SlideShare une entreprise Scribd logo
1  sur  36
Hypertension in Diabetes Mellitus
Hypertension: The Silent Killer Facts & Figures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Top Three Countries for Diabetes Data from King H et al.  Diabetes Care . 1998;21:1414-1431.
What is Hypertension? JNC 7 Definition Hypertension  2003;42:1206-52 Blood Pressure (mm Hg) Category Systolic Diastolic <120 and <80 Normal 120-139 or 80-89 Prehypertension  140-159 or 90-99 Stage 1 hypertension  ≥ 160 or ≥100 Stage 2 hypertension
Types of Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Secondary Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypertension: Predisposing factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypertension: A Significant CV and  Renal Disease Risk Factor National High Blood Pressure Education Program Working Group.  Arch Intern Med.  1993;153:186-208.
CV Mortality Risk Doubles with  Each 20/10 mm Hg BP Increment* *Individuals aged 40-69 years, starting at BP 115/75 mm Hg. CV, cardiovascular; SBP, systolic blood pressure; DBP, diastolic blood pressure Lewington S, et al.  Lancet . 2002; 60:1903-1913. JNC VII.  JAMA.  2003. CV mortality risk SBP/DBP (mm Hg) 0 1 2 3 4 5 6 7 8 115/75 135/85 155/95 175/105
Pathophysiology of hypertension in DM ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vasoactive substances ,[object Object],[object Object],[object Object],[object Object]
Processes important in the development  or perpetuation of hypertension in diabetics ,[object Object],[object Object],[object Object],[object Object]
Reactive oxygen species (ROS) ,[object Object],[object Object],[object Object]
Management: JNC 7 GUIDELINES
What are the goals of therapy? ,[object Object],[object Object],[object Object],[object Object]
But…   There are Reasons for Inadequate BP Control ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],JNC VI.  Arch Intern Med.  1997
And that leads to… ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Refractory Hypertension leads to
Causes of  Refractory Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Approach to Resistant Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Accurate BP Measurement ,[object Object],[object Object],[object Object],[object Object]
Approach to Resistant Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
White Coat Hypertension ,[object Object],[object Object],[object Object]
Approach to Resistant Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pseudoresistance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Approach to Resistant Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Importance of Adherence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques to Improve Adherence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Approach to Resistant Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary Causes of Hypertension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Refractory Hypertension
Management of Refractory Hypertension - 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],N Engl J Med. 2001;344(1):3-10,  Med. 2000;107(5):57-70.
Management of Refractory Hypertension - II ,[object Object],[object Object],[object Object]
Management of Refractory Hypertension - III ,[object Object],[object Object]
Study performed at Mayo Clinics with  Refractory Hypertensive patients ,[object Object],[object Object]
Thank You

Contenu connexe

Tendances

Fixed Dose combination ppt
Fixed Dose combination  pptFixed Dose combination  ppt
Fixed Dose combination pptKamini Sharma
 
Hypertension- Update on current guideline 02.18.16
Hypertension- Update on current guideline 02.18.16Hypertension- Update on current guideline 02.18.16
Hypertension- Update on current guideline 02.18.16Thu Nguyen
 
Management of hypertension in elderly person.
Management of hypertension in elderly person.Management of hypertension in elderly person.
Management of hypertension in elderly person.Ramachandra Barik
 
HTN guidelines For Elderly and whom with Renal impairement
HTN guidelines For Elderly and whom with Renal impairementHTN guidelines For Elderly and whom with Renal impairement
HTN guidelines For Elderly and whom with Renal impairementDr. Mohamed Maged Kharabish
 
Update in hypertension management
Update in hypertension managementUpdate in hypertension management
Update in hypertension managementTarek Khalil
 
JNC 8 guideline to Management of Hypertension
JNC 8 guideline to Management of HypertensionJNC 8 guideline to Management of Hypertension
JNC 8 guideline to Management of HypertensionPranav Sopory
 
