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Description: Slides | 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

Date: March 17, 2019    

Keywords: Antihypertensive Agents, Platelet Aggregation Inhibitors, Atherosclerosis, Atrial Fibrillation, Blood Pressure, Cholesterol, Cardiac Imaging Techniques, Multidetector Computed Tomography, Vascular Calcification, Diabetes Mellitus, Diet, Exercise, Heart Failure, Hypertension, Hypertension, Pulmonary, Life Style, Risk Reduction Behavior, Lipids, Obesity, Overweight, Motor Activity, Primary Prevention, Risk Assessment, Risk Factors, Decision Making, Smoking, Smoking Cessation, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Patient Care Team, Body Weight Changes, Tobacco, Secondary Prevention

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Hypertension PPT Free Download | PowerPoint Presentation

Hypertension PPT Free Download | PowerPoint Presentation: Hello friends, today we are here to provide hypertension ppt for free download. In this era. hypertension has become a very common disease. But its risk factors are really huge and it can take away someone’s life if not treated at the time.

Also See: Non Technical Seminar Topics

Hypertension is also called high blood pressure because, in hypertension, your blood pressure becomes really high. And due that high blood pressure, the human body faces different problems. Hypertension is in reality a silent killer as there are no direct symptoms of it and it kills the human body slowly from inside.

Also See: General Topics for Seminar

• Introduction
• Types of Hypertension
• Risk Factors
• Complications
• Who is most likely to have high blood pressure?
• What medications are used to treat Hypertension?
• Can high blood pressure affect pregnancy?

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HYPERTENSION

Jan 07, 2020

1.04k likes | 1.88k Views

HYPERTENSION. Sustained hypertension can damage blood vessels in kidney, brain and heart = incidence of renal failure, cardiac failure and stroke. Normal BP control mechanisms. Renin –angiotensin –aldosterone system Baroreceptor reflex. Stage. Diastolic Range (mm Hg). Systolic Range (mm Hg).

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• hypertension
• hypertensive emergencies
• cardiac output
• 2 adrenoceptors
• direct acting vasodilator
• 2 adrenoceptors located prejunctionally

Presentation Transcript

Sustained hypertension can damage blood vessels in kidney, brain and heart = incidence of renal failure, cardiac failure and stroke

Normal BP control mechanisms • Renin –angiotensin –aldosterone system • Baroreceptor reflex

Stage Diastolic Range (mm Hg) Systolic Range (mm Hg) High Normal 85-89 130-139 Stage 1 90-99 140-159 Stage 2 100-109 160-179 Stage 3 > 109 >179

Na+ Na+ Drugs acting on therenin-angiotensin system. arteries Angiotensinogen AI AII Renin adrenal glands Aldosterone kidneys

Drugs acting on therenin-angiotensin system arteries Angiotensinogen AI AII Renin adrenal glands Aldosterone kidneys Na+ Na+

ACE Inhibitors AIIRA Calcium Blockers Diuretics Beta-blockers Spironolactone Drugs acting on therenin-angiotensin system. arteries Angiotensinogen AI AII Renin adrenal glands Aldosterone kidneys

Diuretics • Thiazides, loop diuretics, potassium sparing diuretics

ACE inhibitors/ ARB • Captopril, enalapril, ramipril, lisinopril • Losartan, valsartan, irbesartan

Beta blockers • Atenolol, metaprolol, carvedilol, labetalol

Calcium channel blockers • Verapamil, diltiazem, nifedipine, amlodipine

a-blockers • Mechanism of action: blockade of vascular a -adrenoceptors • Non selective (a1 and a2) blockers: Phentolamine, phenoxybenzamine and dibenamine • Selective (a1: prazosin,terazosin, doxazosin, trimazosin)

Hydralazine • Direct acting vasodilator: liberates NO from vascular endothelium which stimulates the production of cGMP in vascular smooth muscle, resulting in relaxation (arterioles > veins) • Can NOT be used for monotherapy • Tachycardia with palpitations, hypotension , nausea, vomiting, sweating, Lupus erythmatosis • Never use as first choice; Try in refractory hypertension as part of a multidrug regimen

Minoxidil • Prodrug of minoxidil sulfate, which is a direct acting vasodilator • Mechanism: K+ channel opener, causes membrane hyperpolarization, reducing ability of smooth muscle to contract. • Other K channel openers: pinacidil, diazoxide • refractory hypertension • Long duration of action (>24 hours)

Minoxidil Adverse Effects • Fluid and water retention: can lead to pulmonary hypertension • Tachycardia and increased cardiac output: • Headache, sweating, hirsutism

DIAZOXIDE • occasionally - hypertensive emergencies. • opening potassium channels • half-life; 24 hours, rapid injection onset 5 minutes lasts 4-12 hours • hypotension→ stroke and myocardial infarction / provoke angina, cardiac failure in patients with ischemic heart disease → when dose of 300 mg is used; instead infuse at 15-30 mg/min • avoided in IHD • inhibits insulin release → used to treat hypoglycemia secondary toinsulinoma

