This document discusses the diagnosis and management of hypertension. It defines hypertension as blood pressure above 140/90 mmHg or being on antihypertensive medication. The main types are essential and secondary hypertension. Lifestyle modifications like weight loss, exercise, and diet changes can help control hypertension before starting medications. Common drug classes for treatment include diuretics, ACE inhibitors, calcium channel blockers, angiotensin receptor blockers, and beta blockers. The goals of treatment are to reduce target organ damage and cardiovascular risk by achieving a blood pressure under 140/90 mmHg or 130/80 mmHg for those with diabetes or chronic kidney disease.
This document discusses the classification, evaluation, and management of hypertensive crises. It defines hypertensive emergency as severe hypertension with acute end-organ damage requiring immediate treatment to lower blood pressure, while hypertensive urgency involves severe hypertension without end-organ damage that usually allows for gradual blood pressure reduction over 24-48 hours. It provides guidelines for initial evaluation, laboratory testing, goals of therapy, recommended antihypertensive agents, and dosing for treating different types of hypertensive crises.
2017 AHA ACC Hypertension Guidelines made simpleMgfamiliar Net
This document provides guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults. It includes tables and figures from the full 2017 ACC/AHA hypertension guideline. Table 6 defines categories of blood pressure. Table 11 lists corresponding blood pressure values for different measurement methods. Figure 1 provides an approach for detecting white coat hypertension or masked hypertension in patients not on drug therapy.
This document provides an overview of hypertension including its diagnosis, management, and treatment. It defines hypertension and classifies blood pressure levels. Lifestyle factors and common causes of primary and secondary hypertension are discussed. Target organ damage from hypertension is described along with clinical manifestations. Treatment involves lifestyle modifications and medication including diuretics, beta blockers, ACE inhibitors, calcium channel blockers, and ARBs. Factors influencing medication choice and treatment failure are also summarized.
(1) The document discusses the evaluation, classification, and treatment of hypertensive emergencies and urgencies. It defines the differences between the two conditions and outlines the goals and approaches for treating each.
(2) For hypertensive urgencies, the goal is to lower blood pressure within several hours to prevent further increases without causing too rapid of a drop. For emergencies, the goal is to reduce blood pressure more quickly to prevent end-organ damage, while maintaining adequate perfusion.
(3) Several intravenous antihypertensive drugs are discussed as options for treatment in hypertensive emergencies, including nitroprusside, nicardipine, labetalol, and
This document discusses the management of hypertensive emergencies and urgencies. It defines hypertensive emergencies as marked blood pressure elevation with acute life-threatening organ damage, requiring rapid BP reduction in an ICU. Hypertensive urgencies involve significant but not life-threatening BP elevation without acute organ dysfunction, allowing gradual oral medication-based BP reduction over hours. The document reviews ideal intravenous antihypertensive agents, special considerations for neurological, cardiovascular and other emergencies, and the treatment of hypertensive urgencies.
This document discusses resistant hypertension and its treatment. It defines resistant hypertension as blood pressure that remains above goal despite use of three antihypertensive agents from different classes including a diuretic. Treatment involves identifying and treating secondary causes, adjusting medications that raise blood pressure, monitoring blood pressure outside the office, making lifestyle changes, and using pharmacologic therapies like diuretics, aldosterone antagonists, and catheter-based renal denervation. While renal denervation showed promise in early trials, the SYMPLICITY HTN-3 trial found it did not significantly reduce blood pressure compared to a sham procedure.
This document provides an overview of hypertension including its definition, causes, prevalence, risk factors, evaluation, treatment goals, lifestyle modifications, medication classes, and treatment targets. Some key points:
- Hypertension is defined as blood pressure over 140/90 mmHg and increases cardiovascular risk. The prevalence increases with age from 4% in children to over 60% in those over 70 years old.
- Risk factors include age, family history, obesity, sleep apnea, smoking, diet, physical inactivity, alcohol, and stress. Evaluation includes tests to identify secondary causes and assess target organ damage.
- Lifestyle modifications like weight loss, the DASH diet, sodium reduction, and exercise can significantly lower blood
hypertension and coronary artery diseasemagdy elmasry
1. The new guidelines recommend treating hypertension in patients with coronary artery disease (CAD) or a history of acute coronary syndrome (ACS) aggressively to reduce cardiovascular risk.
2. For stable CAD, the target blood pressure is <140/90 mmHg, or <130/80 mmHg for those at high risk, using a regimen including a beta-blocker, ACE inhibitor or ARB, and diuretic. For ACS, the target is <140/90 mmHg acutely or <130/80 mmHg upon discharge.
3. For heart failure of ischemic origin, treatments shown to improve outcomes - including ACE inhibitors, beta-blockers, aldosterone antagonists, and
This document discusses the classification, evaluation, and management of hypertensive crises. It defines hypertensive emergency as severe hypertension with acute end-organ damage requiring immediate treatment to lower blood pressure, while hypertensive urgency involves severe hypertension without end-organ damage that usually allows for gradual blood pressure reduction over 24-48 hours. It provides guidelines for initial evaluation, laboratory testing, goals of therapy, recommended antihypertensive agents, and dosing for treating different types of hypertensive crises.
2017 AHA ACC Hypertension Guidelines made simpleMgfamiliar Net
This document provides guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults. It includes tables and figures from the full 2017 ACC/AHA hypertension guideline. Table 6 defines categories of blood pressure. Table 11 lists corresponding blood pressure values for different measurement methods. Figure 1 provides an approach for detecting white coat hypertension or masked hypertension in patients not on drug therapy.
This document provides an overview of hypertension including its diagnosis, management, and treatment. It defines hypertension and classifies blood pressure levels. Lifestyle factors and common causes of primary and secondary hypertension are discussed. Target organ damage from hypertension is described along with clinical manifestations. Treatment involves lifestyle modifications and medication including diuretics, beta blockers, ACE inhibitors, calcium channel blockers, and ARBs. Factors influencing medication choice and treatment failure are also summarized.
