【高血压英文PPT精品课件】Primary Eye Care for The Hypertensive Patient.ppt

per NHANES update: Healthy lifestyles are an unlikely explanation for lower BP and better control among patients with hypertension, because eating patterns became less “DASH-like” and obesity increased over time. * We are now overdue…. Based on the JNC track record new guidelines were published every 4 to 6 yrs. JNC 8 was anticipated by dec 09 for public review * * * * Asking the pt if they monitor their BP at home send the impression that they should. At the conclusion of your exam you can certainly encourage them to do so. Allows the OD to recognize which RF are modifiable and those that are not. * * Kosher Salt v. table salt Coca Cola v. Pepsi Frozen peas/beans v. canned * Just to name a few…. * 3 major organ systems affected by HTN * * * * * * * **KWB (1939) and Scheie (1953) Studies suggest that fundus signs of arteriosclerosis ? increased ALR also occurs in people w/o HTN * Slerotic stage compounded by arteriolsclerosis * Atherosclerosis Risk in Communities study Increased incidence of stroke when HTN ret is “exudative” * * Another reason to perfor * Moderate = CWS, hemorrhages, aneurysms, HYE * * * Hypertensive choroidopathy usually does not receive as much attention. Historically associated with malignant HTN * Peripheral Vascular ResistanceRAAS Renin-Angiotensin system is the major regulator of renal salt reabsorption Highly influenced by the interaction of sodium intake and decrease renal sodium excretion by the kidney Medical Management of HTN BV Diuretics Thiazide Loop Cardiac Workload (CW) and Peripheral Vascular Resistance (PVR) CCB,ACEI, ARB –CW,PVR BB - CW Based on 30 years of morbidity trial experience w/HTN meds, JNC-7 concluded that lowering BP with above agents will be most effective at reducing complications of HTN There’s a shot for that?CYT006-AngQb Decrease in BP by inducing immunity against targets in the RAAS. Lowered daytime by -9/-4mmHg v. placebo and early morning by -25/-13mmHg Still in the early phase (pha