Hypertension 2018 Guidelines - prof. Tarek Medhat
Hypertension 2018 Guidelines - prof. Tarek Medhat Hypertension 2018 Guidelines - prof. Tarek Medhat
Hypertension 2018 Guidelines - prof. Tarek Medhat MNDU net
 
Hyper tension and diabetes the two terrorists together
Hyper tension and diabetes the two terrorists together Hyper tension and diabetes the two terrorists together
Hyper tension and diabetes the two terrorists together Kyaw Win
 
Hypertension in the Elderly
Hypertension in the ElderlyHypertension in the Elderly
Hypertension in the ElderlyMarc Evans Abat
 
Hypertension 2014
Hypertension 2014Hypertension 2014
Hypertension 2014Kyaw Win
 
Fixed Dose Combinations
Fixed Dose CombinationsFixed Dose Combinations
Fixed Dose CombinationsWaris Babur
 
An Evidence Based Approach To Hypertension
An Evidence Based Approach To HypertensionAn Evidence Based Approach To Hypertension
An Evidence Based Approach To HypertensionAline Chammas
 
A Review Hypertension
A Review HypertensionA Review Hypertension
A Review Hypertensionijtsrd
 
Clinical trials in hypertension
Clinical trials in hypertensionClinical trials in hypertension
Clinical trials in hypertensionNidhi Sharma
 
2017 high blood pressure clinical practice guideline
2017 high blood pressure clinical practice guideline2017 high blood pressure clinical practice guideline
2017 high blood pressure clinical practice guidelineDhan Shrestha
 
Recent Developments in the Treatment of Hypertension Recent Developments in...
Recent Developments in the Treatment of Hypertension 	 Recent Developments in...Recent Developments in the Treatment of Hypertension 	 Recent Developments in...
Recent Developments in the Treatment of Hypertension Recent Developments in...MedicineAndFamily
 
Resistant hypertension
Resistant hypertensionResistant hypertension
Resistant hypertensiondibufolio
 
JNC 8 _Dr. Mansij Biswas
JNC 8 _Dr. Mansij BiswasJNC 8 _Dr. Mansij Biswas
JNC 8 _Dr. Mansij BiswasMansij Biswas
 

Tendances (20)

Htn 2017 jama
Htn 2017 jamaHtn 2017 jama
Htn 2017 jama
 
Fixed Dose combination ppt
Fixed Dose combination  pptFixed Dose combination  ppt
Fixed Dose combination ppt
 
Hypertension- Update on current guideline 02.18.16
Hypertension- Update on current guideline 02.18.16Hypertension- Update on current guideline 02.18.16
Hypertension- Update on current guideline 02.18.16
 
Management of hypertension in elderly person.
Management of hypertension in elderly person.Management of hypertension in elderly person.
Management of hypertension in elderly person.
 
HTN guidelines For Elderly and whom with Renal impairement
HTN guidelines For Elderly and whom with Renal impairementHTN guidelines For Elderly and whom with Renal impairement
HTN guidelines For Elderly and whom with Renal impairement
 
Update in hypertension management
Update in hypertension managementUpdate in hypertension management
Update in hypertension management
 
JNC 8 guideline to Management of Hypertension
JNC 8 guideline to Management of HypertensionJNC 8 guideline to Management of Hypertension
JNC 8 guideline to Management of Hypertension
 
Hypertension 2018 Guidelines - prof. Tarek Medhat
Hypertension 2018 Guidelines - prof. Tarek Medhat Hypertension 2018 Guidelines - prof. Tarek Medhat
Hypertension 2018 Guidelines - prof. Tarek Medhat
 
Hyper tension and diabetes the two terrorists together
Hyper tension and diabetes the two terrorists together Hyper tension and diabetes the two terrorists together
Hyper tension and diabetes the two terrorists together
 
Hypertension in the Elderly
Hypertension in the ElderlyHypertension in the Elderly
Hypertension in the Elderly
 
Hypertension 2014
Hypertension 2014Hypertension 2014
Hypertension 2014
 
Fixed Dose Combinations
Fixed Dose CombinationsFixed Dose Combinations
Fixed Dose Combinations
 