(1) The document discusses the evaluation, classification, and treatment of hypertensive emergencies and urgencies. It defines the differences between the two conditions and outlines the goals and approaches for treating each.
(2) For hypertensive urgencies, the goal is to lower blood pressure within several hours to prevent further increases without causing too rapid of a drop. For emergencies, the goal is to reduce blood pressure more quickly to prevent end-organ damage, while maintaining adequate perfusion.
(3) Several intravenous antihypertensive drugs are discussed as options for treatment in hypertensive emergencies, including nitroprusside, nicardipine, labetalol, and
This document discusses the management of hypertensive emergencies and urgencies. It defines hypertensive emergencies as marked blood pressure elevation with acute life-threatening organ damage, requiring rapid BP reduction in an ICU. Hypertensive urgencies involve significant but not life-threatening BP elevation without acute organ dysfunction, allowing gradual oral medication-based BP reduction over hours. The document reviews ideal intravenous antihypertensive agents, special considerations for neurological, cardiovascular and other emergencies, and the treatment of hypertensive urgencies.
This document discusses resistant hypertension and its treatment. It defines resistant hypertension as blood pressure that remains above goal despite use of three antihypertensive agents from different classes including a diuretic. Treatment involves identifying and treating secondary causes, adjusting medications that raise blood pressure, monitoring blood pressure outside the office, making lifestyle changes, and using pharmacologic therapies like diuretics, aldosterone antagonists, and catheter-based renal denervation. While renal denervation showed promise in early trials, the SYMPLICITY HTN-3 trial found it did not significantly reduce blood pressure compared to a sham procedure.
This document provides an overview of hypertension including its definition, causes, prevalence, risk factors, evaluation, treatment goals, lifestyle modifications, medication classes, and treatment targets. Some key points:
- Hypertension is defined as blood pressure over 140/90 mmHg and increases cardiovascular risk. The prevalence increases with age from 4% in children to over 60% in those over 70 years old.
- Risk factors include age, family history, obesity, sleep apnea, smoking, diet, physical inactivity, alcohol, and stress. Evaluation includes tests to identify secondary causes and assess target organ damage.
- Lifestyle modifications like weight loss, the DASH diet, sodium reduction, and exercise can significantly lower blood
hypertension and coronary artery diseasemagdy elmasry
1. The new guidelines recommend treating hypertension in patients with coronary artery disease (CAD) or a history of acute coronary syndrome (ACS) aggressively to reduce cardiovascular risk.
2. For stable CAD, the target blood pressure is <140/90 mmHg, or <130/80 mmHg for those at high risk, using a regimen including a beta-blocker, ACE inhibitor or ARB, and diuretic. For ACS, the target is <140/90 mmHg acutely or <130/80 mmHg upon discharge.
3. For heart failure of ischemic origin, treatments shown to improve outcomes - including ACE inhibitors, beta-blockers, aldosterone antagonists, and
This document summarizes guidelines from the Eighth Joint National Committee (JNC 8) on the prevention, detection, evaluation, and treatment of high blood pressure. It provides recommendations on when to initiate pharmacologic treatment based on age, race, presence of diabetes or chronic kidney disease. It recommends treating to a blood pressure goal of less than 150/90 mmHg for those aged 60 or older, and less than 140/90 mmHg for others. It also provides guidance on first-line antihypertensive drug classes based on patient characteristics.
Unstable angina is a form of ischemic heart disease where a person experiences chest pain or discomfort that occurs at rest or with minimal exertion. It is caused by decreased blood supply to the heart muscle due to partial blockage of the coronary arteries. Diagnosis involves taking a medical history, electrocardiogram, cardiac enzyme tests, and stress testing. Treatment consists of blood thinners, nitroglycerin, blood pressure medications, and cholesterol-lowering drugs medically or early cardiac catheterization and angioplasty or bypass surgery if high risk.
This document discusses hypertension in patients with chronic kidney disease. It begins by noting that hypertension and diabetes are leading causes of end-stage renal disease. It then discusses how poorly controlled hypertension can cause or accelerate renal failure. The document provides an overview of diseases attributable to hypertension and outlines the paradigm shift in hypertension therapy to focus on more than just lowering blood pressure. It also discusses lifestyle modifications, target organ damage, left ventricular hypertrophy, dipping patterns, morbidity and mortality related to hypertension, and approaches to hypertension treatment and management.
This document discusses hypertension, including its definition, staging, classification, causes, risk factors, prevention, and management. Some key points:
- Hypertension is defined as elevated blood pressure over 140/90 mmHg. It is classified as essential (90% of cases) or secondary (10% due to identifiable causes like kidney disease).
- Risk factors include non-modifiable factors like age as well as modifiable behaviors such as diet, physical activity, weight, and alcohol intake.
- Prevention focuses on lifestyle modifications like diet, exercise, weight control to reduce risk, as well as early detection and treatment of elevated blood pressure.
- Management involves lifestyle changes and may include pharmacological treatment starting with
1. The document discusses guidelines and strategies for the prevention, treatment, and control of hypertension.
2. It outlines 4 stages of intervention for hypertension: preventive, primary, secondary, and resistant hypertension. Treatment approaches differ depending on the stage.
3. The challenges of controlling hypertension include special patient populations, factors influencing drug choice, and issues related to resistant hypertension when blood pressure remains high despite treatment with 3 drug classes.
This document discusses hypertension and antihypertensive drugs. It defines hypertension and describes the classification and stages of hypertension based on blood pressure levels. It also covers the types of hypertension, causes, signs and symptoms, investigations, and treatment approach including lifestyle modifications and drug therapy. The document then describes several classes of antihypertensive drugs in detail, including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, and their mechanisms of action, uses, side effects, and drug interactions.
