Post myocardial infarction High CAD risk
2 nd most common reason for visit All family physicians should be experts at HTN.
Hypertension is an important contributing risk factor for morbidity and mortality from both cardiovascular (CV) and renal disease. Hypertension is one of the most significant contributing factors to the development of CV and renal disease. Complications of hypertension include coronary artery disease, congestive heart failure, stroke, renal disease (including end-stage renal disease), and peripheral vascular disease. These diseases account for significant disability, loss of productivity, and decreased quality of life for many Americans. National High Blood Pressure Education Program Working Group. National High Blood Pressure Education Program Working Group report on primary prevention of hypertension. Arch Intern Med. 1993;153:186-208.