(精编)【高血压英文教学精品课件】 HYPERTENSION IN ELDERLY.pptVIP

HYPERTENSION IN ELDERLY;HYPERTENSION;;Benefits of Lowering Blood Pressure;WHITE COAT HYPERTENSION;MASKED HYPERTENSION;MASKED HYPERTENSION;Blood Pressure in 347,978 men aged 35-57 screened for MRFIT;Lifetime Risk of Developing Hypertension in Middle Aged (Vasan et al, JAMA 2002; 287: 1010);Diagnostic Evaluation of the Hypertensive Patient- How much is enough? ;Clinical Manifestations I;Differential Diagnosis;Complications;Management;Management;Hospitalization should be considered if;;DOES ELDERLY HYPERTENSION HAVE SPECIFIC CHARACTERISTICS?;CHARACTERISTICS OF HYPERTENSION IN THE ELDERLY Increased Systolic blood pressure and pulse pressure Left ventricular mass and wall thickness Arterial stiffness Calculated total peripheral resistance Decreased Cardiac output and heart rate Renal blood flow, plasma renin activity, and angiotensin II levels Arterial compliance and blood volume Diastolic blood pressure Black H. JCH 2003; 5:12;Bentley Dw, Izzo JL. J Am Geriatr Soc. 1982; 30:352-359.; Do lifestyle measures really work for elderly hypertension?;Modification;Bar graph shows change in mean arterial blood pressure used to define salt responsivity as a function of age in normotensive [open bars] and hypertensive [color bars] subjects.;Effect of 30 minute walk 3 days a week Age 70 - 79 Systolic Diastolic Exercise Group Baseline 156 ± 10 mm Hg 86 ± 8 mm Hg 3 months 151 ± 15 mm Hg 80 ± 6 mm Hg Control Group Baseline 153 ± 7 mm Hg 85 ± 8 mm Hg 3 months 156 ± 10 mm Hg 85 ± 6 mm Hg Conone et al. Med Scl in Sports and Exercise. 1991 ; What is the effect of drug therapy related to age? Are the recommendations different?;Antihypertensive Drugs;Algorithm for Management of the Elderly - Primarily Systolic Hypertension 1) Lifestyle changes Low dose diuretic (12.5 mg HCTZ) CCB B-Blocker ACE or ARB 3) Stop, Look Listen before dosages Let the Barorece