This document defines hypertensive emergencies and discusses their management. It begins by classifying hypertension and defining hypertensive crises. Hypertensive emergencies are acute severe hypertension with signs of target organ damage, while hypertensive urgencies have severe hypertension without organ damage. The document then covers the epidemiology, etiology, pathophysiology, presentation, investigations, and management of hypertensive emergencies. It discusses treating different organ-specific emergencies like stroke, heart failure, and kidney injury. The management involves rapid blood pressure reduction while monitoring for complications. Various intravenous medications are outlined to treat specific emergencies. Careful titration is needed due to the risk of overtreatment.
Management strategy in HF with ARNI - Recent updates Praveen Nagula
- The document discusses management strategies for heart failure with reduced ejection fraction (HFrEF), including recent updates.
- It summarizes key differences between Indian and Western HF patients, noting that Indians develop HF at a younger age and with lower ejection fractions. Prognosis is also worse for Indian patients compared to those in the West.
- Core therapies for HFrEF are discussed, including a paradigm shift with the approval of sacubitril-valsartan which has been shown to reduce cardiovascular death compared to ACE inhibitors or ARBs alone in clinical trials.
This document summarizes the 2018 ESC guidelines for management of arterial hypertension. It discusses definitions of hypertension, epidemiology including rising prevalence in Africa and Nigeria, recommendations and evidence for treatment, changes from prior guidelines, types of blood pressure measurement, hypertension and common comorbidities, treatment strategies including lifestyle modifications and drug therapy, and management of hypertension in special populations and clinical scenarios.
This document discusses hypertension (high blood pressure). It defines hypertension as a blood pressure reading higher than 140/90 mmHg. It classifies hypertension and notes risks increase with each increment of 20/10 mmHg from 115/75 mmHg. The document outlines primary/essential hypertension which has unknown causes and secondary hypertension which has identifiable causes like renal or endocrine issues. It discusses the pathogenesis of hypertension involving the renin-angiotensin-aldosterone system and sodium retention. The clinical effects of hypertension on the heart, nervous system, and kidneys are covered along with diagnostic tests and pathological findings.
Essential hypertension management and treatmentFabio Grubba
This document discusses hypertension (high blood pressure), including its classification, causes, symptoms, diagnosis, and treatment. It defines the different stages of hypertension according to blood pressure readings. Lifestyle modifications are recommended initially, including diet changes and exercise. If lifestyle changes do not control blood pressure, medications such as diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and other drug classes may be used. The goal of treatment is to prevent complications in target organs like the heart, brain, and kidneys by maintaining a blood pressure below 140/90 mmHg.
The document discusses the rationale and history of using combination therapy to treat hypertension. It notes that combination therapy has been used since the 1950s and studies in the 1960s showed improved blood pressure control and reduced morbidity. Guidelines now recommend initial combination therapy using single pill combinations over stepwise monotherapy due to greater effectiveness in reducing blood pressure and heart disease risk. For patients still uncontrolled on dual therapy, guidelines recommend adding a third drug, often in a single pill combination, to help achieve target blood pressure goals.
1) Hypertension is defined as blood pressure above 140/90 mm Hg and affects about one third of US adults.
2) Primary or essential hypertension, which accounts for 85-95% of cases, has no identifiable cause but is influenced by genetic and environmental factors like obesity, smoking, and stress.
3) Hypertension usually does not cause symptoms until end organ damage occurs, and it increases the risk of heart disease, stroke, kidney disease and other complications if not treated.
This document summarizes guidelines for treating hypertension. It defines hypertension and classifications of blood pressure. The goals of treatment are to reduce risks of stroke, heart disease, heart failure, and kidney disease. Lifestyle changes and medication are used to achieve a target blood pressure of less than 140/90 mmHg or 130/80 mmHg for those with diabetes or chronic kidney disease. Initial drug therapy typically involves thiazide diuretics alone or combined with other classes of drugs depending on individual risk factors and medical conditions. Special considerations are given to treating hypertension in pregnancy, kidney disease, heart disease and other compelling indications.
The document outlines a presentation on hypertension and hypertensive disorders for allied health workers. It begins with an introduction and outline covering hypertension and hypertensive disorders of pregnancy. The outline discusses risk factors and diagnosis of hypertension, as well as management of hypertensive crisis. Guidelines for diagnosing and treating hypertension from sources like the 2020 Philippine CPG are also summarized.
Management of hypertensive condition in 2020 according to AHA/ASA guidelines. We will discuss the presentation, clinical assessment, investigations, and management of hypertension along with major randomized controlled trials and guidelines.
This document provides an outline and overview of hypertension and hypertensive emergencies. It discusses the definition, pathophysiology, evaluation, treatment and management of hypertension as well as specific topics like pediatric, renal and pregnancy-related hypertension. Evaluation involves assessing for secondary causes and end-organ damage to the brain, eyes, heart and kidneys. Treatment goals are to lower blood pressure in a controlled manner to prevent adverse events while preserving organ function. Both oral and intravenous antihypertensive medications are discussed.
Combination Therapy In Hypertension - Dr Vivek Baliga PresentationDr Vivek Baliga
Dr Vivek Baliga of Baliga Diagnostics, Bangalore, discusses the common combination therapies used in the management of hypertension in clinical practice.
Hypertension is defined as blood pressure above 140/90 mmHg or taking antihypertensive medication. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as pharmacologic treatments. Drug therapy aims to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to decrease risk of heart disease and stroke. Treatment involves diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and other drugs depending on individual factors. Goals are to control blood pressure and reduce target organ damage through lifestyle and medical treatment.
Hypertension is defined as blood pressure above 140/90 mmHg or taking antihypertensive medication. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as pharmacologic treatments. Drug therapy aims to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to decrease risk of heart disease and stroke. Treatment involves diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and other drugs depending on individual factors. Goals are to control blood pressure and reduce target organ damage through lifestyle and medical treatment.
