【高血压英文ppt课件】HYPERTENSION IN THE INPATIENT SETTING Mechanisms.ppt

HYPERTENSION IN THEINPATIENT SETTINGMechanisms and Pharmacologic Management;;;Situations Requiring InpatientAntihypertensive Treatment;At least 45% of hospitalized patients have preexisting hypertension About 25% of surgical patients have preexisting hypertension Hypertensive patients frequently have coexisting cardiac and vascular disease;EM MICU SICU OR PACU Obstetrics Suite;Uncontrolled or Malignant Hypertension Drug-Induced Hypertension cocaine, amphetamines drug withdrawal drug-drug interactions Endocrine Disorders;Parenteral Treatment of Hypertension May Be Required During/After Perioperative Period;Factors in the Development ofAcute Hypertension;Adverse Consequences ofUncontrolled Hypertension;Adrenergic Tone;Renin-Angiotensin-Aldosterone Regulation of Blood Pressure;Preoperative Hypertension;Therapy Treat the underlying cause Provide adequate anesthesia/analgesia Administer antihypertensive medications; 50 million adults have high blood pressure 25% are unaware of this condition 72.6% are not well controlled at goal of 140/90 Majority have additional CV risk factors;Classification of Blood Pressure*;Uncomplicated Stage 3 HTN Hypertensive Crises urgencies emergencies ;Hypertension with ? Progressive target organ damage;Severe HTN with acute end organ damage: ? Central nervous system ? Myocardial ischemia or heart failure ? Renal damage ? Active hemorrhage ? Eclampsia ? Microangiopathic hemolytic anemia ? Aortic dissection;Hypertensive Emergencies Are More Than Blood Pressure Measurement;Hypertensive Emergencies: Common Etiologies;? Sympathomimetic drug poisonings ? Eclampsia ? Pheochromocytoma ? MAO inhibitor interactions;? Hypertensive Emergencies Initiate treatment immediately ? Hypertensive Urgencies Reduce BP within a few hours ? Non-urgent Stage 3 Hypertension Reduce BP within one week;? Multiple confirmations of BP, including all four extremities ? Assess target