An Evidence Based Approach To Hypertension
An Evidence Based Approach To HypertensionAn Evidence Based Approach To Hypertension
An Evidence Based Approach To Hypertension
 
A Review Hypertension
A Review HypertensionA Review Hypertension
A Review Hypertension
 
Jnc 8
Jnc 8Jnc 8
Jnc 8
 
Clinical trials in hypertension
Clinical trials in hypertensionClinical trials in hypertension
Clinical trials in hypertension
 
2017 high blood pressure clinical practice guideline
2017 high blood pressure clinical practice guideline2017 high blood pressure clinical practice guideline
2017 high blood pressure clinical practice guideline
 
Recent Developments in the Treatment of Hypertension Recent Developments in...
Recent Developments in the Treatment of Hypertension 	 Recent Developments in...Recent Developments in the Treatment of Hypertension 	 Recent Developments in...
Recent Developments in the Treatment of Hypertension Recent Developments in...
 
Resistant hypertension
Resistant hypertensionResistant hypertension
Resistant hypertension
 
JNC 8 _Dr. Mansij Biswas
JNC 8 _Dr. Mansij BiswasJNC 8 _Dr. Mansij Biswas
JNC 8 _Dr. Mansij Biswas
 

Similaire à Hypertension

Htn pharmacotherapy
Htn pharmacotherapyHtn pharmacotherapy
Htn pharmacotherapyDr P Deepak
 
Diagnosis & Management of Resistant Hypertension
Diagnosis & Management of Resistant HypertensionDiagnosis & Management of Resistant Hypertension
Diagnosis & Management of Resistant HypertensionDr.Vinod Sharma
 
Hipertensão Arterial - Slides da JNC7
Hipertensão Arterial - Slides da JNC7Hipertensão Arterial - Slides da JNC7
Hipertensão Arterial - Slides da JNC7semiologia
 
Hypertension by sourabh kosey
Hypertension by sourabh koseyHypertension by sourabh kosey
Hypertension by sourabh koseysopi_1234
 
Recent guideline for the Prevention, Detection, Evaluation, and Management of...
Recent guideline for the Prevention, Detection, Evaluation, and Management of...Recent guideline for the Prevention, Detection, Evaluation, and Management of...
Recent guideline for the Prevention, Detection, Evaluation, and Management of...Ashutosh Pakale
 
Ht12 - GP education seminar
Ht12 - GP education seminar Ht12 - GP education seminar
Ht12 - GP education seminar alistair begg
 
diagnosis-treatment-of-resistant-hypertension.pdf
diagnosis-treatment-of-resistant-hypertension.pdfdiagnosis-treatment-of-resistant-hypertension.pdf
diagnosis-treatment-of-resistant-hypertension.pdfVinayReddy241577
 
HYPERTENSION.pptx
HYPERTENSION.pptxHYPERTENSION.pptx
HYPERTENSION.pptxMishiSoza
 
week 9 Assessment and Management of Patients with Hypertension- crisis.ppt
week 9 Assessment and Management of Patients with Hypertension- crisis.pptweek 9 Assessment and Management of Patients with Hypertension- crisis.ppt
week 9 Assessment and Management of Patients with Hypertension- crisis.pptAbdallahAlasal1
 
Essential Hypertension
Essential Hypertension Essential Hypertension
Essential Hypertension raheef
 
Understanding hypertension
Understanding hypertensionUnderstanding hypertension
Understanding hypertensionReynel Dan
 
Lec 7 hypertension for mohs
Lec 7  hypertension for mohsLec 7  hypertension for mohs
Lec 7 hypertension for mohsEhealthMoHS
 

Similaire à Hypertension (20)

Hypertension
HypertensionHypertension
Hypertension
 
Htn pharmacotherapy
Htn pharmacotherapyHtn pharmacotherapy
Htn pharmacotherapy
 
Diagnosis & Management of Resistant Hypertension
Diagnosis & Management of Resistant HypertensionDiagnosis & Management of Resistant Hypertension
Diagnosis & Management of Resistant Hypertension
 