This document summarizes guidelines from the Eighth Joint National Committee (JNC 8) on the prevention, detection, evaluation, and treatment of high blood pressure. It provides recommendations on when to initiate pharmacologic treatment based on age, race, presence of diabetes or chronic kidney disease. It recommends treating to a blood pressure goal of less than 150/90 mmHg for those aged 60 or older, and less than 140/90 mmHg for others. It also provides guidance on first-line antihypertensive drug classes based on patient characteristics.
Unstable angina is a form of ischemic heart disease where a person experiences chest pain or discomfort that occurs at rest or with minimal exertion. It is caused by decreased blood supply to the heart muscle due to partial blockage of the coronary arteries. Diagnosis involves taking a medical history, electrocardiogram, cardiac enzyme tests, and stress testing. Treatment consists of blood thinners, nitroglycerin, blood pressure medications, and cholesterol-lowering drugs medically or early cardiac catheterization and angioplasty or bypass surgery if high risk.
This document discusses hypertension in patients with chronic kidney disease. It begins by noting that hypertension and diabetes are leading causes of end-stage renal disease. It then discusses how poorly controlled hypertension can cause or accelerate renal failure. The document provides an overview of diseases attributable to hypertension and outlines the paradigm shift in hypertension therapy to focus on more than just lowering blood pressure. It also discusses lifestyle modifications, target organ damage, left ventricular hypertrophy, dipping patterns, morbidity and mortality related to hypertension, and approaches to hypertension treatment and management.
This document discusses hypertension, including its definition, staging, classification, causes, risk factors, prevention, and management. Some key points:
- Hypertension is defined as elevated blood pressure over 140/90 mmHg. It is classified as essential (90% of cases) or secondary (10% due to identifiable causes like kidney disease).
- Risk factors include non-modifiable factors like age as well as modifiable behaviors such as diet, physical activity, weight, and alcohol intake.
- Prevention focuses on lifestyle modifications like diet, exercise, weight control to reduce risk, as well as early detection and treatment of elevated blood pressure.
- Management involves lifestyle changes and may include pharmacological treatment starting with
1. The document discusses guidelines and strategies for the prevention, treatment, and control of hypertension.
2. It outlines 4 stages of intervention for hypertension: preventive, primary, secondary, and resistant hypertension. Treatment approaches differ depending on the stage.
3. The challenges of controlling hypertension include special patient populations, factors influencing drug choice, and issues related to resistant hypertension when blood pressure remains high despite treatment with 3 drug classes.
This document discusses hypertension and antihypertensive drugs. It defines hypertension and describes the classification and stages of hypertension based on blood pressure levels. It also covers the types of hypertension, causes, signs and symptoms, investigations, and treatment approach including lifestyle modifications and drug therapy. The document then describes several classes of antihypertensive drugs in detail, including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, and their mechanisms of action, uses, side effects, and drug interactions.
This document defines hypertensive emergencies and discusses their management. It begins by classifying hypertension and defining hypertensive crises. Hypertensive emergencies are acute severe hypertension with signs of target organ damage, while hypertensive urgencies have severe hypertension without organ damage. The document then covers the epidemiology, etiology, pathophysiology, presentation, investigations, and management of hypertensive emergencies. It discusses treating different organ-specific emergencies like stroke, heart failure, and kidney injury. The management involves rapid blood pressure reduction while monitoring for complications. Various intravenous medications are outlined to treat specific emergencies. Careful titration is needed due to the risk of overtreatment.
Management strategy in HF with ARNI - Recent updates Praveen Nagula
- The document discusses management strategies for heart failure with reduced ejection fraction (HFrEF), including recent updates.
- It summarizes key differences between Indian and Western HF patients, noting that Indians develop HF at a younger age and with lower ejection fractions. Prognosis is also worse for Indian patients compared to those in the West.
- Core therapies for HFrEF are discussed, including a paradigm shift with the approval of sacubitril-valsartan which has been shown to reduce cardiovascular death compared to ACE inhibitors or ARBs alone in clinical trials.
This document summarizes the 2018 ESC guidelines for management of arterial hypertension. It discusses definitions of hypertension, epidemiology including rising prevalence in Africa and Nigeria, recommendations and evidence for treatment, changes from prior guidelines, types of blood pressure measurement, hypertension and common comorbidities, treatment strategies including lifestyle modifications and drug therapy, and management of hypertension in special populations and clinical scenarios.
This document discusses hypertension (high blood pressure). It defines hypertension as a blood pressure reading higher than 140/90 mmHg. It classifies hypertension and notes risks increase with each increment of 20/10 mmHg from 115/75 mmHg. The document outlines primary/essential hypertension which has unknown causes and secondary hypertension which has identifiable causes like renal or endocrine issues. It discusses the pathogenesis of hypertension involving the renin-angiotensin-aldosterone system and sodium retention. The clinical effects of hypertension on the heart, nervous system, and kidneys are covered along with diagnostic tests and pathological findings.
Essential hypertension management and treatmentFabio Grubba
This document discusses hypertension (high blood pressure), including its classification, causes, symptoms, diagnosis, and treatment. It defines the different stages of hypertension according to blood pressure readings. Lifestyle modifications are recommended initially, including diet changes and exercise. If lifestyle changes do not control blood pressure, medications such as diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and other drug classes may be used. The goal of treatment is to prevent complications in target organs like the heart, brain, and kidneys by maintaining a blood pressure below 140/90 mmHg.
The document discusses the rationale and history of using combination therapy to treat hypertension. It notes that combination therapy has been used since the 1950s and studies in the 1960s showed improved blood pressure control and reduced morbidity. Guidelines now recommend initial combination therapy using single pill combinations over stepwise monotherapy due to greater effectiveness in reducing blood pressure and heart disease risk. For patients still uncontrolled on dual therapy, guidelines recommend adding a third drug, often in a single pill combination, to help achieve target blood pressure goals.
