血管紧张素受体阻滞剂ppt课件.ppt

2001/08/17 Jianzeng Dong * * awareness * * * * * * * * * * * * * * 继发性高血压嗜铬细胞瘤 Renal parenchymal disease Renovascular disease Pheochromocytoma Primary aldosteronismCushing syndromeAortic coarctation Exogenous causes 。。。。。。 2001/08/17 * Jianzeng Dong Risk Assessment Risk strata (typical 10 year risk of stroke or myocardial infarction): Low risk = less than 15%; medium risk = about 15-20% risk; high risk = about 20-30%; very high risk = 30% or more 1. TOD – Target Organ Damage 2. ACC – Associated Clinical Conditions, including clinical cardiovascular disease or renal disease Stratification of Risk to Quantify Prognosis Reference: Chalmers J et al. WHO-ISH Hypertension Guidelines Committee. 1999 World Health Organization - International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens, 1999, 17:151-185. Other Risk Factors Disease History Grade 1 Grade 2 Grade 3 BLOOD PRESSURE (mm Hg) (mild hypertension) SBP 140-159 or DBP 90-99 (moderate hypertension) SBP 160-179 or DBP 100-109 (severe hypertension) SBP ≥ 180 or DBP ≥ 110 MED RISK LOW RISK HIGH RISK V HIGH RISK V HIGH RISK V HIGH RISK MED RISK MED RISK HIGH RISK HIGH RISK V HIGH RISK V HIGH RISK I. no other risk factors II. 1-2 risk factors III. 3 or more risk factors or TOD or diabetes IV. ACC 2001/08/17 * Jianzeng Dong 内分泌性 原醛 嗜咯细胞瘤 肾素瘤 其它 高血压原因 2001/08/17 * Jianzeng Dong 高血压病的治疗--治疗策略 治疗I II级高血压(140~180/90~110mmHG) 改善生活方式 评估: 危险因素 靶器官损害 并存临床表现 很高危 高危 中危 低危 药物治疗 监测3~6月 监测6~12月 BP≥ 150/95 BP 150/95 BP 140/90 BP≥ 140/90 继续监测 2001/08/17 * Jianzeng Dong 适应证 禁忌证 限制作用 利尿剂 心力衰竭 收缩期高血压 痛风 血脂异常 妊娠 老年高血压 β受体阻止剂 劳力型心绞痛 MI后 慢阻肺 哮喘 高甘油三酯血症 快速心律失常 心衰 周围血管病 I型糖尿病 II