Hypertension
HypertensionHypertension
Hypertension
 
Hypertension
HypertensionHypertension
Hypertension
 
Hipertensão Arterial - Slides da JNC7
Hipertensão Arterial - Slides da JNC7Hipertensão Arterial - Slides da JNC7
Hipertensão Arterial - Slides da JNC7
 
Joint National Committee
Joint National CommitteeJoint National Committee
Joint National Committee
 
Hypertension by sourabh kosey
Hypertension by sourabh koseyHypertension by sourabh kosey
Hypertension by sourabh kosey
 
Recent guideline for the Prevention, Detection, Evaluation, and Management of...
Recent guideline for the Prevention, Detection, Evaluation, and Management of...Recent guideline for the Prevention, Detection, Evaluation, and Management of...
Recent guideline for the Prevention, Detection, Evaluation, and Management of...
 
Htn HYpertension
Htn HYpertensionHtn HYpertension
Htn HYpertension
 
Hypertension
HypertensionHypertension
Hypertension
 
Ht12 - GP education seminar
Ht12 - GP education seminar Ht12 - GP education seminar
Ht12 - GP education seminar
 
2.6. HTN.pptx
2.6. HTN.pptx2.6. HTN.pptx
2.6. HTN.pptx
 
diagnosis-treatment-of-resistant-hypertension.pdf
diagnosis-treatment-of-resistant-hypertension.pdfdiagnosis-treatment-of-resistant-hypertension.pdf
diagnosis-treatment-of-resistant-hypertension.pdf
 
HYPERTENSION.pptx
HYPERTENSION.pptxHYPERTENSION.pptx
HYPERTENSION.pptx
 
week 9 Assessment and Management of Patients with Hypertension- crisis.ppt
week 9 Assessment and Management of Patients with Hypertension- crisis.pptweek 9 Assessment and Management of Patients with Hypertension- crisis.ppt
week 9 Assessment and Management of Patients with Hypertension- crisis.ppt
 
Essential Hypertension
Essential Hypertension Essential Hypertension
Essential Hypertension
 
Understanding hypertension
Understanding hypertensionUnderstanding hypertension
Understanding hypertension
 
UPTODATE INFORMATION.pptx
UPTODATE INFORMATION.pptxUPTODATE INFORMATION.pptx
UPTODATE INFORMATION.pptx
 
Lec 7 hypertension for mohs
Lec 7  hypertension for mohsLec 7  hypertension for mohs
Lec 7 hypertension for mohs
 

Plus de dhavalshah4424

Plus de dhavalshah4424 (20)

CAD+And+ACS
CAD+And+ACSCAD+And+ACS
CAD+And+ACS
 
Cardiac+Electrophysiology
Cardiac+ElectrophysiologyCardiac+Electrophysiology
Cardiac+Electrophysiology
 
Hypertension
HypertensionHypertension
Hypertension
 
Management+of+Diabetic+Neuropathy
Management+of+Diabetic+NeuropathyManagement+of+Diabetic+Neuropathy
Management+of+Diabetic+Neuropathy
 
Diabetes+and+Pregnancy
Diabetes+and+PregnancyDiabetes+and+Pregnancy
Diabetes+and+Pregnancy
 
Legg+Calve+Perthes+Disease
Legg+Calve+Perthes+DiseaseLegg+Calve+Perthes+Disease
Legg+Calve+Perthes+Disease
 
Osteoid+Osteoma
Osteoid+OsteomaOsteoid+Osteoma
Osteoid+Osteoma
 
Osteoid+Osteoma
Osteoid+OsteomaOsteoid+Osteoma
Osteoid+Osteoma
 
Osteoid+Osteoma
Osteoid+OsteomaOsteoid+Osteoma
Osteoid+Osteoma
 
Osteoid+Osteoma
Osteoid+OsteomaOsteoid+Osteoma
Osteoid+Osteoma
 
Legg+Calve+Perthes+Disease
Legg+Calve+Perthes+DiseaseLegg+Calve+Perthes+Disease
Legg+Calve+Perthes+Disease
 