1) Hypertension is defined as blood pressure above 140/90 mm Hg and affects about one third of US adults.
2) Primary or essential hypertension, which accounts for 85-95% of cases, has no identifiable cause but is influenced by genetic and environmental factors like obesity, smoking, and stress.
3) Hypertension usually does not cause symptoms until end organ damage occurs, and it increases the risk of heart disease, stroke, kidney disease and other complications if not treated.
This document summarizes guidelines for treating hypertension. It defines hypertension and classifications of blood pressure. The goals of treatment are to reduce risks of stroke, heart disease, heart failure, and kidney disease. Lifestyle changes and medication are used to achieve a target blood pressure of less than 140/90 mmHg or 130/80 mmHg for those with diabetes or chronic kidney disease. Initial drug therapy typically involves thiazide diuretics alone or combined with other classes of drugs depending on individual risk factors and medical conditions. Special considerations are given to treating hypertension in pregnancy, kidney disease, heart disease and other compelling indications.
The document outlines a presentation on hypertension and hypertensive disorders for allied health workers. It begins with an introduction and outline covering hypertension and hypertensive disorders of pregnancy. The outline discusses risk factors and diagnosis of hypertension, as well as management of hypertensive crisis. Guidelines for diagnosing and treating hypertension from sources like the 2020 Philippine CPG are also summarized.
Management of hypertensive condition in 2020 according to AHA/ASA guidelines. We will discuss the presentation, clinical assessment, investigations, and management of hypertension along with major randomized controlled trials and guidelines.
This document provides an outline and overview of hypertension and hypertensive emergencies. It discusses the definition, pathophysiology, evaluation, treatment and management of hypertension as well as specific topics like pediatric, renal and pregnancy-related hypertension. Evaluation involves assessing for secondary causes and end-organ damage to the brain, eyes, heart and kidneys. Treatment goals are to lower blood pressure in a controlled manner to prevent adverse events while preserving organ function. Both oral and intravenous antihypertensive medications are discussed.
Combination Therapy In Hypertension - Dr Vivek Baliga PresentationDr Vivek Baliga
Dr Vivek Baliga of Baliga Diagnostics, Bangalore, discusses the common combination therapies used in the management of hypertension in clinical practice.
Hypertension is defined as blood pressure above 140/90 mmHg or taking antihypertensive medication. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as pharmacologic treatments. Drug therapy aims to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to decrease risk of heart disease and stroke. Treatment involves diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and other drugs depending on individual factors. Goals are to control blood pressure and reduce target organ damage through lifestyle and medical treatment.
Hypertension is defined as blood pressure above 140/90 mmHg or taking antihypertensive medication. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as pharmacologic treatments. Drug therapy aims to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to decrease risk of heart disease and stroke. Treatment involves diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and other drugs depending on individual factors. Goals are to control blood pressure and reduce target organ damage through lifestyle and medical treatment.
Hypertension is defined as blood pressure over 140/90 mmHg or taking medication for it. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as medications. Goals of treatment are to lower blood pressure to under 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to prevent heart disease and stroke. Treatment begins with lifestyle changes and may involve one or more classes of blood pressure medications including diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and ARBs.
This document provides information about hypertension including its definition, types, causes, risk factors, diagnosis, treatment, goals of therapy, and lifestyle modifications. It defines hypertension as blood pressure higher than 140/90 mmHg and describes the classification of blood pressure readings. The treatment section discusses lifestyle changes and various classes of antihypertensive medications used to treat hypertension.
hypertension and pathophysiology and nursing interventionswajidullah9551
This document discusses diagnosis and management of hypertension. It defines hypertension and describes types, risk factors, causes, classification, goals of treatment, lifestyle modifications, and drug therapy options. The main points are:
- Hypertension is defined as blood pressure over 140/90 mmHg or taking medication for it. It can be primary or secondary.
- Risk factors include age, obesity, diabetes, lifestyle factors, and genetics. Secondary causes include renal, endocrine, and other issues.
- Treatment goals are to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease.
- Lifestyle changes like diet, exercise, weight loss and limiting alcohol/
This document provides information on the diagnosis and management of hypertension. It defines hypertension as blood pressure greater than 140/90 mmHg. It describes the types and causes of hypertension, including essential (95% of cases, no identifiable cause) and secondary (underlying cause such as renal or endocrine issues). Target organ damage from uncontrolled hypertension includes effects on the heart, brain, kidneys, and retina. Lifestyle modifications and medication are used to treat hypertension with the goals of reducing blood pressure below 140/90 mmHg to prevent cardiovascular events. Common classes of antihypertensive medications discussed include diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and angiotensin receptor blockers.
Hypertension is defined as blood pressure over 140/90 mmHg or taking medication for it. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, diet changes and medication if needed. Goals are to reduce blood pressure below 140/90 mmHg or 130/80 for those with diabetes or kidney disease. First line drugs include diuretics, ACE inhibitors, calcium channel blockers, and angiotensin receptor blockers. Multiple drugs may be needed and lifestyle changes are important to control hypertension.
1. Hypertension is defined as a systolic blood pressure of 160 mmHg or higher and/or a diastolic blood pressure of 95 mmHg or higher. It can be essential (95% of cases, no identifiable cause) or secondary (5% of cases, an underlying cause such as kidney, endocrine, or other diseases).
2. Risk factors for hypertension include increasing age, male sex, family history, sedentary lifestyle, smoking, diet high in salt and cholesterol, obesity, diabetes, and alcohol use. Target organ damage includes heart, brain, kidneys, and eyes.
