1、ARWA A. AL-KHATIB ARWAAPHARMACY-1.COM,Hypertension,BB,Benefits of Lowering BP,Complication Percent ReductionStroke Incidence 3540% Myocardial Infarction 2025% Heart Failure 50%,Comparison of HTN surveys in 3 countries,BP measurement,Use auscultatory method with a properly calibrated and validated in
2、strument. Patient should be seated quietly for 5 minutes in a chair (not on an exam table), feet on the floor, and arm supported at heart level. Appropriate-sized cuff should be used to ensure accuracy. At least two measurements should be made.,What may induce or aggravate HTN?,Prescription Drugs: N
3、SAIDs, including Coxibs Steroids Oral contraceptive and sex hormones Calcineurin inhibitors (cyclosporin, tacrolimus) Erythropoietin and analoguesOther: Licorice root Salt Excessive alcohol use,HTN management,Goals of therapy Prevention of Hypertension Lifestyle modification Classification and manag
4、ement of BP for adults Pharmacologic treatment,I. Goals of therapy,Reduce CVD and renal morbidity and mortality. Treat to BP 140/90 mmHg or BP 130/80 mmHg in patients with diabetes or chronic kidney disease.,II. Prevention of hypertension,To reduce the possibility of becoming hypertensive,Healthy di
5、et: high in fresh fruits, vegetables and low fat dairy products, low in saturated fat and salt Regular physical activity: accumulation of 30-60 minutes of moderate intensity dynamic exercise 4-7/week 3. Low risk alcohol consumption (2 standard drinks/day and less than 14/week for men and less than 9
6、/week for women) Maintenance of ideal body weight (BMI 18.5-24.9 kg/m2) Waist Circumference 102 cm for men 88 cm for women Restriction of salt intake to less than 100 mmol/day Smoke- free environment,III. Lifestyle Recommendations for Hypertension Physical Activity,Classification and management of B
7、P for adultsPharmacologic treatment,Compelling Indication,How to choose the best option?,Associated risk factors? or Target organ damage/complications? or Concomitant diseases/conditions?,Vascular Protection,Statins are recommended in high-risk hypertensive patients with established atherosclerotic
8、disease or with at least 3 of the following criteria Male age 55 or older Smoking Type 2 Diabetes Total-C/HDL-C ratio of 6 mmol/L or higher Family History of Premature CV disease Previous Stroke or TIA LVH (left ventricular hypertrophy) ECG abnormalities Microalbuminuria or Proteinuria Peripheral Vascular Disease,
