内科学教学课件：Hypertension-prevention and treatment.ppt

Bronchial Asthma or Chronic Airway Disease Elevated blood pressure is common in acute asthma and is possibly related to treatment with systemic corticosteroids or ?-agonists. ?-blockers and??-?-blockers may exacerbate asthma. ACE inhibitors only rarely induce bronchospasm. Over-the-counter medications are generally safe in limited doses for patients on drug therapy. Gout Diuretics can increase serum uric acid levels. Diuretics should be avoided in patients with gout. Diuretic-induced hyperuricemia does not require treatment in the absence of gout or urate stones. Patients Undergoing Surgery When possible, surgery should be delayed until blood pressure is 180/110 mm Hg. Those not on prior drug therapy may be best treated with cardioselective??-blockers before and after surgery. Those with controlled blood pressure should continue medication until surgery and begin as soon after surgery as possible. Erythropoietin Erythropoietin often increases blood pressure in treatment of patients with end-stage renal disease. Management includes optimal volume control, antihypertensive agents, and reducing erythopoietin dose or changing method of administration. A population-wide strategy to reduce overall blood pressure by only a few mm Hg could affect overall cardiovascular morbidity and mortality as much as or more than treatment alone. A Population-Wide Strategy * 各个年龄组，20-50岁最快，工作人群 * 1999年第一个正式的中国高血压指南问世，大量的证据和研究为高血压及其相关疾病提供系统，深入的认识，但是 高血压的三率仍然很低 Lifetime Risk of Developing Hypertension Beginning at Age 65 Data from the Framingham Heart Study’s long-term follow-up indicate that the lifetime risk of developing hypertension is about 90 percent. The data are from a community-based prospective cohort study of 1,298 participants from the Framingham Heart Study who were between 55 and 65 years old and free of hypertension at baseline (1976-1998). The residual life-time risk for developing hypertension (depicted above) was estimated for participants who reached the age of 65 fre