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Hypertension

Hypertension. Arwa A. Al- Khatib ARWAA@PHARMACY-1.COM. BB. Benefits of Lowering BP. Complication Percent Reduction Stroke Incidence 35–40% Myocardial Infarction 20–25% Heart Failure 50% . Comparison of HTN surveys in 3 countries . BP measurement.

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Hypertension

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  1. Hypertension Arwa A. Al-Khatib ARWAA@PHARMACY-1.COM

  2. BB

  3. Benefits of Lowering BP Complication Percent Reduction Stroke Incidence 35–40% Myocardial Infarction 20–25% Heart Failure 50%

  4. Comparison of HTN surveys in 3 countries

  5. BP measurement • Use auscultatory method with a properly calibrated and validated instrument. • 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.

  6. What may induce or aggravate HTN?? • Prescription Drugs: • NSAIDs, including Coxibs • Steroids • Oral contraceptive and sex hormones • Calcineurin inhibitors (cyclosporin, tacrolimus) • Erythropoietin and analogues • Other: • Licorice root • Salt • Excessive alcohol use

  7. HTN management • Goals of therapy • Prevention of Hypertension • Lifestyle modification • Classification and management of BP for adults • Pharmacologic treatment

  8. 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.

  9. II. Prevention of hypertension To reduce the possibility of becoming hypertensive, • Healthy diet: 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/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

  10. III. Lifestyle Recommendations for Hypertension Physical Activity

  11. Classification and management of BP for adults • Pharmacologic treatment

  12. Compelling Indication

  13. How to choose the best option? Associated risk factors? or Target organ damage/complications? or Concomitant diseases/conditions?

  14. Vascular Protection Statins are recommended in high-risk hypertensive patients with established atherosclerotic 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

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