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1、HypertensionDrZakaHaq,MBBS,MRCPCardiologyRegistrarQueensHospitalRomfordHypertensionPrevalence(UK)NICEBetaBlockersChallengesPrimaryCareHypertension-OverviewHypertensionitself-IntroductionTypesClassificationRiskFactorsSequelsHypertensioninspecialcircumstancesManagementFollowUpGuidelinesReferralto
2、SecondarycareHypertension,Introduction.HypertensionisoneofthemostimportantpreventablecausesofprematuremorbidityandmortalityintheUK.Hypertensionisamajorriskfactorforstroke(ischemicandhaemorrhagic),myocardialinfarction,heartfailure,chronickidneydisease,cognitivedeclineandprematuredeath.Untreatedh
3、ypertensionmayresultinvascularandrenaldamagethatcanculminateinatreatment-resistantstate.Theriskassociatedwithincreasingbloodpressureiscontinuous,witheach2mmHgriseinsystolicbloodpressureassociatedwitha7%increasedriskofmortalityfromischemicheartdiseaseanda10%increasedriskofmortalityfromstroke.Hyp
4、ertension,Introduction.Diastolicpressureismorecommonlyelevatedinyoungerpeople.Withageing,systolichypertensionbecomesamoresignificantproblem.Theclinicalmanagementofhypertensionisoneofthemostcommon22interventionsinprimarycare,accountingforapproximately£1billionindrugcostsalonein2006.Hypertensioni
5、softensymptomless,soscreeningisvital-beforedamageisdone.Manysurveyscontinuetoshowthathypertensionremainsunderdiagnosed,undertreatedandpoorlycontrolledintheUKHypertension,IntroductionInmanycountries,50%ofthepopulationolderthan60yearshashypertension.Overall,approximately20%oftheworld’sadultsarees
6、timatedtohavehypertension.UK,1inevery4thpersonhasHypertensionandthisincreasesto1ineverysecondpersonagedover60.TypesofhypertensionEssentialhypertension(Primary)90%NounderlyingcauseSecondaryhypertension5%UnderlyingcauseCausesofSecondaryHypertensionRenaldiseaseApproximately75%arefromintrinsicrenal
7、disease:glomerulonephritis,polyarteritisnodosa,systemicsclerosis,chronicpyelonephritis,orpolycystickidneys. Approximately25%areduetoRenovasculardisease-mostfrequentlyatheromatous(e.g.elderlycigarettesmokerswithperipheralvasculard