3. Treatment involves lifestyle modifications like weight loss, exercise, diet changes, and limiting alcohol. Medic
Hypertension is defined as blood pressure above 140/90 mmHg. It can be essential (95% of cases, no identifiable cause) or secondary (5% of cases, due to an underlying condition like kidney disease). Lifestyle modifications like weight loss, reduced salt intake, exercise, and moderation of alcohol can help control hypertension. If lifestyle changes are not enough, medications may be prescribed. Common classes of medications include diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and ARBs, which work to lower blood pressure by different mechanisms like reducing fluid volume or relaxing blood vessels. Controlling high blood pressure helps prevent damage to organs like the heart, brain, and kidneys that can
this presentation describes the rational treatment of hypertension and its management. there are some pharmacological and non - pharmacological approaches.
Hypertension is defined as blood pressure above 140/90 mmHg. It can be essential (95% of cases, no identifiable cause) or secondary (5% of cases, due to an underlying cause like kidney or endocrine diseases). Treatment involves lifestyle modifications like reduced salt intake, weight loss, exercise, as well as pharmacotherapy using diuretics, ACE inhibitors, calcium channel blockers, ARBs or other drugs. Goals of treatment are to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or chronic kidney disease to decrease risks of heart disease, stroke and other complications. Resistant hypertension may require multiple drug classes or identification and treatment of an underlying secondary cause.
Hypertension is defined as blood pressure over 140/90 mmHg or taking medication for it. It has no known cause (essential) in 95% of cases. Treatment involves lifestyle changes like losing weight, reducing salt, and medication. Goals are to lower blood pressure below 140/90 mmHg to reduce risks of heart disease, stroke, kidney disease and death. Treatment begins with lifestyle changes and may involve drugs like diuretics, ACE inhibitors, calcium channel blockers, and ARBs alone or in combination based on individual factors. Strict control is needed to prevent complications.
This document provides an overview of hypertension, including its causes, symptoms, types, complications, diagnosis, treatment, and management. It discusses essential and secondary hypertension, complications such as heart failure and stroke, diagnostic criteria, lifestyle modifications, drug therapy options including diuretics, beta blockers, ACE inhibitors, and more. Treatment involves lifestyle changes, medication, and monitoring to control blood pressure and reduce complications.
This Will Give Detail Information On HYPERTENSION likes Types, Sign and Symptoms, Causes , Identification Test, Treatment, Drug Use for It .
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This document discusses hypertension, including:
1. Factors that influence blood pressure such as heart rate, sympathetic nervous system activity, vasoconstriction, and fluid volume.
2. Definitions of blood pressure measurements and classifications of hypertension.
3. Causes of primary and secondary hypertension, as well as risk factors for primary hypertension.
4. Potential complications of uncontrolled hypertension like heart disease, stroke, kidney disease, and eye damage.
5. Treatment involves lifestyle modifications and medication to lower blood pressure and reduce cardiovascular risk.
This document discusses hypertension, including:
1. Factors that influence blood pressure such as heart rate, sympathetic nervous system activity, vasoconstriction, and fluid volume.
2. Definitions of blood pressure measurements and classifications of hypertension.
3. Causes of primary and secondary hypertension, as well as risk factors for primary hypertension.
4. Potential complications of uncontrolled hypertension like heart disease, stroke, kidney disease, and eye damage.
5. Treatment involves lifestyle modifications and medication to lower blood pressure and reduce cardiovascular risk.
Hypertension is defined as blood pressure above 140/90 mmHg or taking medication for it. It is usually essential or primary hypertension with no identifiable cause (95% of cases). Secondary hypertension has an identifiable underlying cause like kidney, endocrine or other issues. Diagnosis involves measuring blood pressure with the correct technique on multiple occasions. Treatment aims to reduce blood pressure below 140/90 mmHg (130/80 for those with diabetes or kidney disease) through lifestyle changes and medication if needed. Lifestyle changes include weight loss, reduced salt, increased exercise and moderation of alcohol. Medications include diuretics, ACE inhibitors, calcium channel blockers, beta blockers and others, often in combination depending on the individual's
Hypertension, or high blood pressure, is a condition where the blood pressure in the arteries is consistently higher than normal. The document discusses hypertension in detail, including:
- Definitions of prehypertension and hypertension based on blood pressure readings
- Types of hypertension such as essential and secondary
- Causes and risk factors for developing hypertension
- Evaluation and testing used to diagnose hypertension and check for target organ damage
- Diseases and health complications attributable to uncontrolled hypertension
- Lifestyle changes and medications used to treat hypertension, including diuretics, ACE inhibitors, calcium channel blockers, and beta blockers.
VA ECMO provides both respiratory and cardiac support by draining venous blood, oxygenating it, and returning it to the arterial system. It can be done through peripheral cannulation of the femoral vessels or through central cannulation of the neck vessels. Careful patient selection and technical considerations like cannula size and placement are important. Monitoring of clinical parameters, labs, imaging, and the ECMO circuit are vital to detect any complications early.
Este documento describe y compara diversas técnicas para el diagnóstico de la cardiopatía isquémica, incluyendo técnicas funcionales como la ergometría, el ecoestrés, la SPECT, la PET y la RMN, así como técnicas anatómicas como el TC para medir el score de calcio coronario y la coronariografía TC. Se discuten las ventajas y limitaciones de cada técnica y su utilidad para la detección de isquemia, la evaluación de la viabilidad miocárdica y la visualización
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hypertension final.ppt
1. Diagnosis and management
of Hypertension
Dr. Kauser Usman (MD)
Associate Professor
Department of Medicine
King George’s Medical University, Lucknow
2. Hypertension is defined as systolic blood
pressure (SBP) of 140 mmHg or greater,
diastolic blood pressure (DBP) of
90 mmHg or greater, or taking
antihypertensive medication.
