复旦大学：《内科学 Internal Medicine MBBS》课程教学资源（课件讲稿）循环系统_Essential Hypertension

HUASHAN HOSPITA 莘山院 Essential Hypertension Ying Shan Department of cardiology Huashan Hospital

Essential Hypertension Ying Shan Department of cardiology Huashan Hospital

HUASHAN HOSPITA 莘山院 Outline ° Epidemiology · Mechanism Pathology Clinical manifestation Diagonsis and differentiation Treatment

Outline • Epidemiology • Mechanism • Pathology • Clinical manifestation • Diagonsis and differentiation • Treatment

HUASHAN HOSPITA 莘山院 Obiectives Be able to? Make diagnosis of hypertension Identifying potential secondary cause of hypertension Assessing the overall cv risks and target organ damage of the patients with htN Familiar with the principles of treatment Familiar with non-pharmacological strategy and pharmacological treatment of HTN

Objectives Be able to:  Make diagnosis of hypertension  Identifying potential secondary cause of hypertension  Assessing the overall CV risks and target organ damage of the patients with HTN  Familiar with the principles of treatment  Familiar with non-pharmacological strategy and pharmacological treatment of HTN

HUASHAN HOSPITA 莘山院 Hypertension is one of the leading public health problems worldwide, if untreated, often leads to lethal complication

Hypertension is one of the leading public health problems worldwide, if untreated, often leads to lethal complication

HUASHAN HOSPITA 莘山院 Epidemiology of hypertension 50 million individuals in the United states have hypertension 三60 277000 deaths annually in US due to hypertension 1American Association of Clinical Endocrinologists Medical Guidelines For Clinical Practice for the Diagnosis and reatment of Hypertension. Endocrine Practice, Vol 12 No. 2 March/April 2006 2National Center for Health Statistics. Health. United States 2005 with Chartbook on the health of Americans Hyattsville,Maryland2004.Availableat:http://www.cdc.gov/nchs/hus.htm

5 Epidemiology of Hypertension • 50 million individuals in the United States have hypertension1 • 277,000 deaths annually in US due to hypertension2 1American Association of Clinical Endocrinologists Medical Guidelines For Clinical Practice for the Diagnosis and Treatment of Hypertension. Endocrine Practice, Vol 12 No. 2 March/April 2006 2National Center for Health Statistics. Health, United States, 2005, with Chartbook on the Health of Americans. Hyattsville, Maryland: 2004. Available at: http://www.cdc.gov/nchs/hus.htm

HUASHAN HOSPITA 莘山院 t hat percent of Canadians have hypertension 60 50 40 EO8 30 20 10 18-2425-3435-4444-55566565-74 age CCHS CMAJ 1992

What percent of Canadians have hypertension? 0 10 20 30 40 50 60 18-24 25-34 35-44 44-55 56-65 65-74 age % of Canadians CCHS CMAJ 1992

HUASHAN HOSPITA 莘山院 International Collaborative Study of t Cardiovascular Disease in ASIA(InterASIA) 27 2% of the Chinese adult population age 35 to 74 years has hypertension The percentage of those with hypertension who were aware(44.7%), treated ( 28. 2%), and controlled (8.1%)was unacceptably low

International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA)  27.2% of the Chinese adult population age 35 to 74 years has hypertension  The percentage of those with hypertension who were aware(44.7% ), treated(28.2% ), and controlled(8.1% ) was unacceptably low

HUASHAN HOSPITA 莘山院 ypertension Remains One of the Most Important factors of cv risk BP>140/90 mm Hg is associated with: 91% 77% 74% 69% 0% 209 60% 80% 100% First Mis Current CHF First Strokes Eventual chF BP, blood pressure; CHF, congestive heart failure; MI, myocardial infarction Rosamond w et al. Circulation. 2007: 115: 1-103

Hypertension Remains One of the Most Important factors of CV Risk BP >140/90 mm Hg is associated with: 69% 74% 77% 91% 0% 20% 40% 60% 80% 100% First MIs Current CHF First Strokes Eventual CHF  277,000 deaths in 2003 Rosamond W et al. Circulation. 2007;115:1-103. BP, blood pressure; CHF, congestive heart failure; MI, myocardial infarction

HUASHAN HOSPITA 莘山院 MECHANISMS OF ESSENTIAL HYPERTENSION (1) Genetic Predisposition --one of the most common complex genetic disorder Genetic heritability 30%

MECHANISMS OF ESSENTIAL HYPERTENSION (1)  Genetic Predisposition --one of the most common complex genetic disorder  Genetic heritability 30%

HUASHAN HOSPITA 莘山院 MECHANISMS OF ESSENTIAL HYPERTENSION (2) Environment -salt intake, obesity, occupation alcohol intake, crowding

 Environment – salt intake, obesity, occupation, alcohol intake, crowding. MECHANISMS OF ESSENTIAL HYPERTENSION (2)