血管紧张素受体阻滞剂课件.pptVIP

2001/08/17 Jianzeng Dong 常规检查（JNC-VI 报告）Laboratory Tests Recommended Before Initiating Therapy 尿液分析（Urinalysis） 全血细胞记数（Complete blood count） 血生化（Blood chemistry ）：血糖、电解质、肾功能、血尿酸  血脂分析（Lipid profile）  ECG（12-lead electrocardiogram） 其它（选择性）检查 Optional Laboratory Tests   眼底检查 动态血压 评价高血压靶器官损害的程度 诊断继发性高血压的检查 动态血压Ambulatory BP Monitoring , ABPM 其它（选择性）检查 Optional Laboratory Tests diabetes or renal disease lower goal blood pressure targets are appropriate 24 hour or over night urine protein increased creatinine or renal disease renal ultrasound to exclude obstructionsymptom triad of headache, sweating, palpitations measure 24 hour urine catecholamine metabolites(VMA) to  assess for pheochromocytoma…… Arteriovenous nicking in association with hypertension(yellow arrow) Flame-shaped hemorrhage in association with severe hypertension(yellow arrow) Papilledema from malignant hypertension.There is blurring of the borders of the optic disk with hemorrhage(yellow arrows) and excudates(white arrow) Smoking Dyslipidemia Diabetes mellitus Age older than 60 years Sex (men or postmenopausal women) Family history of cardiovascular disease 把并发症写出 把选择性检查逐个写出，对应目的 把书上的正常值写出便可 每个病的典型特征 此表内容插入每一部分 把选择性检查逐个写出，对应目的 Hypertension hypotension 继发性高血压嗜铬细胞瘤 Renal parenchymal disease Renovascular disease Pheochromocytoma Primary aldosteronismCushing syndromeAortic coarctation Exogenous causes 。。。。。。 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 Organizati