SODIUM NITROPRUSSIDE • hypertensive emergencies as well as severe heart failure • dilates both arterial and venousvessels, ↓ PVR & venous return - cardiac output decreases • activation of guanylylcyclase -relaxesvascular smooth muscle • In heart failure and low cardiac output, output often increases owing to afterload reduction

Rapid & short acting 1- 10 minutes on discontinuation - IV infusion • Metabolic acidosis, arrhythmias, hypotension • methemoglobunemia

FENOLDOPAM • D1 agonist peripheral arteries and natriuresis= hypertensive emergencies and postoperative hypertension. • rapidly metabolized conjugation half-life 10 minutes continuous intravenous infusion. • Reflex tachycardia, flushing, headache increases intraocular pressureavoid in glaucoma

Centrally Acting Sympatholytics:a2-Adrenoceptor Agonists • a-Methyldopa • Clonidine

a2-Adrenoceptor Agonists Mechanisms of Action • Central Action: Stimulation of a2 adrenoceptors in the brainstem reduces sympathetic tone, causing a centrally mediated vasodilatation and reduction in heart rate • Prejunctional action: Stimulation of a2 adrenoceptors located prejunctionally on peripheral neurons reduces norepinephrine release

Clonidine • Partial agonist - a2A • Lipid soluble, short half life. • Dry mouth, sedation, salt & water retention, hypotension, • Sudden withdrawal = hypertensive crises • Moderately potent antihypertensive

Methyldopa • Mild to moderately severe HT • ↓ PVR, ↓ CO & HR, ↓ renal vascular resistance. • Sedation, orthostatic hypertension, impaired mental conc. , lactation, nightmares, mental depression, fluid retention.

Reserpine Molecular mechanism of action: Inhibition of noradrenergic function. • Interferes with uptake mechanism, Storage vesicles are destroyed and nerve ending loses capacity to store and release norepinephrine and serotonin • Pharmacological consequences: reduction of cardiac output and TPR

Reserpine • Extremely long acting • Mild to moderate HT • Postural hypotension, diarrhoea, abdominal cramps • CNS effects: • Sedation, loss of concentration • psychotic depression. • Extrapyramidal effects

Guanithidine • Sympathoplegic • Inhibits release release of NA from sympathetic nerve ending. • Long half life (5 days) • Hypotension, diarrhoea, delayed or retrograde ejaculation

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First reliable and effective antihypertensive agents: ganglionic blockers (ca. 1950 ). Unbearable side effects: extreme orthostatic hypotension, incapacitating intestinal immobility, and severe sexual dysfunction (viz. only in life-threatening hypertension). First large-scale efficacy

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British Hypertension Society guidelines for hypertension management 1999. BMJ 4.9.1999Ramsay et al. Non-pharmacological measures suitable for everyone. Low salt dietWeight reductionExerciseHealthy dietSmoking cessationReduce excessive alcohol. Initiate treatment in sustained Blood Pressure ov

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. Hypertension should not be diagnosed until a sustained repetitive elevation of blood pressure has been documented.For diagnosis, at least three readings averaging greater than 140 mmHg systolic or 90 mmHg diastolic must be documented, preferably by the same observer using the same technique.. P

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Hypertension. 26 th September 2012 Dr Julian Tomkinson. Aims. To understand the diagnosis, impact and management of hypertension in General Practice. Method. Overview of NICE guidelines Applying to General Practice as we go along Case examples / scenarios. Questions?.

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Hypertension. Dr. Meg- angela Christi Amores. Hypertension. doubles the risk of cardiovascular diseases present in all populations except for a small number of individuals living in primitive, culturally isolated societies accounts for 6% of deaths worldwide. Pathologic consequences.

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Hypertension. Case 1. A 31 year old Burmese male presents with shortness of breath x2 weeks. His blood pressure is 210/130 and he has evidence of volume overload. The creatinine is 2.0 and he has severe LV dysfunction on an echo. Case 1.

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Hypertension. By Ryan chow, Ayesha Faisal, and Lucy Cao. What is Hypertension?. A cardiac condition in which the arterial blood pressure is elevated. It’s the opposite of hypotension. Also known as high blood pressure

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HYPERTENSION. Background for understanding the Hypertension literature. Jeffrey J. Kaufhold, MD Nephrology. HYPERTENSION SUMMARY. Background for understanding the literature of Hypertension Review of Joint National Commission Recommendations (VII) 2003

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HYPERTENSION. SHAHKUR SHABIR GP REGISTRAR DR ELLA RUSSELL -GP TRAINER SUNNYBANK MEDICAL CENTRE OCT 2011. What is Blood pressure?. This is the pressure in the arteries when the heart contracts and rests between beats. Some Facts!. How many people in the UK have high Blood pressure.

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Hypertension. Resting BP consistently >140 mmHg systolic or >90 mmHg diastolic. Epidemiology. 20% of adult population ~ 35,000,000 people 25% do not know they are hypertensive Twice as frequent in blacks than in whites 25% of whites and 50% of blacks > 65 y/o. Types.

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