Osteoid+Osteoma
Osteoid+OsteomaOsteoid+Osteoma
Osteoid+Osteoma
 
Complications+of+Diabetes
Complications+of+DiabetesComplications+of+Diabetes
Complications+of+Diabetes
 
Interventional+Procedures
Interventional+ProceduresInterventional+Procedures
Interventional+Procedures
 
Angiogram
AngiogramAngiogram
Angiogram
 
Polypharmacy+in+Schizophrenia
Polypharmacy+in+SchizophreniaPolypharmacy+in+Schizophrenia
Polypharmacy+in+Schizophrenia
 
Depression+and+Diabetes
Depression+and+DiabetesDepression+and+Diabetes
Depression+and+Diabetes
 
Antidepressants+in+Psychiatric+Disorder
Antidepressants+in+Psychiatric+DisorderAntidepressants+in+Psychiatric+Disorder
Antidepressants+in+Psychiatric+Disorder
 
Osteoarthritis
OsteoarthritisOsteoarthritis
Osteoarthritis
 
Juvenile+Rheumatoid+Arthritis+slides
Juvenile+Rheumatoid+Arthritis+slidesJuvenile+Rheumatoid+Arthritis+slides
Juvenile+Rheumatoid+Arthritis+slides
 

Dernier

💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...Sheetaleventcompany
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...adilkhan87451
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...chennailover
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...parulsinha
 
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...GENUINE ESCORT AGENCY
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...chennailover
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋TANUJA PANDEY
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...khalifaescort01
 
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...parulsinha
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Availableperfect solution
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...khalifaescort01
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...karishmasinghjnh
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...parulsinha
 

Dernier (20)

💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
 
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 

Hypertension

  • 2.
  • 3. Top Three Countries for Diabetes Data from King H et al. Diabetes Care . 1998;21:1414-1431.
  • 4. What is Hypertension? JNC 7 Definition Hypertension 2003;42:1206-52 Blood Pressure (mm Hg) Category Systolic Diastolic <120 and <80 Normal 120-139 or 80-89 Prehypertension 140-159 or 90-99 Stage 1 hypertension ≥ 160 or ≥100 Stage 2 hypertension
  • 5.
  • 6.
  • 7.
  • 8. Hypertension: A Significant CV and Renal Disease Risk Factor National High Blood Pressure Education Program Working Group. Arch Intern Med. 1993;153:186-208.
  • 9. CV Mortality Risk Doubles with Each 20/10 mm Hg BP Increment* *Individuals aged 40-69 years, starting at BP 115/75 mm Hg. CV, cardiovascular; SBP, systolic blood pressure; DBP, diastolic blood pressure Lewington S, et al. Lancet . 2002; 60:1903-1913. JNC VII. JAMA. 2003. CV mortality risk SBP/DBP (mm Hg) 0 1 2 3 4 5 6 7 8 115/75 135/85 155/95 175/105
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. Management: JNC 7 GUIDELINES
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. Management of Refractory Hypertension
  • 32.
  • 33.
  • 34.
  • 35.

Notes de l'éditeur

  1. 2 nd most common reason for visit All family physicians should be experts at HTN.
  2. Hypertension is an important contributing risk factor for morbidity and mortality from both cardiovascular (CV) and renal disease. Hypertension is one of the most significant contributing factors to the development of CV and renal disease. Complications of hypertension include coronary artery disease, congestive heart failure, stroke, renal disease (including end-stage renal disease), and peripheral vascular disease. These diseases account for significant disability, loss of productivity, and decreased quality of life for many Americans. National High Blood Pressure Education Program Working Group. National High Blood Pressure Education Program Working Group report on primary prevention of hypertension. Arch Intern Med. 1993;153:186-208.