hypertension(高血壓)

症狀/併發症(symptom/complication)
病因(etiology)	definition |normal: systolic/diastolic: <120 and <80 mm hg |prehypertension: systolic/diastolic: 120~135 or 80~90 mm hg |hypertension: systolic/diastolic: >140 or >90 mm hg ||stage 1: 140~160 or 90~100mm hg ||stage 2: 160~179 or 100~109 mm hg ||stage 3: >180 or >110 mm hg 參見：血壓量測(blood pressure measurement) other |blood pressure= cardiac output* peripheral vascular resistance= heart rate* stroke volume* peripheral vascular resistance classification |primary hypertension(原發性高血壓): Unknown causes, may be associated with genetic, diet, environment, stress-related ||Excess renal sodium retention ||Over activity of sympathetic nervous system ||Renin angiotensin excess ||Hyperinsulinemia: due to insulin resistance(胰島素抵抗) ||Alterations in vascular endothelium |secondary hypertension(次發性高血壓) ||Renal: These account for over 80% of the cases of secondary hypertension. The common causes are diabetic nephropathy, chronic glomerulonephritis, adult polycystic disease, chronic tubulointerstitial nephritis, and Renovascular hypertension(腎血管性高血壓) ||Endocrinal: These include |||Hyperaldosteronism(醛固酮過多)=Conn syndrome |||adrenal hyperplasia |||acromegaly(肢端肥大症) |||Pheochromocytoma(嗜鉻細胞瘤) |||hypercortisolism(皮質醇過多)=Cushing’s Syndrome(庫欣氏症) ||Drugs |||oral contraceptive: estrogen |||非類固醇抗發炎藥(Non-Steroidal Anti-inflammatory Drugs) |||MAO inhibitor with tyramine food ||Pregnancy-induced hypertension ||coarctation of the aorta, CoA(主動脈窄縮) ||vasculitis 資料來源：zuniv
檢查/準則(examination/criteria)	#Renovascular hypertension(腎血管性高血壓): Abdominal bruit especially with a diastolic component
治療(treatment)	$primary hypertension: Symptomatic treatment $secondary hypertension: Curative treatment for the reasons $Antihypertensive drugs should prevent ischemic cerebral stroke 資料來源：蘇丹卡布斯大學 other treatment classificaiton $Nonpharmacological approaches $$得舒飲食(DASH Diet) $$low sodium chloride diet $$weight reduction $$exercise $$cessation smoking $$decrease in excessive alcohol consumption $$psychological method $$polyunsaturated fat intake $Pharmacological approaches: if monotherapy is not effective, try to combine several kinds of drugs-->Hypotensive as soon as possible, do not reduce BP too low $$STITCH-care shows that give twice kinds drug is better than one at first diagnosis $low 2 mm hg-->7% reduction in risk of ischemic heart disease mortality, 10% reduction in risk of stroke mortality
鑑別診斷(Differential Diagnosis)
流行病學(Epidemiology)	+<50 y/o: Isolated diastolic hypertension +50~60 y/o: Systoilic-diastolic hypertension +>60 y/o: Isolated systolic hypertension +secondary hypetension patients usually ++at age < 30 yrs ( Fibromuscular dysplasi) or > 55 (athelosclerotic renal artery stenosis) ++Episodic, headache and chest pain/palpitation +Morbid obesity with history of snoring and daytime sleepiness (sleep disorders) +Systolic BP is more risk than Diastolic BP

看更多see more：疾病(disease)

HomeAny source