高血压病(高职康复)

1、HypertensionHypertension高血压有什么高血压有什么危害？危害？” (ESH/ESC20(ESH/ESC201313,China20,China201010) )v第一三次抽样调查，筛选人群年龄均为第一三次抽样调查，筛选人群年龄均为大于大于1515岁岁v第二次抽样调查，采用当时第二次抽样调查，采用当时WHOWHO的标准：的标准：161/95mmHg161/95mmHg为确诊高血压，为确诊高血压， 140140160/90160/9095mmHg95mmHg为临界高血压；第三次也采用当时的为临界高血压；第三次也采用当时的WHOWHO标准：标准：SBP140mmHgSBP140

2、mmHg和和/ /或或90mmHg90mmHgv20022002年为卫生部组织的年为卫生部组织的营养与健康状况调查营养与健康状况调查，2727万万1818岁及以上居民岁及以上居民 EpidemiologyEpidemiologyv患病率达患病率达2525v1 1 个 高 血个 高 血压压/ /2 23 3个家庭个家庭 EpidemiologyEpidemiology发病率发病率患病人数患病人数1959年年1980年年1991年年04000800012000万人万人160002002年年20%010% EpidemiologyEpidemiology三三 高高三三 低低三个误区三个误区 Epid

3、emiologyEpidemiology= 100万名患者万名患者The Seventh Report of the Joint National Committee on Prevention, The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)

4、EtiologyEtiologyGenetic and Genic Factors Genetic and Genic Factors Genetic and Genic Factors Genetic and Genic Factors Factors ofFactors of Environment and lifestyleEnvironment and lifestyle High salt intakeHigh salt intakeLess physical exerciseLess physical exerciseSmokingSmokingAlcohol abuseAlcoh

5、ol abuse Overweight or ObesityOverweight or Obesity Oral contraceptivesOral contraceptives OSASOSASq体重指数（体重指数（Body Mass Index,BMIBody Mass Index,BMI）：）：q中国成人正常中国成人正常BMIBMI：191924 24 kg/mkg/m2 2q超重超重：体重体重 理想体重理想体重1010；WHOWHO：BMI25BMI25，中国标准：，中国标准：BMI24 BMI24 q肥胖肥胖：体重：体重 理想体重理想体重2020；WHOWHO：BMI30BMI30

6、，中国标准：，中国标准：BMI28BMI28 PathogenesisPathogenesis PathogenesisPathogenesis PathogenesisPathogenesis PathogenesisPathogenesis PathogenesisPathogenesis PathogenesisPathogenesisVascuclar RemodelingVascuclar Remodeling PathogenesisPathogenesis PathologyPathology Early StageEarly Stage Middle StageMiddle S

7、tage Later StageLater Stage HeartHeart BrainBrainKidneyKidney Clinical manifestationsClinical manifestationsSymptomsSymptomsSignsSigns Clinical manifestationsClinical manifestationsComplicationsComplications Clinical manifestationsClinical manifestationsBlood pressure measurementBlood pressure measu

8、rementOffice or clinic BPOffice or clinic BPHome BPHome BPAmbulartory BP,ABPAmbulartory BP,ABPBlood pressure measurementBlood pressure measurementBlood pressure measurementBlood pressure measurementLaboratory investigations and auxiliary Laboratory investigations and auxiliary examinationsexaminatio

9、nsLaboratory investigations and auxiliary Laboratory investigations and auxiliary examinationsexaminationsLaboratory investigations and auxiliary Laboratory investigations and auxiliary examinationsexaminationsLaboratory investigations and auxiliary Laboratory investigations and auxiliary examinatio

10、nsexaminationsLaboratory investigations and auxiliary Laboratory investigations and auxiliary examinationsexaminationsLaboratory investigations and auxiliary Laboratory investigations and auxiliary examinationsexaminationsLaboratory investigations and auxiliary Laboratory investigations and auxiliar

11、y examinationsexaminationsDiagnosisDiagnosis Classification of HypertensionClassification of HypertensionEssential Hypertension,EHEssential Hypertension,EHSecondary HypertensionSecondary Hypertension 5 5Definitions and Classification ofDefinitions and Classification ofblood pressure (BP) levels (mmH

12、g)blood pressure (BP) levels (mmHg) Differential diagnosis Differential diagnosis Differential diagnosis Differential diagnosis PheochromocytomaPheochromocytomaHypercortisolismHypercortisolismCushings syndromeCushings syndromeBlood pressure targetBlood pressure target Therapeutic principalTherapeuti

13、c principalTherapeutic methodsTherapeutic methodsNon-Pharmacologic managementNon-Pharmacologic management Non-Pharmacologic managementNon-Pharmacologic managementNon-Pharmacologic managementNon-Pharmacologic managementNon-Pharmacologic managementNon-Pharmacologic managementNon-Pharmacologic manageme

14、ntNon-Pharmacologic managementPharmacologic managementPharmacologic managementPharmacologic managementPharmacologic managementBeta-receptor/adrenergic blockersBeta-receptor/adrenergic blockersBeta-receptor/adrenergic blockersBeta-receptor/adrenergic blockersACEIACEIAngiotensin Angiotensin Receptor Blocker, ARB Receptor Blocker, ARBCalcium Channel Blockade,CCBCalcium Channel Blockade,CCBSeveral special types of HypertensionSeveral special types of HypertensionElderly hypertensionElderly hypertensionWhite coat hypertensionWhite coat hypertensionResista