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1、HypertensionDrZakaHaq,MBBS,MRCPCardiologyRegistrarQueensHospitalRomfordHypertensionPrevalence(UK)NICEBetaBlockersChallengesPrimaryCareHypertension-OverviewHypertensionitself-IntroductionTypesClassificationRiskFactorsSequelsHypertensioninspecialcircumstancesManagementFo
2、llowUpGuidelinesReferraltoSecondarycareHypertension,Introduction.HypertensionisoneofthemostimportantpreventablecausesofprematuremorbidityandmortalityintheUK.Hypertensionisamajorriskfactorforstroke(ischemicandhaemorrhagic),myocardialinfarction,heartfailure,chronickidney
3、disease,cognitivedeclineandprematuredeath.Untreatedhypertensionmayresultinvascularandrenaldamagethatcanculminateinatreatment-resistantstate.Theriskassociatedwithincreasingbloodpressureiscontinuous,witheach2mmHgriseinsystolicbloodpressureassociatedwitha7%increasedriskof
4、mortalityfromischemicheartdiseaseanda10%increasedriskofmortalityfromstroke.Hypertension,Introduction.Diastolicpressureismorecommonlyelevatedinyoungerpeople.Withageing,systolichypertensionbecomesamoresignificantproblem.Theclinicalmanagementofhypertensionisoneofthemostco
5、mmon22interventionsinprimarycare,accountingforapproximately£1billionindrugcostsalonein2006.Hypertensionisoftensymptomless,soscreeningisvital-beforedamageisdone.Manysurveyscontinuetoshowthathypertensionremainsunderdiagnosed,undertreatedandpoorlycontrolledintheUKHyperten
6、sion,IntroductionInmanycountries,50%ofthepopulationolderthan60yearshashypertension.Overall,approximately20%oftheworld’sadultsareestimatedtohavehypertension.UK,1inevery4thpersonhasHypertensionandthisincreasesto1ineverysecondpersonagedover60.TypesofhypertensionEssentialh
7、ypertension(Primary)90%NounderlyingcauseSecondaryhypertension5%UnderlyingcauseCausesofSecondaryHypertensionRenaldiseaseApproximately75%arefromintrinsicrenaldisease:glomerulonephritis,polyarteritisnodosa,systemicsclerosis,chronicpyelonephritis,orpolycystickidneys. Appr
8、oximately25%areduetoRenovasculardisease-mostfrequentlyatheromatous(e.g.elderlycigarettesmokerswithperipheralvasculard
