高血压英文ppt精品课件hypertension（ht） high blood pressure （hbp）

slide 1 Hypertension (HT) High Blood Pressure (HBP) slide 2 Introduction Definition: Hypertension is defined as elevated arterial blood pressure. Hypertension is one of the most common disease in the world In our country, 160 million people over the age of 15 have established or borderline HP HP Essential HP (95%) Secondary HP (5%) slide 3 Etiology Genetic Environment Dietary: Salt intake Alcohol intake Obesity Infant dysnutrition slide 4 Pathogenesis High activity of the SNS (Sympathetic Nervous System) RAAS (Renin-Angiotension Aldosterone System) Renal Sodium Handling Vascular Remodelling Endothelial Cell Dysfunction Insulin Resistance slide 5 Pathological consequences target organs hemorrhage the CNS stroke thrombosis LVH HF HBP the Heart CHD AP MI HF arrhythmia the Kidney progressive renal nephrosclerosis progressive scarring of the glomerula renal failure the Arteriosclerosis stenosis thrombosis occlusion dilatation rapture hemorrhage slide 6 The pathological changes of small artery slide 7 The pathological change of the Heart Left ventricular hypertrophy (LVH) Heart failure Coronary artery atherosclerosis Myocardial infarction slide 8 Pathological change of the Brain Stroke: Ischemic stroke Hemorrhagic stoke Arterial Aneurysm slide 9 Pathological change of Renal Hypertension induced nephrosclerosis, atrophy of renal cortex slide 10 Clinical Features The blood pressure varies widely over time, depending on many variables, including SNS activity, posture, state of hydration, and skeletal muscle tone. Symptoms: Always asymptomatic Symptoms often attributed to hypertension: headache, tinnitus, dizziness, fainting slide 11 Clinical Features Complications of Hypertension Heart: LVH, CHD,HF Brain: TIA, Stroke Renal: Microalbuminuria, renal dysfunction Ratinopathy slide 12 Laboratory Examination Blood pressure measurement: Clinic Blood Pressure Home Blood Pressure Ambulatory monitoring slide 13 Ambulatory Measurement Ambulatory monitoring can provide: readings throughout day during usual activities readings during sleep to assess nocturnal changes measures of SBP and DBP load Exclude white coat or office hypertension Ambulatory readings are usually lower than in clinic (hypertension is defined as 135/85 mm Hg) slide 14 Laboratory Examination Urinalysis Blood examination Chest X Ray EKG UCG (Ultrasound cardiography) Retina examination slide 15 slide 16 slide 17 slide 18 The Keith-Wagner Criteria (change in retina) KW I: Minimal arteriolar narrowing, irregularity of the lumen, and increased light reflex KW II: More marked narrowing and irregularity with arteriovenous nicking (crossing defects) KW III: Flame-shaped hemorrhages and exudates in addition to above arteriolar changes KW IV: Any of the above with addition of papilledema slide 19 Flame shaped h