Hyertension课件.ppt

Hypertension 告報者：劉佩姎 營養師 日期：93/03/25 Hypertension Hypertension is the most common public health problem in developed countries. Called Silent Killer No cure is available, but prevention and management decrease the incidence of hypertension and disease sequelae. Classification Essential or Primary hypertension: 90 ~ 95% the cause can’t be determined, therefore treatment is nonspecific. Secondary hypertension: caused by another disease, ex: renal or endocrine Definition SBP (systolic blood pressure) ? 140 mmHg and/or DBP (diastolic blood pressure) ? 90 mmHg Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure Prevalence Physiology Blood pressure levels: a function cardiac output mutipied by peripheral resistance (the resistance in blood vessels to the flow of blood) Diameter of blood vessels Sympathetic nerve system ( for short-term control) Kidney (for long-term control) Blood Pressure fail ↓ Sympathetic nerve system ↓ Norepinephrin ↓ Act on small arteries and arterioles ↓ ↑ peripheral resistance ↓ ↑Blood Pressure Decreased arterial pressure ↓ Renin (Kidney) ↓ Renin substrate Angiotensin I (Plasma protein) Regulatory mechanism falter, hypertension develop. Neurohormonal and intrarenal Peripheral resistance↑→ left ventricle of heart increase effort in pumping blood → left ventricular hypertrophy → congestive f=heart failure Primary prevention A population strategy: lower the blood pressure in general population A targeted strategy: direct intervention to lower blood pressure at individuals who are at greatest risk of developing hypertension. Genetic predisposition to H/N interacts Obesity Life-style Dietary components Diet-related factors influencing development of hypertension Changing four modifiable factors has documented efficacy in the primary prevention of hypertension. -Overweight -High salt intake -Alcohol consumption -Physical inactivity Overweight Two to six times h