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hypertension فشار بلند ابتدایی
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Transcript of hypertension فشار بلند ابتدایی
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الرحمن الله بسمالرحيم
Design by:Mohammad Mujtaba(Daqiq)
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مجتبی
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What is blood pressure?
Measures force of blood in the arteries
High blood pressure (HBP) = hypertension (HTN)
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How is BP measured?
Blood pressure cuffmm mercury2 numbers shown as a fraction
Systolic/Diastolic Ex. 120/80
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Systolic
The top number in blood pressure readingsMeasures the pressure in arteries when
heart is beating
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Diastolic
The bottom number in blood pressure readings
Measures pressure when heart is at rest
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HypertensionDefinition
Hypertension is sustained elevation of BP Systolic blood pressure 140 mm Hg Diastolic blood pressure 90 mm Hg
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HypertensionComplications
Cerebrovascular Disease• Stroke
Peripheral Vascular Disease Nephrosclerosis Retinal Damage
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HypertensionComplications
Hypertensive Heart Disease
• Coronary artery disease• Left ventricular hypertrophy• Heart failure
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Hypertension: Complications
Complications are primarily related to development of atherosclerosis (“hardening of arteries”), or fatty deposits that harden with age
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Left Ventricular Hypertrophy
Fig. 32-3
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Kieran McGlade Nov 2001Department of General Practice QUB
This left ventricle is very thickened (slightly over 2 cm in thickness), but the rest of the heart is not greatly enlarged. This is typical for hypertensive heart disease. The hypertension creates a greater pressure load on the heart to induce the hypertrophy.
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Kieran McGlade Nov 2001Department of General Practice QUB
The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy.
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Hypertension
For persons over age 50, SBP is more important than DBP as a CVD risk factor
Starting at 115/75 mmHg, CVD risk doubles with each increment of 20/10 mmHg throughout the BP range
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HypertensionComplications
The common complications are Target organ diseases occurring in the
HeartBrainKidneyEyes
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جاوید
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Who is at risk for HBP?
Individuals With Family History Parents, brother, sister
Increasing ageGender
Women - after menopause Early middle age more common in men
Race More common among blacks (Occurs earlier)
These factors are beyond our control.
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Risk Factors
Factors Within our Control Excess weight
Increases volume of blood Increases pressure/resistance that heart has to pump
against---enlarged heart muscle Inactivity
Heart is not used to “work” = heart beats harder/faster = more force on arteries = uses more oxygen per beat = higher heart rate at rest
Tobacco use Can lead to damage of artery wall, increases heart rate,
encourages narrowing of arteries Stress
Causes unpredictable blood pressure and pulse increases along with potential inflammation in the vessel walls.
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Risk Factors
More Factors Within Our Control Sodium intake
Leads to more fluid/water in the vessels = increased blood pressure
Low potassium intake Potassium helps balance sodium in
cells and control heart rhythm Excessive alcohol
Long term: damages liver and pressure within our circulation and heart.
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How do I know if I have it?
Very few people experience symptoms. This is a silent disease.
Damage is done before symptoms develop.
Some symptoms may be: Headaches Dizzy spells More nosebleeds than normal
This is why we screen for HBP!
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Risk Factors for Primary Hypertension
Age (> 55 for men; > 65 for women)AlcoholCigarette smokingDiabetes mellitusElevated serum lipidsExcess dietary sodiumGender
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Risk Factors for Primary Hypertension
Family historyObesity (BMI > 30)Ethnicity (African Americans)Sedentary lifestyleSocioeconomic statusStress
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شفیع
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Blood Pressure Classification
BP Classification SBP mmHg DBP mmHg
Normal < 120 and < 80
Pre-hypertension* 120-139 or 80-89
Stage 1 Hypertension 140-159 or 90-99
Stage 2 Hypertension > 160 or > 100
*newly recognized, requiring lifestyle modifications
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Classification of Hypertension
Primary Hypertension- Contributing factors:
• SNS activity • Diabetes mellitus
• Sodium intake • Excessive alcohol intake
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Classification of Hypertension
• Secondary Hypertension- Contributing factors:
• Coarctation of aorta• Renal disease• Endocrine disorders• Neurologic disorders
- Rx: Treat underlying cause
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Classification of Hypertension
Primary (Essential) Hypertension- Elevated BP with unknown cause- 90% to 95% of all cases
Secondary Hypertension- Elevated BP with a specific cause- 5% to 10% in adults
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HypertensionDiagnosis
• Diagnosis requires several elevated readings over several weeks (unless > 180/110)
• BP measurement in both arms- Use arm with higher reading for subsequent measurements
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HypertensionDiagnosis
Ambulatory BP Monitoring For “white coat” phenomenon, hypotensive or
hypertensive episodes, apparent drug resistance
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Supporting Materials
Website www.nhlbi.nih.govFor patients and the general public
• Facts About the DASH Eating Plan• Your Guide to Lowering Blood Pressure
• For health professionals• Reference Card
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پايانThanks,for you
Design by:Mohammad Mujtaba(Daqiq)