VI JNC, 1997
3. Types of hypertension
• Essential hypertension
– 95%
– No underlying cause
• Secondary hypertension
– Underlying cause
6. Blood Pressure
Classification
Normal <120 and <80
Prehypertension 120–139 or 80–89
Stage 1
Hypertension
140–159 or 90–99
Stage 2
Hypertension
>160 or >100
BP
Classification
SBP
mmHg
DBP
mmHg
7. Incidence in India
• 25% of urban population and 10 % of rural
population suffer from hypertension
• 70% of all hypertensive patients are stage I
hypertension
• 12% of all hypertensive suffer from isolated systolic
hypertension
9. Hypertension:
Predisposing factors
• Advancing Age
• Sex (men and postmenopausal women)
• Family history of cardiovascular disease
• Sedentary life style & psycho-social stress
• Smoking ,High cholesterol diet, Low fruit
consumption
• Obesity & wt. gain
• Co-existing disorders such as diabetes, and
hyperlipidaemia
• High intake of alcohol
14. Diseases Attributable to
Hypertension
HYPERTENSION
Gangrene of the
Lower Extremities
Heart
Failure
Left Ventricular
Hypertrophy Myocardial
Infarction
Coronary Heart
Disease
Aortic
Aneurym
Blindness
Chronic
Kidney
Failure
Stroke Preeclampsia/
Eclampsia
Cerebral
Hemorrhage
Hypertensive
encephalopathy
Adapted from Dustan HP et al. Arch Intern Med. 1996; 156: 1926-1935
15. Target Organ Damage
Heart
• Left ventricular hypertrophy
• Angina or myocardial infarction
• Heart failure
Brain
• Stroke or transient ischemic attack
Chronic kidney disease
Peripheral arterial disease
Retinopathy
16. CVD Risk
The BP relationship to risk of CVD is continuous,
consistent, and independent of other risk factors.
Prehypertension signals the need for increased
education to reduce BP in order to prevent
hypertension.
18. Clinical manifestations
• No specific complains or manifestations other than
elevated systolic and/or diastolic BP (Silent Killer )
• Morning occipital headache
• Dizziness
• Fatigue
• In severe hypertension, epistaxis or blurred vision
19. Self-Measurement of BP
Provides information on:
1. Response to antihypertensive therapy
2. Improving adherence with therapy
3. Evaluating white-coat HTN
Home measurement of >135/85 mmHg is generally
considered to be hypertensive.
Home measurement devices should be checked
regularly.
20. Measuring
Blood Pressure
• Patient seated quietly for at least
5minutes in a chair, with feet on the
floor and arm supported at heart
level
•An appropriate-sized cuff (cuff bladder encircling at least
80% of the arm)
•At least 2 measurements
Continue…
21. • Systolic Blood Pressure is the point at which
the first of 2 or more sounds is heard
• Diastolic Blood Pressure is the point of
disappearance of the sounds (Korotkoff 5th)
Continue…
Measuring
Blood Pressure
22. • Ambulatory BP Monitoring - information about
BP during daily activities and sleep.
• Correlates better than office measurements
with target-organ injury.
Continue…
Measuring
Blood Pressure
23. Laboratory Tests
Routine Tests
• Electrocardiogram
• Urinalysis
• Blood glucose,
• Serum potassium, creatinine, or the corresponding estimated GFR,
and calcium
• Lipid profile, after 9- to 12-hour fast, that includes high-density and
low-density lipoprotein cholesterol, and triglycerides
Optional tests
• Measurement of urinary albumin excretion or albumin/creatinine
ratio
More extensive testing for identifiable causes is not generally indicated
unless BP control is not achieved
25. Treatment Overview
Goals of therapy
Lifestyle modification
Pharmacologic treatment
Algorithm for treatment of hypertension
Follow up and monitoring
26. Goals of Therapy
Reduce Cardiac and renal morbidity and mortality.
Treat to BP <140/90 mmHg or BP <130/80 mmHg in
patients with diabetes or chronic kidney disease.
27. Non pharmacological
Treatment of hypertension
Avoid harmful habits ,smoking ,alcohal
Reduce salt and high fat diets
Loose weight , if obese
Regular exercise
DASH
diet
28. Life style modifications
• Lose weight, if overweight
• Increase physical activity
• Reduce salt intake
• Stop smoking
• Limit intake of foods rich in fats and
cholesterol
• increase consumption of fruits and
vegetables
• Limit alcohol intake
29. Lifestyle Modification
Modification Approximate SBP reduction
(range)
Weight reduction 5–20 mmHg / 10 kg weight loss
Adopt DASH eating
plan
8–14 mmHg
Dietary sodium
reduction
2–8 mmHg
Physical activity 4–9 mmHg
Moderation of alcohol
consumption
2–4 mmHg
32. Diuretics
Example: Hydrochlorothiazide
• Act by decreasing blood volume and cardiac output
• Decrease peripheral resistance during chronic therapy
• Drugs of choice in elderly hypertensives
Side effects-
• Hypokalaemia
• Hyponatraemia
• Hyperlipidaemia
• Hyperuricaemia (hence contraindicated in gout)
• Hyperglycaemia (hence not safe in diabetes)
• Not safe in renal and hepatic insufficiency
33. Beta blockers
Example: Atenolol, Metoprolol, nebivolol,
• Block 1 receptors on the heart
• Block 2 receptors on kidney and inhibit release of renin
• Decrease rate and force of contraction and thus reduce
cardiac output
• Drugs of choice in patients with co-existent coronary
heart disease
Side effects-
• lethargy, impotency, bradycardia
• Not safe in patients with co-existing asthma and
diabetes
• Have an adverse effect on the lipid profile
34. Calcium channel blockers
Example: Amlodipine
• Block entry of calcium through calcium channels
• Cause vasodilation and reduce peripheral
resistance
• Drugs of choice in elderly hypertensives and
those with co-existing asthma
• Neutral effect on glucose and lipid levels
Side effects
Flushing, headache, Pedal edema
35. ACE inhibitors
Example: Ramipril, Lisinopril, Enalapril
• Inhibit ACE and formation of angiotensin II
and block its effects
• Drugs of choice in co-existent diabetes
mellitus, Heart failure
Side effects-
dry cough, hypotension, angioedema
36. Angiotensin II receptor
blockers
Example: Losartan
• Block the angiotensin II receptor and
inhibit effects of angiotensin II
• Drugs of choice in patients with co-
existing diabetes mellitus
Side effects-
safer than ACEI, hypotension,
37. Alpha blockers
Example: prazosin
• Block -1 receptors and cause vasodilation
• Reduce peripheral resistance and venous
return
• Exert beneficial effects on lipids and insulin
sensitivity
• Drugs of choice in patients with co-existing
BPH
Side effects-
Postural hypotension,
38. Antihypertensive therapy:
Side-effects and Contraindications
Class of drugs Main side-effects Contraindications/
Special Precautions
Diuretics Electrolyte imbalance, Hypersensitivity,
Anuria
(e.g. Hydrochloro- total and LDL cholesterol
thiazide) levels, HDL cholesterol
levels, glucose levels,
uric acid levels
-blockers Impotence, Bradycardia,
(e.g. Atenolol) Fatigue Bradycardia,
Conduction
disturbances,
Diabetes,
Asthma, Severe
cardiac
failure
39. Algorithm for
Treatment of Hypertension
Not at Goal Blood Pressure (<140/90 mmHg)
(<130/80 mmHg for those with diabetes or chronic kidney disease)
Initial Drug Choices
Drug(s) for the compelling
indications
Other antihypertensive drugs (diuretics,
ACEI, ARB, BB, CCB)
as needed.
