💊Hypertension Lecture💊

#Learning_Objective:-

➡ Definition Of HTN
➡ Classifications Of HTN
➡ Etiology Of HTN
➡ Complications Of HTN
➡ Clinical diagnosis & analysis of HTN
➡ White Coat HTN
➡ Treatment Of HTN
➡ Hypertension Crisis
➡ Treatment Of HTN if Other Diseases found

__Nawaf__________

➡ Definition:-
It's Elecation of Systolic and /or Diastolic B.P above 140 / 90 mmHg

Or

Tension exerted by the blood on the Vessel wall

=> it's also one of the most Siginificant *Risk factor for C.V ( Cardiovascular) Morbidity and mortality*
⬇
Resulting From ( *target organ damage* )

Like [ Heart , Kidney , Brain , Eye ]

❤

➡ Classifications:-
As Shown in the pic 1⃣ Herewith

❤

➡ Etiology:-

# 😳 In most patients ( more than 90% ) the Cause of HTN unknown and referred to as primary HTN

# In Secondary HTN ( 10 % ) there is an Identifiable Cause such as:-
1) CKD ( Kidney failure)
2) Endocrine HTN ( tomar in adrenal gland --> increase secreting of Adrenaline
3) Some drug [ NSAIDs , Corticosteroids , Six Hormones

❤

➡ Complications:-

*target Organs damage*

May be Happened in Slow increase P.B , or in Rapid increase P.B

As Shwon in the pic 2⃣ Herewith

❤

➡ Clinical diagnosis and analysis:-

Initial diagnosis mostly *not* estimated from patient

*HTN is Asymptomatic disease*
⬇

Rather it is Confirmed by B.P Measurement

⬇
Accurate measurement of a patient's B.P requires the control of factors that may influence Variability in the measure
-> body position
-> Cuff size
-> Dietary intake prior to the Visit
⬇
Those may lead to misclassification

❤

➡ White Coat HTN:-
Patients who have consistently elevated B.P Values measured in clinical environment in presence of a health Care professional.
⬇
Require to ABPM
( Ambulatory B.P monitoring )


❤

➡ Hypertension crisis

هذا النوع يقسم الى قسمين
1 ) HTN emergancy
2 ) HTN uregency
⬇

1) HTN EMERGENCY
With Acut or progressive target organs damag
يعني بيرتفع الضغط فوق
180 / 119
هذا الشي بيترافق مع تدمر للاعضاء ..( القلب . الدماغ . الكليه . العين )
هنا نحتاج لادخال المريض عنايه مركزه ..
وااستخدام I.V medication
وغالبا بيستخدموا
Isosornid 5- 10mg
Or
Na nitroprusside
بشكل I.V.

For immediate B.P lowering
ونعمل
Intra- arterial B.P monitoring

2) Urgency HTN
Without Targen organs
damage
ودام انه مافيش اي دمار للاعضاء
مابيحتاج انقصل الضغط بشكل لحضي مثل الي حدث في حاله معالجة Emergency
لذا يقولك هنا تعمل
Reduce Slowly within 24 hur


❤

➡ Treatment:-
-> Non pharmacological:-
- lifestyle modification
As decrease Na in diet...
> 1.5 g/ Day of *Na*
= 3.8mg/ day of *Nacl*

-> Pharmacological treatment:-
By 3 groups:-
1 ) Diuretics
2 ) Vasodilators
3 ) Sympatholytic


❤

➡ Treat HTN if Other Diseases found

1) HTN only
First choice is Thiazide diuretic

2 ) HTN & D.M
First choice is ACEI or ARBs

3) CKD & HTN
B.Blocker + ACEI or ARBs

4) HF + HTN
ACEI or ARBs + B.Blocker + diuretic





Good luck

9-11-2017


#د_ص/ #نواف_عبدالعزيز_الصلوي
#مشرف_مجال_الصيدلة_السريرية

https://t.me/joinchat/B56piw6Ku2s--H4ZKGqWjQ

#برنامج_تطوير_مهنة_الصيدلة
#مدير_البرنامج
#البروف_محمود_البريهي
#استاذ_صيدلانيات_جامعة_صنعاء

https://t.me/ppdprogram