(精编)【高血压精品英文课件】高心病 HYPERTENSIVE HEART DISEASE -A brief Review.pptVIP

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2018-03-21 发布于天津
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(精编)【高血压精品英文课件】高心病 HYPERTENSIVE HEART DISEASE -A brief Review.ppt

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hypertension * HYPERTENSIVE HEART DISEASEA Brief ReviewJoshua M.Crasner, DO,FACC,FACOI DEFINITION the reponse of the left ventricle to increased peripheral resistance due to increased systemic arterial pressure JNC-7 Definition of HTN CATEGORY SYSTOLIC BP DIASTOLIC BP normal 120 and 80 Pre-HTN 120-139 or 80-89 Hypertension Stage 1 140-159 or 90-99 Stage 2 ≥ 160 or ≥ 100 JAMA 289; 2560-72: 2003 JNC-6 (old criteria) STAGE SYSTOLIC BP DIASTOLIC BP 1 160-179 or 100-109 2 ≥180 or ≥ 110 HYPERTENSION WITH AGE Systolic BP rises continuously with age Diastolic rises up to age 50, then falls Pulse pressure then widens with age Vasan, et al.JAMA, 2002; 287(8):1003-10 ETIOLOGY HTN “essential” 90 % Genetics, environment African descent and elderly have low renin; more sensitive to salt and volume non-African/young pts have high renin ESSENTIAL HYPERTENSION Most common HBP( 90 %)--multifactorial increased peripheral resistance perpetuates the process of high blood pressure and all of its secondary effects structural hypertrophy giving rise to smooth muscle hypercontractility pressure varies throughout the day major risk factor for coronary, renal, and cerebrovascular disease (50% of all USA deaths) leading cause of doctor’s visit carries prognostic value: 16X increased risk 40 y.o. smokes TARGET ORGAN DAMAGELeft Ventricular Hypertrophy End result of hypertensive heart disease structural adaptation to pressure overload initially adaptive and later pathologic mass 100-130 g/m2 TARGET ORGAN DAMAGELEFT VENTRICULAR HYPERTROPHY Eccentric: isotonic exercise, increased volume load mass/volume ratio low Concentric: isometric exercise, increased pressure load mass/volume ratio high degree does not correlate with blood pressure Prognostic value: sudden cardiac death, ischemi