With Compelling
Indications
Lifestyle Modifications
Stage 2 Hypertension
(SBP >160 or DBP >100 mmHg)
2-drug combination for most (usually
thiazide-type diuretic and
ACEI, or ARB, or BB, or CCB)
Stage 1 Hypertension
(SBP 140–159 or DBP 90–99 mmHg)
Thiazide-type diuretics for most.
May consider ACEI, ARB, BB, CCB,
or combination.
Without Compelling
Indications
Not at Goal
Blood Pressure
Optimize dosages or add additional drugs
until goal blood pressure is achieved.
Consider consultation with hypertension specialist.
40. Choice of Drug
Condition Preferred drugs Other drugs Drugs to be
that can be used avoided
Asthma Calcium channel -blockers/Angiotensin-II -blockers
blockers receptor blockers/Diuretics/
ACE-inhibitors
Diabetes -blockers/ACE Calcium channel blockers Diuretics/
mellitus inhibitors/ -blockers
Angiotensin-II
receptor blockers
High cholesterol -blockers ACE inhibitors/ A-II -blockers/
levels receptor blockers/ Calcium Diuretics
channel blockers
Elderly patients Calcium channel -blockers/ACE-
(above 60 years) blockers/Diuretics inhibitors/Angiotensin-II
receptor blockers/- blockers
BPH -blockers -blockers/ ACE inhibitors/
Angiotensin-II receptor
blockers/ Diuretics/
Calcium channel blockers
43. Causes of
Resistant Hypertension
Improper BP measurement
Excess sodium intake
Inadequate diuretic therapy
Medication
• Inadequate doses
• Drug actions and interactions (e.g., (NSAIDs), illicit drugs,
sympathomimetics, OCP)
• Over-the-counter drugs and some herbal supplements
Excess alcohol intake
Identifiable causes of HTN
44. take home message --------------
• Hypertension is a major cause of morbidity and mortality, and
needs to be treated
• It is an extremely common condition; however it is still under-
diagnosed and undertreated
• Hypertension is easy to diagnose and easy to treat
• Aim of the management is to save the target organ from the
deleterious effect
• Besides pharmacology we have other choices and one has to be
acquainted with that choice
• Life style modification should always be encouraged in all
Hypertensive patients
46. Que 1) Life style intervention for
management of hypertension includes all
except:
a) Regular aerobic activity 30 min /day
b) Salt intake to <6 gm./day
c) Attain and maintaining BMI >25k/m2
d) Diets rich in fruits and vegetables and restricted
content of saturated fats
e) Moderation of alcohol consumption
47. Que 2) Hypertension management is helpful
in the prevention of all except:
a) Coronary heart disease
b) Heart failure
c) Chronic kidney disease
d) Deep venous thrombosis
e) Cerebrovascular disease
48. Que 3) Isolated systolic hypertension is common
in:
a) Young
b) Elderly
c) Pregnancy
d) Blacks
49. Que 4) Antihypertensive agent
recommended for the protection of
cardiovascular diseases is:
a) Calcium channel blockers
b) Diuretics
c) ACE inhibitors
d) Alpha antagonists
e) Central sympatholytic
50. Que 5) Angiotensin Receptor Blockers play
Reno protective effect through all except:
a) Decreasing proteinuria
b) Decreasing intraglomerular pressure
c) Preventing endothelial dysfunction
d) Inhibiting conversion of angiotensin-I to
angiotensin –II
e) Blocking the angiotesin mediated renal
remodelling
51. Que 6) which of the following is the side
effect of ACE inhibitors:
a) Hyperkalaemia
b) Hypercalcemia
c) Hyperglycaemia
d) Hypertension
e) Hypermagnesemia
52. Que 7) Calcium channel blockers cause all
except:
a) Pedal oedema
b) Flushing
c) Hyperkalaemia
d) Headache
53. Que 8) : Safest drug for hypertension in
pregnancy is:
a) ACE inhibitors
b) Angiotensin receptor blockers
c) Diuretic
d) Methyldopa
54. Que9) the first line antihypertensive in
diabetic patients is:
a) Diuretics
b) Angiotensin converting enzyme inhibitors
c) Beta blockers
d) Calcium channel blockers
55. Que10) which of the following antihypertensive
agent is relatively contraindicated in congestive
cardiac failure:
a) ACE inhibitors
b) Angiotensin receptor blockers
c) Beta blockers
d) Diuretics